75 results on '"Hardiker NR"'
Search Results
2. Harmonising nursing terminologies using a conceptual framework
- Author
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Jansen, K, Kim, TY, Coenen, A, Saba, V, and Hardiker, NR
- Abstract
The International Classification for Nursing Practice (ICNP®) and the Clinical Care Classification (CCC) System are standardised nursing terminologies that identify discrete elements of nursing practice, including nursing diagnoses, interventions, and outcomes. While CCC uses a conceptual framework or model with 21 Care Components to classify these elements, ICNP, built on a formal Web Ontology Language (OWL) description logic foundation, uses a logical hierarchical framework that is useful for computing and maintenance of ICNP. Since the logical framework of ICNP may not always align with the needs of nursing practice, an informal framework may be a more useful organisational tool to represent nursing content. The purpose of this study was to classify ICNP nursing diagnoses using the 21 Care Components of the CCC as a conceptual framework to facilitate usability and inter-operability of nursing diagnoses in electronic health records. Findings resulted in all 521 ICNP diagnoses being assigned to one of the 21 CCC Care Components. Further research is needed to validate the resulting product of this study with practitioners and develop recommendations for improvement of both terminologies
- Published
- 2016
3. Challenges associated with the secondary use of nursing data
- Author
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Hardiker, NR, Sermeus, W, Janson, K, Saranto, K, Weaver, CA, and Chang, P
- Abstract
There is a prevailing 'collect once, use many times' view of clinical data and its secondary use. This study challenges this view through an assessment of the degree to which the International Classification for Nursing Practice (ICNP) might be used to provide raw data for the Belgian Nursing Minimum Data Set (B-NMDS). A mapping exercise identified exact matches between ICNP and B-NMDS for just 8% of B-NMDS care descriptions; no matches at all for 23%; possible broader matches in ICNP for 55%; possible narrower matches for 8%; and a possible broader and narrower match for 1%. Refining ICNP content and developing and implementing purposive data sets or catalogues that accommodate both ICNP concepts and B-NMDS care descriptions would lay the foundations for the potential re-use of primary ICNP-encoded data in populating the B-NMDS. One unexpected result of the study was to re-affirm the utility of ICNP as a reference terminology.
- Published
- 2014
4. Self management of long term conditions: A literature review
- Author
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Hardiker, NR, Grant, MJ, and Jones, I
- Subjects
health_and_wellbeing - Abstract
A number of policy documents have been published recently that support the principle of self care and self management and call for ‘implementation’. Partners across the north west of England are working together, through the development of a pilot service, to reduce emergency readmissions of patients with long-term conditions while simultaneously improving quality and outcomes. In order to inform this work, this study has drawn on published evidence around self-management, with a particular focus on people living with chronic obstructive pulmonary disease and/or heart failure in urban areas of high-deprivation, to allow a comparison between the model that underpins the pilot service and other reported models of self-management, including how these models are delivered, their impact in terms of patient outcomes, and their relative cost-effectiveness.\ud \ud A total of 79 articles (identified from among 923 abstracts) were included in the literature review. Each article fell into one of five themes. The majority of articles fell within the education or counselling theme, followed by personal plans, education or counselling with exercise, telehealth and exercise only.\ud \ud The results for all studies of exercise only interventions were positive, demonstrating increased activity/ exercise, improved quality of life and self-efficacy, and improved status. \ud \ud Personal plans appear to have made a positive impact in the majority of studies, particularly in terms of hospitalisations and health care utilisation, status and outcomes and behaviour.\ud \ud For those studies that described a combination of education or counselling with an exercise programme, the results were largely positive (particularly in terms of status or outcome).\ud \ud The range of education or counselling interventions (without exercise) appear to have made a modest positive impact in the majority of cases (particularly in terms of behaviour and status and outcomes).\ud \ud While some studies showed positive effects from the use of telehealth, no difference between control and intervention groups was reported more often. \ud \ud Only one study included any negative effect – increased exacerbations for the intervention group in a combined educational/counselling and exercise, although the reasons for this are unclear.\ud \ud In all cases, there was no identifiable predictor for any positive (or negative) effect, although most educational/counselling interventions (with or without exercise) involved human contact and many provided some degree of ongoing support.\ud \ud The majority of interventions to support self-management appear to make some positive impact in terms of behaviour, status, outcome, use of health services or quality of life; there is also some indication, albeit limited that costs of care can be reduced as a result. However, due to the heterogeneous nature of the interventions in published reports, further primary research is needed to identify common predictors of success and the longevity of success.\ud \ud The findings from a number of relevant previous literature reviews support the findings from this review.
