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The correct NIC-code and definition of Attachment Promotion is: (NIC 6710) Facilitating the development of an affective, enduring relationship between infant and parent. Enviromental Managament aimed a proces at patiënts and therefore qualifies as a nursing intervention (precedure in SNOMED). For clarity and guidance, I will provide the label, code, definition, and research references for the following NIC interventions: Environmental Management, Environmental Management: Community, Environmental Management: Safety, Environmental Management: Violence Prevention, and Environmental Management: Worker Safety. Environmental Management (NIC 6480): Establishing and maintaining surroundings for therapeutic benefit, sensory appeal, and psychological well-being. Research reference: Aziz, M. G. (2021). Hygiene and self-care. In R. F. Craven, C. J. Hirnle, & C. J. Henshaw (Eds.), Fundamentals of nursing: Human health and function (8th ed.). Wolters-Kluwer. Berman, A., Snyder, S. J., & Frandsen, G. (2018). Hygiene. In Kozier and Erb’s Fundamentals of nursing: Concepts, process and practice (pp. 684–688) (10th ed.). Pearson. De Abreu Moniz, M., Vago Daher, D., Sabóia, V. M., & Batista Ribeiro, C. R. (2020). Environmental health: Emancipatory care challenges and possibilities by the nurse. Revista Brasileira de Enfermagem, 73(3), 1–5. Perry, A. G., Potter, P. A., Ostendorf, W. R., & Laplante, N. (2022). Clinical Nursing Skills and Techniques (10th ed.). Elsevier. Valatka, R., Krizo, J., & Mallat, A. (2021). A survey-based assessment of "matter of balance" participant fall-related experience. Journal of Trauma Nursing, 28(5), 304–309. Williams, P. (2020). Basic geriatric nursing (7th ed.). Elsevier.  Yamaguchi, Y., Greiner, C., Ryuno, H., & Fukuda, A. (2019). Dementia nursing competency in acute care settings: A concept analysis. International Journal of Nursing Practice, 25(3), 1–5. Environmental Management: Community (NIC 6484): Monitoring and modifying physical, social, cultural, economic, and political conditions that affect community health. Research references:  Jakubec, S. L., Szabo, J., Gleeson, J., Currie, G., & Flessati, S. (2021). Planting seeds of community-engaged pedagogy: Community health nursing practice in an intergenerational campus-community gardening program. Nurse Education in Practice. 51, 102980. Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. (2020). Fundamentals of Nursing (10th ed.). Elsevier. Resnik, D. B., MacDougall, D. R., & Smith, E. M. (2018). Ethical dilemmas in protecting susceptible subpopulations from environmental health risks: Liberty, utility, fairness, and accountability for reasonableness. American Journal of Bioethics, 18(3), 29–41. Sela-Vilensky, Y., Grinberg, K., & Nissanholtz-Gannot, R. (2020). Attracting Israeli nursing students to community nursing. Israel Journal of Health Policy Research. 9(1), 1–7. Weaver, C. P., & Miller, C. A. (2019). A framework for climate changerelated research to inform environmental protection. Environmental Management, 64(3), 245–257. Environmental Management: Safety (NIC 6486): Establishing and maintaining the physical environment to promote safety. Research references: Dehdashti, A., Fatemi, F., Jannati, M., Asadi, F., & Kangarloo, M. B. (2020). Applying health, safety, and environmental risk assessment at academic settings. BMC Public Health, 20(1), 1328. Gualniera, P., Scurria, S., Sapienza, D., & Asmundo, A. (2021). Electrosurgical unit: Iatrogenic injuries and medico-legal aspect. Italian legal rules, experience and article review. Annals of Medicine and Surgery, 62, 26–30. King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. (2018). Impact of fall prevention on nurses and care of fall risk patients. Gerontologist, 58(2), 331–340. Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. (2022). Fundamentals of Nursing (10 ed). Elsevier. Takano, H., & Inoue, K. I. (2017). Environmental pollution and allergies. Journal of Toxicologic Pathology, 30(3), 193–199. Turner, S. L., Johnson, R. D., Weightman, A. L., Rodgers, S. E., Arthur, G., Bailey, R., & Lyons, R. A. (2017). Risk factors associated with unintentional house fire incidents, injuries and deaths in high-income countries: a systematic review. Injury prevention: journal of the International Society for Child and Adolescent Injury Prevention. 23(2), 131–137. Environmental Management: Violence Prevention (NIC 6487): Monitoring and manipulation of the physical environment to decrease the potential for violent behavior directed toward self, others, or environment. Research references: Bracken, M. I., Messing, J. T., Campbell, J. C., La Flair, L. N., & Kub, J. (2010). Intimate partner violence and abuse among female nurses and nursing personnel: Prevalence and risk factors. Issues in Mental Health Nursing, 31(2), 137–148. Campbell, J. C., Webster, D. W., & Glass, N. (2009). The danger assessment: Validation of a lethality risk assessment instrument for intimate partner femicide. Journal of Interpersonal Violence, 24(4), 653–674. Constantino, R. E., & Privitera, M. R. (2010). Prevention terminology: Primary, secondary, tertiary and an evolution of terms. In M. R. Privitera (Ed.), Workplace violence in mental and general healthcare settings (pp. 15–22). Jones and Bartlett. Cutcliffe, J. R., & Barker, P. (2004). The Nurses’ Global Assessment of Suicide Risk (NGASR): Developing a tool for clinical practice. Journal of Psychiatric and Mental Health Nursing, 11(4), 393–400. Delaney, K. R., Esparza, D., Hinderliter, D., Lamb, K., & Mohr, W. K. (2006). Violence and abuse within the community. In W. K. Mohr (Ed.), Psychiatric-mental health nursing (6th ed., pp. 353–376). Lippincott Williams & Wilkins. Larsson, P., Nilsson, S., Runeson, B., & Gustafsson, B. (2007). Psychiatric nursing care of suicidal patients described by the sympathy-acceptanceunderstanding-competence model for confirming nursing. Archives of Psychiatric Nursing, 21(4), 222–232. Moracco, K., & Cole, T. (2009). Preventing intimate partner violence: Screening is not enough. JAMA: Journal of the American Medical Association, 302(5), 568–570. Ramsay, J., Carter, Y., Davidson, L., Dunne, D., Eldridge, S., Hegarty, K., Rivas, C., Taft, A., Warburton, A., & Feder, G. (2009). Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse. Cochrane Database of Systematic Reviews, (3). https://doi.org/10.1002/14651858.CD005043.pub2 https://doi.org/10.1002/14651858.CD005043.pub2. Article CD005043 Schmidt, H., III., & Ivanoff, A. (2007). Behavioral prescriptions for treating self-injurious and suicidal behaviors. In O. J. Thienhaus & M. Piasecki (Eds.), Correctional psychiatry: Practice guidelines and strategies (pp. 7/1–7/23). Civic Research Institute. Environmental Management: Worker Safety (NIC 6498): Monitoring and manipulation of the worksite environment to promote safety and health of workers. Research references: Fink, J. L. W. (2013). Keeping nurses safe: Nursing is one of the most dangerous professions. Healthcare Traveler. http://healthcaretraveler.modernmedicine.com/healthcare-traveler/content/tags/american-nursesassociation/keeping-nurses-safe-nursing-one-most-da http://healthcaretraveler.modernmedicine.com/healthcare-traveler/content/tags/american-nursesassociation/keeping-nurses-safe-nursing-one-most-da Geiger-Brown, J., & Lipscomb, J. (2010). The health care work environment and adverse health and safety consequences for nurses. Annual Review of Nursing Research, 28(1), 191–231. Guzik, A. (2013). Essentials for occupational health nursing. Wiley Blackwell.  United States Department of Labor, Occupational Safety & Health Administration. (n.d.). Clinicians. https://www.osha.gov/dts/oom/clinicians/NIC https://www.osha.gov/dts/oom/clinicians/NIC 7e Part 3 D-G.doc Zaidman, B. (2010). Evaluation of the workplace safety consultation nursing home ergonomics services program. Minnesota Department of Labor & Industry. http://www.dli.mn.gov/RS/PDF/nursinghome_ergo.pdf http://www.dli.mn.gov/RS/PDF/nursinghome_ergo.pdf

