Marc Jamoulle, MD, MPH                                                                             Febr. 2010

Family Doctor

Health data management specialist

CAMG UCL (Belgium). WICC member

marc@jamoulle.com

 

Coding Street health Nursing Issues 2 by ICPC-2

 

 

OSCAR is a suite of Open Source applications which serve to enhance the health and social service community's ability to provide the highest level of care[i].

Considering the interest of OSCAR developers for ICPC2, I have looked at the Oscar web site   and have encountered the Street Health Nursing Issue  2 terminology. The reading of the terminology was extremely appealing and I have made the exercise to code all the 257 entries. I have made it by hand, with the manual ICPC 2 R [ii]  as source of verification. The coding  exercise needs several  hours. The results are interesting. 

As the results are so compelling, I have been on the net to meet the Street Nurses. I have found this;  Street Health is a non-profit community-based agency providing physical and mental health programs to homeless and underhoused individuals in the southeast core of Toronto[iii]   This definition is well documented by the terminology published.

Thus I have analyzed the terminology of a group of dedicated people working with homeless. This is rather the same experience as Médecin du Monde in France and Europe in which the CASO (centre d’accueil, de soins et d’orientation )  helps people facing social and economic exclusion[iv].  CASO ‘s doctors are using  French ICPC to classify the health problems of their consulting patients.

About ICPC

International classification of Primary Care[v] has been designed by general practitioners under the leadership of Wonca, the World organization of Family doctors. It is intended for Primary care but not primarily for Nurses.

ICPC is biaxial, with 17 chapters representing 15 body parts and P for Mental problem, and Z for social problem. Symptoms and complaints are numbered from 01 to 29, process from 30 to 69 and diagnosis from 70 to 99. Process are common for each chapters.

The 17 chapters are

A. General

K. Circulatory

S. Skin

Y.Male genital

B. Blood, blood forming

L. Musculoskeletal

T. Metabolic, endocrine, nutrition

Z. Social

D. Digestive

N. Neurological

U. Urinary

F. Eye

P. Psychological

W. Pregnancy, family planning

H. Ear

R. Respiratory

X. Female genital

 

Quick look at SHNI terminology

The terminology has an embryo of internal classification;

The general frame is :  – Items name – subcategory – category – role

Number

               Items name    -    subcategory    -     category

role

 

The  SHNI terminology is characterized by a mix between process description (what to do) and symptom/diagnosis (what to think about) . They are some neither medical nor direct health related items (like money, clothes and so on)

SHNI is distributed in categories and each entry is flagged with at least two categories


The first flag is chosen between those subcategories (11 systems and 4 activities)

Central Nervous System

Head and Neck

Systemic Symptoms

Musculoskeletal System

Skin

Cardiovascular System

Respiratory Problems

Gastro-Intestinal System

Endocrine System

Genito-urinary System

Other

Advocacy & Support

Clinical Treatment

Referral

Supplies/Support

 

The second flag is chosen between  4

Mental Health

Non-Physical Problems

Physical Problems

Treatment

 


Example :

Nursing11500204

Wants a pregnancy test  - Genito-urinary System - Physical Problems

Nurse

 

Street Health Nursing Issue versus ICPC

Let we have a look at the distribution of the SHNI entries versus ICPC2. The result are presented below.

Interestingly, 95% of the SHNI can be coded by ICPC. Only 12 items are out of the scope of ICPC added by some acronyms difficult to identify.

number of SHNI entries

257

number of SHNI entries codable by ICPC2

243

SHNI entries coded at the level of one ICPC chapter (only the letter)

 6

More than one ICPC code for one SHNI code

 36

Double SHNI codes

 4

Out of the scope of ICPC2  (coded NC)

 7

Acronyms  not understandable by lack of precision

3

SHNI entries coded with ICPC2 process codes (between 30 and 69)

91

SHNI entries coded with ICPC2 unique symptom codes (between 01 and 29)

77

SHNI entries coded with ICPC2 ragbags (29, 69, 99 )

 7

SHNI entries coded with two ICPC2 codes

25

SHNI entries coded with more than two ICPC2

8

Table 1 Qualitative analysis of SHNI content

When I say codable by ICPC, I mean that the SHNI concept expressed by a particular term is correlated with an ICPC concept not necessarily by an ICPC word. Some SHNI could relate to various ICPC codes. (see table1)

Some problems with abbreviation or acronyms

In the following table TTC could on Internet  indifferently mean “Try To Conceive” or “Toronto Transit Commission” which refer to quite different meaning indeed.