- Published
- 2013
5. Developing standardised terminologies to support nursing practice
- Author
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Hardiker, NR, McGonigle, D, and Mastrian, K
- Subjects
health_and_wellbeing - Published
- 2011
6. Advanced terminological approaches in nursing
- Author
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Hardiker, NR, Bakken, S, Kim, TY, Saba, VK, and McCormick, KA
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health_and_wellbeing - Published
- 2011
7. A synthesis of grey literature around public health interventions and programmes
- Author
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Hardiker, NR, Mcgrath, ML, and Mcquarrie, C
- Subjects
RA0421 ,health_and_wellbeing - Published
- 2009
8. Factors that affect public engagement with eHealth services: a literature review
- Author
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Hardiker, NR and Grant, MJ
- Subjects
QA75 ,other ,health_and_wellbeing - Published
- 2009
9. Standards to support the ongoing development and maintenance of nursing terminologies
- Author
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Hardiker, NR, Coenen, A, Oud, Nico, Sheerin, Fintan, Ehnfors, Margareta, and Sermeus, Walter
- Subjects
QA75 ,other ,health_and_wellbeing ,RT - Published
- 2007
10. Shaping the future for primary care education and training project. Education and training provision to deliver\ud integrated health & social care: course finder
- Author
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Hardiker, NR
- Subjects
health_and_wellbeing - Abstract
Within the Shaping the Future for Primary Care Education and Training Project, the literature review concerning integrated health and social care identified a number of\ud implications or recommendations for service and education. For education, these recommendations may be categorised under a number of headings or themes: Team working,\ud Communication, Role Awareness, Practice Development and Leadership,Partnership Working.\ud It would follow that if agencies in the North West are to deliver truly integrated health and social care services, educational curricula across the region should cover these themes.\ud Prior to the Shaping the Future Project there was no simple way of looking across the entire region to gain insights into current education and training provision. One of the\ud core objectives of the Shaping the Future Project was to develop a webbased Course Finder tool and to map existing regional provision of education and training which can\ud support the delivery of integrated health and social care services
- Published
- 2006
11. Mutual enhancement of diverse terminologies
- Author
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Hardiker, NR, Casey, A, Coenen, A, Konicek, D, and Bates, D
- Subjects
QA75 ,other ,health_and_wellbeing ,RT - Abstract
The purpose of this study was to map the North American Nursing Diagnosis Association (NANDA) nursing diagnoses to the International Classification for Nursing Practice Ver-sion 1.0 (ICNP®) and to compare the resulting representa-tions and relationships to those within SNOMED® Clinical Terms (CT). Independent reviewers reached agreement on 25 (i.e. 64%) of the 39 parent-child relationships identified via the mappings between NANDA entities. Other parent-child relationships were more questionable and are in need of fur-ther discussion. This work does not seek to promote one ter-minology over any other. Rather, this collaborative effort has the potential to mutually enhance all three terminologies involved in the study: ICNP®, SNOMED® CT and NANDA. In doing so it provides an example of the type of collaborative effort that is needed to facilitate the development of tools to support interoperability at a global level
- Published
- 2006
12. An international standard for nursing terminologies
- Author
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Hardiker, NR and Bryant, J
- Subjects
QA75 ,other ,health_and_wellbeing ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) ,RT - Abstract
The plethora of nursing terminologies in use across the world has motivated the development of an International Standard (ISO FDIS 18104) for statements describing nursing diagnoses and nursing actions. The Standard has the potential to enhance the quality of individual terminologies, to promote consistency across a range of terminologies, to facilitate re-use in terminology development and to support integration with terminologies used in other domains. The Standard represents a significant achievement. However, attention must now turn away from consensus building and towards practical application. This paper presents an overview of the Standard and argues the need for further work around tools, validation and user guidance.
