The gender gap in names of prokaryotes honouring persons.

The aim of this study is to analyse prokaryotic names which honour persons, eponyms, from a gender perspective. Data were retrieved from the List of Prokaryotic names with Standing in Nomenclature. Excluding new combinations, the etymologies of 23 315 unique names at the rank of genus, species and subspecies were analysed. A total of 2018 (8.7 %) names honour persons (eponyms), for which the development of the female share over time was further investigated. Women started to be honoured very recently (1947) compared to men (1823). Moreover, only 14.8 % of all prokaryotic eponyms refer to females. This ratio has hardly improved since 1947, although the number of women whose contributions to microbiology could have been recognized has increased over time. In contrast, about 50 % of prokaryotic names derived from mythological characters refer to females. To reduce this gender gap, we encourage authors proposing new taxon names to honour female scientists who can serve as role models for new generations.

Description of COVID-19 patients and mapping nursing data to ICNP 2021 reference set in SNOMED CT.

AIM: To describe nursing care of COVID-19 patients with International Classification for Nursing Practice (ICNP) 2019, ICNP 2021 reference set, and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT). BACKGROUND: From the beginning of the COVID-19 pandemic, nurses have realised the importance of documenting nursing care. INTRODUCTION: It is important to recognise how real nursing data match the ICNP reference set in SNOMED CT as that is the terminology to be used in Iceland. METHODS: A descriptive study with two methods: (a) statistical analysis of demographic and coded clinical data identified and retrieved from Electronic Health Record (EHR) and (b) mapping of documented nursing diagnoses and interventions in EHRs into ICNP 2019, ICNP 2021 and SNOMED CT 2021. RESULTS: The sample consisted of all (n = 91) adult COVID-19 patients admitted to the National University Hospital between 28 February and 30 June 2020. Nurses used 62 different diagnoses and 79 interventions to document nursing care. Diagnoses and interventions were best represented by SNOMED CT (85.4%; 100%), then by ICNP 2019 version (79.2%; 85%) and least by the ICNP 2021 reference set (70.8; 83.3%). Ten nursing diagnoses did not have a match in the ICNP 2021 reference set. DISCUSSION: Nurses need to keep up with the development of ICNP and submit to ICN new terms and concepts deemed necessary for nursing practice for inclusion in ICNP and SNOMED CT. CONCLUSION: Not all concepts in ICNP 2019 for COVID-19 patients were found to have equivalence in ICNP 2021. SNOMED CT-preferred terms cover the description of COVID-19 patients better than the ICNP 2021 reference set in SNOMED CT. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Through the use of ICNP, nurses can articulate the unique contribution made by the profession and make visible the specific role of nursing worldwide.

Perceived knowledge on the ICNP© in undergraduate nursing students: the development of a scale.

OBJECTIVES: To develop and validate an instrument to assess nursing students' perceived knowledge on the International Classification for Nursing Practice. METHODS: The study design is an initial development of a scale by a longitudinal, prospective, monocentric study. An instrument, including a final pool of 6 items, was developed and through a Content Validity approved by experts. Cronbach's alpha coefficient, Exploratory Factor Analysis and Confirmatory Factor Analysis were calculated in a sample of nursing students. RESULTS: The instrument demonstrated a CVI of 1.0. Cronbach's alpha coefficient was 0.879. Exploratory Factor Analysis indicated one component, with a saturation of items in the range between 0.594 and 0.856. Confirmatory Factor Analysis confirmed the structure. CONCLUSIONS: Although further studies are needed, the preliminary analyses of the instrument suggest satisfaction in terms of content validity, factorial structure, and reliability. This instrument may rise interest in international nursing educational context.

Preparing a revision of the International Code of Nomenclature of Prokaryotes.

The Editorial Board of the International Code of Nomenclature of Prokaryotes here explains the proposed procedure towards the production of the next revision of the Prokaryotic Code, to include public discussion of a draft version, to be prepared by the editors, followed by balloting of the members of the International Committee on Systematics of Prokaryotes.