Nursing19900527

Needs TTC       - Supplies - Non-Physical Problems

Nursing24200218

Provided transportation other than TTC    - Supplies/Support - Treatment

Nursing24300038

Provided TTC       - Supplies/Support - Treatment

 

Items difficult to code

The first one of the following table refers to an evaluation of gravity for which Parkerson’s Dusoi[vi] would fit perfectly. The 6 following refer to actions taken which are out of the scope of ICPC.

Nursing14300145

Exacerbation of illness/symptoms     - Systemic Symptoms - Physical Problems

Nursing24400037

Given clothing/socks - Supplies/Support - Treatment

Nursing24500231

Given food/water  - Supplies/Support - Treatment

Nursing24600039

Given personal supplies (shampoo, lotion, etc)   - Supplies/Support - Treatment

Nursing24700040

Given dressing supplies (gauze, H202, ointment, etc.)  - Supplies/Support - Treatment

Nursing26800056

Harm reduction supplies given     - Clinical Treatment - Treatment

Nursing26900057

Money given       - Clinical Treatment - Treatment

 

Street nurse : a difficult job

Considering the distribution of SHNI code versus ICPC chapter, one is attracted by the huge number of P issues (chapter P Psychological problems) and Z issues (chapter Z Social problems) which indicate that the health workers are submitted to a very heavy job. The number of L problems (Locomotor) , Trauma (A80) and S problem (Skin) indicates much stress and  violence and poor hygiene in the field .  As nurses are involved, I imagine most of them female, the huge number of X (Genital female) could be explained. The items ‘police assault’ is quite unexpected for an European observer. (fig 1)

The process code analysis by ICPC-2 shows  20% counseling, 33% therapeutic activities and 40% referrals. (fig 2)

 

Figure 1  Number of SHNI codes by ICPC chapter (more than one ICPC code by SNHI entry)

 

Figure 2 Distribution of SNHI process following ICPC-2

Conclusion

This interesting exercise shows how a terminology could reflect the huge workload and deep commitment needed by the health workers in the street of Toronto and consequently the unbelievable poor state of health and lack of access to health care of poor people in one of the richest cities in the world.

SHNI / ICPC-2 coding exercise

 

                SNHI Code

ICPC-2

Description

Nursing2600001

F

Vision problems       - Head and Neck - Physical Problems

Nursing2700002

F75, F76, F79

Eye injury       - Head and Neck - Physical Problems

Nursing2800003

F70, F73

Infected eye       - Head and Neck - Physical Problems

Nursing2900004

F76

Foreign body in the eye    - Head and Neck - Physical Problems

Nursing3000005

F72

Sty        - Head and Neck - Physical Problems

Nursing3100006

F

Eye condition       - Head and Neck - Physical Problems

Nursing3200007

H83, H84, H85,
H86

Hearing problems       - Head and Neck - Physical Problems

Nursing3300008

H01

Earache        - Head and Neck - Physical Problems

Nursing3400009

H71

Infected ears       - Head and Neck - Physical Problems

Nursing3500010

H81

Cerumen in ears      - Head and Neck - Physical Problems

Nursing3600011

R06

Nosebleed       - Head and Neck - Physical Problems

Nursing3700013

D20

Bleeding gums       - Head and Neck - Physical Problems

Nursing3800014

D20

Dental problems       - Head and Neck - Physical Problems

Nursing3900015

D20

Mouth sores/lesions      - Head and Neck - Physical Problems

Nursing4000016

R21

Cold sore       - Head and Neck - Physical Problems

Nursing4100017

A80

Facial injury       - Head and Neck - Physical Problems

Nursing4200030

L20

Pain/swelling in joints (including arthritis)    - Musculoskeletal System - Physical Problems

