2025-10-20 Nursing Hybrid Business Meeting

Meeting summary 

The meeting focused on updates and discussions related to SNOMED CT, nursing terminologies, and their integration efforts. Presentations covered topics including NANDA-I's diagnosis development process, the use of nursing interventions classification, and the challenges of recording clinical information in SNOMED CT. The group explored potential collaborations to improve data collection and research using nursing terminologies, while discussing the ambiguous nature of certain concepts and the need for further clarification.

Next steps

• Ian Green to finalize collaboration agreements with NANDA, NIC, and NOC by the end of the year.

• Ian Green to explore ways to run education sessions for ICNP collaboration centers about how SNOMED works.

• Elaine Wooler to post a small example of how "Attention to stoma" is used in Belgium to the forum.

• Elaine Wooler to investigate the "Attention to stoma" and "Stoma care procedure" hierarchies and their relationship.

• Elaine Wooler to look into the "ostomy care" leaf node discovered during the terminology consultation.

• Cheryl Wagner and Karen Dunn-Lopez to continue working with Ian Green and Kelly on updating NIC terms in SNOMED.

• Yerno to consider attending the Mental Health and Behavioral Group session discussing assessment instruments.

Summary

SNOMED CT and Nursing Terminologies

The meeting focused on updates and discussions related to SNOMED CT, nursing terminologies, and collaborations. Ian Green provided an update on SNOMED CT, highlighting changes in platforms for discussions and collaborations with nursing classifications like ICNP, NANDA, and NOC. He discussed ongoing efforts to refine governance processes and align terminologies. Camila Takao Lopes presented on NANDA-I's diagnosis development process, emphasizing the importance of evidence in validating nursing diagnoses and introducing Nanda360, a new clinical reasoning framework. Participants discussed the integration of nursing terminologies into SNOMED CT and the potential for enhanced clinical documentation and research.

Diagnosis Validation and Integration Process

The meeting focused on the validation process for diagnoses, with Camila explaining that it typically takes 2-4 years for researchers to submit proposals, and the review process depends on the availability of experts. Camila also discussed the integration of new diagnoses with SNOMED CT concepts, noting that annual updates would be possible under the Nomad project, which follows a 3-year classification release cycle. The group explored the embedding of NANDA terminology in electronic health records, with Karen sharing a study on the secondary use of standardized nursing care data.

Clinical Findings vs. Observables Discussion

Elaine Wooler, presenting for Kathy Richardson, discussed terminology content related to compliance concepts, specifically clinical findings and observable entities. She sought feedback from nursing professionals on their preference between clinical findings and observables, noting that observables are broader and include social norms while findings focus on treatment compliance. The discussion highlighted the distinction between using observables for assessments and findings for progress notes, with a request for input on how this content might be utilized in clinical documentation.

SNOMED CT Clinical Documentation Challenges

The group discussed the challenges of recording clinical information in SNOMED CT, particularly regarding the distinction between observations and findings. Ed Cheatham raised concerns about the redundancy and inconsistency of having multiple ways to record the same concept, while Stan and others argued that this flexibility is necessary for different clinical contexts. The team agreed to continue allowing both question-answer and nominalized finding approaches in SNOMED, though they acknowledged the need for better guidance on implementation and documentation burden. They also briefly touched on the need to clarify the relationship between stoma care procedures and attention to stoma concepts in SNOMED.

Clarifying 'Attention to' in Nursing

The meeting focused on discussing the ambiguous nature of the "attention to" concept in nursing terminologies, particularly in relation to ostomy care. Participants, including Jerno from Belgium, explained that "attention to" is used to indicate a visual check or surveillance of a stoma or wound, without performing any direct care actions. The group agreed that the term is ambiguously worded and may need further clarification. They also discussed the recent creation of the "attention to stoma" concept and its potential use cases. The conversation ended with an announcement that Dr. Cheryl Wagner and Dr. Karen Dunn-Lopez would present on the Nursing Interventions Classification next.

Nursing Interventions Classification Overview

Dr. Cheryl Wagner and Dr. Karen Dunn-Lopez presented an overview of the Nursing Interventions Classification (NIC), highlighting its structure, research basis, and clinical applications. They emphasized the importance of using evidence-based classifications rather than terminologies in electronic health records to ensure valid research and accurate representation of nursing practice. The presentation also covered the differences between classifications, terminologies, and taxonomies, stressing the need for standardized nursing languages like NANDA, NIC, and NOC to effectively capture and communicate nursing interventions.

Nursing Terminologies and SNOMED Integration

The meeting focused on nursing terminologies and their integration with SNOMED. Karen and Cheryl presented on the use of nursing interventions and care plans, highlighting the benefits of detailed nursing terminology. The discussion touched on challenges in using SNOMED for nursing documentation, with concerns raised about the lack of depth compared to nursing classifications like NANDA-I and NIC. The presenters and participants explored potential collaborations to improve data collection and research using nursing terminologies. The conversation ended with a reminder of an upcoming session on assessment instruments in mental health and behavioral health.