scholarly journals Visibility of Community Nursing Within an Administrative Health Classification System: Evaluation of Content Coverage (Preprint)

2018 ◽  
Author(s):  
Lorraine J Block ◽  
Leanne M Currie ◽  
Nicholas R Hardiker ◽  
Gillian Strudwick

BACKGROUND The World Health Organization is in the process of developing an international administrative classification for health called the International Classification of Health Interventions (ICHI). The purpose of ICHI is to provide a tool for supporting intervention reporting and analysis at a global level for policy development and beyond. Nurses represent the largest resource carrying out clinical interventions in any health system. With the shift in nursing care from hospital to community settings in many countries, it is important to ensure that community nursing interventions are present in any international health information system. Thus, an investigation into the extent to which community nursing interventions were covered in ICHI was needed. OBJECTIVE The objectives of this study were to examine the extent to which International Classification for Nursing Practice (ICNP) community nursing interventions were represented in the ICHI administrative classification system, to identify themes related to gaps in coverage, and to support continued advancements in understanding the complexities of knowledge representation in standardized clinical terminologies and classifications. METHODS This descriptive study used a content mapping approach in 2 phases in 2018. A total of 187 nursing intervention codes were extracted from the ICNP Community Nursing Catalogue and mapped to ICHI. In phase 1, 2 coders completed independent mapping activities. In phase 2, the 2 coders compared each list and discussed concept matches until consensus on ICNP-ICHI match and on mapping relationship was reached. RESULTS The initial percentage agreement between the 2 coders was 47% (n=88), but reached 100% with consensus processes. After consensus was reached, 151 (81%) of the community nursing interventions resulted in an ICHI match. A total of 36 (19%) of community nursing interventions had no match to ICHI content. A total of 100 (53%) community nursing interventions resulted in a broader ICHI code, 9 (5%) resulted in a narrower ICHI code, and 42 (23%) were considered equivalent. ICNP concepts that were not represented in ICHI were thematically grouped into the categories family and caregivers, death and dying, and case management. CONCLUSIONS Overall, the content mapping yielded similar results to other content mapping studies in nursing. However, it also found areas of missing concept coverage, difficulties with interterminology mapping, and further need to develop mapping methods.

2017 ◽  
Vol 24 (4) ◽  
pp. 722-728 ◽  
Author(s):  
Nicola Fortune ◽  
Nicholas R Hardiker ◽  
Gillian Strudwick

Abstract Objective: The International Classification of Health Interventions, currently being developed, seeks to span all sectors of the health system. Our objective was to test the draft classification’s coverage of interventions commonly delivered by nurses, and propose changes to improve the utility and reliability of the classification for aggregating and analyzing data on nursing interventions. Materials and methods: A 2-phase content mapping method was used: (1) three coders independently applied the classification to a dataset comprising 100 high-frequency nursing interventions; (2) the coders reached consensus for each intervention and identified reasons for initial discrepancies. Results: A consensus code was found for 80 of the 100 source terms; for 34% of these, the code was semantically equivalent to the source term, and for 64% it was broader. Issues that contributed to discrepancies in Phase 1 coding results included concepts in source terms not captured by the classification, ambiguities in source terms, and uncertainty of semantic matching between “action” concepts in source terms and classification codes. Discussion: While the classification generally provides good coverage of nursing interventions, there remain a number of content gaps and granularity issues. Further development of definitions and coding guidance is needed to ensure consistency of application. Conclusion: This study has produced a set of proposals concerning changes needed to improve the classification. The novel method described here will inform future health terminology and classification content coverage studies.


2019 ◽  
Vol 24 (34) ◽  
pp. 4007-4012 ◽  
Author(s):  
Alessandra Lumini ◽  
Loris Nanni