Nursing4300031

L77, L78, L79

Sprain/strain       - Musculoskeletal System - Physical Problems

Nursing4400032

L73, L74, L75,
L76

Fracture        - Musculoskeletal System - Physical Problems

Nursing4500024

L17

Foot problem       - Musculoskeletal System - Physical Problems

Nursing4600023

L12

Sore/injured hand       - Musculoskeletal System - Physical Problems

Nursing4700033

L09

Sore/injured arm       - Musculoskeletal System - Physical Problems

Nursing4800034

L14

Sore/injured leg       - Musculoskeletal System - Physical Problems

Nursing4900039

L15

Sore/injured knee       - Musculoskeletal System - Physical Problems

Nursing5000026

L17

Sore/injured foot       - Musculoskeletal System - Physical Problems

Nursing5100035

L01

Sore/injured neck       - Musculoskeletal System - Physical Problems

Nursing5200036

L03

Sore/injured back       - Musculoskeletal System - Physical Problems

Nursing5300037

L08

Sore/injured shoulder       - Musculoskeletal System - Physical Problems

Nursing5400020

S17

Blister        - Skin - Physical Problems

Nursing5500021

A88

Frostbite        - Skin - Physical Problems

Nursing5600025

S74

Fungal infection       - Skin - Physical Problems

Nursing5700040

S21

Dry skin       - Skin - Physical Problems

Nursing5800042

S06, S07

Rash        - Skin - Physical Problems

Nursing5900043

S91, S87

Psoriasis/eczema       - Skin - Physical Problems

Nursing6000044

S80

Sunburn        - Skin - Physical Problems

Nursing6100045

S73/S72/S12, S13/S12

Lice/scabies/bites/stings      - Skin - Physical Problems

Nursing6200046

S54

Wants stitches/staples removed      - Skin - Physical Problems

Nursing6300047

S

Infected wound       - Skin - Physical Problems

Nursing6400048

S15

Foreign body       - Skin - Physical Problems

Nursing6500051

S10

Abscess        - Skin - Physical Problems

Nursing6600052

S76

Skin wound/lesion/abrasion/laceration    - Skin - Physical Problems

Nursing6700053

S14

Burn        - Skin - Physical Problems

Nursing6800055

S13

Animal/ human bite      - Skin - Physical Problems

Nursing6900060

N01

Headache       - Central Nervous System - Physical Problems

Nursing7000061

N80

Head injury       - Central Nervous System - Physical Problems

Nursing7100063

N88

Seizure/seizure disorder       - Central Nervous System - Physical Problems

Nursing7200065

N05

Numbness/tingling       - Central Nervous System - Physical Problems

Nursing7300066

N29

Gait disturbance      - Central Nervous System - Physical Problems

Nursing7400067

P20

Cognitive impairment      - Central Nervous System - Physical Problems

Nursing7500201

N18

Parasthesia/paralysis      - Central Nervous System - Physical Problems

Nursing7600070

K31

Wants blood pressure (BP) check    - Cardiovascular System - Physical Problems

Nursing7700071

K01

Chest pain       - Cardiovascular System - Physical Problems

Nursing7800072

K03

Peripheral edema       - Cardiovascular System - Physical Problems

Nursing7900073

K94

Phlebitis        - Cardiovascular System - Physical Problems

Nursing8000074

S76

Cellulitis        - Cardiovascular System - Physical Problems

Nursing8100075

K92

Peripheral vascular disease      - Cardiovascular System - Physical Problems

Nursing8200076

S97

Venous stasis ulcer      - Cardiovascular System - Physical Problems

Nursing8300077

K86, K87

Hypertension       - Cardiovascular System - Physical Problems

Nursing8400078

