Automating pressure ulcer risk assessment using documented patient data

Kim, Hyeoneui; Choi, June-Seek; Thompson, Sarah; Meeker, Lindsay; Dykes, Patricia C.; Goldsmith, Denise; Ohno-Machado, Lucila

doi:10.1016/j.ijmedinf.2010.08.005

Cited by 14 publications

(18 citation statements)

References 17 publications

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“…Several examples are available from recent literature where different types of information technology with emphasis on clinical decision support [e.g. data entry templates (35), data mining techniques (37), algorithm processing with documented data (22, 38)] are tested to improve documentation, assessment, prevention or identification of pressure ulcers.…”

Section: Discussionmentioning

confidence: 99%

Accuracy, completeness and comprehensiveness of information on pressure ulcers recorded in the patient record

Thoroddsen¹,

Sigurjónsdóttir²,

Ehnfors³

et al. 2012

Scandinavian Caring Sciences

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The purpose of documentation to record, communicate and support the flow of information in the patient record was not met. The patient records lacked accuracy, completeness and comprehensiveness, which can jeopardise patient safety, continuity and quality of care. The information on pressure ulcers in patient records was found not to be a reliable source for the evaluation of quality in health care. To improve accuracy, completeness and comprehensiveness of data in the patient record, a systematic risk assessment for pressure ulcers and assessment and treatment of existing pressure ulcers based on evidence-based guidelines need to be implemented and recorded in clinical practice. Health information technology, including the electronic health record with decision support, has shown promising results to facilitate and improve documentation of pressure ulcers.

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Section: Discussionmentioning

confidence: 99%

Accuracy, completeness and comprehensiveness of information on pressure ulcers recorded in the patient record

Thoroddsen¹,

Sigurjónsdóttir²,

Ehnfors³

et al. 2012

Scandinavian Caring Sciences

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“…BART, a prototype decision support tool for automatically assessing pressure ulcer risk using documented patient data based on the Braden Scale, was developed in an attempt to address many issues in current practice of pressure ulcer risk assessment of patients who are hospitalized. Among others, redundant documentation and difficulty in aggregating necessary data were the two most significant issues [8]. In the previous study, 56 discrete data items were identified and used to develop decision rules in using the BART [8].…”

Section: Braden Scale Based Automated Risk Assessment Tool (Bart)mentioning

confidence: 99%

“…Pressure ulcers are considered as an indicator of quality of care, and pressure ulcer treatment has been a large financial burden on health care institutions [7]. As an attempt to improve assessing skin risk for pressure ulcer, Kim and colleagues developed a rule-based prototype decision support tool based on the Braden Scale with the idea to derive pressure ulcer risk scores of the Braden Scale using documented clinical patient data automatically [8].…”

Section: Introductionmentioning

confidence: 99%

“…Although this prototype system, Braden Scale based Automated Risk Assessment Tool (BART), improved workflow efficiency and showed the feasibility of automatic pressure ulcer assessment utilizing data re-use, it identified two major and two minor areas that required further investigation [8]. The first area was enhancing decision rules, especially on moisture status and nutritional status parameters.…”

Section: Introductionmentioning

confidence: 99%

“…For example, the BART determines the level of Moisture Exposure based on the frequencies of changing diapers, incontinence pads, bed linen, absorbent pads, or wound dressings. Those data were not sufficiently documented [8]. Assessing the nutritional status parameter was another issue.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Enhancement of Decision Rules to Increase Generalizability and Performance of the Rule-Based System Assessing Risk for Pressure Ulcer

Choi¹,

Kim²

2013

Appl Clin Inform

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KeywordsGeneralizability, decision support system, guideline interchange format, pressure ulcer risk SummaryBackground: A rule-based system, the Braden Scale based Automated Risk Assessment Tool (BART), was developed to assess risk for pressure ulcer in a previous study. However, the BART illustrated two major areas in need of improvement, which were: 1) the enhancement of decision rules and 2) validation of generalizability to increase performance of BART. Objectives: To enhance decision rules and validate generalizability of the enhanced BART. Method: Two layers of decision rule enhancement were performed: 1) finding additional data items with the experts and 2) validating logics of decision rules utilizing a guideline modeling language. To refine the decision rules of the BART further, a survey study was conducted to ascertain the operational level of patient status description of the Braden Scale. The enhanced BART (BART2) was designed to assess levels of pressure ulcer risk of patients (N = 99) whose data were collected by the nurses. The patients' level of pressure ulcer risk was assessed by the nurses using a Braden Scale, by an expert using a Braden Scale, and by the automatic BART2 electronic risk assessment. SPSS statistical software version 20 (IBM, 2011) was used to test the agreement between the three different risk assessments performed on each patient. Results: The level of agreement between the BART2 and the expert pressure ulcer assessments was "very good (0.83)". The sensitivity and the specificity of the BART2 were 86.8% and 90.3% respectively. Conclusion: This study illustrated successful enhancement of decision rules and increased generalizability and performance of the BART2. Although the BART2 showed a "very good" level of agreement (kappa = 0.83) with an expert, the data reveal a need to improve the moisture parameter of the Braden Scale. Once the moisture parameter has been improved, BART2 will improve the quality of care, while accurately identifying the patients at risk for pressure ulcers.

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A data-driven and practice-based approach to identify risk factors associated with hospital-acquired falls: Applying manual and semi- and fully-automated methods

Lucero

Lindberg

Fehlberg

et al. 2019

International Journal of Medical Informatics

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Automating pressure ulcer risk assessment using documented patient data

Cited by 14 publications

References 17 publications

Accuracy, completeness and comprehensiveness of information on pressure ulcers recorded in the patient record

Accuracy, completeness and comprehensiveness of information on pressure ulcers recorded in the patient record

Enhancement of Decision Rules to Increase Generalizability and Performance of the Rule-Based System Assessing Risk for Pressure Ulcer

A data-driven and practice-based approach to identify risk factors associated with hospital-acquired falls: Applying manual and semi- and fully-automated methods

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