Background: Anatomical Therapeutic Chemical (ATC) classification of unknown compound has raised high significance for both drug development and basic research. The ATC system is a multi-label classification system proposed by the World Health Organization (WHO), which categorizes drugs into classes according to their therapeutic effects and characteristics. This system comprises five levels and includes several classes in each level; the first level includes 14 main overlapping classes. The ATC classification system simultaneously considers anatomical distribution, therapeutic effects, and chemical characteristics, the prediction for an unknown compound of its ATC classes is an essential problem, since such a prediction could be used to deduce not only a compound’s possible active ingredients but also its therapeutic, pharmacological, and chemical properties. Nevertheless, the problem of automatic prediction is very challenging due to the high variability of the samples and the presence of overlapping among classes, resulting in multiple predictions and making machine learning extremely difficult. Methods: In this paper, we propose a multi-label classifier system based on deep learned features to infer the ATC classification. The system is based on a 2D representation of the samples: first a 1D feature vector is obtained extracting information about a compound’s chemical-chemical interaction and its structural and fingerprint similarities to other compounds belonging to the different ATC classes, then the original 1D feature vector is reshaped to obtain a 2D matrix representation of the compound. Finally, a convolutional neural network (CNN) is trained and used as a feature extractor. Two general purpose classifiers designed for multi-label classification are trained using the deep learned features and resulting scores are fused by the average rule. Results: Experimental evaluation based on rigorous cross-validation demonstrates the superior prediction quality of this method compared to other state-of-the-art approaches developed for this problem. Conclusion: Extensive experiments demonstrate that the new predictor, based on CNN, outperforms other existing predictors in the literature in almost all the five metrics used to examine the performance for multi-label systems, particularly in the “absolute true” rate and the “absolute false” rate, the two most significant indexes. Matlab code will be available at https://github.com/LorisNanni.


Author(s):  
Rajesh Melaram ◽  

Microcystins (MCs) are blue-green algal toxins produced by freshwater cyanobacteria. Their environmentally relevant concentrations throughout global surface waters have tampered with human populations’ drinking and recreational supplies. MCs have gained immense public health attention due to their potential health effects. Microcystin-LR (MC-LR) is the most toxic variant of the MCs. Investigations on MC-LR toxicity and detection in water signify a growing potential environmental health concern worldwide. The World Health Organization established a provisional drinking water guidance value of 1 μg/L and a provisional recreational exposure guidance value of 10 μg/L for MC-LR. This review surveys human MC exposure pathways and integrates epidemiological studies to support MCs’ critical exposure pathways. A discussion on monitoring and mitigation strategies provides a guide for policy development in adopting MCs’ regulatory levels to protect public health.


Author(s):  
June YY Leung ◽  
Sally Casswell

Background The World Health Organization (WHO) has engaged in consultations with the alcohol industry in global alcohol policy development, including currently a draft action plan to strengthen implementation of the Global strategy to reduce the harmful use of alcohol. WHO’s Framework for Engagement with Non-State Actors (FENSA) is an organization-wide policy that aims to manage potential conflicts of interest in WHO’s interactions with private sector entities, non-governmental institutions, philanthropic foundations and academic institutions. Methods We analysed the alignment of WHO’s consultative processes with non-state actors on "the way forward" for alcohol policy and a global alcohol action plan with FENSA. We referred to publicly accessible WHO documents, including the Alcohol, Drugs and Addictive Behaviours Unit website, records of relevant meetings, and other documents relevant to FENSA. We documented submissions to two web-based consultations held in 2019 and 2020 by type of organization and links to the alcohol industry. Results WHO’s processes to conduct due diligence, risk assessment and risk management as required by FENSA appeared to be inadequate. Limited information was published on nonstate actors, primarily the alcohol industry, that participated in the consultations, including their potential conflicts of interest. No minutes were published for WHO’s virtual meeting with the alcohol industry, suggesting a lack of transparency. Organizations with known links to the tobacco industry participated in both web-based consultations, despite FENSA’s principle of non-engagement with tobacco industry actors. Conclusion WHO’s consultative processes have not been adequate to address conflicts of interest in relation to the alcohol industry, violating the principles of FENSA. Member states must ensure that WHO has the resources to implement and is held accountable for appropriate and consistent safeguards against industry interference in the development of global alcohol policy.


2015 ◽  
Vol 5 (4) ◽  
pp. 197-203
Author(s):  
Yukiko Kusano ◽  
Erica Ehrhardt

Background: Equity and access to primary health care (PHC) services, particularly nursing services, are key to improving the health and well-being of all people. Nurses, as the largest group of healthcare professionals delivering services wherever people are, have a unique opportunity to put people at the centre of care, making services more effective, efficient and equitable.Objectives: To assess contributions of nurses to person and people-centered PHC. Methods: Analysis of nursing contributions under each of the four sets of the PHC reforms set by the World Health Organization.Results: Evidence and examples of nursing contributions are found in all of the four PHC reform areas. These include: expanding access;addressing problems through prevention; coordination and integration of care; and supporting the development of appropriate, effective and healthy public policies; and linking field-based innovations and policy development to inform evidence-based policy decision making.Conclusions:Nurses have significant contributions in each of the four PHC reform areas. The focus of nursing care on people-centeredness, continuity of care, comprehensiveness and integration of services, which are fundamental to holistic care, is an essential contribution of nurses to people-centered PHC. Nurses’ contributions can be optimised through positive practice environments, appropriate workforce planning and implementation andadequate education and quality control though strong regulatory principles and frameworks. People-centered approaches need to be considered both in health and non-health sectors as part of people-centered society. A strategic role of nurses as partners in services planning and decision-making is one of the key elements to achieve people-centered PHC.