Introducing standardised care plans as a new recording tool in municipal health care.

AIMS AND OBJECTIVES: To explore how nurses use standardised care plans as a new recording tool in municipal health care, and to identify their thoughts and opinions. BACKGROUND: In spite of being an important information source for nurses, care plans have repeatedly been found unsatisfactory. Structuring and coding information through standardised care plans is expected to raise the quality of recorded information, improve overviews, support evidence-based practice and facilitate data aggregation. Previous research on this topic has mostly focused on the hospital setting. There is a lack of knowledge on how standardised care plans are used as a recording tool in the municipal healthcare setting. DESIGN: An exploratory design with a qualitative approach using three qualitative methods of data collection. The study complied with the Consolidated Criteria for Reporting Qualitative Research. METHODS: Empirical data were collected in three Norwegian municipalities through participant observation and individual interviews with 17 registered nurses. In addition, we collected nursing records from 20 electronic patient records. RESULTS: Use of standardised care plans was influenced by the nurses' consideration of their benefits. Partial implementation created an opportunity for nonuse. There was no consensus regarding how much information to include, and the standardised care plans could become both short and generic, and long and comprehensive. The themes "balancing between the old and the new care planning system," "considering the usefulness of standardised care plans as a source of information" and "balancing between overview and detail" reflect these findings. CONCLUSIONS: Nurses' use of standardised care plans was influenced by the plans' partial implementation, their views on usefulness and their personal views on the detail required in a care plan. RELEVANCE TO CLINICAL PRACTICE: The structuring of nursing records is a fast-growing trend in health care. This study gives valuable information for those attempting to implement such structures in municipal health care.

Developing a prenatal nursing care International Classification for Nursing Practice catalogue.

AIM: This study aimed to develop a prenatal nursing care catalogue of International Classification for Nursing Practice. BACKGROUND: As a programme of the International Council of Nurses, International Classification for Nursing Practice aims to support standardized electronic nursing documentation and facilitate collection of comparable nursing data across settings. This initiative enables the study of relationships among nursing diagnoses, nursing interventions and nursing outcomes for best practice, healthcare management decisions, and policy development. The catalogues are usually focused on target populations. Pregnant women are the nursing population addressed in this project. METHODS: According to the guidelines for catalogue development, three research steps have been adopted: (a) identifying relevant nursing diagnoses, interventions and outcomes; (b) developing a conceptual framework for the catalogue; (c) expert's validation. RESULTS: This project established a prenatal nursing care catalogue with 228 terms in total, including 69 nursing diagnosis, 92 nursing interventions and 67 nursing outcomes, among them, 57 nursing terms were newly developed. All terms in the catalogue were organized by a framework with two main categories, i.e. Expected Changes of Pregnancy and Pregnancy at Risk. Each category had four domains, representing the physical, psychological, behavioral and environmental perspectives of nursing practice. IMPLICATIONS FOR NURSING PRACTICE: This catalogue can ease the documentation workload among prenatal care nurses, and facilitate storage and retrieval of standardized data for many purposes, such as quality improvement, administration decision-support and researches. The documentations of prenatal care provided data that can be more fluently communicated, compared and evaluated across various healthcare providers and clinic settings.

A case study of the introduction of the International Classification for Nursing Practice(®) in Poland.

INTRODUCTION: The development of a nursing practice, improvements in nurses' autonomy, and increased professional and personal responsibility for the medical services provided all require professional documentation with records of health status assessments, decisions undertaken, actions and their outcomes for each patient. The International Classification for Nursing Practice is a tool that meets all of these needs, and although it requires continuous evaluation, it offers professional documentation and communication in the practitioner and researcher community. AIM: The aim of this paper is to present a theoretical critique of an issue related to policy and experience of the current situation in Polish nursing - especially of the efforts to standardize nursing practices through the introduction and development of the Classification in Poland. DISCUSSION: Despite extensive promotion and training by International Council of Nurses members worldwide, there are still many countries where the Classification has not been implemented as a standard tool in healthcare facilities. Recently, a number of initiatives were undertaken in cooperation with the local and state authorities to disseminate the Classification in healthcare facilities. CONCLUSIONS: Thanks to intense efforts by the Polish Nurses Association and the International Council of Nurses Accredited Center for ICNP(®) Research & Development at the Medical University of Lódz, the Classification is known in Poland and has been tested at several centres. Nevertheless, an actual implementation that would allow for national and international interoperability requires strategic governmental decisions and close cooperation with information technology companies operating in the country. IMPLICATIONS FOR NURSING & HEALTH POLICY: Discussing the barriers to the implementation of the Classification can improve understanding of it and its use. At a policy level, decision makers need to understand that use Classification in eHealth services and tools it is necessary to achieve interoperability.

