1 Introduction

SNOMED CT is the most comprehensive and precise clinical health terminology product in the world, owned and distributed around the world by The International Health Terminology Standards Development Organisation (IHTSDO). 

The SNOMED CT Nursing Health Issues Reference Set and the SNOMED CT Nursing Activities Reference Set are the is the result of work carried out by the Nursing Refsets Clinical Project Group, a subgroup of the newly established Nursing Clinical Reference Group, one of several Clinical Reference Groups working collaboratively to develop new and improve existing content in SNOMED CT. 

2 Background

Nursing Health Issues has been defined as:

• representation of an issue related to the health of a subject of care as identified by one or more healthcare actors
  

EXAMPLES: A loss of weight, a heart attack, a drug addiction, an injury, dermatitis

The initial scope of the new references sets was determined informed by the existingpublished:a) Equivalence

•  Equivalence table between the International Classification for Nursing Practice (ICNP®) and SNOMED Clinical Terms (SNOMED CT®) for nursing diagnoses 

b) Equivalence table between ICNP and SNOMED CT for nursing interventions.

The result is intended to support nursing care and enable effective decision-making, and provide information to inform nursing education and health policy.  

As the subset is implemented, feedback will lead ot further development, with professional oversight by the Nursing Refset Editorial Group.

3 Purpose

To provide a subset of frequently used SNOMED CT concepts for use in nursing practise within the following data fields:

• Nursing Health Issues
• Nursing Activities

4 Content

The Nursing Activities Reference Set is comprised of 883 active concepts from the Procedure hierarchy and the Nursing Health Issues Reference Set is comprised of 452 active concepts from the Clinical finding hierarchy.

. The Reference Set will be maintained in line with each release of SNOMED CT and content added based on usage over time. A Nursing Editorial Group will have clinical responsibility for agreeing that proposed additions are relevant to nurses internationally.

5 Obtaining the Reference Sets

Access within IHTSDO SNOMED International member countries is provided by the Member National Release Centre in each country, via the relevant Member web page. Affiliates of IHTSDO in of SNOMED International in non-member countries can access the reference sets in IHTSDO SNOMED CT Release Format 2 (RF2) through their MLDS (Member Licensing & Distribution Service) account https://mlds.ihtsdotools.org. Please contact info@ihtsdo.org for more information if required. 

6 Feedback

IHTSDO are SNOMED International are keen to receive feedback on this product – from both a clinical content perspective and from an implementer's perspective. Feedback should be sent to info@ihtsdo.org. Feedback should include any issues relating to implementation, suggestions for future content inclusion or general comments regarding the equivalence tableReference Sets.

7 Technical Notes

RF2 package format

The RF2 package convention dictates that it contains all relevant files, regardless of whether or not there is content to be included in each particular release.  Therefore, the package contains a mixture of files which contain both header rows and content data, and also files that are intentionally left blank (including only a header record).  The reason that these files are not removed from the package is to draw a clear distinction between:

1. ...files that have been deprecated (and therefore removed from the package completely), due to the content no longer being relevant to RF2 in this or future releases, and 
2. ...files that just happen to contain no data in this particular release (and are therefore included in the package but left blank, with only a header record), but are still relevant to RF2, and could therefore potentially contain data in future releases.

This allows users to easily distinguish between files that have purposefully been removed or not, as otherwise if files in option 2 above were left out of the package it could be interpreted as an error, rather than an intentional lack of content in that release.