Development of terminology subsets using ICNP

For healthcare terminologies to provide coverage of a domain, many have evolved into very large and complex sets, creating a challenge for implementation. The International Classification of Nursing Practice (ICNP) Version 2 has over 2800 concepts. Thus, development of terminology subsets is considered as a potential solution to facilitate implementation.

Based on early efforts to develop ICNP Catalogues, or clinically relevant subsets of the terminology, a process model was developed based on the ICNP life cycle. The steps involved in developing a subset are (a) identifying client(s) and health priority, (b) gathering terms and concepts relevant to a given priority, (c) mapping the identified concepts to the ICNP terminology, (d) modeling new concepts, (e) finalizing a Catalogue, and (f) disseminating the Catalogue.

The ICNP model was applied to subset development resulting in three ICNP Catalogues: (a) Partnering with Patients and Families to Promote Adherence to Treatment, (b) Palliative Care for Dignified Dying, and (c) Canadian Health Outcomes for Better Information and Care. Although the three Catalogues were very different in the focus of health priority addressed, there are overlapping concepts across the Catalogues ranging from 1.0 to 14.2%.

The ICNP process model for Catalogue development can be used by other terminology developers and potentially assist in the creation of subset of ICNP to be used at the electronic health record interface. Further research is needed to address challenges and implications for testing and applications of terminology subsets.