K

Ongoing cardiac problems      - Cardiovascular System - Physical Problems

Nursing8500080

R96

Allergies        - Respiratory Problems - Physical Problems

Nursing8600081

R21

Sore throat       - Respiratory Problems - Physical Problems

Nursing8700082

R74, R97

Nasal/sinus congestion      - Respiratory Problems - Physical Problems

Nursing8800083

R05

Cough        - Respiratory Problems - Physical Problems

Nursing8900084

R74

Upper Respiratory Tract Infection (URTI)    - Respiratory Problems - Physical Problems

Nursing9000085

R81

Pneumonia       - Respiratory Problems - Physical Problems

Nursing9100086

R01

Difficulty breathing       - Respiratory Problems - Physical Problems

Nursing9200087

A70

Tuberculosis       - Respiratory Problems - Physical Problems

Nursing9300088

R95

Lung disease/ (COPD)      - Respiratory Problems - Physical Problems

Nursing9400090

R96

Asthma        - Respiratory Problems - Physical Problems

Nursing9500202

R96

Hemoptysis       - Respiratory Problems - Physical Problems

Nursing9600095

D09

Nausea        - Gastro-Intestinal System - Physical Problems

Nursing9700096

D10

Vomiting        - Gastro-Intestinal System - Physical Problems

Nursing9800097

T08

Weight loss       - Gastro-Intestinal System - Physical Problems

Nursing9900099

T31

Wants to be weighed     - Gastro-Intestinal System - Physical Problems

Nursing10000101

D07

Gastric upset       - Gastro-Intestinal System - Physical Problems

Nursing10100102

Q03

Epigastric pain       - Gastro-Intestinal System - Physical Problems

Nursing10200103

D06

Abdominal pain       - Gastro-Intestinal System - Physical Problems

Nursing10300104

D10

Constipation       - Gastro-Intestinal System - Physical Problems

Nursing10400105

D11

Diarrhea        - Gastro-Intestinal System - Physical Problems

Nursing10500106

D16

Rectal bleeding/hemorrhoids     - Gastro-Intestinal System - Physical Problems

Nursing10600203

D14

Hematemesis       - Gastro-Intestinal System - Physical Problems

Nursing10700113

D72

Hepatitis        - Gastro-Intestinal System - Physical Problems

Nursing10800158

D97

Liver disease       - Gastro-Intestinal System - Physical Problems

Nursing10900157

D13

Jaundice        - Gastro-Intestinal System - Physical Problems

Nursing11000110

T89, T90

Diabetes        - Endocrine System - Physical Problems

Nursing11100111

T81, T85, T86

Thyroid problems       - Endocrine System - Physical Problems

Nursing11200112

T34

Wants blood glucose testing     - Endocrine System - Physical Problems

Nursing11300158

D99

Pancreatic disease       - Endocrine System - Physical Problems

Nursing11400115

W78

Pregnancy/?Pregnancy      - Genito-urinary System - Physical Problems

Nursing11500204

W33

Wants a pregnancy test     - Genito-urinary System - Physical Problems

Nursing11600116

W82, W83

Abortion/miscarriage      - Genito-urinary System - Physical Problems

Nursing11700117

X14

Vaginal discharge      - Genito-urinary System - Physical Problems

Nursing11800118

X72

Yeast infection       - Genito-urinary System - Physical Problems

Nursing11900119

X02, X03, X06,
 X07, X08, X09

Menstrual problems       - Genito-urinary System - Physical Problems

Nursing12000120

X

Gynecological problems       - Genito-urinary System - Physical Problems

Nursing12100121

X70, X71, X72,
X73, X92

Sexually Transmitted Infections(STI)     - Genito-urinary System - Physical Problems