Commentary on the proposed Section 10 amendments to the International Code of Nomenclature of Prokaryotes regarding Candidatus names.

Amendments were proposed to the International Code of Nomenclature of Prokaryotes (ICNP) in January [Arahal et al. (2024) Int. J Syst. Evol. Microbiol. 74: 006188] that would cause major changes in the treatment of Candidatus names. The amendments introduce Section 10 to name taxa whose names cannot be validly published under the ICNP because of the absence of type strains. This section creates a parallel 'pro-nomenclature' and formalizes alternative material which could serve as nomenclatural types. When conspecific isolates of taxa with Candidatus names are deposited in culture collections as type strains, the names can be validly published, and it is required that the same Candidatus name be used. While the amendments are promoted to provide stable names and rules of nomenclature for uncultivated taxa, the system is deeply flawed. It removes the permanent association between names and types, which will make the meaning of names imprecise and ambiguous. It creates 'pro-nomenclature', which is confusing and unnecessary. Since many taxa which cannot be validly named under the ICNP can already be named under the SeqCode, it duplicates and creates overlap with an established nomenclatural system without providing tangible benefits. As the SeqCode recognizes names formed under the ICNP, the ICNP should recognize names formed under the SeqCode as they have done for the Cyanobacteria named under the International Code of Nomenclature for algae, fungi and plants (ICN). For these reasons, we urge the members of the International Committee of Systematics of Prokaryotes (ICSP) to reject these amendments.

SeqCode facilitates naming of South African rhizobia left in limbo.

South Africa is well-known for the diversity of its legumes and their nitrogen-fixing bacterial symbionts. However, in contrast to their plant partners, remarkably few of these microbes (collectively referred to as rhizobia) from South Africa have been characterised and formally described. This is because the rules of the International Code of Nomenclature of Prokaryotes (ICNP) are at odds with South Africa's National Environmental Management: Biodiversity Act and its associated regulations. The ICNP requires that a culture of the proposed type strain for a novel bacterial species be deposited in two international culture collections and be made available upon request without restrictions, which is not possible under South Africa's current national regulations. Here, we describe seven new Mesorhizobium species obtained from root nodules of Vachellia karroo, an iconic tree legume distributed across various biomes in southern Africa. For this purpose, 18 rhizobial isolates were delineated into putative species using genealogical concordance, after which their plausibility was explored with phenotypic characters and average genome relatedness. For naming these new species, we employed the rules of the recently published Code of Nomenclature of Prokaryotes described from Sequence Data (SeqCode), which utilizes genome sequences as nomenclatural types. The work presented in this study thus provides an illustrative example of how the SeqCode allows for a standardised approach for naming cultivated organisms for which the deposition of a type strain in international culture collections is currently problematic.

Proposal of names for 329 higher rank taxa defined in the Genome Taxonomy Database under two prokaryotic codes.

