Input is being sought from the Nursing CRG to assist with the addition of definitions to the following concepts.
386520000 |Attachment promotion (procedure)| https://dailybuild.ihtsdotools.org/?perspective=full&conceptId1=386520000&edition=MAIN&release=&languages=en
133917009 |Bonding encouragement (procedure)| https://dailybuild.ihtsdotools.org/?perspective=full&conceptId1=133917009&edition=MAIN&release=&languages=en
386283002 |Environmental management: attachment process (procedure)| http
11 March call summary of discussion for this topic:
Attachment promotion (procedure):
Hierarchical placement suggests parent/child but terming isn't specific
could be any attachment - person or thing. What about breastfeeding attachment?
Not clear on the from and to aspect.
What ages does this apply to? Infant to parent? Adolescents?
Need input from a behavioural/ mental health perspective as well.
Term comes from NIC 7190 with the definition 'facilitating the development of close, affectionate relationship between parents, caregivers and children'.
This intervention in NIC is placed within the Childrearing Care class - Interventions to assist in raising children, within the Family-domain.
Reach out to Cheryl Wagner re this concept (Christine)
Environmental management: attachment process (procedure):
Environmental can be interpreted in many ways
Questions on where this one came from.
In NIC Environmental Management is defined as 'Manipulation of the patient’s surroundings for therapeutic benefit, sensory appeal, and psychological well-being'.
Different types - comfort, community, home preparation and safety/violence/prevention. (there are concepts in SNOMED for these).
No discussion on Bonding encouragement (procedure).
Erica raised the concepts with a nursing group in Sweden.
Attachment promotion - important for nursing
Environmental management: attachment process- didn't like the terming.
Nursing group will seek further input from the neonatal/child hospital in Sweden.
Activities of everyday life – this term is used in the following concepts
284545001 |Ability to perform activities of everyday life (observable entity)|
365031000 |Finding related to ability to perform activities of everyday life (finding)|
129025006 |Activity of daily living (observable entity)| | - in the synonym Activities of everyday life.
Searches on that term bring up sites relating to ADL’s. That phrasing is not used. I expect the concepts and synonym need inactivation. Prio
PADL - personal activities of daily living – this term is used as a synonym on the concept 285592006 |Personal care activity (observable entity)|. It is not used elsewhere in the terminology. The term and its abbreviation can be found online but in limited sources.
https://www.seslhd.health.nsw.gov.au/sites/default/files/groups/Executive_Services/Clinical%20Abbreviations%20List%20-%20SESLHDPR%20282.pdf
https://pursuitah.com.au/personal-activities-of-daily-living-padl-assessments/#:~:text
Notes for CRG call:
- Content tracker issue. Note, you need to be logged in to view. Uses the confluence log in.
PADL - personal activities of daily living - not used in the Netherlands.
US- not a huge amount of information. Links above provided.
We have received a request for information on the meaning of the concept 133919007 |Communication of alternative technique (regime/therapy)|. From what we can ascertain it may be a nursing term. Are members of this group able to provide information on the meaning to assist with this query.
Please provide responses by 5th June 2024.
Thank you.
Cathy
Based on the definition from the American Speech-Language-Hearing Association https://www.asha.org/practice-portal/professional-issues/augmentative-and-alternative-communication/ https://www.asha.org/practice-portal/professional-issues/augmentative-and-alternative-communication/
Augmentative and alternative communication (AAC) is an area of clinical practice that supplements or compensates for impairments in speech-language production and/or comprehension, including spoken and written modes of communication. AAC falls under the broader umbrella of assistive technology, or the use of any equipment, tool, or strategy to improve functional daily living in individuals with disabilities or limitations.
AAC is augmentative when used to supplement existing speech, alternative when used in place of speech that is absent or not functional, or temporary as when used by patients postoperatively in intensive care (Elsahar et al., 2019)
https://www.oxfordhealth.nhs.uk/cit/resources/aac/ https://www.oxfordhealth.nhs.uk/cit/resources/aac/
Augmentative and Alternative Communication (AAC), refers to the use of objects, symbols, charts, photographs, signing and electronic aids to help a child communicate.
Some of the references state that augmentative and alternative communication are synonyms. SNOMED CT International defines augmentative and alternative communication as individual concepts.
Communication interventions (regime/therapy) SCTID: 225220004
Augmentative communication (regime/therapy) SCTID: 406154009
Communication of alternative technique (regime/therapy) SCTID: 133919007
Thank you,
Cyndie Lundberg, RN, MSN
LOINC Clinical Terminology Manager
The International Edition of SNOMED CT currently has five <x> needs met (finding) concepts:
•736691007 |Social needs met (finding)|
•406530005 |Healthcare needs met by service (finding)|
•736689004 |Total care needs met (finding)|
•707744000 |Personal care needs met (finding)|
•707743006 |Activity of daily living needs met (finding)|
Looking at historical request information four concepts were part of a batch submitted by the UK in 2011. Definitions were not provided but a use care
These seem valid.
Social determinants of health (who.int) https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
Activities of Daily Living - StatPearls - NCBI Bookshelf (nih.gov) https://www.ncbi.nlm.nih.gov/books/NBK470404/#:~:text=The%20activities%20of%20daily%20living%20are%20classified%20into%20basic%20ADLs,transferring%20or%20ambulating%2C%20and%20eating.
