Review Article
Volume 3 Issue 6 - 2021
Strategy for Categorizing Clinical Complexity in Community Care
Marta Fernández Batalla1*, Alexandra González Aguña2, Enrique Monsalo San Macario3, Sara Herrero Jaén4, Blanca Gonzalo de Diego5 and José María Santamaría García6
1PhD, Research Group MISKC, University of Alcalá, and Specialist Nurse in Torres de la Alameda Health Centre, Community of Madrid Health Service, Madrid, Spain
2MSc, Research Group MISKC, University of Alcalá, and Nurse in Henares University Hospital, Community of Madrid Health Service, Madrid, Spain
3MSc, Research Group MISKC, University of Alcalá and Specialist Nurse in La Garena Health Centre, Community of Madrid Health Service, Madrid, Spain
4MSc, Research Group MISKC, University of Alcalá and Nurse in Mejorada del Campo Health Centre, Community of Madrid Health Service, Madrid, Spain
5MSc, Research Group MISKC, University of Alcalá and Nurse in Meco Health Centre, Community of Madrid Health Service, Madrid, Spain
6PhD, Research Group MISKC, University of Alcalá and Nurse in Meco Health Centre, Community of Madrid Health Service, Madrid, Spain
*Corresponding Author: Marta Fernández Batalla, PhD, Research Group MISKC, University of Alcalá, and Specialist Nurse in Torres de la Alameda Health Centre, Community of Madrid Health Service, Madrid, Spain.
Received: March 04, 2021; Published: May 27, 2021


Introduction: The Family and Community Nurse works with multiples clinical cases. This means that there are different levels of difficulty. The variables which occur in a case, how to relationship to each one and the tipology makes that the nurse found a degree of difficulty therapeutic as well as diagnostic. This is called “complexity”. The relationship between the explicit terms of a case and the implicit logical consequence, make the case advances the implementation and its value in training. It is important to note the type of data that make up the clinical course. These data are classified in three groups.

Aim of the Study: The aim of this work is to establish a system for classifying clinical cases in chronic health processes based on their complexity of care.

Methodology: Delphi method to "n" turns to achieve unanimous consensus of the experts involved.

Results: The system makes distinction between the difficulty level of a clinical course and the number of normalized variables. In case of variables number which give greater or lesser complexity to a course is because it is not known if more or less information helps the course is more or less complex, as it depends on the quality of information be given.

Conclusion: People with chronic processes require care from the health system, but the amount and quality of care must be provided based on its complexity. For this reason, this study is presented that allows to know the level of complexity of a clinical case before these processes. With this classification system, the provision of services and resources can be better targeted. As future lines, the study of the correlation of the complexity with the index of care severity of a case of people with chronic health processes is proposed.

Keywords: Primary Care Nursing; Chronic Disease; Needs Assessment; Clinical Competence


  1. Spain of Government. approving and publishing the training program for the specialty of Family and Community Nursing”. Order (2010).
  2. Establishes the bases for the call for the objective test provided for in the second transitory provision of Royal Decree. Nº Official State Gazette, nº182, (29-7.2005). General Secretariat of Universities. Spain (2009).
  3. Spain of Government. aprueba el conjunto mínimo de datos de los informes clínicos en el Sistema Nacional de Salud. Royal decree (2010).
  4. Arribas Cachá Antonio A., et al. “Standardized Nurse Assessment: Classification of nursing assessment criteria”. Madrid: FUDEN (2010).
  5. Herdman T and Kamitsuru S. “NANDA International nursing diagnoses: Definitions and classification, 2018-2020”. Thieme (2017).
  6. International Council of Nurses. ICNP Download (2018).
  7. Jiménez ML., et al. “Knowledge representation for diagnosis of care problems through an expert system: Model of the auto‐care deficit situations”. Expert Systems with Applications (2008): 2847-2857.
  8. Spain of Government. autorización a organismos de investigación para suscribir convenios de acogida”. Order (2011).
  9. European Higher Education Area. Chronological Development. 2006-2008 (2020).
  10. Fernández Batalla and Marta Y Otros. “Design of an analysis method to calculate vulnerability as a predictor of frailty in health”. Revista ENE de Enfermería (2018): 12.1.
  11. Fernández Batalla Marta and María Lourdes Jiménez Rodríguez. “Documentación De Casos Clínicos A Través De Una Herramienta Computacional: Un Estudio De Credibilidad Y Eficiencia”. Revista Ene de Enfermería (2015): 9.1.
  12. Portfolio of services primary care. Development, organization, uses and content. Technical report. Madrid: Ministry of Health and Social Policy (2010).
  13. González Aguña Alexandra and José María Santamaría García. “El Ciclo Del Cuidado: El Modelo Profesional De Cuidado Desde El Enfoque Del Pensamiento”. Revista Ene de Enfermería (2015): 9.1.
  14. Santamaría Pérez., et al. “Propuesta de un marco para una bioética del cuidado, o como si la vida importase”. Revista Ene de Enfermería (2018): 12.3.
  15. Santamaría García., et al. “The axioms of care”. Madrid: Grupo MISKC_ENE (2016).
  16. Fernández Batalla Marta. “The person in the continuum of care”. Madrid: Universidad de Alcalá, (2018).
  17. Pinto Freyre and Jesus Y Otros. “Cuidadosofía: una introducción a la relación entre cuidado y filosofía”. Revista Ene-Enfermería (2017): 11.3.
  18. Arribas Cachá., et al. “Education on Care. Standardization of research for the acquisition of knowledge about the language of care”. Madrid: FUDEN (2010).
  19. Vilas Boas Dias and Bruno Y Otros. “The Nurse in Welcoming with Risk Rating: Integrative Literature Review”. EC Nursing and Healthcare3 (2019): 01-06.
Citation: Marta Fernández Batalla., et al. “Strategy for Categorizing Clinical Complexity in Community Care”. EC Nursing and Healthcare 3.6 (2021): 63-69.

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