The Genome Taxonomy Database (GTDB) is a taxonomic framework that defines prokaryotic taxa as monophyletic groups in concatenated protein reference trees according to systematic criteria. This has resulted in a substantial number of changes to existing classifications (https://gtdb.ecogenomic.org). In the case of union of taxa, GTDB names were applied based on the priority of publication. The division of taxa or change in rank led to the formation of new Latin names above the rank of genus that were only made publicly available via the GTDB website without associated published taxonomic descriptions. This has sometimes led to confusion in the literature and databases. A number of the provisional GTDB names were later published in other studies, while many still lack authorships. To reduce further confusion, here we propose names and descriptions for 329 GTDB-defined prokaryotic taxa, 223 of which are suitable for validation under the International Code of Nomenclature of Prokaryotes (ICNP) and 49 under the Code of Nomenclature of Prokaryotes described from Sequence Data (SeqCode). For the latter, we designated 23 genomes as type material. An additional 57 taxa that do not currently satisfy the validation criteria of either code are proposed as Candidatus.

Description of two cultivated and two uncultivated new Salinibacter species, one named following the rules of the bacteriological code: Salinibacter grassmerensis sp. nov.; and three named following the rules of the SeqCode: Salinibacter pepae sp. nov., Salinibacter abyssi sp. nov., and Salinibacter pampae sp. nov.

Current -omics methods allow the collection of a large amount of information that helps in describing the microbial diversity in nature. Here, and as a result of a culturomic approach that rendered the collection of thousands of isolates from 5 different hypersaline sites (in Spain, USA and New Zealand), we obtained 21 strains that represent two new Salinibacter species. For these species we propose the names Salinibacter pepae sp. nov. and Salinibacter grassmerensis sp. nov. (showing average nucleotide identity (ANI) values < 95.09% and 87.08% with Sal. ruber M31T, respectively). Metabolomics revealed species-specific discriminative profiles. Sal. ruber strains were distinguished by a higher percentage of polyunsaturated fatty acids and specific N-functionalized fatty acids; and Sal. altiplanensis was distinguished by an increased number of glycosylated molecules. Based on sequence characteristics and inferred phenotype of metagenome-assembled genomes (MAGs), we describe two new members of the genus Salinibacter. These species dominated in different sites and always coexisted with Sal. ruber and Sal. pepae. Based on the MAGs from three Argentinian lakes in the Pampa region of Argentina and the MAG of the Romanian lake Fara Fund, we describe the species Salinibacter pampae sp. nov. and Salinibacter abyssi sp. nov. respectively (showing ANI values 90.94% and 91.48% with Sal. ruber M31T, respectively). Sal. grassmerensis sp. nov. name was formed according to the rules of the International Code for Nomenclature of Prokaryotes (ICNP), and Sal. pepae, Sal. pampae sp. nov. and Sal. abyssi sp. nov. are proposed following the rules of the newly published Code of Nomenclature of Prokaryotes Described from Sequence Data (SeqCode). This work constitutes an example on how classification under ICNP and SeqCode can coexist, and how the official naming a cultivated organism for which the deposit in public repositories is difficult finds an intermediate solution.

Harmonizing Prokaryotic Nomenclature: Fixing the Fuss over Phylum Name Flipping.

Lloyd and Tahon recently criticized proposed bacterial phylum nomenclature changes (K.G. Lloyd, G. Tahon, Nat Rev Microbiol 20:123-124, 2022, https://doi.org/10.1038/s41579-022-00684-2) precipitated by the International Committee on Systematics of Prokaryotes (ICSP)'s official recognition of phylum nomenclature rules. Here, we extend the critique. While we applaud bringing consistency to phylum names, we prognosticate what this minute but momentous change entails for the future of microbial nomenclature and how this will sow confusion among researchers. Several pitfalls of the proposed ICSP framework-based nomenclature are also detailed, including (i) improper type genus name and suffix usage, (ii) loss of Bacteria/Archaea distinctions, (iii) disruption of major phylum name prefixes, and (iv) absence of organism name prevalidation. Finally, we suggest new names for the key bacterial phyla Proteobacteria (Proteobacteriota), Firmicutes (Firmicuteota), Actinobacteria (Actinobacteriota), and Tenericutes (Tenericuteota), while keeping the archaeal phylum names Crenarchaeota, Thaumarchaeota, and Euryarchaeota. Together, these changes will help researchers attain chaos-free uniform nomenclature.

It is time for a new type of type to facilitate naming the microbial world.

