INTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE Rossano C. Martinez Jr., R.N. MI224 - Coding, Classification and Terminology in Medicine Master of Science in Health Informatics (Medical Informatics) College of Medicine – Medical Informatics Unit University of the Philippines – Manila I C N P ®
Transcript
1. ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
Rossano C. Martinez Jr., R.N. MI224 - Coding, Classification and
Terminology in Medicine Master of Science in Health Informatics
(Medical Informatics) College of Medicine Medical Informatics Unit
University of the Philippines Manila
2. The ICNP is a unified nursing language system. It is a
compositional terminology for nursing practice that facilitates the
development of and the cross-mapping among local terms and existing
terminologies.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
3. The objectives of the ICNP, as set out in the initial
ICNpublication, are:1) to establish a common language for
describing nursingpractice in order to improve communication among
nurses andbetween nurses and others;2) to describe the nursing care
of people (individuals, families,and communities) in a variety of
settings, both institutional andnon-institutional;3) to enable
comparison of nursing data across clinicalpopulations, settings,
geographic areas, and time;4) to demonstrate or project trends in
the provision of nursingtreatments and care and the allocation of
resources to patientsaccording to their needs based on nursing
diagnoses;5) to stimulate nursing research through links to data
available innursing information systems and health information
systems; and6) to provide data about nursing practice in order to
influencehealth policy making.ICNPINTERNATIONAL CLASSIFICATION FOR
NURSING PRACTICE
4. VISION & GOALS OF ICNPVISION ICNP is an integral part of
the global information infrastructure informing health care
practice and policy to improve patient care worldwide.STRATEGIC
GOALS Serve as a major force to articulate nursings contribution to
health and health care globally. Promote harmonization with other
widely used classifications and the work of standardization groups
in health and nursing.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
5. ICNP makes a significant contribution to theacquisition of
data about health care delivery. As astandardized terminology, ICNP
can generatereliable and valid data about the work of nursing.As a
unifying framework, ICNP can also map withother terminologies to
expand data sets for retrievaland analysis.Patient or client care
outcomes can be examined inrelation to nursing diagnoses and
nursinginterventions so that what nurses do and what makesa
difference in patient or client outcomes can bequantitatively
evaluated and compared acrosspoints of care
worldwide.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
6. ICNP Timeline1989 - ICN Resolution for ICNP1990 - ICNP
Development Team1993 - ICNP Working Paper1995 - ICNP Alpha
Version1999 - ICNP Beta Version2000 - ICNP Evaluation Committee
& Review2001 - ICNP Beta 2 Version2005 - ICNP Version 12008 -
ICNP Version 1.1 released with new Browser - became a member of the
WHO Family of International Classifications2009 - ICNP Version 2
launched at 24th Quadrennial ICN Congress, Durban, South Africa2011
- Version 2011 Released (Released date:
05/06/2011)ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
8. ICNP ELEMENTS Nursing phenomena (nursing diagnoses) Nursing
actions Nursing outcomesICNPINTERNATIONAL CLASSIFICATION FOR
NURSING PRACTICE
9. Alpha Version (1995)The initial alpha version of ICNP was
organized intothree components:Human Needs - included nursing
problems, patientproblems, nursing factors and nursing
phenomena.What Nurses Do - included nursing interventions,actions,
and treatments.Outcomes - included nursing outcomes and
nursing-sensitive patient outcomes.ICNPINTERNATIONAL CLASSIFICATION
FOR NURSING PRACTICE
10. The alpha version of ICNP comprised:1. Nursing Phenomena -
arranged as a hierarchy: A. Human being (functions and person) B.
Environment (human and nature).2. Nursing Interventions - were
organized along multiple axes: A. Action types B. Objects C.
Approaches D. Means E. Body F. Time/Place.The developers noted that
nursing outcomes would beincluded with next version of
ICNP.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
11. Beta and Beta 2 Versions (1999, 2001)The Beta version
expanded on the use of a multi-axial approach. Two multi-axial
models were proposed:1. 8-Axis Model for Nursing Phenomena a.
Nursing Practice b. Judgement c. Frequency d. Duration e. Topology
f. Body Site g. Likelihood h. Bearer2. 8-Axis Model for Nursing
Actions. a. Action Type b. Target c. Means d. Time e. Topology f.
