ENP – a language for nursing

ENP stands for European Nursing care Pathways. The nursing classification system has been continuously developed since 1989. The standardized & cross-sectoral nursing terminology is distinguished from other classifications by concrete and specific descriptions for the respective nursing situation: the ENP practice guideline. ENP is available both as a book publication and as a database for the integration into RECOM-GRIPS as well as an external database in third-party systems.

Detailed information on ENP research and development can be found under ENP development. ENP is registered as an official instrument for the clear telematic data exchange at the German Institute for Medical Documentation and Information with the OID In addition, ENP is the first nursing classification to be included in the German Gematik Directory.

  • ENP
  • Advantages
  • Areas of application
  • ENP development

ENP for All Nursing Areas

ENP is not only designed for a specific nursing facility, but can be used in all settings where nursing care is provided. Institutions providing inpatient hospital care, rehabilitation, psychiatry, short-term care as well as nursing homes and outpatient care services are now working with ENP – in many European countries.

More Than 70,000 Users Across Europe

ENP is used in EU countries by more than 70,000 users in hospitals, geriatric care facilities and mobile services to illustrate and document the entire nursing care process. In many nursing schools in Germany, ENP is an integral part of the training. Translations of ENP are available in French, Italian, English and Spanish. In Luxembourg, ENP is about to be used nationwide with more than 8,000 users in institutions across all sectors.

Benefits of ENP

  • ENP with its practice guidelines is both a nursing terminology and a classification system.
  • applicable in all nursing sectors
  • continuous development within a scientific team
  • development of new nursing diagnoses from practice via theory into practice
  • Each ENP practice guideline is aligned with current international literature
  • Particularly suitable for electronic data evaluation, e.g. for outcome measurements

ENP as Standardized Terminology

ENP stands for European Nursing care Pathways. Since 1989 the nursing terminology has been developed out of the need for appropriate practice-oriented and cross-sectoral communication tools to describe the nursing care process. ENP is aimed at all areas in which care is performed: institutions providing inpatient hospital care, rehabilitation, psychiatry, short-term care as well as geriatric care facilities and mobile services are now working with ENP – in many European countries.

ENP as Classification System

In addition, ENP represents a classification system consisting of the categories of nursing diagnosis with characteristics, etiologies, resources, outcomes, interventions as well as detailed guiding interventions. ENP is distinguished from other classifications by its low level of abstraction, i.e., ENP provides specific descriptions for each nursing situation throughout the nursing care process. All the necessary elements for describing the nursing situation are available as a formulation aid. In addition, ENP is linked to nursing time values enabling the measurement of nursing effort.

576 Nursing Diagnoses with ENP Practice Guidelines

To support of the nursing process the nurse is provided with a corresponding selection of possible characteristics, etiologies and resources for a nursing diagnosis. Characteristics describe, how the nursing problem can be recognized, etiologies clarify why the problem occurred, and resources point to positive aspects of the care receiver for the treatment process. A selection of possible nursing outcomes and interventions is also provided. In the graphic (see link) a practice guideline is visualized as an example based on a nursing diagnosis with one selected item from each category.

The current ENP version 3.2 (2021) consists of 576 nursing diagnoses with corresponding practice guidelines. In four domains and 21 classes, about 20,000 items are available for the user for the individual description of the nursing care process of a patient/resident.

Example of the structure of an ENP practice guideline

Electronic Application in Practice

The standardization of ENP and the electronic practical application allow to obtain transparency about the process of nursing care in the different healthcare institutions and to examine nursing interventions for effectiveness, e.g. with regard to the outcomes.

In addition, ENP is linked to systems of workload management and personnel calculation (e.g. LEP nursing 3 and PPR nursing staff regulation). Similarly, cross-mappings with medical classifications, like ICD-9, ICD-10 and OPS (operation and procedure coding) as well as risk assessment tools have been established.

Thus, ENP is not only a valuable and practice-oriented tool for nurses, but also provides a solid data basis for nursing controllers, manager and scientists as well as medical controllers and case managers.

ENP Is Applicable in All Nursing Areas

Institutions providing inpatient hospital care, rehabilitation, psychiatry, short-term care as well as nursing homes and outpatient care services are now working with ENP – in many European countries.

Optimal Cross-Sectoral Communication with ENP

By using ENP as a standardized nursing terminology, e.g. in elderly car, it is possible that all nursing staff can accurately and professionally describe the resident’s health status. This makes it possible for all nursing staff within an institution to optimize nursing communication across sectors, even beyond institutional boundaries (with regard to transitional care). The resident's situation can be described individually and is still formulated in a way that is comprehensible to third parties.

Formulation Aids according to PESR Format

Due to the structure provided by ENP – formulation aids according to the PESR format (nursing problem, etiology, signs/symptoms, ressources) as been described by the MDS, German Medical Service of the Central Association of Health Insurance Funds – it is possible to describe the entire nursing process with ENP. However, the nursing terminology is not designed for a specific nursing institution, but can be used in all areas where nursing takes place. To achieve this goal a special setting, a selection of applicable content, for each type of institution.

ENP Offers Unique Practice Guidelines

With ENP, the entire nursing care process is supported, because all the necessary elements for the description of the nursing situation are available as a formulation. In addition, another major added value for clinicians is that ENP provides practice guidelines based on nursing diagnosis. The practice guidelines suggest specific guiding interventions to the ENP user. These are fundamentally based on current nursing expertise. This ensures that ENP users are always working at the current level of nursing science.

ENP in Education

ENP Online combines professional pedagogical aspects & nursing diagnostics in a vivid way. The tool is a browser-based learning platform for studying the nursing terminology European Nursing care Pathways (ENP) and associated nursing planning and documentation, for example. For this purpose, a free starter version and the optional use of PREMIUM functions are available. Interesting for teachers and students alike!

Note: the two-week offer is a trial offer by RECOM GmbH. It is not intended to be used to equip entire classes and courses for teaching. RECOM GmbH reserves the right to limit the issue of test licenses.

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