2015 ◽  
Vol 23 (5) ◽  
pp. 781-788 ◽  
Author(s):  
João Francisco Possari ◽  
Raquel Rapone Gaidzinski ◽  
Antônio Fernandes Costa Lima ◽  
Fernanda Maria Togeiro Fugulin ◽  
Tracy Heather Herdman

Objective: to analyze the distribution of nursing professionals' workloads, according to the Nursing Intervention Classification (NIC), during the transoperative period at a surgical center specializing in oncology.Methods: this was an observational and descriptive cross-sectional study. The sample consisted of 11 nurses, 25 nursing technicians who performed a variety of roles within the operating room, 16 nursing technicians who worked with the surgical instrumentation and two nursing technicians from patient reception who worked in the surgical center during the transoperative period. An instrument was developed to collect data and the interventions were validated according to NIC taxonomy.Results: a total of 266 activities were identified and mapped into 49 nursing interventions, seven domains and 20 classes of the NIC. The most representative domains were Physiological-Complex (61.68%) and Health System (22.12%), while the most frequent interventions were Surgical Care (30.62%) and Documentation (11.47%), respectively. The productivity of the nursing team reached 95.34%.Conclusions: use of the Nursing Intervention Classification contributes towards the discussion regarding adequate, professional nursing staffing levels, because it shows the distribution of the work load.


2011 ◽  
Vol 19 (2) ◽  
pp. 429-436 ◽  
Author(s):  
Luís Carlos Carvalho da Graça ◽  
Maria do Céu Barbiéri Figueiredo ◽  
Maria Teresa Caetano Carreira Conceição

This study aimed to analyze the contributions of the Primary Healthcare nursing interventions, with primiparae in the promotion of breastfeeding. This is a quasi-experimental, longitudinal study, with a sample consisting of 151 primiparae, who had less than 28 weeks of pregnancy, with the child living for at least six months after the birth, performed between 15 October 2007 and 29 February 2008. Almost all the women initiated breastfeeding, with a sharp decline verified in the prevalence at six months. The mean duration of breastfeeding was 123.8±68.9 days. The intervention that began in the prepartum and continued into the postpartum period, using various strategies (individual consultation, preparation courses for parenting/childbirth, and domicile visits) and intervention contexts (health services and domicile) had significant effects on the duration of breastfeeding, which was not verified in the prevalence.


Author(s):  
Daniela Ferreira D’Agostini Marin ◽  
Amanda Wernke ◽  
Daniela Dannehl ◽  
Dyulie Araujo ◽  
Gustavo Koch ◽  
...  

OBJECTIVE: The objective of this study was to evaluate C-section rates, before and after the implementation of the Project Appropriate Birth based on the Robson 10-group classification system. DESIGN: An observational, cross-sectional study. SETTING: Maternity hospital in South Brazil. POPULATION: All pregnant women attending, April 2016 through April 2017 (phase 1, pre-implementation of the Project Appropriate Birth) and June 2017 through June 2018 (phase 2, post-implementation of the Project Appropriate Birth). METHODS: Maternal and obstetric characteristics were evaluated, including Robson’s classification, based on the characteristics of pregnancy and childbirth. Chi-square test and crude and adjusted prevalence ratios were used to analyze study variables. The significance level was set at 5%. MAIN OUTCOME MEASURES: C-section rate for each group, their contribution to the overall c-section rate and the differences in these contributions before and after PPA implementation. RESULTS: C-section rates decreased from 62.4% to 55.6%, which represented a 10.9% reduction after the implementation of the Project Appropriate Birth. Pregnant women in Robson classification groups 1 through 4 had the greatest decrease in C-section rates, ranging from 49.1% to 38.6%, which represents a 21.5% reduction. The greatest contributors to the overall C-section rates were group 5 and group 2, accounting for more than 60% of the C-section deliveries. CONCLUSION: The Project Appropriate Birth had an important impact on the reduction of C-section rates, especially in Robson classification groups 1 through 4, which indicates that providing mothers with evidence-based interventions for labor and childbirth assistance will contribute to reduce C-section rates.


Sign in / Sign up

Export Citation Format

Share Document