ICNP SNOMED CT Nursing Practice Refset Release Notes - January 2024
Date | 20240101 |
Document Version | 1.0 |
Release Status | PRODUCTION |
Introduction
The International Classification of Nursing Practice (ICNP) Reference Set is a product agreed as part of a collaboration agreement between the International Council of Nurses (ICN) and the International Health Terminology Standards Organisation (IHTSDO), trading as SNOMED International. ICNP content has been incorporated into SNOMED CT and is being released as a reference set by SNOMED International on behalf of ICN. This production release is based on ICNP 2019 plus additional content requested by ICN.
Background
ICN and SNOMED International have worked together since 2006 to advance terminology harmonisation and foster interoperability in health information systems. This work resulted in the release of an equivalence table between the International Classification for Nursing Practice (ICNP®) and SNOMED Clinical Terms (SNOMED CT®) for nursing diagnoses and an equivalence table between ICNP and SNOMED CT for nursing interventions which were released 6 monthly until 2018. It also resulted in the SNOMED CT Nursing Activities Reference Set and SNOMED CT Nursing Health Issues Reference Set which were released until October 2021. No further releases of these reference sets are planned.
ICN initiated a review of its role in health informatics globally, enabling them to develop a strategy for supporting nursing globally. It is this review which lead to the new agreement between ICN and SNOMED International, with the following key components:
ICNP 2019 incorporated into SNOMED CT
SNOMED International to maintain and distribute ICNP as a SNOMED reference set on behalf of ICN
ICN to retain ownership of ICNP – SNOMED International to retain ownership of SNOMED CT
ICN to continue to lead on ICNP clinical development over time and its quality assurance through ICN governance processes
Free for use in SNOMED International member countries and licensed by ICN in non-member countries
ICN has established the ICNP Editorial Board through which decisions on the content of ICNP are made. The ICNP Editorial Board has put in place a mechanism for requesting changes and additions to ICNP reference set - for more information please contact icnp@icn.ch.
Motivation
The key drivers for this approach are:
To ensure that nursing remains connected to the wider health information landscape globally
To ensure that SNOMED CT continues to adequately reflect global nursing practice
To ensure that information collected using ICNP can link to SNOMED CT encoded records and be shared with other healthcare professionals to support the care of individuals
To capture nursing care in a standardised way thus avoiding local mapping which will lead to inconsistency
To facilitate the sharing of ICNP-based information in a standardised way to support delivery of patient care, usage for research purposes and participation in health policy making
The ICNP, and therefore this reference set, is a terminology that enables nurses to describe and report their practice in a systematic way. The resulting information is used to support care and effective decision-making, and to inform nursing education and health policy.
As ICNP is intended for use by and for nurses, ICN has been able to focus attention on the development of ICNP specifically for nursing practice. This has resulted in a rich and comprehensive resource that nurses can use to describe and report in detail the things that they assess (diagnoses e.g. nausea) and the things that they do (interventions e.g. counselling). The potential benefits of a consistent approach to capturing nursing data are far-reaching. However, nurses do not practice in isolation, they practice alongside many other disciplines. One of the potential risks of a specific nursing-focus is that nursing will be somehow disconnected from a larger health information landscape, hence the integration of ICNP into SNOMED CT.
Design
The decisions about additions and changes to SNOMED CT as a result of the incorporation of ICNP 2019 and additional content into SNOMED CT has been directed by the advice given by subject matter experts from both organisations and also members of ICNP Editorial Board at ICN. To ensure fit with international requirements and other sources of terminology, the SNOMED International Nursing Clinical Reference Group has also provided advise and expertise.
This work provided an opportunity for ICN to review and make decisions about the content of ICNP 2019 and additional content.
Versions
The version of ICNP used in this reference set is the May 2019 release plus additional content requested by ICN.
The version of SNOMED CT used is the January 2024 International Release.
Content
The 2024 International Classification of Nursing Practice (ICNP) Reference Set is comprised of 2120 active concepts from the SNOMED CT Clinical Finding, Procedure and Situation with Explicit Context hierarchies. Changes to the membership of the reference set for the 2024 release includes replacements for inactivated concepts as well as the addition of new concepts. The table below details the changes.