Nursing12200122

X01

Pelvic pain       - Genito-urinary System - Physical Problems

Nursing12300123

U70, U71

Urinary tract infection      - Genito-urinary System - Physical Problems

Nursing12400124

Y03

Penile discharge      - Genito-urinary System - Physical Problems

Nursing12500125

U01, U02

Urinary symptoms      - Genito-urinary System - Physical Problems

Nursing12600127

U06

Hematuria       - Genito-urinary System - Physical Problems

Nursing12700128

U04, P12

Urinary incontinence      - Genito-urinary System - Physical Problems

Nursing12800129

W45

Wants abortion information/referral     - Genito-urinary System - Physical Problems

Nursing12900130

A29

Fall        - Trauma - Physical Problems

Nursing13000131

A80

Motor vehicle accident (MVA)     - Trauma - Physical Problems

Nursing13100132

A80

Work-related injury       - Trauma - Physical Problems

Nursing13200133

Z25

Assault        - Trauma - Physical Problems

Nursing13300134

Z25, Z09

Police assault       - Trauma - Physical Problems

Nursing13400135

Z25

Sexual assault       - Trauma - Physical Problems

Nursing13500136

S18, P80

Self inflicted wound      - Trauma - Physical Problems

Nursing13600205

P74

?Post Traumatic Stress Disorder (PTSD)    - Trauma - Physical Problems

Nursing13700206

A80, A88

Fire        - Trauma - Physical Problems

Nursing13800140

A03

Fever        - Systemic Symptoms - Physical Problems

Nursing13900141

N17

Dizziness        - Systemic Symptoms - Physical Problems

Nursing14000142

A04

Fatigue        - Systemic Symptoms - Physical Problems

Nursing14100143

A04

General malaise       - Systemic Symptoms - Physical Problems

Nursing14200144

B02

Enlarged nodes NYD      - Systemic Symptoms - Physical Problems

Nursing14300145

NC

Exacerbation of illness/symptoms     - Systemic Symptoms - Physical Problems

Nursing14400146

*63

Follow-up with medical problems     - Systemic Symptoms - Physical Problems

Nursing14500147

P19

Withdrawal symptoms      - Systemic Symptoms - Physical Problems

Nursing14600207

P06

Insomnia        - Systemic Symptoms - Physical Problems

Nursing14700208

A01

Chronic pain       - Systemic Symptoms - Physical Problems

Nursing14800151

B90

HIV/AIDS infection       - Systemic Symptoms - Physical Problems

Nursing14900150

X19, Y16

Breast Lump/mass      - Other - Physical Problems

Nursing15000152

P16, P19

Overdose drugs/alcohol      - Other - Physical Problems

Nursing15100154

A85

Medication Side effect      - Other - Physical Problems

Nursing15200155

*59

Needs personal care      - Other - Physical Problems

Nursing15300501

*58

In to talk      - Mental Health - Non-Physical Problems

Nursing15400502

*58

Ongoing support       - Mental Health - Non-Physical Problems

Nursing15500503

P04

Anxiety/nervousness      - Mental Health - Non-Physical Problems

Nursing15600504

P03, P76

Depression       - Mental Health - Non-Physical Problems

Nursing15700505

P03

Loneliness/isolation       - Mental Health - Non-Physical Problems

Nursing15800506

P

Mental health problem      - Mental Health - Non-Physical Problems

Nursing15900507

Z25, A80

Sexual abuse trauma      - Mental Health - Non-Physical Problems

Nursing16000508

Z2, A80

Physical abuse trauma      - Mental Health - Non-Physical Problems

Nursing16100509

P15, P16

Substance use-alcohol      - Mental Health - Non-Physical Problems

Nursing16200510

P18, P19

Substance use-other drug      - Mental Health - Non-Physical Problems

