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 as was the release in October 2021.
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:
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.
The key drivers for this approach are:
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.
The SNOMED ICNP reference set is released October 2022 as planned. It has been agreed with ICN that the next release of the SNOMED ICNP reference set will be April 2024 and then annually in April. This supports changes to the release cycles of derivatives at SNOMED International and will also allow ICN a further period to collect and agree additions to ICNP which are being proposed by users through the ICNP Editorial Board. This heralds the start of an annual update cycle by ICN, ensuring that the ICNP refset remains current and in line with global nursing practice.
It should be noted that the content of the ICNP refset (October 2022) will be included in the free for use Global Patient Set which will be issued in October 2022 by SNOMED International, replacing the Nursing Health Issues and Nursing Activities reference sets.
The decisions about additions and changes to SNOMED CT as a result of the incorporation of ICNP 2019 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.
The version of ICNP used in this reference set is the May 2019 release.
The version of SNOMED CT used is the July 2022 International Release.
The 2022 International Classification of Nursing Practice (ICNP) Reference Set is comprised of 1958 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 2022 release include replacements for inactivated concepts plus new content to represent some of ICNP terms that did not have an equivalence in the 2021 reference set release. The table below details the changes.
Concept | Status |
---|---|
1231385002 |Demonstrates knowledge of complementary therapy (finding)| | New member |
1141699006 |Demonstrates knowledge of traditional therapy (finding)| | Concept inactivated - no longer an active reference set member |
1231386001 |Deficient knowledge of complementary therapy (finding)| | New member |
704491001 |Deficient knowledge of traditional therapy (finding)| | Concept inactivated - no longer an active reference set member |
1231388000 |Assessment of knowledge of complementary therapy (procedure)| | New member |
710861001 |Assessment of knowledge of traditional therapy (procedure)| | Concept inactivated - no longer an active reference set member |
1231383009 |Support for use of complementary therapy (regime/therapy)| | New member |
710866006 |Support for use of traditional therapy (regime/therapy)| | Concept inactivated - no longer an active reference set member |
1231389008 |Assessment of use of complementary therapy (procedure)| | New member |
711010004 |Assessment of use of traditional therapy (procedure)| | Concept inactivated - no longer an active reference set member |
1163215007 |Pressure injury (disorder)| | New member |
399912005 |Pressure ulcer (disorder)| | Concept inactivated - no longer an active reference set member |
1217332007 |Persistent sadness (finding)| | New member |
1217127002 |Effective continuity of care (finding)| | New member |
224965009 |Grief finding (finding)| | New member |
1230052008 |Impaired ability to manage medication regime (finding)| | New member |
1217330004 |Impairment of integrity of oral mucous membrane (finding)| | New member |
417163006 |Traumatic or non-traumatic injury (disorder)| | New member |
1217126006 |Deficient knowledge of fluid regimen (finding)| | New member |
1236741000 |Parenting stress (finding)| | New member |
284778005 |Difficulty performing personal care activity (finding)| | New member |
1217125005 |Assessment of nausea (procedure)| | New member |
1230050000 |Assisting with dressing activity (procedure)| | New member |
1217461009 |Facilitation of ability to communicate about dying process (procedure)| | New member |
1217334008 |Management of respiratory device (procedure)| | New member |
1172582009 |Preparation of family for childbirth (situation)| | New member |
395076009 |Bereavement support (regime/therapy)| | New member |
1172619003 |Support of victim of child abuse (regime/therapy)| | New member |
1172620009 |Support of victim of elder abuse (regime/therapy)| | New member |
1172621008 |Support of victim of incest (regime/therapy)| | New member |
1172623006 |Support of victim of intimate partner violence (regime/therapy)| | New member |
225423004 |Complementary therapy (regime/therapy)| | New member |
Obtaining the reference set
This reference set covers content of ICNP 2019 and is published as a Production release in October 2022. It should be noted that SNOMED International is not providing an equivalence table as part of the 2022 release. For further information regarding a human readable version of the current equivalence table please contact icnp@icn.ch
Access within SNOMED international member countries is provided by the Member National Release Centre in each country, via the relevant Member page. Users of ICNP in non-member countries need to gain a licence from ICN in the first instance, unless they are also SNOMED CT Affiliates in which case they will be able to access the files using their MLDS accounts. Please contact info@snomed.org and icnp@icn.ch for more information if required.
Feedback should be sent jointly to info@snomed.org and icnp@icn.ch. Feedback should include any issues relating to implementation, suggestions for future content inclusion or general comments regarding the subset.
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:
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.
Delta files have been removed from both International and Managed Service release packages, and are now being removed from all Derivative products in line with this new Standard.
The Delta files have therefore been removed from this 2022 ICNP Nursing Practice Release package. Please contact support@snomed.org if you have any questions about these improvements.
Approvals
Download .pdf here: |
Draft Amendment History
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