crichardson The problem is solved and I can respond to your topics again.

Notes for CRG call: - Content tracker issue. Note, you need to be logged in to view. Uses the confluence log in.  PADL - personal activities of daily living  - not used in the Netherlands.  US- not a huge amount of information. Links above provided. 

Based on the definition from the American Speech-Language-Hearing Association  https://www.asha.org/practice-portal/professional-issues/augmentative-and-alternative-communication/ https://www.asha.org/practice-portal/professional-issues/augmentative-and-alternative-communication/ Augmentative and alternative communication (AAC) is an area of clinical practice that supplements or compensates for impairments in speech-language production and/or comprehension, including spoken and written modes of communication. AAC falls under the broader umbrella of assistive technology, or the use of any equipment, tool, or strategy to improve functional daily living in individuals with disabilities or limitations. AAC is augmentative when used to supplement existing speech, alternative when used in place of speech that is absent or not functional, or temporary as when used by patients postoperatively in intensive care (Elsahar et al., 2019) https://www.oxfordhealth.nhs.uk/cit/resources/aac/ https://www.oxfordhealth.nhs.uk/cit/resources/aac/ Augmentative and Alternative Communication (AAC), refers to the use of objects, symbols, charts, photographs, signing and electronic aids to help a child communicate.  Some of the references state that augmentative and alternative communication are synonyms. SNOMED CT International defines augmentative and alternative communication as individual concepts. Communication interventions (regime/therapy)  SCTID: 225220004       Augmentative communication (regime/therapy) SCTID: 406154009       Communication of alternative technique (regime/therapy) SCTID: 133919007 Thank you, Cyndie Lundberg, RN, MSN LOINC Clinical Terminology Manager

