Development of ICNP-based inpatient falls prevention catalogue.

Abstract

The International Council of Nurses supports the development of International Classification for Nursing Practice® (ICNP®) catalogues to support the construction of electronic health records and evidence-based practice. Such a catalogue is needed for inpatient falls. The ICNP®-Based Inpatient Fall-Prevention Catalogue ('The Catalogue') was developed following the six steps recommended by the International Council of Nurses: (1) identifying inpatient falls as a priority, (2) gathering relevant concepts from 10 international guidelines and comparing locally defined sets of fall-prevention terms, (3) mapping the concepts to the ICNP® terminology, (4) identifying new concepts, (5) conducting a clinical face validation with a 12-member panel and finalizing The Catalogue and (6) setting a strategy for dissemination. The high-level structure of the International Classification for Patient Safety was used as a theoretical framework. Eighteen nursing care elements and 141 terms were identified. A local vocabulary set had 89 terms (63.1%) that all corresponded to the identified terms. The exact and post-coordination mapping rates to the ICNP® were 75% and 40.6% for assessment/diagnosis/outcomes and interventions, respectively. The 54 new terms corresponded to 52 primitive concepts. An external review of The Catalogue showed that it had adequate understandability and validity. However, one-third of assessments/diagnoses/outcomes and one-fourth of interventions were not found in a tertiary hospital practice. A fall-prevention catalogue has been developed based on evidence and a theoretical framework and also clinically validated. The Catalogue is a standardized interface terminology and content subset in any electronic health recordssystem that can directly deliver evidence on fall prevention. It can also be used as an informatics tool to aggregate, analyse, interpret and compare nursing data worldwide.