icnp - international classification for nursing practice

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

7. ICNP Worldwide ParticipationNational Nurses AssociationsICNP CommitteesICNP ReviewersTranslators & ResearchersInformatics Experts (IMIA-NI; ISO)ICNP CentersGovernments/Software Vendors/Terminology Developers etc.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

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

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

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

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

icnp - international classification for nursing practice

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