Concept | Status | Replaced by | Status of Replacement concept(s) |
|---|---|---|---|
103693007 |Diagnostic procedure (procedure)| | Concept inactivated - no longer an active reference set member | 386053000 |Evaluation procedure (procedure)| | New refset member |
1144845004 |Risk of suicide decreased (finding)| | Concept inactivated - no longer an active reference set member | 394687007 |At low risk for suicide (finding)| | New refset member |
16386004 |Dry skin (finding)| | Concept inactivated - no longer an active reference set member | 52475004 |Xeroderma (disorder)| | New refset member |
191816009 |Drug dependence (disorder)| | Concept inactivated - no longer an active reference set member | 1254812006 |Substance dependence (disorder)| | New refset member |
249475006 |Thirst symptom (finding)| | Concept inactivated - no longer an active reference set member | 289159000 |Thirst finding (finding)| | New refset member |
313332003 |Dressing patient (procedure)| | Concept inactivated - no longer an active reference set member | 1230126004 |Performing dressing activity for full body of subject (procedure)| | New refset member |
399122003 |Swallowing problem (finding)| | Concept inactivated - no longer an active reference set member | 288939007 |Difficulty swallowing (finding)| | New refset member |
402863005 |Venous stasis ulcer of leg (disorder)| | Concept inactivated - no longer an active reference set member | 1237117000 |Venous ulcer of lower leg (disorder)| | New refset member |
409041001 |Reproductive risk (finding)| | Concept inactivated - no longer an active reference set member |
| No replacement |
409043003 |Infertility risk (finding)| | Concept inactivated - no longer an active reference set member | 1269478006 |At increased risk for male infertility (finding)| 1269477001 |At increased risk for female infertility (finding)| | New refset member
New refset member |
409044009 |Contraception risk (finding)| | Concept inactivated - no longer an active reference set member | 1279828000 |At increased risk for disorder due to contraceptive use (finding)| | New refset member |
409046006 |Perinatal risk (finding)| | Concept inactivated - no longer an active reference set member | 1269553009 |At increased risk for perinatal disorder (finding)| | New refset member |
409048007 |Labor risk (finding)| | Concept inactivated - no longer an active reference set member | 1269476005 |At increased risk for complication during labor and delivery (finding)| | New refset member |
409049004 |Delivery risk (finding)| | Concept inactivated - no longer an active reference set member | 1269476005 |At increased risk for complication during labor and delivery (finding)| | New refset member |
409050004 |Postpartum risk (finding)| | Concept inactivated - no longer an active reference set member | 1269562006 |At increased risk for postpartum disorder (finding)| | New refset member |
410304007 |Relaxation/breathing techniques education, guidance, and counseling (procedure)| | Concept inactivated - no longer an active reference set member | 1284867003 |Education about relaxation technique (procedure)| | New refset member |
443999008 |Risk of exposure to communicable disease (situation)| | Concept inactivated - no longer an active reference set member | 1296884009 |At increased risk of exposure to communicable disease (finding)| | New refset member |
52651000119105 |At risk of unplanned pregnancy (situation)| | Concept inactivated - no longer an active reference set member | 1286875007 |At increased risk for unplanned pregnancy (finding)| | New refset member |
706892001 |At risk of intimate partner abuse (finding)| | Concept inactivated - no longer an active reference set member | 22791000175108 |At increased risk of intimate partner violence (finding)| | New refset member |
710976005 |Maintaining ventilation (procedure)| | Concept inactivated - no longer an active reference set member | 40617009 |Artificial ventilation (regime/therapy)| 266700009 |Assisted breathing (regime/therapy)| 11140008 |Respiratory assist, manual (procedure)| | New refset member New refset member New refset member |
710986006 |Monitoring drug withdrawal (regime/therapy)| | Concept inactivated - no longer an active reference set member | 1254959003 |Monitoring substance withdrawal (regime/therapy)| | New refset member |
