Embedding nursing interventions into the World Health Organization’s International Classification of Health Interventions (ICHI)

Objective: The International Classification of Health Interventions (ICHI) is currently being developed. ICHI seeks to span all sectors of the health system. Our objective was to test the draft classification’s coverage of interventions commonly delivered by nurses, and propose changes to improve the utility and reliability of the classification for aggregating and analyzing data on nursing interventions. Materials and methods: A two-phase content mapping method was used: (1) three coders independently applied the classification to a data set comprising 100 high-frequency nursing interventions; (2) the coders reached consensus for each intervention and identified reasons for initial discrepancies. Results: A consensus code was found for 80 of the 100 source terms: for 34% of these the code was semantically equivalent to the source term, and for 64% it was broader. Issues that contributed to discrepancies in Phase 1 coding results included concepts in source terms not captured by the classification, ambiguities in source terms, and uncertainty of semantic matching between ‘action’ concepts in source terms and classification codes. Discussion: While the classification generally provides good coverage of nursing interventions, there remain a number of content gaps and granularity issues. Further development of definitions and coding guidance is needed to ensure consistency of application. Conclusion: This study has produced a set of proposals concerning changes needed to improve the classification. The novel method described here will inform future health terminology and classification content coverage studies

Understanding the use of standardized nursing terminology and classification systems in published research : a case study using the International Classification for Nursing Practice®

Background In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice®, Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions’ impact on quality, safety and patient outcomes in published research is relatively unknown. Purpose This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice® as a case study. Methods A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice® were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. Results Since 2006, 38 studies have been published on the International Classification for Nursing Practice®. The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. Conclusions Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care

Equivalencia semántica entre diagnósticos de la taxonomía NANDA-I y el sistema unificado de lenguaje CIPE. Una aproximación a la armonización del lenguaje enfermero

Gran parte de la historia de Enfermería se escribe y se describe como la búsqueda de formas de evidenciar su identidad profesional. Actualmente, en un marco académico, jurídico y deontológico, se sitúa a la disciplina como profesión de referencia en el cuidado de la salud. De forma paralela, ha sido una constante el estudio de las denominaciones de los fenómenos, situaciones y/o problemas, competencia de Enfermería, en la búsqueda de formas de expresión oral y escrita que representen el saber y el quehacer profesional y constituyan un lenguaje profesional. Hoy en día Enfermería dispone de distintos lenguajes estandarizados. En lo que se refiere a diagnósticos enfermeros, el más utilizado en nuestro país es NANDA I y en el ámbito internacional, además de éste, CIPE. A pesar de ello, aunar la utilización de un lenguaje profesional normalizado e interoperable es todavía, en la mayoría de las ocasiones, difícil de conseguir. Sin embargo, la posibilidad que proporcionan los sistemas informáticos de salud, de combinar la utilización de distintos lenguajes semánticamente equivalentes, puede facilitar la armonización que nos conduzca a un lenguaje profesional preciso, con el que no haya duda en nombrar los cuidados propios de la competencia enfermera..

Strengths and limitations of the draft classification of public health interventions in the World Health Organization’s International Classification of Health Interventions: A developmental appraisal

Statistical classifications provide a basis for collecting and analysing data, for building knowledge and communicating information. A classification of public health interventions is being developed as part of the World Health Organization’s International Classification of Health Interventions (ICHI). This is a pioneering development, as there have been no previous efforts to produce a standard classification of public health interventions. A comprehensive developmental appraisal of the draft classification of public health interventions was undertaken to gain an understanding of its strengths and limitations, and to identify what should be done to improve its utility. The classification was used to code three data sets of public health interventions, to identify problems encountered and to assess inter-coder reliability. Views of potential users were elicited through key-informant interviews. An analytical structure was developed, comprising a set of criteria concerning the desired features of a statistical classification and a model representing the main elements that make up a statistical classification. ICHI was found to have some utility for representing data on public health interventions. Limitations identified included coverage gaps, overlap between categories, lack of clarity concerning how the classification axes are operationalised for public health interventions, and difficulty splitting complex interventions into their constituent components for coding. This study makes a significant and timely contribution to the development of the draft classification, by providing specific proposals for improvements to ICHI, explicating some fundamental conceptual issues that should be addressed, and indicating a path forward for the further development and use of ICHI in the field of public health. The analytical structure developed through the conduct of this research represents a novel methodological contribution to the field of classification development