Within Australia, I think these terms would mostly be used within aged care
QI Program Module 7 – Activities of daily living (health.gov.au) https://www.health.gov.au/sites/default/files/2023-02/qi-program-module-7-managing-qi-program-data_0.pdf
But also other support services (or assessment of suitability of services), e.g. NDIS assessments.
Requests have been received for the addition of new concepts to the Qualifier Value and Social Context hierarchies to represent the specialist community and public health nurse occupation and speciality. The concepts requested have been termed: Specialist community and public health nurse (occupation) and Community and public health nursing specialty (qualifier value)
Is this an internationally recognised speciality? It appears to be in the UK: https://www.nmc.org.uk/standards/standards-for-
Hello, each country has its own legislation on who can work in the social and health professions. So I would see that this is a matter of the UK's own legislation.
Requests have been received for the addition of new concepts to the Qualifier Value and Social Context hierarchies to represent the critical care nursing occupation and speciality. The concepts are termed: Critical care nurse (occupation) and Critical care nursing specialty (qualifier value).
We can see this is an internationally recognised nursing speciality:
https://acccn.com.au/
https://caccn.ca/ https://www.nzno.org.nz/groups/colleges_sections/colleges/new_zealand_college_of_critical_c
https://cdn.ps.emap.com/wp-content/uploads/sites/3/2021/10/211020-Essential-critical-care-skills-1-what-is-critical-care-nursing1.pdf https://cdn.ps.emap.com/wp-content/uploads/sites/3/2021/10/211020-Essential-critical-care-skills-1-what-is-critical-care-nursing1.pdf
Critical care typically covers the entire scope of enhanced care, Intensive Care predominantly covers Level 3 and High Dependency typically Level 2 although many Units now have beds that flex between level 2 and 3. The audit (in the UK) usually looks at the patient needs rather than the bed provision. I am no longer working actively in this area but this paper is relatively recent. Intensive care is a subtype of critical care.
It largely depends on how nursing and multidisciplinary care is to be documented, 736375002 |Hemodialysis care plan (record artifact)| COULD be used if care is typically planned and evaluated, however if you wish to represent a report sent to primary care this may be less suitable. Many nations are now making full records available to other sectors of the healthcare system (and patients) and thus summary/discharge reports are becoming less critical. In addition a pre-coordinated representation for every service, health issue etc may be less scalable and probably undesirable too. Most services could use common structures in FHIR messages but this is why both international and national communities cannot consider terminology in isolation.
At the July 2021 meeting following a request for input, the Nursing CRG discussed goal concepts.
The Nutrition Group had had a finding concept added: 1162727003 |Goal discontinued (finding)|. Since this concept together with other current goal finding concepts 390800000 |Goal achievement finding (finding)| and subtypes was relevant to other domains including nursing, the Nursing group was asked to comment on this type of content.
See: https://dailybuild.ihtsdotools.org/?perspective=fu
Thanks Cathy,
I don't think there is a rush on including these goal attainments we discussed. I'll do some more digging and try and find current concepts that could be useful in describing those we discussed.
zwhitewood that is great to hear and from my perspective I think that is the path forward . We have a bit more work to do here in Sweden before we are able to implement this strategy widespread but we do have a lot of new health care information system procurement that hopefully will make this possible in the future.
I can say Swedish nurses are very interested in using SNOMED CT. Some that are currently using ICNP, have mentioned there is a lack of terms in regard to goal achievement; specifically involving the way they document them in their care plans. Which means incomplete data analysis reports of their patient care for evaluation and reporting. This may be something that we need to address in house until we have more advanced health information systems in place that can use the full power of SNOMED CT's DL.
Hi all,
I am seeking input on the understanding and use of the terms adherence and compliance by nurses. Are they seen the same or different? If different, how would you define the two?
Thank you.
Hi fraemaekers,
Firstly, I am not sure if you are aware but twice a year we hold business meetings- in April and October. The April meetings are being held next week and given this the Nursing CRG will be meeting as part of those instead of its normal time slot. The meeting will be held on Tuesday 20th April 2000UTC and run for an hour and a half. The agenda will be posted very shortly. You can register (for free)for this and the other meetings we have via:https://snomed.eventsair.com/snomed-international-april-2021-business-meetings https://snomed.eventsair.com/snomed-international-april-2021-business-meetings This helps us with planning. There is a session for clinicians which igreen or jmillar could provide more details on.
Adherence and Compliance:
In this discussion we were focusing on a patient's adherence or compliance not that of a device. The question had been raised given the ICNP - SNOMED work currently underway and input had been gathered from nursing SME's amongst other sources to support the decision. The internal group I mentioned is predominately made up of Terminologists in the Internal Content Team plus a small number of SMEs. It includes our Head of Terminology.
When we make content decisions we need to consider the international aspect as well as the fact these concepts may be used by different clinical domains. At this point in time the information we have did not support creating different concepts for these terms at the international level. We are aware that some do see them as different in meaning.
Provision of input from SME's such as yourself is welcomed. You will also find some other topics in the discussion area on this site that are currently open for comment.
At present the focus is on completing the ICNP - SNOMED work for the upcoming release. I am aware the adherence - compliance issue is broader than this and will be looking to set up a content issue to record the additional work required. I can post that link here when it is created. You would also be welcome to watch and comment on that issue.
Kind regards,
Cathy
Cathy Richardson