Objective: The purpose of this study was to evaluate the adequacy of the International Classification of Nursing Practice Version 1.0 as the representational underpinning for a domain model for nursing assessment documentation in preparation for electronically capturing, sharing and reusing assessment data across an integrated care delivery system.
Design and measurements: To identify representational requirements of the nursing assessment data, we mapped the key concepts and semantic relations extracted from sets of standardized and local nursing assessment items to the ICNP. In addition, the ICNP was evaluated with respect to its expressiveness and flexibility for representing nursing assessment concepts within the nursing assessment domain model. The resulting model was tested against 60 inpatient assessment records and a set of 300 randomly selected defining characteristics phrases from the North American Nursing Diagnosis Association taxonomy.
Results: A total of 805 assessment concepts were identified. Forty-three percent had exact matches in the ICNP, and an additional 20% had matches in the ICNP classified as narrower, broader or “other”. Of the concepts without matches in the ICNP, 80.8% had exact matches found in other ANA accepted terminologies. In addition to the 30 existing ICNP semantic relations (identified in the Protégé OWL version of the ICNP), an additional 17 semantic relations were identified as necessary for the ICNP to function as a domain model for nursing assessment documentation.
Conclusion: The broad concept coverage and the logic-based structure make the ICNP flexible and robust enough for extension to meet the representational requirements of a nursing assessment documentation system. With necessary terminology and semantic relation extensions, the ICNP can serve as the representational underpinning for a domain model for nursing assessment documentation. In addition, with recommended extensions, the ICNP represents a core building block for evidence-based practice, as it provides a means to capture atomic level data and facilitate lossless data transformation.
Dykes, P.C., Hyeon-eui, K., Goldsmith, D.M., Choi, J., Esumi, K., Goldberg, H.S. (2009). The Adequacy of ICNP Version 1.0 as a Representational Model for Electronic Nursing Assessment Documentation, J Am Med Inform Assoc, 16, 2,238-246.