Nursing16300538

Z12

Relationship problems       - Mental Health - Non-Physical Problems

Nursing16400545

*58

Wants counseling      - Mental Health - Non-Physical Problems

Nursing16500548

P29

Delusional       - Mental Health - Non-Physical Problems

Nursing16600549

P29

Hallucinations       - Mental Health - Non-Physical Problems

Nursing16700550

P20

Memory loss/confusion      - Mental Health - Non-Physical Problems

Nursing16800551

P72

Paranoia        - Mental Health - Non-Physical Problems

Nursing16900552

P77

Suicidal ideation       - Mental Health - Non-Physical Problems

Nursing17000553

P76

Altered mood/affect      - Mental Health - Non-Physical Problems

Nursing17100554

P29

Altered personal grooming      - Mental Health - Non-Physical Problems

Nursing17200555

T02, T04, T05,
 T07

Eating disorder       - Mental Health - Non-Physical Problems

Nursing17300209

P72, P73, P98

Psychotic        - Mental Health - Non-Physical Problems

Nursing17400511

*45

Has health question      - Advocacy & Support - Non-Physical Problems

Nursing17500512

*45

Needs non-health information     - Advocacy & Support - Non-Physical Problems

Nursing17600513

*67

Wants family physician      - Advocacy & Support - Non-Physical Problems

Nursing17700514

*67

Wants doctor’s appointment     - Advocacy & Support - Non-Physical Problems

Nursing17800515

*67

Wants dentist appointment     - Advocacy & Support - Non-Physical Problems

Nursing17900516

*68

Wants detox/drug treatment referral     - Advocacy & Support - Non-Physical Problems

Nursing18000517

B33

Wants diagnostic test (HIV, Hep. C, etc.)  - Advocacy & Support - Non-Physical Problems

Nursing18100518

*50

Wants prescription/docette filled      - Advocacy & Support - Non-Physical Problems

Nursing18200214

*65

Wants chiropodist appointment     - Advocacy & Support - Non-Physical Problems

Nursing18300215

*57

Wants chiropractic appointment     - Advocacy & Support - Non-Physical Problems

Nursing18400546

Z10

Wants health card      - Advocacy & Support - Non-Physical Problems

Nursing18500216

*44

Wants immunization      - Advocacy & Support - Non-Physical Problems

Nursing18600530

*45, Z07

Needs help to read mail    - Advocacy & Support - Non-Physical Problems

Nursing18700531

*45, Z07

Needs help with forms/documents    - Advocacy & Support - Non-Physical Problems

Nursing18800539

P28

Wants ID/ID problems      - Advocacy & Support - Non-Physical Problems

Nursing18900540

*45, Z09

Immigration problems/questions      - Advocacy & Support - Non-Physical Problems

Nursing19000543

Z09

Legal problems/questions      - Advocacy & Support - Non-Physical Problems

Nursing19100525

Z03

Housing problems       - Advocacy & Support - Non-Physical Problems

Nursing19200520

Z11

Medication problem       - Advocacy & Support - Non-Physical Problems

Nursing19300541

Z01

Income questions       - Advocacy & Support - Non-Physical Problems

Nursing19400547

Z10

Hospital discharge without follow-up     - Advocacy & Support - Non-Physical Problems

Nursing19500524

Z03

Wants housing       - Advocacy & Support - Non-Physical Problems

Nursing19600526

*62

Wants letter (income/housing)     - Advocacy & Support - Non-Physical Problems

Nursing19700532

Z05

Wants employment      - Advocacy & Support - Non-Physical Problems

Nursing19800533

Z07

Wants schooling/schooling problems      - Advocacy & Support - Non-Physical Problems

Nursing19900527

?

