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13 May, 2019 00:00 00 AM

International Nurses Day

International Council of Nurses
International Nurses Day

International Nurses Day is celebrated around the world every May 12, the anniversary of Florence Nightingale's birth. ICN commemorates this important day each year with the production and distribution of the International Nurses' Day (IND) resources and evidence.

According to their scope of practice, nurses provide appropriate, accessible and evidence-based care.

For Health for All to be achieved there must be a transformation in the approach to health and wellbeing

With a core role as a patient advocate, their scientific reasoning skills, numbers and spectrum of care across the continuum, nurses are ideally placed to lead and inform health services decision making and policy development.

As one of the most trusted and respected health professions, nursing has a pivotal role to addressing the multiple health challenges that are being faced all over the world. Nurses are the engine room of the health system and are required to respond to the health needs of individuals, communities and the world.

The ICN Code of Ethics states that “Inherent in nursing is a respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status.

Nurses render health services to the individual, the family and the community and coordinate their services with those of related groups. The need for nursing is universal.” (International Council of Nurses, 2012).

Health for All

‘Health for All’, the precursor to Universal Health Coverage (UHC), was first articulated with appropriate guidelines and actions in the Alma Ata declaration on Primary Healthcare.

At its core, ‘Alma-Ata’ affirmed that improvements to health can only be obtained through the combination of health science, sound economics and policies, and actions against social injustices.

“Health for All means that health is brought into reach of everyone in a given country.” Health in this context means not just the availability of health services, but a complete state of physical and mental health that enables a person to lead a socially and economically productive life (Mahler, 2016)

Nurse practitioner/advanced practice nurse: definition and characteristics

Advances in technology, the increasing complexity of health services, structural changes in health care delivery, and changing health care needs underscore the search for innovative, cost-effective approaches to health care worldwide.

An increasingly popular solution is utilizing nurses with advanced knowledge and skills. Research evidence indicates that advanced nursing roles are safe, effective and well received by clients.

The expertise, education and skills associated with these roles are diverse and context sensitive. A variety of titles are used throughout the world to denote advanced nursing practice (ANP).

They include family nurse practitioner, adult nurse practitioner, primary care nurse practitioner, nurse midwife, clinical nurse specialist, nurse anaesthetist, community health nurse practitioner and women’s health nurse practitioner.

Paediatric nurse practitioner, gerontological nurse practitioner, emergency room as well as acute care nurse practitioner are also titles applied to ANP roles.

To facilitate an understanding of emerging nurse practitioner and advanced practice nursing roles globally, and to guide role development, the International Council of Nurses, through the expertise of it’s  International Nurse Practitioner/Advanced Practice Nursing Network (INPAPNN), has developed the following definition (ICN, 2002):

“A Nurse Practitioner/Advanced Practice Nurse is a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A Masters degree is recommended for entry level.”

Role characteristics

The following NP/APN characteristics reflect ICN’s official position (ICN, 2002) and represent current and potential roles worldwide. These guidelines are seen as characteristics to aim for prior to role development but do not necessarily characterize the current status in all countries where NPs and APNs practice.

With a core role as a patient advocate, their scientific
reasoning skills, numbers and spectrum of care across the continuum, nurses are
ideally placed to lead and inform health services
making and policy

Educational preparation

1. Educational preparation at an advanced level,

2. Formal recognition of educational programs preparing nurse practitioners/advanced practice nurses roles that are accredited or approved,

3. Formal system of licensure, registration, certification and credentialing.

Nature of practice

4. Integrates research, education, practice and management,

5. High degree of professional autonomy and independent practice,

6. Case Management/own case load,

7. Advanced health assessment skills, decision-making skills and diagnostic reasoning skills,

8. Recognized advanced clinical competencies,

9. Provision of consultant services to other health providers,

10. Plans, implements and evaluates programs,

11. Recognized first point of contact for clients.

Regulatory mechanisms – Country specific regulations underpin NP/APN practice

12. Right to diagnose,

13. Authority to prescribe medication,

14. Authority to prescribe treatment,

15. Authority to refer clients to other professionals,

16. Authority to admit patients to hospital,

17. Legislation to confer and protect the title “Nurse Practitioner/Advanced Practice Nurse”,

18. Officially recognized titles for nurses working in advanced practice roles.

Standards and regulation

Standards, regulations and supportive legislation underpin the development of advanced nursing practice worldwide.  International and national nursing associations have key roles to play in the development of education and practice standards and regulation.  

As NPs and APNs seek employment and educational opportunities in other countries, and provide services across national and state borders, clarity and consistency in credentialing NPs and ANPs and accrediting educational programs will be required.

The International Council of Nurses (ICN) is a federation of more than 130 national nurses associations representing the millions of nurses worldwide. Operated by nurses and leading nursing internationally, ICN works to ensure quality nursing care for all and sound health policies globally.

International classification for nursing practice information sheet

What is the ICNP?

The International Classification for Nursing Practice provides a formal terminology for nursing practice and a framework into which existing vocabularies and classifications can be cross-mapped to enable comparison of nursing data.

What elements are included in the ICNP?

Nursing Diagnoses and Nursing-Sensitive Patient Outcomes: Include pre- coordinated concepts representing the client’s condition. Examples of diagnoses include: “acute pain”, “lack of transportation” or “parental stress”. Patient outcome examples include: “no pain”, “ability to prepare meals”, “urinary continence” and “improved nutritional status“. Nursing diagnoses and patient outcomes can also be used to identify patient goals.

Nursing Interventions: Include pre-coordinated concepts representing therapeutic activities of nurses. Examples include: “Assess attitude toward treatment regime”, “collaborate in initiating patient controlled analgesia”, Teach about managing pain”, “teach family about delirium”.

Why is an ICNP important?

The objectives were set out in an initial International Council of Nurses proposal (ICN, 1991) continue to direct the ICNP Programme and indicate its importance:

Establish a terminology for describing nursing practice in order to improve communication among nurses, and between nurses and others.

Describe the nursing care of people (individuals, families and communities) in a variety of settings, both institutional and non-institutional.

Enable comparison of nursing data across clinical populations, settings, geographic areas and time.

Demonstrate or project trends in the provision of nursing treatments and care and the allocation of resources to patients, according to their needs based on nursing diagnoses.Stimulate nursing research through links to data available in nursing information systems and health information systems.

Provide data about nursing practice in order to influence health policy making.

Does the ICNP restrict multidisciplinary practice?

No. Like the ICD, the development of an ICNP is a long-term project that will provide a structured terminology and a classification that can be used to describe and organize nursing data. In turn this data can be integrated into multidisciplinary health information systems.

Who are the terminology developers that ICN collaborates with to maintain and advance ICNP?

ICN has a number of formal agreements to best represent the nursing domain and promote semantic interoperability. ICNP is recognised as a related classification within the World Health Organisation (WHO) Family of International Classifications to promote harmonisation with the other WHO classifications.

The International Health Terminology Standards Development Organisation (IHTSDO) and ICN have engaged in a formal Harmonisation Agreement to ensure that nursing requirements are adequately captured within SNOMED CT.

In addition to harmonising ICNP and SNOMED CT, ICN serves as the international representation for nursing practice to the IHTSDO. ICN also has Liaison A status with the International Organization for Standardization (ISO) Technical Committee on Health Informatics (TC215) and is represented at the International Medical Informatics Association through participation in the Nursing Special Interest Group.

 ICN is dedicated to providing a terminology and related tools to support nursing information needs in practice. This commitment requires collaboration and coordination with global standards organisations, stakeholders, and both clinical and informatics experts.

How can I participate?

The ICNP Programme facilitates participation of individuals and groups in the ongoing development and maintenance of the ICNP.  Individual researchers and organisations, such  as ICN-accredited ICNP R&D Centres, are encouraged to collaborate closely with ICN through their National Nurses Associations.

How does ICNP fit with other ICN initiatives?

ICNP is one component of the ICN eHealth Programme which falls within ICN’s Professional Practice pillar.

In addition to supporting eHealth practice, and positioning ICN centrally as a recognised authority on eHealth, the eHealth Programme seeks to support the work of ICN itself, transforming nursing practice through the visionary application of information and communications technology.

How often is ICNP released?

ICNP is released and disseminated at 2-yearly intervals along with translations and other derived products in order to maintain currency and keep pace with advances in nursing practice. With each new release, ICNP translations are updated.


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Editor : M. Shamsur Rahman

Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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