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Ebook: ICNP$^{\reg}$ and Telematic Applications for Nurses in Europe
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International Classification for Nursing Practice (ICNP) functions as a common language for nursing in Europe. It is developed as a common nomenclature and classification system, reflecting the specific clinical realities of nursing practice. Telenurse promotes the use of ICNP in Europe according to a double strategy involving the following approaches; 1) organisation of dissemination conferences on a European level and dissemination meetings on a national level and; 2) building of simple demonstrators illustrating possible real uses of ICNP in shared electronic patient records. Telenurse has focused on two aspects of the use of ICNP in electronic records. Firstly, entry of ICNP data in relation to daily systematic documentation of nursing care and secondly, statistical analysis of ICNP data extracted from the electronic patient records in relation to the development of clinical quality and resource management. In relation to the DataIn phase Telenurse spans both streams within the group of projects concerned with electronic patient records, viz. the stream concerned with the architecture of electronic patient records and the stream concerned with the architecture of terminology’s. In relation to the DataOut phase the small scale demonstrators of electronic patient records have been equipped with data extraction mechanisms for clinical databases. These developments have been supplemented by software showing how the results of the analysis of data stored in the databases can be fed back to clinical practice using electronic means.
By agreeing to set up the project to develop an International Classification for Nursing Practice (ICNP), the International Council of Nurses (ICN) took what has been hailed as one of its most significant initiatives in the latter half of this century. With the trend towards internationalisation of health care the ICNP provides an internationally accessible management, education and research tool to describe and organise data about nursing practice which in turn can be integrated into local, national and international nursing and multidisciplinary health information systems.
ICN, as the organisation responsible for advancing nursing internationally, welcomed the opportunity to collaborate with the European Telenurse project in the field testing of the ICNP. This experience has brought the ICNP to the attention of many nurses throughout Europe as well as to groups outside nursing interested in the developing classifications and health information systems. In turn the Telenurse project has benefited from the ICNP work done by nurses who form ICN's international network outside Europe.
The thinking about how to make this classification a truly international and useful tool has been tempered by the experience and feedback received from ICN’s international contacts. In field testing of the ICNP, the Telenurse project has contributed significantly ICNP developments.
The wide-ranging programme of this second consensus conference is a tribute to the enthusiasm and richness of contributions of the various partners to the emerging Beta version of the ICNP. ICN looks forward to participate during the conference and to receiving its conclusions.
Kirsten Stallknecht
President, International Council of Nurses
The aim of this presentation is to show how the combinatorial design of ICNP beta can be used both as a unifying framework i.e. a cross classification assumed to work behind the screen or scene as well as a classification in its own right i.e. a front-end classification reaching beyond pure crossmapping toward the end-users of nursing practice. It is argued that the combinatorial design of ICNP might enhance professional unity by combining and merging a plurality of existing classification systems into one international cross classification with the aim of comparing for research purposes. The user need for a data entry tool for structuring clinical data for daily purposes is not fulfilled with ICNP as a cross classification. However using ICNP as a front-end classification has the potentiality of enhancing nursing practice encompassing a plurality of nursing care settings and cultures by replacing the expressive weakness of previous nursing classifications with the expressive power of ICNP beta. Depending on the use of ICNP, different types of strategies for validating ICNP combinations of concepts require different types of user involvement in the further development of a common language for nursing practice.
A nursing module of an electronic healthcare record system (EHCR) has been tested during 12 weeks at two wards of the acute geriatric hospital of the University hospitals of Geneva. During this test period 27 patient observations have been recorded. The clinical verification phase yield among others following results: (1) the hypertext paradigm is consistent with the nursing care process reasoning, (2) use of EHCR is well accepted by nurses, (3) training of nurses can be limited to a reasonable time. The possibility of recycling clinical data for management purpose has also been demonstrated. Integration points of the nursing module with an overall patient electronic healthcare record (EHCR) are identified. The various integration aspects are: injection of doctors orders in the nursing care process management tool, (i.e. the nursing problem solving strategy): linking of medical problems (diagnosis) with nursing phenomena, and implementing view of the doctors on the nursing care process.
Structured and standardized clinical nursing data used by clinical nurses, nurse managers, health care administrators, policy makers and clinical researchers is important for nursing. Information from clinical nursing has been very limited and not comparable primarily due to lack of nomenclatures and classifications in nursing. For success clinical nursing record systems have to be clinically appropriate and extraction of data from databases made possible. This paper shows examples of data from nurses and information on different activities of nurses in three different primary health care centers in Iceland. This paper could therefore be renamed and called ICNP from a clinical point of view like the one presented in Athens two years ago[l].
This paper describes what a Nursing Minimum Data Set is and the conditions which have to be fulfilled to include ICNP in a NMDS. The ICNP-data from the validation site of the University Hospital of Amsterdam are analysed with a clear focus of incorporation into a NMDS. Based on the results of this analysis, recommendations for inclusion are formulated.
The use of computers and electronic documentation systems in the nursing environment has put forward new requirements on terminologies. In this paper, we present an introduction to the development of formal terminological systems along a cognitive, linguistic and communicative dimension. The goal is to arrive at formal terminologies that assist nurses in their documentation activities while minimising the burdens related to the use of traditional terminologies.
The Electronic Healthcare Record in its various forms is firmly established as a concept but as yet there are few commercially available implementations of record systems. One of the obstacles to be overcome is the integration of record based components, such as the Synapses Federated Healthcare Record Server, with other components in current legacy systems, particularly Healthcare Information Systems. In addition, the involvement of users in determining what type of systems are to be developed and installed is problematic when the complexity of such information systems increases. SynEx aims to address both the integration and user-involvement issues through its approach of placing record-based components within a middleware layer and through the support of a range of software tools.
In 1997 the DIHNR initiated a project to develop a complete translation of the ICNP into German language. This translation was based on three previous translations with an an emphasis on consensus building in analysed translation differences. The aim of the project was to promote and support the process of coming to an agreement about concepts and contexts of nursing phenomena and nursing interventions.
This paper gives the background and an introduction to the present activities and results of the German-speaking ICNP User Group. The importance of the involvement of healthcare professionals, e.g. nurses, in the standardisation process in nursing informatics is stressed. The paper emphases the need for increased awareness for the standardisation efforts in order to accomplish a higher degree of commitment in healthcare professionals. The strategies and activities of the German-speaking ICNP User Group are described.