alison wallis, clinical advisor putting scottish community nurses on the map

Alison Wallis, Clinical Advisor

Putting

Scottish Community Nurses

on the Map

Agenda

What’s it about?

Why terminology?

Mapping process and progress

What’s next?

What’s it about?

Development of a catalogue of standardised community nursing terms for use in electronic patient records: Collaboration between Scottish Government Health Directorates, ISD & International Classification of Nursing Practice (ICNP). Development of a web-based collaborative tool.

Aims: Support communication within community nursing and across other disciplines. Provide a consistent terminology for nurses to articulate what they do. Facilitate description, comparison, and reuse of data to improve care.

Community Nursing Census

April 2008 – National, one day census

Filled information gap about community nursing

Provided information to support service redesign, workload management and policy decisions Tested a national minimum dataset for community nursing which could be embedded in electronic records to provide secondary information

Provided source terms for nursing problems and interventions for mapping to a recognised terminology

Why Standardise?

Think of ways you have used standardisation

at home?

on the move?

at work?

Why Standardise Terminology?

“In comparing the deaths of one hospital with those of another, any statistics are justly considered absolutely valueless which do not give the age, the sexes, and the diseases of all the cases.”Florence Nightingale, 1860

“The need for cost-effectiveness and accountability for quality in care demand descriptions and organization of data on nursing care.” Clark & Lang, 1992

“The availability of standardized nursing data can advance knowledge by enabling the study of health problems across populations, settings, and caregivers and by linking nursing diagnoses with interventions and outcomes.”McCloskey & Bulechek, 1992

Why Standardise Terminology?

ICD 10

OPCS 4

READSnomed CT

ICF

NANDA, NIC, NOCOmaha

ICNP

ICNP

International Classification of Nursing Practice

Flexibility – new items can be submitted to the ICNP for addition to the classification.

Comprehensive and adaptable –can express nursing diagnoses, interventions, and outcomes.

Transferability –other terminologies can be mapped to ICNP (e.g. SNOMED CT)

Comparability – international classification facilitates comparison with other countries.

Mapping Process

Nursing Problems

NursingInterventions

Categorisedlists

Categorisedlists

CENSUS

Catalogue of

Community Nursing

Catalogue of

Community Nursing

SnowCloudSnowCloud

Scottishterms

Scottishterms ICNPICNP

Mapping Process

Method: C-Space launched, April 2009

developed by SnowCloud password protected will host other catalogue developments in future

Editorial Group formed, May 2009 practising community nurses project manager NMAHP eHealth Clinical Lead ICN staff Nursing Problem & Intervention Mapping via C-Space

Invitations to participate and validate mappings, Aug 2009 individual clinicians professional organisations clinical networks lead professionals universities

Mapping Process

Mapping Process

Challenges: Clinicians

Yawn Factor ! Not familiar with terminology Lack of time to participate Hesitant about participating online

ICNP Locating matching terms Trans Atlantic translation & communication Different models of health Emerging models in Scotland

C-Space Scottish Census group first users Complex process for online media Requires time to participate

Mapping Process

Status: 142 nursing problems

164 nursing interventions

Mapping Process

Mapping Issues: Granularity Ambiguity

Examples:Nursing Problem Attention SeekingDisease PreventionVulnerable Child

Nursing InterventionsCase ConferenceToilet Training (child)Financial/ Employment support

What’s Next?

Complete mapping – new ICNP terms for no/ partial matches

Promote use of ICNP in community nursing systems Support ‘Shifting the Balance of Care’ Support Modernising Community Nursing Support new models of care delivery

Categorise terms to support high level reporting

Identify missing problems/ interventions

Outcomes???

Ongoing catalogue maintenance by ICNP

Any Questions??

Alison.Wallis@nhs.net

http://icnp.clinicaltemplates.org