Identifying nursing sensitive indicators from electronic health records in acute cardiac care―Towards intelligent automated assessment of care quality

Abstract

Aim:The aim of this study is to explore the potential of using electronic health records for assessment of nursing care quality through nursing-sensitive indicators in acute cardiac care.Background: Nursing care quality is a multifaceted phenomenon, making a holistic assessment of it difficult. Quality assessment systems in acute cardiac care units could benefit from big data-based solutions that automatically extract and help interpret data from electronic health records.Methods: This is a deductive descriptive study that followed the theory of valueadded analysis. A random sample from electronic health records of 230 patients was analysed for selected indicators. The data included documentation in structured and free-text format.Results: One thousand six hundred seventy-six expressions were extracted and divided into (1) established and (2) unestablished expressions, providing positive, neutral and negative descriptions related to care quality. Conclusions:Electronic health records provide a potential source of information for information systems to support assessment of care quality. More research is warranted to develop, test and evaluate the effectiveness of such tools in practice.Implications for Nursing Management: Knowledge-based health care management would benefit from the development and implementation of advanced information systems, which use continuously generated already available real-time big data for improved data access and interpretation to better support nursing management in quality assessment.

Information Management in Hospital Unit Daily Operations

“…37 User-centered information system development requires an iterative developmental process involving all end user perspectives from the beginning to the end of the developmental process. 38 This regards important aspect related to the content, functionality, and intuitiveness of the developed system (the software), but also to the usability, location, and ergonomics related to the use of the system (the hardware). 39 It also highlights the need to consider the key role nursing and medical professionals working in operational leadership roles have in creating the culture to support the adoption, 39 as the system cannot work to its full potential unless all users commit to using the system as intended.…”

“…The work practices and dynamics of the operating environment should be carefully pre-examined to support not only the purpose the system is developed but also both existing and emerging ways of working 37 . User-centered information system development requires an iterative developmental process involving all end user perspectives from the beginning to the end of the developmental process 38 . This regards important aspect related to the content, functionality, and intuitiveness of the developed system (the software), but also to the usability, location, and ergonomics related to the use of the system (the hardware) 39 .…”

Towards Automated Evaluation of Patient Centered Care–Assessing the Potential of Electronic Health Records

“…In their practice, nurse managers use EHRs to monitor nurse-sensitive quality markers, but they report a lack of tools to extract the information they need [7]. Previous studies indicate that, combined with artificial intelligence methods such as natural language processing, secondary use of EHR data would benefit automated evaluation of quality of nursing care components [8]. However, the utilization of free text EHR data in evaluating PCC is still lacking [9].…”

Nursing Informatics' Contribution to One Health

“…Research shows the importance of standardised languages and knowledge as the foundation of nursing [29] in producing uniform nursing information [30]. Demands for secondary use of data has increased [31] to better support practice, patient outcomes [32] and nursing management [33].…”