Since January 1, 2001, the only acceptable nomenclatural type for species under the International Code of Nomenclature of Prokaryotes (ICNP) has been pure cultures. Here, we argue that this requirement is discordant with the more inclusive nature of nomenclatural types accepted under other codes of nomenclature and posit that the unique rigidity of the ICNP has failed to serve the broad research community and has stifled progress. This case is based on the axiom that many archaea and bacteria are interdependent in nature and therefore difficult, if not impossible, to grow, preserve, and distribute as pure cultures. As such, a large proportion of Earth's biodiversity cannot be named under the current system, which limits our ability to communicate about microbial diversity within and beyond the microbiology research community. Genome sequence data are now encouraged for valid publication of new taxa in microbial systematics journals, and metagenome-assembled genomes and single cell-amplified genomes are being generated rapidly from every biome on Earth. Thus, genome sequences are available for both cultivated and uncultivated microorganisms and can readily serve as a new category of nomenclatural type, allowing for a unified nomenclature for all archaea and bacteria, whether or not they are available as pure cultures. Ideally this would be under a single code of nomenclature but, as we review here, the newly established SeqCode will operate in parallel with the ICNP as a first step toward this goal.

A comparison between the ICNP and the ICF for expressing nursing content in the electronic health record.

BACKGROUND: The use of standardised terminologies for electronic health records (EHRs) is important and a sufficient coverage of all aspects of health care is increasingly being developed worldwide. The International Classification of Functioning, Disabilities and Health (ICF) is suggested as a unifying terminology suitable in a multi-professional EHR, but the level of representation of nursing content is unclear. OBJECTIVES: The aim was to describe lexical and semantic accordance in relation to comprehensiveness and granularity of concepts between the International Classification of Nursing Practise (ICNP) and the ICF. METHODS: 806 pre-coordinated concepts for diagnoses and outcomes in the ICNP terminology were manually mapped to 1516 concepts on level 4-6 in the ICF. RESULTS: Several dimensions of nursing diagnoses and outcomes in the ICNP were missing in the ICF. 60% of the concepts for diagnosis and outcome in the ICNP could not be stated using the ICF while another 31% could only be matched either as a subordinate or as a superordinate concept. CONCLUSIONS: The lexical and semantic accordance in relation to comprehensiveness and granularity between concepts in the ICNP and ICF was rather low. A large proportion of concepts for diagnoses and outcomes in the ICNP could not be satisfactorily stated using the ICF. Standardised terminologies rooted in a nursing tradition (e.g., the ICNP) is needed for communication and documentation in health care to represent the patient's health situation as well as professional diagnostic decisions and evaluations in nursing.

Continuous professional development of nurses and ICNP® introduction in Poland.

OBJECTIVES: The aim of the study was to explore Polish nurses' readiness to use the International Classification for Nursing Practice (ICNP®) as part of continuous professional development and life-long learning. MATERIAL AND METHODS: The study included 772 nurses, divided into 2 study groups. The first group comprised those who had participated in a course enhancing the knowledge and improving skills in the use of ICNP® terminology (N = 457). The second group comprised people who had not yet attended such a course (N = 315). RESULTS: In the pre-course group, education correlated significantly with a general knowledge of ICNP® and its components, as the answers to 9 out of 13 questions revealed (p > 0.05). In the postcourse group, such a correlation was observed in the answers to all the questions except the following: "Is it possible to implement ICNP® in your place of work?" (ρ = 0.066, p = 0.137). Statistically significant differences were found when it comes to the correlation of all 13 questions and the results with the overall level of knowledge of ICNP®. A higher level of agreement with the questions and a higher level of knowledge were observed in the post-course group. However, this did not apply to the following question: "Is it possible to implement ICNP® in your place of work?" (Z = -0.06, p = 0.955, r = 0.002). CONCLUSIONS: Effective pre- and postgraduate education prepares nurses for working with ICNP® terminology. In fact, IT tools, implemented into the education process, could help to develop skills and the understanding of how nurses can use ICNP® in the nursing process. There are some obvious difficulties with the practical implementation of ICNP® into clinical practice. Int J Occup Med Environ Health. 2020;33(3):353-63.