- Published
- 2004
13. Requirements of tools and techniques to support the entry of structured nursing data
- Author
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Hardiker, NR, Bakken, S, Fieschi, M, Coiera, E, and Yu-Chan, JL
- Subjects
QA75 ,other ,health_and_wellbeing ,RT - Abstract
The benefits of structured data are widely accepted within the nursing informatics community. However, despite the exis-tence of structured data in the form of well-established nurs-ing terminologies, computer-based nursing record systems are yet to achieve widespread adoption and few of the poten-tial benefits have yet to be realized. In this paper we argue the need for tools and techniques to support the entry of structured nursing data into computer-based systems. In the absence of a generally accepted solution, we build on preliminary work carried out at the 2002 Nursing Terminology Summit and analyze the results of other studies in order to identify a preliminary set of requirements or desiderata for such tools and techniques. These requirements are centered on: how structured data is presented to users for selection; how to mediate between a variety of conceptual structures -terminologies, information models, user interface models and models of the clinical process; and how to reduce the considerable modeling burden through re-use of modeling constructs. Further applied research is needed with the ultimate goal of developing a general solution that will benefit nurses, other professionals and ultimately their patients.
- Published
- 2004
14. Understanding the dialogue between users and formal terminology systems
- Author
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Hardiker, NR, Coenen, A, Hovenga, E, Sensmeier, J, Smith, A, Zingo, C, Marin, HF, Marques, EP, Hovenga, Evelyn, and Goossen, William
- Subjects
QA75 ,other ,health_and_wellbeing ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) ,RT - Abstract
In response to the increasing demands placed on existing nursing terminology systems, a number of authors have argued the need for formal terminology systems and significant advances have been made. Until recently the focus has been on using such systems as ’reference terminologies’. However more recently there has been a shift in emphasis with formal terminology systems being considered for direct use in clinical applications. This approach has profound implications both for the pplications themselves and for their users; in the case of formal terminology systems it is no longer possible to ‘plug and play’. In this article the authors describe preliminary work that seeks to facilitate the mplementation and direct use of formal terminology systems in clinical applications i.e. to support the dialogue between users and formal terminology systems, and use a range of techniques to: a) expose potential difficulties and b) contribute to the development of solutions.
- Published
- 2003
15. Telehealth: The effects on clinical outcomes, cost effectiveness and the patient experience: a systematic overview of the literature
- Author
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Brettle, AJ, Brown, TM, Hardiker, NR, Radcliffe, JN, Smith, CL, Brettle, AJ, Brown, TM, Hardiker, NR, Radcliffe, JN, and Smith, CL
- Abstract
Telehealth is seen as a way of improving access to patient care for long term conditions and there is a considerable volume of published literature available. This report provides an overview of the best available evidence by summarising recent systematic reviews. It was found that there is more evidence for some conditions than others, but on the whole the trends are largely positive suggesting that telehealth is effective in: • Reducing patient mortality and hospital admissions for chronic heart failure • Reducing hospital admissions for COPD • Reducing blood pressure in hypertension, improving glycaemic control in diabetes and reducing symptoms in asthma For a wide range of other clinical outcomes and across conditions, telehealth seems to be as good as usual patient care, suggesting that it is fulfilling its promise of increasing access to services. Patients appear to be satisfied with telehealth services across a wide range of conditions, although there may be a need for considering individual patient requirements in some contexts. However there is a debate regarding the quality and nature of evaluations of telehealth systems and this cannot be ignored. Repeated systematic reviews have commented on the quality of evaluations. Future evaluations should incorporate mixed methods or a realist approach to examine what works for whom and why; this may well provide the way forward in examining in more depth the more meaningful effects of telehealthcare.
- Published
- 2013
16. Barriers and facilitators that affect public engagement with eHealth services.
- Author
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Hardiker NR, Grant MJ, Safran C, Reti S, and Marin H
- Published
- 2010
17. Connecting health and humans. Structured terminologies in clinical information systems: implementation through collaboration.
- Author
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Haskell RE, Hardiker NR, Watkins TJ, Lundberg CB, Brokel JM, Wilson ML, Saranto K, Brennan PF, Park H, Tallberg M, and Ensio A
- Published
- 2009
18. Connecting health and humans. Validation of the Impact of Health Information Technology (I-HIT) Scale: an international collaborative.