Location g. Routes h. BeneficiaryICNPINTERNATIONAL CLASSIFICATION
FOR NURSING PRACTICE
12. Beta 2 VersionsDefinition for Nursing diagnosis, outcomeand
action were developed, as wereguidelines for composing a
nursingdiagnosis, nursing outcome and nursingintervention using
multi-axial models.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
13. Nursing Phenomenon: aspect of health of relevance tonursing
practice. Nursing diagnosis: label given by a nurse to the decision
about a phenomenon which is the focus of nursing interventions. A
nursing diagnosis is composed of concepts contained in the
Classification of Phenomenon axes.Nursing Outcomes: the measure or
status of a nursingdiagnosis at points of time after a nursing
intervention.Nursing Action: behavior of nurses in practice.
Nursing intervention: action taken in response to a nursing
diagnosis in order to produce a nursing a nursing outcome. A
nursing intervention is composed of concepts contained in the
Classification of Action axes.ICNPINTERNATIONAL CLASSIFICATION FOR
NURSING PRACTICE
14. While nursing phenomenon was defined inthe beta versions,
the transition from thelabel phenomenon to the label diagnosiswas
made during the development of thebeta versions. Similarly, nursing
action wasdefined but there was a transition from thelabel action
to the label intervention inthe beta versions.ICNPINTERNATIONAL
CLASSIFICATION FOR NURSING PRACTICE
15. ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
16. Version 1.0 (2005)Version 1.0 was developed using a
representation language withformal modeling rules (Web Ontology
Language (OWL)). Thisallowed automated reasoning to be applied to
the terminologyto ensure consistency and accuracy of concepts.The
International organization for Standardization (ISO)Technical
Specification 17117 stipulated structural attributes
forterminologies that ICNP developers were determined to follow(ISO
2002)The structural attributes included concept-orientation,
non-redundancy, non-ambiguity, and non-vagueness and
internalconsistency. The terminology would need to have context
freeand unique identifiers, concept descriptions and
establishedprocesses for version control.ICNPINTERNATIONAL
CLASSIFICATION FOR NURSING PRACTICE
17. ICNP 7-Axis ModelThe development of version 1.0 allowed
atransition from the 8-axis classifications ofbeta 2 to one 7-axis
model.The new structure greatly simplified therepresentation and it
resolved to a largeextent the redundancy and ambiguityinherent in
beta 2.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
18. ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
19. The axes are defined as follows:Focus: The area of
attention that is relevant to nursing (e.g., pain,homelessness,
elimination, life expectancy, knowledge).Judgement: Clinical
opinion or determination related to the focus of nursingpractice
(e.g., decreasing level, risk, enhanced, interrupted,
abnormal).Client: Subject to which a diagnosis refers and who is
the recipient of anintervention (e.g., newborn, caregiver, family,
community).Action: An intentional process applied to or performed
by a client (e.g.,educating, changing, administering,
monitoring).Means: A manner or method of accomplishing an
intervention (e.g., bandage,bladder-training technique,
nutritionist service).Location: Anatomical and spatial orientation
of a diagnosis or intervention (e.g.,posterior, abdomen, school,
community health centre).Time: The point, period, instance,
interval or duration of an occurrence (e.g.,admission, child birth,
chronic).ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
20. Semi-formal Foundation(ICNP beta 2 examples)Redundancy
2B.2.1.2.2.1 Dressing (Target) 2C.1.2.1 Wound Dressing
(Means)ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
21. Semi-formal Foundation(ICNP beta 2 examples)Ambiguity-
2A.3.4.2 Dressing (Action Type)- 2B.2.1.2.2.1 Dressing
(Target)ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
22. Semi-formal foundation(ICNP beta 2 examples)Context-laden
Identifiers- 1A.1.1.2.2.1.1.8.9 Ambulation- 1A.1.1.2.2.1.1.8.9.2
Walking- 1.A.1.1.2.2.1.1.8.9.2.1 Walking using
deviceICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
23. Formal Foundation of Version 1.0 Non-redundancy 10021227
Wound dressing Non-ambiguity 10016199 Putting on clothes 10021227
Wound dressing Context-free Identifiers 10012120 Mobilizing
