1. Nursing Special Interest Subgroup – Observables Mapping
Susan Matney, RN, MSN, PhD(c), FAAN
Chair Nursing SIG

2. Nursing Special Interest Group (SIG)
‘…a community of practice for the nursing profession, supporting worldwide nursing participation in the development, validation, uptake, implementation, and correct use of SNOMED CT and related products.’
sufficient and appropriate terminology content to support nursing requirements
guidance about the use of SNOMED CT and related products in nursing settings

3. Main activities
Evaluation of content for specific uses / in response to issues raised
Content development process
[Request submission]
Implementation support ‘products’
Mapping and subset development - Early stages
Guidance materials – nursing user priority or nursing specific audience (not duplicating general materials)
[Educational materials]

4. International Classification for Nursing Practice (ICNP®)
A standardised terminology used to represent nursing diagnoses, interventions and outcomes
Available in 14 languages
Formally modeled in OWL and use of auto-reasoner and Protégé annotations
A formal infrastructure that facilitates cross-mapping and allows output in multiple formats
A related classification in the WHO Family of International Classifications
Harmonisation agreements in place with IHTSDO (SNOMED-CT)

5. ICNP Maps approved for release for – Public Good

7. Process (evaluation done by myself, K. Hannah and J. Warren)
Created a spreadsheet with “Observable” attributes as headers (with definitions)
Loaded nursing outcomes, chose six for modeling
Initially mapped using Observables guidance document
Met with D. Karlsson in Copenhagen
Modeled six
Identified patterns or heuristics for outcome observations

8. Nursing Outcomes Indicators
Concepts in Four Categories:
functional status
therapeutic self-care (readiness for discharge)
symptom management (pain, nausea, fatigue, dyspnea)
safety (falls, pressure ulcers)

9. Sample Measure NAUSEA - Assess for last 24 hours 0. No nausea
1. Mild nausea: occasionally experienced but does not interfere with eating and/or activities
2. Moderate nausea: interferes somewhat with eating and/or some activities most days
3. Severe nausea: interferes daily with eating and/or activities
4. Incapacitating: remains in bed part of each day due to nausea and interferes with eating and activities

10. Outcome concept modeling (spreadsheet)
Observable
SCT code | PT
Property Type
Inheres in
Towards
Bathing
| ability to perform bathing activity
function (observable entity)
Homo sapiens (organism)
current (qualifier value)
skin hygiene (observable entity)
Walking
|ability to walk|
mobility (observable entity)
Toilet use
| ability to use toilet
ability to perform toileting activities (observable entity)
Pain Intensity
| pain intensity |
perception, function (observable entity)
level of physical comfort (observable entity)
Nausea
New term submitted - nausea level
Knowledge of medications currently taking
| knowledge level: medication
Knowledge (new concept)
knowledge level (observable entity)
Understand purpose of the medication
|Ability to vaerbalize understanding

11. Discussion New Properties Function, Perception, Knowledge Towards
We discuss this being a goal but decided not.
Review what we did.
Technique
Patient Stated - missing
Patterns
The properties above always inhere in the person (homo sapien)
Perception and knowledge is always stated by the patient