NI 2012 : 11th International Congress on Nursing Informatics, June 23-27, 2012, Montreal, Canada. International Congress in Nursing Informatics (11th : 2012 : Montreal, Quebec)最新文献

Obesity is a global epidemic demanding the use of clinical decision support tools to help clinicians in the identification, assessment and management of healthy weight gain in children. Over the last decade, numerous systematic reviews have shown that clinical decision support systems (CDSS) have positively impacted clinician's performance for drug ordering/dosing and preventive care reminders. CDSS that are built into the clinician's workflow at the point of care also have a positive impact on provider's performance. There are limited studies that examine CDSS in nursing practice. This paper describes a comparative effectiveness study being conducted in school-based clinics to examine the impact of web-based training with and without a CDSS that contains tailored recommendations. The study involves the use of a CDSS tool focused on cardiovascular risks, HeartSmartKids™. This research is an important example of an interdisciplinary team using information technology to address the global issue of obesity prevention.

The establishment of a Nursing Minimum Data Set (NMDS) can facilitate the use of health information systems. The adoption of these sets and represent them based on archetypes are a way of developing and support health systems. The objective of this paper is to describe the definition of a minimum data set for nursing in endometriosis represent with archetypes. The study was divided into two steps: Defining the Nursing Minimum Data Set to endometriosis, and Development archetypes related to the NMDS. The nursing data set to endometriosis was represented in the form of archetype, using the whole perception of the evaluation item, organs and senses. This form of representation is an important tool for semantic interoperability and knowledge representation for health information systems.

Keeping individuals aware of their own health is a global challenge in health care. Observations of Daily Living (ODLs), cues to health that are derived from and personally meaningful to an individual, provide a detailed picture of one's experience of health. Project HealthDesign, an 8-year initiative of the Robert Wood Johnson Foundation, is investigating ODLs and devising innovative ways of tracking them through personal health record deployment in diverse communities and health care settings. Nursing informatics knowledge base and skills, applied to the ODL challenge can accelerate their identification, capture, and interpretation, thus empowering individuals toward meaningful action and facilitating more robust information exchange between individuals and their health care providers.

Objectives: The aim of this study is examine the reliability and validity of the patient classification which is based on clinical data with comparing to nurse's check.

Method: Nurse Experts estimated the content validity of extracting KPCS-1(Korea patient classification system for nurses Version 1) activities score from clinical data in storage of AMIS (Asan Medical Center information system). After verifying the content validity of extraction method from clinical data, two methods extracting KPCS-1 score (from clinical data vs. nurses' recording) were compared for 348 patients.

Results: This study demonstrated that extracting patient classification from clinical data is high value of validity (except 4 items excluded from this study), reliability between two methods extracting KPCS-1(from clinical data and nurses' recording) is high value (ICC=0.96, p<.001) and construct validity of two methods has similarity.

Conclusions: It is believed that the patient classification system which is made from only clinical data without nurse's work burden is available. And 4 items which was excluded on KPCS-1 and examine area which had low level of reliability are needed to be amended.

In Canada there are few nurses who have advanced practice competencies in nursing informatics. This is a significant issue for regional health authorities, governments and electronic health record vendors in Canada who are implementing electronic health records. Few Schools of Nursing provide formalized opportunities for nurses to develop informatics competencies. Many of these opportunities take the form of post-baccalaureate certificate programs or individual undergraduate or graduate level courses in nursing. The purpose of this paper will be to: (1) describe the health and human resource issues in this area in Canada, (2) provide a brief overview of the design and development of a new, innovative double degree program at the intersection of nursing and health informatics that interleaves cooperative learning, (3) describe the integration of cooperative learning into this new program, and (4) outline the lessons learned in integrating cooperative education into such a graduate program.

To explore the usefulness of narrative nursing records documented using a standardized terminology-based electronic nursing records system, we conducted three different studies on (1) the gaps between the required nursing care time and the actual nursing care time, (2) the practice variations in pressure ulcer care, and (3) the surveillance of adverse drug events. The narrative nursing notes, documented at the point of care using standardized nursing statements, were extracted from the clinical data repository at a teaching hospital in Korea and analyzed. Our findings were: the pediatric and geriatric units showed relatively high staffing needs; overall incidence rate of pressure ulcer among the intensive-care patients was 15.0% and the nursing interventions provided for pressure-ulcer care varied depending on nursing units; and at least one adverse drug event was noted in 53.0% of the cancer patients who were treated with cisplatin. A standardized nursing terminology-based electronic nursing record system allowed us to explore answers to different various research questions.

The electronic nursing record (ENR) as part of the larger electronic health record has been discussed for years. Its implementation is not that widespread as often considered. E.g. in the Netherlands, a fraction of hospitals uses it. This paper describes a nurse led project in a Dutch hospital where an electronic nursing record system has been defined, based on requirements analysis, standardization through Detail Clinical Models (DCM), and implementation. Standardization of data with DCM is a method and a format to organize clinical knowledge, concepts, and data elements such that managing and exchanging semantics of data is independent from specific technology. 28 DCM are used in the specifications of the ENR. Using the DCM standards approach and the mapping of data elements to professional terminologies enable a vendor to develop what is needed for quality care, rather then sell a fixed set product.

A survey was carried out to describe the current state of art in the use of nursing documentation, terminologies, standards and education. Key informants in European countries were targeted by the Association for Common European Nursing Diagnoses, Interventions and Outcomes (ACENDIO). Replies were received from key informants in 20 European countries. Results show that the nursing process was most often used to structure nursing documentation. Many standardized nursing terminologies were used in Europe with NANDA, NIC, NOC and ICF most frequently used. In 70% of the countries minimum requirements were available for electronic health records (EHR), but nursing not addressed specifically. Standards in use for nursing terminologies and information systems were lacking. The results should be a major concern to the nursing community in Europe. As a European platform, ACENDIO can play a role in enhancing standardization activities, and should develop its role accordingly.

Patient safety incident reporting systems are used to monitor adverse events, generate information for risk management and to improve patient safety. A number of electronic reporting systems have been developed, but their data elements appear relatively similar. An inductive data analysis was carried out to find out especially what is the content of descriptions of contributing factors of adverse events. The data consisted of incident reports entered in a hospital based reporting system in the years 2008-2010. Overall, 82 reports of 785 contained free text information about patients' and relatives' involvement in the events reported by staff. We found that patients themselves noticed almost half of these incidents. Of the incidents they noticed, most resulted in moderate harm.

Current strategies for improving the care of millions of elderly people living in nursing homes (NH) include the implementation of information technology (IT). Few studies exist about the implementation of NH IT although there is evidence of increasing NH IT sophistication globally. NH IT sophistication includes a measure of the maturity and diversity of IT used to support resident care, clinical support, and administration. The current paper includes a case study of 1 NH known to have high IT sophistication in the Midwestern USA. The NH was purposively selected from 185 NHs taking part in a statewide evaluation of NH IT sophistication in Missouri. This NH reported the highest IT sophistication among 185 NHs. The research aim was to explore communication strategies for evidence based pressure ulcer preventions in NH IT. Focus group and observational data were collected to assess facilitators and barriers to communicating pressure ulcer preventions.