These seem valid. Social determinants of health (who.int) https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1 Activities of Daily Living - StatPearls - NCBI Bookshelf (nih.gov) https://www.ncbi.nlm.nih.gov/books/NBK470404/#:~:text=The%20activities%20of%20daily%20living%20are%20classified%20into%20basic%20ADLs,transferring%20or%20ambulating%2C%20and%20eating. Within Australia, I think these terms would mostly be used within aged care QI Program Module 7 – Activities of daily living (health.gov.au) https://www.health.gov.au/sites/default/files/2023-02/qi-program-module-7-managing-qi-program-data_0.pdf But also other support services (or assessment of suitability of services), e.g. NDIS assessments.

Hello, each country has its own legislation on who can work in the social and health professions. So I would see that this is a matter of the UK's own legislation.

https://cdn.ps.emap.com/wp-content/uploads/sites/3/2021/10/211020-Essential-critical-care-skills-1-what-is-critical-care-nursing1.pdf https://cdn.ps.emap.com/wp-content/uploads/sites/3/2021/10/211020-Essential-critical-care-skills-1-what-is-critical-care-nursing1.pdf Critical care typically covers the entire scope of enhanced care, Intensive Care predominantly covers Level 3 and High Dependency typically Level 2 although many Units now have beds that flex between level 2 and 3.  The audit (in the UK) usually looks at the patient needs rather than the bed provision.  I am no longer working actively in this area but this paper is relatively recent.  Intensive care is a subtype of critical care.  

It largely depends on how nursing and multidisciplinary care is to be documented, 736375002 |Hemodialysis care plan (record artifact)| COULD be used if care is typically planned and evaluated, however if you wish to represent a report sent to primary care this may be less suitable.  Many nations are now making full records available to other sectors of the healthcare system (and patients) and thus summary/discharge reports are becoming less critical.  In addition a pre-coordinated representation for every service, health issue etc may be less scalable and probably undesirable too.  Most services could use common structures in FHIR messages but this is why both international and national communities cannot consider terminology in isolation.

Thanks Cathy,  I don't think there is a rush on including these goal attainments we discussed. I'll do some more digging and try and find current concepts that could be useful in describing those we discussed.  zwhitewood that is great to hear and from my perspective I think that is the path forward . We have a bit more work to do here in Sweden before we are able to implement this strategy widespread but we do have a lot of new health care information system procurement that hopefully will make this possible in the future.   I can say Swedish nurses are very interested in using SNOMED CT. Some that are currently using ICNP, have mentioned there is a lack of terms in regard to goal achievement; specifically involving the way they document them in their care plans. Which means incomplete data analysis reports of their patient care for evaluation and reporting. This may be something that we need to address in house until we have more advanced health information systems in place that can use the full power of SNOMED CT's DL. 

Hi fraemaekers, Firstly, I am not sure if you are aware but twice a year we hold business meetings- in April and October. The April meetings are being held next week and given this the Nursing CRG will be meeting as part of those instead of its normal time slot. The meeting will be held on Tuesday 20th April 2000UTC and run for an hour and a half.  The agenda will be posted very shortly. You can register (for free)for this and the other meetings we have via:https://snomed.eventsair.com/snomed-international-april-2021-business-meetings https://snomed.eventsair.com/snomed-international-april-2021-business-meetings This helps us with planning. There is a session for clinicians which igreen or jmillar  could provide more details on.  Adherence and Compliance: In this discussion we were focusing on a patient's adherence or compliance not that of a device. The question had been raised given the ICNP - SNOMED work currently underway and input had been gathered from nursing SME's amongst other sources to support the decision. The internal group I mentioned is predominately made up of Terminologists in the Internal Content Team plus a small number of SMEs. It includes our Head of Terminology. When we make content decisions we need to consider the international aspect as well as the fact these concepts may be used by different clinical domains. At this point in time the information we have did not support  creating different concepts for these terms at the international level. We are aware that some do see them as different in meaning.  Provision of input from SME's such as yourself is welcomed. You will also find some other topics in the discussion area on this site that are currently open for comment.  At present the focus is on completing the ICNP - SNOMED work for the upcoming release. I am aware the adherence - compliance issue is broader than this and will be looking to set up a content issue to record the additional work required. I can post that link here when it is created. You would also be welcome to watch and comment on that issue. Kind regards, Cathy