International Classification for Nursing Practice (ICNP): Most-frequently Asked Questions

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7-1-1998

International Classi#cation for Nursing Practice

(ICNP): Most-frequently Asked Questions

Judith J. Warren

University of Nebraska at Omaha

Amy Coenen

Marquee University

Accepted version. Journal of the American Medical Informatics Association, Vol. 5, No. 4 (July 1998):

NOT THE PUBLISHED VERSION; this is the author’s final, peer-reviewed manuscript. The published version may be

accessed by following the link in the citation at the bottom of the page.

Journal of the American Medical Informatics Association, Vol. 5, No. 4 (July-August 1998): pg. 335-336. DOI. This article is

Oxford University Press does not grant permission for this article to be further copied/distributed or hosted elsewhere

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International Classification for

Nursing Practice (ICNP): Most-

frequently Asked Questions

Judith J. Warren

University of Nebraska

Omaha, NE

Amy Coenen

Nursing, Marquette University

Milwaukee, WI

Abstract

The International Classification for Nursing Practice (ICNP) is a collaborative

project under the auspices of the International Council of Nurses. The alpha

version ia available online for comment in reparation for the release of the

beta version in 1999. The authors answer the most-frequently asked

questions about the ICNP and encourage nurses in the United States to

participate in the revision by sending comments and suggestions to the

American Nurses Association.

What is the International Classification for

Nursing Practice (ICNP)?

The ICNP is a nursing classification being developed by the

International Council of Nurses (ICN) in Geneva, Switzerland. The

American Nurses Association (ANA), through its Steering Committee

NOT THE PUBLISHED VERSION; this is the author’s final, peer-reviewed manuscript. The published version may be

accessed by following the link in the citation at the bottom of the page.

Journal of the American Medical Informatics Association, Vol. 5, No. 4 (July-August 1998): pg. 335-336. DOI. This article is

Oxford University Press does not grant permission for this article to be further copied/distributed or hosted elsewhere

without the express permission from Oxford University Press.

on Databases Supporting Clinical Nursing Practice, has supported this

international work by facilitating collaboration between the ICNP team

and the developers of the ANA-recognized nursing classifications: the

North American Nursing Diagnosis Association (NANDA)

Taxonomy 1,

Nursing Interventions Classification (NIC),

Omaha System,

Home

Health Care Classification,

and Nursing Outcomes Classifications

(NOC).

At the request of the ICN and the ICNP team, the ANA

Steering Committee on Databases Supporting Clinical Nursing Practice

is encouraging nurses in the United States to participate in the

evaluation of this new classification effort.

The ICNP provides a structured and defined vocabulary as well

as a classification for nursing and a framework into which existing

vocabularies and classifications can be cross-mapped to enable

comparison of nursing data.

The three primary elements of the ICNP are: 1) nursing

phenomena—i.e., the focus of nursing, sometimes referred to as

nursing diagnoses; 2) nursing interventions—i.e., the actions or

activities nurses perform; and 3) nursing outcomes—i.e., the results of

nurses’ actions in terms of change in the focus at a specific time.

Why is the ICNP important?

The objectives of the ICNP, as set out in the initial ICN

publication,

are: 1) to establish a common language for describing

nursing practice in order to improve communication among nurses and

between nurses and others; 2) to describe the nursing care of people

(individuals, families, and communities) in a variety of settings, both

institutional and non-institutional; 3) to enable comparison of nursing

data across clinical populations, settings, geographic areas, and time;

4) to demonstrate or project trends in the provision of nursing

treatments and care and the allocation of resources to patients

according to their needs based on nursing diagnoses; 5) to stimulate

nursing research through links to data available in nursing information

systems and health information systems; and 6) to provide data about

nursing practice in order to influence health policymaking.

The original proposal also set out the criteria that the

NOT THE PUBLISHED VERSION; this is the author’s final, peer-reviewed manuscript. The published version may be

accessed by following the link in the citation at the bottom of the page.

Journal of the American Medical Informatics Association, Vol. 5, No. 4 (July-August 1998): pg. 335-336. DOI. This article is

Oxford University Press does not grant permission for this article to be further copied/distributed or hosted elsewhere

without the express permission from Oxford University Press.

ICNP must meet. The classification must be: 1) broad enough to serve

the multiple purposes required by different countries; 2) simple

enough to be seen by the ordinary practitioner of nursing as a

meaningful description of practice and a useful means of structuring

practice; 3) consistent with clearly defined conceptual frameworks but

not dependent on a particular theoretic framework or model of

nursing; 4) based on a central core to which additions can be made

through a continuing process of development and refinement; 5)

sensitive to cultural variability; 6) reflective of the common value

system of nursing across the world as expressed in the ICN Code for

Nurses; and 7) usable in a complementary or integrated way with the

family of classifications developed within the World Health

Organization, the core of which is the International Classification of

Diseases.

