For licensing information please contact Bonita Allen at Elsevier: b.allen.1@elsevier.comFor permission to use NIC and NOC, please contact Elsevier Global RIghts:

NIC and NOC are developed at the University of Iowa College of Nursing but are published and copyrighted by Elsevier located in St. Louis.  Requests for permissions to use and license the Classifications should be sent to Elsevier.  The purpose of this document is to discuss copyright, and when permission to use these languages is needed. In brief, a license is always needed when you incorporate the languages in a computerized information system or a software program.  This applies to individuals in all countries, not just the United States.  Even if an edition of NIC or NOC has been translated into another language and you are putting the other language in your information system, you need to purchase a license from Elsevier. Beyond licensure, permission is needed if you are reproducing the work manually or electronically in any product that you are selling or are producing to be used by a number of individuals repeatedly (e.g. a book or article that you are writing, a course syllabus, talk handout, web site) in lieu of a purchase of the NIC and NOC books. Read on for more of the ins and outs of all of this.

Copyright does not restrict fair use. According to guidelines by the American Library Association, fair use allows materials to be copied if: 1) the portion copied is selective and sparing in comparison to the whole work; 2) they are not used repeatedly; 3) no more than one copy is made for each person; 4) the source and copyright notice is included on each copy; and 5) persons are not assessed a fee for the copy beyond the actual cost of reproduction. The determination of the amount that can be copied under fair use policies has to do with the effect of the copying on sales of the original material. The American Library Association says that no more than 10% of a work should be copied.

A license is needed if you put NIC and/or NOC in a nursing information system or if you will use a substantial part of the Classification for commercial gain or advantage. Schools of nursing and health care agencies that want to use NIC and/or NOC in their own organizations (in manual form) and have no intention of selling a resulting product are free to do so. Fair use policies exist however. For example, NIC and NOC should not be copied and used in syllabi semester after semester--the classification books should be adopted for use. Similarly, health care agencies need to purchase a reasonable number of books (say, one per unit) rather than reproduce the interventions in an agency procedure manual.

Requests for use of NIC and NOC should be sent to the permissions department of Elsevier (see below). Many requests for permission to use do not violate copyright and permission is given with no fee. Fees for use in a book depend on the amount of material used. Fees for use in information systems depend upon the number of users and averages about $5.00 per user per year per classification. There is a flat fee for incorporating NIC/NOC into a vendor's database and then a sublicense fee for each sublicense undertaken based on the number of users. The fees are very reasonable and substantial portions of the fees are forwarded to the Center for Nursing Classification for development and refinement of NIC and NOC.

Both NIC and NOC were developed with assistance from NIH research grant funds. Contrary to some popular opinion, the award of these grant funds does NOT indicate that the work is in the public domain. According to NIH policy, the researchers are expected to make the results and accomplishments available to the research community and to the public at large using the processes of publication, patent, copyright, and licensing to transfer grant supported work to the general discipline for use and development.

Most other health care classifications are copyrighted and fees are required for use. For example, the CPT (Current Procedural Terminology) is copyrighted by the American Medical Association, DSM (Diagnostic and Statistical Manual of Mental Disorders) is copyrighted by the American Psychiatric Association, and SNOMED Clinical Term (SNOMED CT) is copyrighted by the International Health Terminology Standards Development Organization (IHTSDO). Health care institutions regularly pay license fees now, only most nurses are not aware of these. For example, at one tertiary care hospital that we know of, there are 97 vendor software products installed and more than $1,220,000 is spent annually in software license fees.

License fees are often included as part of the software costs. NIC and NOC can be licensed from Elsevier (use of the language) for incorporation in an existing information system or purchased from a vendor with software (the vendor has purchased the license from Elsevier and the software price includes the cost of the license). As more nurses understand the advantages of using standardized language and desire this in purchases of new information systems, more vendors will include NIC and NOC in their products.

In nursing, none of the professional organizations have the resources to maintain the languages so another avenue was needed. Housing the Classifications in a university setting has advantages over the professional organizational model whereby politics (what is in and what is out) come into play. Ongoing development and maintenance, however, require resources. Classifications and other works in the public domain are often those for which there will be no upkeep-you can use what is there but don't expect it to be kept current. We have attempted to make NIC and NOC as accessible as possible but to also collect fees so that we can have a revenue stream to finance the maintenance work that must continue.

For more information about permissions (use of work in an article, book, or presentation) contact Elsevier Grobal Rights: Please note that permission takes 4-6 weeks to process. For information about licensure (use in information systems/software) contact Bonita Allen at Elsevier: