The recommendation is to inactivate the < <1287775006 |Attention to stoma (procedure)|, though in noting that there is other ‘Attention to’ content predominately relating to devices, see << 1287773004 |Attention to device (procedure)|
Which procedure concepts relating to stoma care are clinical useful to nurses?
Nurses understand the meaning of ‘care of’ however ‘attention to’ is ambiguous.
Nurses do not differentiate between procedure and regime/therapy concepts.
1287775006 |Attention to stoma (procedure)| was added in 2023 but the subtypes were much older (2002-2005) .
UMLS - nothing is mapped to ‘attention to’
225194008 |Stoma care procedure (regime/therapy)|was noted as mapping to ICNP.
Attention to is used by Belgium for visual checking e.g., look at stoma without removing bag, but there is acknowledgement the wording is ambiguous.
From the chat: NIC uses ‘ostomy’ and ‘ostomy care’. The NIC includes attention in its activities, you just would not select any care activities when you select the NIC if you are just examining the ostomy
For procedures relating to stomas the ICNP refset includes ‘care’ but not ‘attention to’ concepts as well as one assessment concept.
Relevant refset concepts:
Colostomy care (regime/therapy)
Nephrostomy care (regime/therapy)
Stoma assessment (regime/therapy)
Stoma care procedure (regime/therapy)
Tracheostomy care (regime/therapy)
Urostomy management and care (regime/therapy)
Most of the ‘attention to’ concepts are potentially classification constructs.
In ICD-9 code V55 relates Attention to artificial openings with specific codes for several stomas e.g., V55.0 - Attention to tracheostomy The scope statement for V55 notes this includes toilet and cleansing as well as relevant catheter procedures and closure. The content is also present in ICD-10 (Z43) with a like definition as well as ICD-11. https://icd.who.int/browse/2025-01/mms/en#1612365096
Looking at OPCS “Attention to” is a high-level concept. This PCP pattern includes notes which focus on the attention to device concepts but the same logic applies: https://projects.jira.snomed.org/browse/PCP-29
Given the above and the feedback at the Nursing CRG << 1287775006 |Attention to stoma (procedure)| will be looked at for inactivation. The concepts in the remaining two hierarchies will be reviewed for consistency in modelling.
Note, for performing a visual inspection there is the hierarchy << 32750006 |Inspection (procedure)|. Currently there are no subtypes relating to stomas.
As work on this progresses there is an additional question for the group: While a stoma and an ostomy are different in meaning the terms seem to be used interchangeably in practice. This raises the question would nurses see 225194008 |Stoma care procedure (regime/therapy)| and 385712009 |Ostomy care (regime/therapy)| as the same or different?