The importance of designating type material for uncultured taxa.

Naming of uncultured Bacteria and Archaea is often inconsistent with the International Code of Nomenclature of Prokaryotes. The recent practice of proposing names for higher taxa without designation of lower ranks and nomenclature types is one of the most important inconsistencies that needs to be addressed to avoid nomenclatural instability. The Code requires names of higher taxa up to the rank of class to be derived from the type genus name, with a proposal pending to formalise this requirement for the rank of phylum. Designation of nomenclature types is crucial for providing priority to names and ensures their uniqueness and stability. However, only legitimate names proposed for axenic cultures can be used for this purpose. Candidatus names reserved for taxa lacking cultured representatives may be granted this right if recent proposals to use genome sequences as type material are endorsed, thereby allowing the Code to be fully applied to lineages represented by metagenome-assembled genomes (MAGs) or single amplified genomes (SAGs). Genome quality standards need to be considered to ensure unambiguous assignment of type material. Here, we illustrate the recommended practice by proposing nomenclature type material for four major uncultured prokaryotic lineages based on high-quality MAGs in accordance with the Code.

Automating lexical cross-mapping of ICNP to SNOMED CT.

OBJECTIVES: The purpose of this study was to examine the feasibility of automating lexical cross-mapping of a logic-based nursing terminology (ICNP) to SNOMED CT using the Unified Medical Language System (UMLS) maintained by the U.S. National Library of Medicine. METHODS: A two-stage approach included patterns identification, and application and evaluation of an automated term matching procedure. The performance of the automated procedure was evaluated using a test set against a gold standard (i.e. concept equivalency table) created independently by terminology experts. RESULTS: There were lexical similarities between ICNP diagnostic concepts and SNOMED CT. The automated term matching procedure was reliable as presented in recall of 65%, precision of 79%, accuracy of 82%, F-measure of 0.71 and the area under the receiver operating characteristics (ROC) curve of 0.78 (95% CI 0.73-0.83). When the automated procedure was not able to retrieve lexically matched concepts, it was also unlikely for terminology experts to identify a matched SNOMED CT concept. CONCLUSIONS: Although further research is warranted to enhance the automated matching procedure, the combination of cross-maps from UMLS and the automated procedure is useful to generate candidate mappings and thus, assist ongoing maintenance of mappings which is a significant burden to terminology developers.

Understanding the use of standardized nursing terminology and classification systems in published research: A case study using the International Classification for Nursing Practice(®).

BACKGROUND: In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown. PURPOSE: This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study. METHODS: A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. RESULTS: Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. CONCLUSIONS: Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care.

Appropriateness of ICNP in Korean home care nursing.

OBJECTIVES: There are several hospitals in Korea that introduced the ICNP (International Classification for Nursing Practice) as the standard terminology for clinical and home care nursing. This research attempted to determine the appropriateness of ICNP in Korean, hospital based, home care nursing. METHODS: The data was collected from a home care nursing center from January 1, 2009 to September 21, 2012. The center is operated by a Korean teaching hospital equipped with an ICNP based electronic nursing record (ENR) system. Via a refining process, 40,082 simplified sentences of nursing intervention were acquired from 41,158 nursing records. Among them, 545 preferred nursing statements were extracted, then mapped, to ICNP 2011 at both axis and sentence levels. RESULTS: The mapping results were classified into three categories based on the axis of concept origin and the level of hierarchy. These categories were titled: complete, incomplete and no mapping. Out of 45 unique concepts in the action axis, 42 (93.33%) concepts were completely mapped. However, only 38 (15.08%), out of 252 unique concepts, were completely mapped in the focus axis. At the statement level, only 19.63% of statements were completely mapped. CONCLUSIONS: The ICNP is not useful as a tool for home care nursing in its present form. The granularity of ICNP has to be improved and more concepts, specific to home care nursing, need to be added in the focus and action axes. Also, a new measure needs to be introduced to prevent information loss during mapping.