If I have been using a classification system, such

as the NANDA Taxonomy, do I have to change?

No. The ICNP provides a unifying framework into which existing

nursing vocabularies can be cross-mapped to enable comparison of

nursing data collected using other recognized nursing vocabularies and

classifications.

Does the ICNP restrict multidisciplinary practice?

No. Like the ICD, the development of the ICNP is a long-term

project that will provide a structured vocabulary and a classification

that can be used to describe and organize data about nursing. The

ICNP can be integrated with other health care classification systems to

create multidisciplinary health vocabularies or lexicons within

information systems.

What other information on the ICNP is available?

The ICN published an alpha version of the ICNP in 1996.

This is

available from the ICN (fax: 141-22-908-01-01; e-mail:

ICN@uni2a.unige.ch). In addition, there have been a number of

NOT THE PUBLISHED VERSION; this is the author’s final, peer-reviewed manuscript. The published version may be

accessed by following the link in the citation at the bottom of the page.

Journal of the American Medical Informatics Association, Vol. 5, No. 4 (July-August 1998): pg. 335-336. DOI. This article is

Oxford University Press does not grant permission for this article to be further copied/distributed or hosted elsewhere

without the express permission from Oxford University Press.

articles about the ICNP published in the ICN’s journal, International

Nursing Review.

The ICNP can be accessed on the Internet. To access the sites you

need at least Windows 95 and Microsoft Internet Explorer 3.0. There

are two sites:

 You will find the published alpha version at:

http://www.nethotel.dk/dihnr/Telenurse/ICNP

 You will find the experimental version, where changes are made

in response to feedback, and further development on the road

to the beta version at:

http://www.nethotel.dk/dihnr/Telenurse/ICNP/Beta

How can I participate?

The alpha version is evaluated in different ways and at several

levels. An evaluation form and forms for submitting new terms are

included in the appendix of the alpha version, and any other feedback

is welcome by the ICN. Individuals may complete these forms and

send them to the ICNP team. However, since the ICNP is a product of

the ICN, the formal communication network is through ICN member

organizations. The ANA is the member organization in the United

States. While technical information and a system for monitoring

development will be provided by the ICN headquarters in Geneva,

Switzerland, individual researchers and organizations are encouraged

to collaborate closely with the ICN through their national nurses

associations. The ANA has asked the Steering Committee on

Databases Supporting Clincial Nursing Practice to coordinate this

activity. Please contact either of us if you have questions.

What’s next?

At present, much effort is continuing with the translation,

dissemination, and evaluation of the alpha version of the ICNP. This

work will foster the development of a beta version, scheduled for

release and further testing by the ICN in 1999. A process for the

continuous revision of the ICNP is under development.

NOT THE PUBLISHED VERSION; this is the author’s final, peer-reviewed manuscript. The published version may be

accessed by following the link in the citation at the bottom of the page.

Journal of the American Medical Informatics Association, Vol. 5, No. 4 (July-August 1998): pg. 335-336. DOI. This article is

Oxford University Press does not grant permission for this article to be further copied/distributed or hosted elsewhere

without the express permission from Oxford University Press.

References

1. North American Nursing Diagnosis Association. NANDA nursing diagnoses:

definitions and classification, 1992–1993. Philadelphia, Pa: NANDA,

1992.

2. McCloskey JC, Bulechek GM. Nursing Interventions Classification. 2nd ed.

St. Louis, Mo: CV Mosby Co, 1996.

3. Martin KS, Scheet NJ. The Omaha System: Applications for Community

Health Nursing. Philadelphia, Pa: WB Saunders Co, 1992.

4. Saba VK. Home Health Care Classification. Caring Mag. 1992;11(4):58–60.

5. Johnson M, Maas M (eds). Nursing Outcomes Classification (NOC). St.

Louis, Mo: CV Mosby Co, 1997.

6. Clark J, Lang NM. Nursing’s next advance: an international classification for

nursing practice. Int Nurs Rev. 1992;39:109–112, 119.

7. International Council of Nurses. The International Classification for Nursing

Practice: a unifying framework. Geneva, Switzerland: International

Council of Nurses, 1996.

8. Nielson GH, Mortensen RA. The architecture for an International

Classification of Nursing Practice (ICNP). Int Nurs Rev. 1996;

About the Authors

Affiliations of the authors: University of Nebraska, Omaha, Nebraska (JJW);

Marquette University, Milwaukee, Wisconsin (AC).

Correspondence and reprints: Judith J. Warren, PhD, RN, C, FAAN,

Chairperson, ANA Steering Committee on Databases Supporting Clinical

Nursing Practice, Associate

Professor and Clinical Nurse Researcher, University of Nebraska Medical

Center, Omaha, NE 68198-5330. e-mail: <[email protected]>.