The challenges with working with documentation and implementation of standardized nursing language in electronic health records are often not country specific. The Nordic Countries Sweden, Denmark and Norway decided in 2015 to meet for discussions about documentation practice and standardized vocabulary. We identified very quickly that the respective national struggle showed many resemblances between the countries. We decided to continue to meet on an annual basis in a Nordic Documentation Council.
So, a group of representatives from the national nursing organizations and registered nurses from national nursing informatics organizations started meeting. We have now met three times, last time in December 2017 in Aarhus in Denmark to share experiences and discuss future directions of the work. Here we took part of ongoing projects, e.g. implementation of ICNP (International Classification of Nursing Practice) in two large hospitals, implementation of ICNP in nursing education, comparison between the ICNP and the ICF (International classification of Functioning, Disability and health) for representing nursing. We also heard about e.g., a survey regarding nurses’ documentation practice in Denmark and the use of SNOMED CT (Standardized Nomenclature of Medicine – Clinical Terms), the establishment of a Norwegian ICNP® Research and development Centre, and the use of ICNP in order to optimize decision support. The program span from lunch to lunch with a lovely get together in the evening.
The development in the three countries regarding standardized language are partly similar but show some differences. Norway is focusing on ICNP now after having previously translated and started using NANDA (North American Nursing Diagnosis Association), NIC (Nursing Intervention Classification) and NOC (Nursing Outcome Classification. Sweden have translated NANDA, which is in some limited clinical use, and also ICNP which is now regarded as the terminology with best potential. Apart from that, Sweden also has translated the SNOMED CT reference terminology. In Denmark, the SNOMED CT is used in increasing scale. The other terminologies are not available in Danish.
Despite the differences, we find it very fruitful to share experiences and support one another in the continuing work with making nursing visible in the EHR using standardized vocabulary. We now plan some joint projects. A call to the reader: Consider the potential and seek opportunities to organize such a collaboration between countries.
Jan Florin
