Modeling nursing terminology using the GRAIL representation language

Objective: The purpose of the study is to explore the use of formal systems to model nursing terminology. Design: GRAIL is a formal, compositional terminologic language, closely related to frame-based systems and conceptual graphs, which allows concepts to be formed from atomic-level primitives and automatically classified in a multiple hierarchy. A formal model of the alpha version of the International Classification for Nursing Practice (ICNP) classification of nursing interventions was constructed in GRAIL. Measurements: The model was analyzed for completeness, coherence, clarity, expressiveness, usefulness, and maintainability. Results: GRAIL is capable of representing the complete set of atomic-level concepts within the ICNP as well as certain cross-mappings to other vocabularies. It also has the potential to represent many more concepts, to an arbitrary level of detail. Conclusions: Formal systems such as GRAIL can overcome many of the difficulties associated with traditional nursing vocabularies without restricting the level of detail needed to describe nursing care.