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Applying ICF in nursing practice: classifying elements of nursing diagnoses.

M M Heinen1, T van Achterberg, G Roodbol

  • 1Centre for Quality of Care Research, Nursing Science, University Medical Centre St Raboud, Nijmegen, The Netherlands. m.heinen@kwazo.umcn.nl

International Nursing Review
|October 22, 2005
PubMed
Summary

The International Classification of Functioning, Disability and Health (ICF) is relevant to nursing diagnoses, though nurses encounter challenges using it. Further exploration and participation in revisions can improve its application in nursing care.

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Area of Science:

  • Nursing
  • Rehabilitation
  • Public Health

Background:

  • The International Classification of Functioning, Disability and Health (ICF) is a multidisciplinary framework for classifying human functioning.
  • Despite its potential relevance, nurses have historically underutilized the ICF in clinical practice.
  • This study investigates the applicability and challenges of using the ICF in the context of nursing diagnoses.

Purpose of the Study:

  • To determine the relevance of the International Classification of Functioning, Disability and Health (ICF) to nursing diagnoses.
  • To assess the feasibility of classifying nursing diagnostic elements using the ICF framework.
  • To identify challenges and areas for improvement in the application of the ICF in nursing.

Main Methods:

  • Two parts were conducted: Part 1 involved classifying 427 diagnostic elements from 51 diverse anonymous nursing diagnoses using the ICF by a panel of six nurses.

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  • Part 2 involved classifying 223 elements from 30 nursing diagnoses of patients the panel had directly cared for.
  • Inter-rater reliability was assessed at both the component level and the detailed 3-digit level of the ICF.

    • Main Results:

    • The ICF proved capable of classifying nearly all nursing diagnostic elements, with body functions and activities being the most frequently assigned categories.
    • Agreement on ICF component classification was 61% for anonymous patient data and 75% for familiar patient data.
    • Agreement at the more specific 3-digit level was 42% for anonymous and 60% for familiar patient data, indicating room for improvement.

    Conclusions:

    • The ICF demonstrates relevance to nursing care, although it was not specifically designed for nursing practice.
    • Observed difficulties and moderate agreement levels highlight the need for adaptation and nurse involvement in refining the ICF for nursing applications.
    • Nurses are encouraged to further explore ICF utilization and actively participate in its future revision processes to enhance its utility in nursing.