University of Salford Manchester

International Standards for Nursing Terminology

Terminology work within nursing has been ongoing for several decades. Prior to the application of the research that underpins this case study, the development and maintenance of nursing terminologies was a largely manual process. Professor Nicholas Hardiker, of the School of Nursing, Midwifery, Social Work and Social Policy has developed research in the use of description logics, specifically the application of the Web Ontology Language (OWL) to explore the utility of statements that describe nursing diagnoses and nursing-sensitive patient outcomes:
  • Bringing together practice-level data from a range of sources and utilising the Web Ontology Language (OWL) within a nursing context, leading to the development of a formal foundation for standardised terminologies for nursing;
  • The only nursing-specific terminology within the World Health Organisation Family, the International Classification for Nursing Practice (ICNP®) has been accepted as a Related Classification within the World Health Organisation Family of International Classifications (WHO-FIC);
  • Translated into 16 languages ICNP is emerging as an international standard for nursing, facilitating more effective nursing care and improved patient outcomes

Standardising data internationally, to improve health care 

ICNP improves communication and statistical reporting practices across health services and remains the only international production standardised nursing terminologies to be underpinned with a formal foundation. ICNP has promoted harmonisation with other widely used standards, made visible nursing’s contribution to health and health care globally and improved healthcare and patient outcomes. 
  • The utility and efficiency of ICNP is demonstrated by the level of uptake, ICNP is available in 16 languages (with Swedish, Icelandic and Slovenian also in progress). This significant translation effort has been largely voluntary with individuals and national organisation seeing the potential benefits of ICNP and investing resources to facilitate national adoption. 
  • Emerging as a national standard for nursing in a number of countries, ICNP is recognised by the American Nurses association as an interface terminology that supports nursing practice.
  • The Canadian Nurses Association (CNA) endorses ICNP for documenting professional nursing practice in Canada. CNA has developed mapping between ICNP and its own outcomes measurement instrument, the Canadian Health Outcomes for Better Information and Care (C-HOBIC). 
  • The Portuguese version of ICNP (Classificação Internacional para a Prática de Enfermagem – CIPE) is now widely used in software applications within the Portuguese national health system (SNS). ICNP has been promoted as the preferred nursing terminology within Portugal for over 10 years; all Portuguese Government-funded nursing information systems are required to be ICNP-compliant. 
  • The World Health Organisation accepted ICNP within the Family of International Classifications (WHO-FIC) to extend coverage of the domain of nursing practice as an essential and complementary part of professional health services. ICNP is the only nursing-specific terminology within the Family. ICNP is also strongly influencing the development of the multidisciplinary International Classification of Health Interventions (ICHI). The 11th revision of the WHO International Classification of Diseases has broken convention in adopting a formal approach that is similar to ICNP to underpin the terminology. 
  • Nicolas continues to play an active role in formal standardisation efforts, contributing to terminology-related standards activity within ISO, the European Committee for Standardisation (CEN), the British Standards Institute (BSI) and the International Medical Informatics Association (IMIA).
  • Nicolas was invited to join the Nursing Peer Group of the National Advisory Group to the UK NHS Connecting for Health Programme, England’s Chief Nursing Officer’s Next Stage Review Nursing and Midwifery Advisory Board and its successor, the National Nursing Informatics Strategic Taskforce and is a founder member of the Steering Committee of the Vanderbilt University Nursing Terminology Summit, a US-based ‘think tank’, providing global strategic direction for research and development around terminologies, and Chair of the Health Information Systems Society (HIMSS) Europe Governing Council.