Needs TTC       - Supplies - Non-Physical Problems

Nursing20000528

Z01

Needs clothing/socks      - Supplies - Non-Physical Problems

Nursing20100529

*54

Needs eye glasses/hearing aid/assistive devices    - Supplies - Non-Physical Problems

Nursing20200534

Z01

Needs personal supplies (toiletries, etc.)    - Supplies - Non-Physical Problems

Nursing20300535

Z01

Needs dressing supplies      - Supplies - Non-Physical Problems

Nursing20400536

*50

Needs therapeutic supplies/medications    - Supplies - Non-Physical Problems

Nursing20500537

P19

Needs harm reduction supplies needles, etc.)   - Supplies - Non-Physical Problems

Nursing20600557

Z02

Needs food/water      - Supplies - Non-Physical Problems

Nursing20700211

*54

Needs crutches/canes/walker/wheelchair    - Supplies - Non-Physical Problems

Nursing20800212

*69

Other        - Other (Non-Physical) - Non-Physical Problems

Nursing20900213

NC

Outreach visit       - Other (Non-Physical) - Non-Physical Problems

Nursing21000006

*46, *47

Made a phone call about client   - Referral - Treatment

Nursing21100007

*48

Wrote letter for client     - Referral - Treatment

Nursing21200008

*46

Helped to find a family physician   - Referral - Treatment

Nursing21300009

*67

Referred to St.  Mike’s Family Practice   - Referral - Treatment

Nursing21400010

*67

Referred to Sherbourne HC     - Referral - Treatment

Nursing21500011

*67

Referred to Anishnawbe H.C.     - Referral - Treatment

Nursing21600012

*67

Referred to Regent Park CHC    - Referral - Treatment

Nursing21700013

*67

Referred to Sexually Transmitted Infection testing   - Referral - Treatment

Nursing21800014

*67

Referred to diagnostic testing (HIV/Hep. C)   - Referral - Treatment

Nursing21900015

*67

Referred to other physician     - Referral - Treatment

Nursing22000016

*65

Referred to own physician     - Referral - Treatment

Nursing22100017

*67

Referred to Sent to Emergency Room   - Referral - Treatment

Nursing22200018

*68

Referred to Accompanied to Emergency Room   - Referral - Treatment

Nursing22300019

Z10

Refused MD/ hospital      - Referral - Treatment

Nursing22400020

*67

Referred to dentist      - Referral - Treatment

Nursing22500021

*66

Referred to chiropodist     - Referral - Treatment

Nursing22600217

*57

Referred to chiropractor     - Referral - Treatment

Nursing22700022

*66

Referred to HomeCare     - Referral - Treatment

Nursing22800023

*67

Referred to vision care     - Referral - Treatment

Nursing22900024

*68

Referred to Public Health     - Referral - Treatment

Nursing23000025

*67

Referred to detox/drug treatment     - Referral - Treatment

Nursing23100027

*66

Referred to income supports (OW, OAS, ODSP,etc) - Referral - Treatment

Nursing23200028

*67

Referred to legal clinic     - Referral - Treatment

Nursing23300033

*66

Referred to shelter      - Referral - Treatment

Nursing23400034

*66

Referred to housing      - Referral - Treatment

Nursing23500035

*67

Referred to mental health service    - Referral - Treatment

Nursing23600036

*68

Referred to Consultation/co-ordination of care with other workers - Referral - Treatment

Nursing23700064

*67

Referred to other Street Health Clinic   - Referral - Treatment

Nursing23800066

*68

Referred to pharmacist     - Referral - Treatment

Nursing23900070

*67

Referred to abortion clinic     - Referral - Treatment

Nursing24000071

Z10

Referred to Left during visit    - Referral - Treatment

Nursing24100072

*66

Referred to Outreach visit     - Referral - Treatment

Nursing24200218

?

Provided transportation other than TTC    - Supplies/Support - Treatment

Nursing24300038

?

