In the ever-evolving landscape of healthcare, the International Council of Nurses (ICN) has taken a significant step forward with its recent statement on digital healthcare.

This statement, long overdue and warmly welcomed by the nursing community, outlines crucial expectations for national nursing associations and individual nurses alike. At its core, the ICN’s digital statement identifies four key themes that the nursing profession must address to thrive in the digital era: user-centred design, education, inclusion and sustainability.

Central to this document is the International Classification of Nursing Practice (ICNP), a standardised nursing terminology owned by the ICN. The importance of this terminology cannot be overstated, as it serves as the foundational language upon which the higher aspirations of digital transformation are built.

“The ICN’s digital statement marks a significant milestone in nursing’s journey toward embracing digital healthcare”

While artificial intelligence and data-driven technologies are frequently discussed, their effectiveness hinges on the availability of high-quality data – precisely the kind that ICNP can provide. However, despite 30 years of development, the ICNP has not been universally adopted, and the reasons are complex.

One primary challenge lies in the theory/practice gap. The ICNP has often been viewed as the domain of a select few specialist nurses primarily working in academia. While these experts excel in capturing the art and science of nursing, their work often lacks real-world application. Without demand for ICNP from nurses in practice, there’s little incentive for electronic patient record (EPR) vendors and healthcare organisations to integrate it as a standard.

Another hurdle is the value attributed to nursing. SNOMED, a disease-centred terminology, has gained widespread adoption because it underpins reimbursement systems – a language that suppliers and healthcare institutions readily comprehend. In contrast, the ICNP’s adoption lags behind, highlighting a broader issue: nursing’s role is often perceived as a cost rather than a critical contributor to patient safety and outcomes.

Unlike SNOMED, there hasn’t been a consensus on which standardised nursing terminology should be universally adopted. This lack of agreement hampers the development of a unified approach and the associated benefits.

Fortunately, some of these issues are being resolved, notably through the recent mapping of the ICNP to SNOMED. This presents an opportunity to simplify the integration of the ICNP into broader healthcare terminologies while preserving nursing’s unique meaning and value.

As ICN takes its stance as the international voice of nursing, we must consider not only the recommendations laid out but also ICN’s role in terminology maintenance, development, and implementation. Collaboration is key, and a roundtable discussion among stakeholders is urgently needed to transform this position statement into a shared action plan. Emphasising ICNP adoption is crucial, but our focus should shift towards meaningful digital transformation, addressing pressing professional challenges such as workforce shortages, increasing healthcare demands, and inequity of access.

Now, let’s return to the broader context of the ICN’s statement. The lessons learned from the ICNP’s development and adoption offer valuable insights into delivering large-scale change, aligning with the ambitions of global healthcare organisations’ digital healthcare plans.

Education to bridge the theory-practice gap

Bridging this gap is essential to ensure that nursing terminology has practical relevance in healthcare settings.

User-centred design involving frontline nurses

Rather than pushing terminology onto the profession, involve frontline nurses in the design process to create a genuine pull towards adoption.

Inclusion and sustainability

Start with diverse conversations that include various stakeholders instead of relying solely on a small group of experts working in isolation.

Effective leadership across practice, research and education

Leadership across various domains of nursing is vital, from policy to practice, to drive meaningful change.

National nursing associations (NNAs)

NNAs are well-placed to provide the necessary leadership in shaping professional standards and representing the nursing community. Some NNAs have already set impressive examples:

  • The Every Nurse an E-Nurse campaign by the UK’s Royal College of Nursing;
  • The Norwegian NNA’s evidence-based nursing documentation system mapped to the ICNP, widely adopted in practice;
  • The Australian NNA’s nursing-specific digital competency framework.

We must learn from these pioneering organisations, accelerate their efforts, and consolidate our knowledge under the ICN umbrella, which represents a federation of NNAs. Perhaps it’s time to move beyond a mere editorial board for a terminology and establish an executive board leading a global community of practice for holistic digital transformation.

In conclusion, the ICN’s digital statement marks a significant milestone in nursing’s journey toward embracing digital healthcare. However, for its vision to become a reality, collaboration, education, and inclusive leadership are paramount. As we collectively navigate this digital age, let’s empower nurses worldwide to harness the full potential of technology in delivering high-quality, patient-centred care. What’s your view on this transformative journey?

Natasha Phillips is founder, Future Nurse

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