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SNOMED CT Nursing Health Issues Refset package license
SNOMED CT Nursing Health Issues Refset package license

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Table of Contents

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Page At A Glance

Table of Contents

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 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 informed by the published:

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

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

4 Content

The Nursing Health Issues Reference Set is comprised of 453 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. The Nursing Derivatives Editorial Group has clinical responsibility for agreeing that proposed additions are relevant to nurses internationally.

4.1 Updates

The Nursing Health Issues Reference set has been updated to reflect changes published in the January 2018 release of SNOMED CT as follows: 

Concept ID
StatusReplaced with:

81877007 |Housing problems (finding)|


105531004 |Housing unsatisfactory (finding)|

276617005 |Growth delay (disorder)|


276603001 |Perinatal disorder of growth and/or development (disorder)|

129823000 |Childhood growth AND/OR development alteration (finding)|

12441001 |Epistaxis (disorder)|


249366005 |Bleeding from nose (finding)|

5 Obtaining the Reference Sets

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

6 Feedback

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 Feedback should include any issues relating to implementation, suggestions for future content inclusion or general comments regarding the Reference 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.

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Final Version






Jane MillarApproved

Lesley MacNeil (or Monica Harry)Approved





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Draft Amendment History








Andrew AtkinsonInitial draft
0.2March 16 2018Monica HarryMinor edits drafted for review


Jane MillarFinal updates