Provided TTC       - Supplies/Support - Treatment

Nursing24400037

NC

Given clothing/socks      - Supplies/Support - Treatment

Nursing24500231

NC

Given food/water      - Supplies/Support - Treatment

Nursing24600039

NC

Given personal supplies (shampoo, lotion, etc)   - Supplies/Support - Treatment

Nursing24700040

NC

Given dressing supplies (gauze, H202, ointment, etc.)  - Supplies/Support - Treatment

Nursing24800041

*50

Given therapeutic supplies (vitamins, etc.)    - Supplies/Support - Treatment

Nursing24900042

*50

Given medications (antibiotic ointment, drops, analgesics,etc.)  - Supplies/Support - Treatment

Nursing25000063

*45

Given (non-health) information     - Supplies/Support - Treatment

Nursing25100001

*58

Talked        - Supplies/Support - Treatment

Nursing25200002

*45

Ongoing support       - Supplies/Support - Treatment

Nursing25300003

*45

Assisted with problem solving     - Supplies/Support - Treatment

Nursing25400004

*58

Counselling       - Supplies/Support - Treatment

Nursing25500005

*58

Crisis intervention      - Supplies/Support - Treatment

Nursing25600043

*45

Health teaching       - Supplies/Support - Treatment

Nursing25700044

*45

Helped with documentation     - Supplies/Support - Treatment

Nursing25800045

*52

Foot care/callous reduced      - Clinical Treatment - Treatment

Nursing25900046

*52

Wound care       - Clinical Treatment - Treatment

Nursing26000047

*52

Dressing        - Clinical Treatment - Treatment

Nursing26100048

K31

Blood pressure       - Clinical Treatment - Treatment

Nursing26200049

*52

Removed foreign body (FB)     - Clinical Treatment - Treatment

Nursing26300051

*51

Instilled drops (eye, ear)     - Clinical Treatment - Treatment

Nursing26400052

*54

Splint/sling/tensor given       - Clinical Treatment - Treatment

Nursing26500053

*54

Stitches/staples removed       - Clinical Treatment - Treatment

Nursing26600054

*43

Sputum sample collected      - Clinical Treatment - Treatment

Nursing26700055

*59

Personal care (hair cut, fingernails trimmed, etc)  - Clinical Treatment - Treatment

Nursing26800056

NC

Harm reduction supplies given     - Clinical Treatment - Treatment

Nursing26900057

NC

Money given       - Clinical Treatment - Treatment

Nursing27000058

W33

Pregnancy test performed     - Clinical Treatment - Treatment

Nursing27100059

T31

Weighed        - Clinical Treatment - Treatment

Nursing27200060

A30, A31

Examined (IPPA)       - Clinical Treatment - Treatment

Nursing27300061

A31

Vital signs (TPR)      - Clinical Treatment - Treatment

Nursing27400062

*63

Follow-up with medical problems     - Clinical Treatment - Treatment

Nursing27500065

T34

Blood glucose testing      - Clinical Treatment - Treatment

Nursing27600067

*50

Assisted with medications     - Clinical Treatment - Treatment

Nursing27700068

S50

Lice/scabies treatment given      - Clinical Treatment - Treatment

Nursing27800069

*54

Assistive devices given      - Clinical Treatment - Treatment

Nursing27500065

double

Vital signs (TPR)      - Clinical Treatment - Treatment

Nursing27600067

double

Follow-up with medical problems     - Clinical Treatment - Treatment

Nursing27700068

double

Blood glucose testing      - Clinical Treatment - Treatment

Nursing27800069

double

Assisted with medications     - Clinical Treatment - Treatment

 

 

 

References



[i] OSCAR ; http://www.oscarcanada.org/

[ii]  WONCA . ICPC-2-R: International Classification of Primary Care (Oxford Medical Publications) 2005

[iii]  Street Health. http://www.streethealth.ca  

[iv]  Médecins du Monde. Rapport de l’Enquête européenne sur l’accès aux soins des personnes en situation irrégulière (septembre 2007) http://www.medecinsdumonde.be/IMG/pdf/rapport_observatoire_FR.pdf

[v] More on ICPC ; http://trix.docpatient.net

[vi] Parkerson GR Jr. User's Guide for Four Duke Health Measures: Duke Health Profile (DUKE), Duke Severity of Illness Checklist (DUSOI), Duke Case-Mix System (DUMIX), Duke Social Support and Stress Scale (DUSOCS). Durham, NC: Department of Community and Family Medicine, Duke University Medical Center, 1998.