713103003 |Giving encouragement to be urinary continent (procedure)| | Concept inactivated - no longer an active reference set member |
| No replacement |
713105005 |Giving encouragement to be bowel continent (procedure)| | Concept inactivated - no longer an active reference set member |
| No replacement |
87502001 |At risk for imbalanced body temperature (finding)| | Concept inactivated - no longer an active reference set member |
| No replacement |
199312002 |Finding related to risk factor in pregnancy (finding)| | Concept inactivated - no longer an active reference set member |
| No replacement |
370773004 |Administration of prescribed medications and solutions (procedure)| | Concept inactivated - no longer an active reference set member | 18629005 |Administration of drug or medicament (procedure)| | Existing refset member |
370774005 |Administration of prescribed medications based on arterial blood gas results (procedure)| | Concept inactivated - no longer an active reference set member | 18629005 |Administration of drug or medicament (procedure)| | Existing refset member |
13197004 |Uses contraception (finding)| | New refset member |
|
|
282298003 |Able to balance (finding)| | New refset member |
|
|
871870009 |Able to demonstrate health literacy (finding)| | New refset member |
|
|
300199007 |Able to hear (finding)| | New refset member |
|
|
301570003 |Able to mobilize using mobility aids (finding)| | New refset member |
|
|
706954003 |Able to perform intermittent urethral self-catheterization (finding)| | New refset member |
|
|
705075002 |Able to see (finding)| | New refset member |
|
|
609328004 |Allergic disposition (finding)| | New refset member |
|
|
87486003 |Aphasia (finding)| | New refset member |
|
|
424167000 |At increased risk for unstable blood glucose level (finding)| | New refset member |
|
|
715238005 |At increased risk of electrolyte imbalance (finding)| | New refset member |
|
|
248279007 |Frailty (finding)| | New refset member |
|
|
74506000 |Bereavement due to life event (finding)| | New refset member |
|
|
131148009 |Bleeding (finding)| | New refset member |
|
|
48782003 |Delivery normal (finding)| | New refset member |
|
|
871869008 |Difficulty demonstrating health literacy (finding)| | New refset member |
|
|
102835006 |Difficulty passing urine (finding)| | New refset member |
|
|
3006004 |Disturbance of consciousness (finding)| | New refset member |
|
|
288784001 |Does communicate needs and wishes (finding)| | New refset member |
|
|
129882008 |Dysfunctional coping using self defense mechanisms (finding)| | New refset member |
|
|
300463007 |Efficient emptying of urinary bladder (finding)| | New refset member |
|
|
449892005 |Feeling safe (finding)| | New refset member |
|
|
271591004 |Fully conscious (finding)| | New refset member |
|
|
418363000 |Itching of skin (finding)| | New refset member |
|
|
278040002 |Loss of hair (finding)| | New refset member |
|
|
405273008 |Manic mood (finding)| | New refset member |
|
|
123640000 |Mucous membrane dryness (finding)| | New refset member |
|
|
169961004 |Normal birth (finding)| | New refset member |
|
|
45332005 |Normal capillary filling (finding)| | New refset member |
|
|
271720007 |Normal intracranial pressure (finding)| | New refset member |
|
|
162081000 |Not constipated (finding)| | New refset member |
|
|
301146007 |Peripheral pulse palpable (finding)| | New refset member |
|
|
228151002 |Personal care disability (finding)| | New refset member |
|
|
764816006 |Physically prepared to undergo surgery (finding)| | New refset member |
|
|
161047009 |Poor adaptation to disability (finding)| | New refset member |
|
|
301179007 |Poor venous access (finding)| | New refset member |
|
|
47295007 |Psychomotor agitation (finding)| | New refset member |
|
|
416751004 |Reduced drugs misuse (finding)| | New refset member |
|
|
286688002 |Splitting - mental defense mechanism (finding)| | New refset member |
|
|
226077000 |Therapeutic diet (finding)| | New refset member |
|
|
110483000 |Tobacco user (finding)| | New refset member |
|
|
418107008 |Unconscious (finding)| | New refset member |
|
|
95930005 |Victim of neglect (finding)| | New refset member |
|
|
271398006 |Weight steady (finding)| | New refset member |
|
|
87715008 |Xerostomia (finding)| | New refset member |
|
|
65971000052100 |Acute psychosis (disorder)| |
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