10020886 Walking 10020903 Walking using deviceICNPINTERNATIONAL
CLASSIFICATION FOR NURSING PRACTICE
24. Formal Model Advantages:Amenable to computer
processingEliminates redundancy, ambiguity in theterminologyReduces
context-laden identifiersAdds reliability to a
combinatorialterminologyICNPINTERNATIONAL CLASSIFICATION FOR
NURSING PRACTICE
25. ICNP Version 1.0, 7-Axis Model, and CataloguesICNP
developers recognized that nursesusing the classification at the
point of careneeded more easily used resources forclinically
relevant, applicable diagnoses,interventions and client
outcomes.ICNP catalogues were envisioned as subsetsof the
classification.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
26. ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
27. ICNP Version 1.1Was released in mid-2008 and included
newconcepts; a new, more user-friendlybrowser; and the first
catalogue of ICNPpre-coordinated statements. Three hundredand
seventy-six (376) new concepts wereadded to this
version.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
28. ICNP Version 2More than 400 new entities were added
toversion 2. Many concepts were diagnosisand intervention
statements developed forICNP catalogues.Distribution Formats for
ICNP Version 2 OWL Representation 7-Axis Model ICNP
CataloguesICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
29. ICNP C-Space(http://icnp.clinicaltemplates.org)A new web
based collaborative ICNP workspace, ICNP C-Space,will be available
with the release of Version 2.Will be used initially for ICNP
Catalogue and mapping projects.ICNP Browser - provides user and
others who are interested inICNP options to browse and search the
terminology.Browser and BaT Tool(http://docu.icnp-bat.de/doku.php)A
software tool that assists distributive work by translation
teamsvia internet.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
30. ICNP Version 2011Version 2011 was released on May 06,
2011.The 2011 release moves ICNP forward withthe addition of new
content, including manynew pre-coordinated nursing
diagnosis,intervention, and outcome statements.ICNPINTERNATIONAL
CLASSIFICATION FOR NURSING PRACTICE
31. The ICNP Programme is organized in threemajor areas, all
attended to support thevision of ICNP. Research & Development
ICN-Accredited ICNP Research and Development Centres ICNP
Catalogues ICNP Translations Maintenance and Operations
Dissemination and EducationICNPINTERNATIONAL CLASSIFICATION FOR
NURSING PRACTICE
32. ICNP TRANSLATIONSTranslations are essential for
implementingICNP in practice. The translations areusually
accomplished on a voluntary basis bynurses in cooperation with the
NationalNursing Association.ICNPINTERNATIONAL CLASSIFICATION FOR
NURSING PRACTICE
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34. ICNP Maintenance and OperationsICNP is released every two
years, tocoincide with the ICN Congress
orConference.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
35. PERMISSION TO USE ICNPICNP is owned and copyrighted by the
InternationalCouncil of Nurses (ICN). ICN is interested
infacilitating access to ICNP and promoting its use. Any use of
ICNP, be it commercial or not, requires the signing of an agreement
authorizing such use. ICN is interested in protecting its copyright
of ICNP. All those wanting to use ICNP for any purpose need
permission from ICN.ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
36. ICN (International Council of Nurses) is currently
developingnew tools and techniques for browsing and
downloadingICNP, as an alternative to the prototype platform
C-Space.These tools and techniques will support the 2013 release
ofICNP (Spring 2013).ICNPINTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE
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41. ICNPINTERNATIONAL CLASSIFICATION FOR NURSING PRACTICE
42. References:
http://www.icn.ch/pillarsprograms/international-classification-for-nursing-practice-icnpr/
http://bioportal.bioontology.org/
http://bioportal.bioontology.org/ontologies/1401
http://www.nlm.nih.gov/research/umls/sourcereleasedocs/current/ICNP/index.html
http://www.who.int/classifications/icd/adaptations/icnp/en/index.html
http://icnp.clinicaltemplates.org/icnp/v3_0/
http://moodle.stoa.usp.br/file.php/863/2010_ICNP_Version_2001.pdf
http://docu.icnp-bat.de/doku.phpICNPINTERNATIONAL CLASSIFICATION
FOR NURSING PRACTICE
43. Thank You! ICNP INTERNATIONAL CLASSIFICATION FOR NURSING
PRACTICE