- Author
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Dykes PC, Hurley AC, Brown S, Carr R, Cashen M, Collins R, Cook R, Currie L, Docherty C, Foster J, Hardiker NR, Honey ML, Killalea R, Murphy J, Sensmeier J, Weaver C, Saranto K, Brennan PF, Park H, and Tallberg M
- Published
- 2009
19. Telehealth: The effects on clinical outcomes, cost effectiveness and the patient experience: a systematic overview of the literature
- Author
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Brettle, AJ, Brown, TM, Hardiker, NR, Radcliffe, JN, and Smith, CL
- Subjects
education ,health_and_wellbeing - Abstract
Telehealth is seen as a way of improving access to patient care for long term conditions and there is a considerable volume of published literature available. This report provides an overview of the best available evidence by summarising recent systematic reviews. \ud \ud It was found that there is more evidence for some conditions than others, but on the whole the trends are largely positive suggesting that telehealth is effective in:\ud \ud • Reducing patient mortality and hospital admissions for chronic\ud heart failure\ud • Reducing hospital admissions for COPD\ud • Reducing blood pressure in hypertension, improving glycaemic\ud control in diabetes and reducing symptoms in asthma\ud \ud For a wide range of other clinical outcomes and across conditions, telehealth seems to be as good as usual patient care, suggesting that it is fulfilling its promise of increasing access to services. \ud \ud Patients appear to be satisfied with telehealth services across a wide range of conditions, although there may be a need for considering individual patient requirements in some contexts.\ud \ud However there is a debate regarding the quality and nature of evaluations of telehealth systems and this cannot be ignored. Repeated systematic reviews have commented on the quality of evaluations. \ud \ud Future evaluations should incorporate mixed methods or a realist approach to examine what works for whom and why; this may well provide the way forward in examining in more depth the more meaningful effects of telehealthcare.
20. Shaping the future for primary care education and training project. Best practise in education and training strategies for integrated health and social care: a benchmarking tool
- Author
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Howarth, ML, Holland, Karen, and Hardiker, NR
- Subjects
health_and_wellbeing - Abstract
This tool has been designed to encourage the systematic evaluation of current services offered in your organisation in relation to education and training. The aim of the\ud benchmarking process is to enable your organisation to judge its ability in six domains: team working, communication, role awareness, personal and professional development, practice development and leadership and team working. Associated with each domain are a set of key questions you should ask about your services in relation to evidencebased ‘best practice’. ‘Best’ practice has been identified and summarised through a systematic review of the literature and through consultation with services users and professionals.
21. Structured terminologies in clinical information systems: implementation through collaboration. The 10th international congress on nursing informatics
- Author
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Haskell, R, Hardiker, NR, Watkins, T, Lundberg, C, Brokel, J, and Wilson, M
- Subjects
health_and_wellbeing ,RT - Abstract
The structure and content of the dialog with a clinical enduser is a critical aspect of clinical information system use, data capture and retrieval, and efficient and effective health care. This dialog is driven ultimately by embedded structures and processes that: a) provide functional models of clinical expression in support of professional practice, and b) determine how structured terminologies ought to populate these models. Based on diverse practical experience, this study identifies challenges to implementing structured clinical terminologies, categorizing them by both stakeholder group and application area. Collaboration across all stakeholders and across a wide range of application areas is identified as a key ingredient to successful terminology implementation and use.
22. Using Dooyeweerd's aspects to understand down to earth issues in use of medical records
- Author
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Khojah, GMA, Basden, A, and Hardiker, NR
- Abstract
This research is about experience of using electronic medical records (EMR). Chapter 1\ud introduces and justifies the main research question “How can Down To Earth issues that are\ud important in uses of EMR be studied by using Dooyeweerd's aspects?”\ud \ud Down To Earth (DTE) issues are those meaningful in daily uses of patient medical records\ud rather than those meaningful for management, ICT suppliers and academics.\ud \ud A survey of the literature (Chapter 2) reveals that high level issues rather than DTE issues are\ud mostly discussed. Even where the literature mentions DTE issues, there is a need for three\ud research activities\ud 1-reveal DTE issues to bring to light those which are significant and important\ud 2-uncover the hidden issues and the reasons for these hidden issues.\ud 3-classify the issues to identify which of these are the most significant\ud \ud After considering a range Information Systems (IS) Theories, Dooyeweerd’s aspects emerged\ud as a suitable theoretical framework to reveal, uncover and classify DTE issues (Chapter 3).\ud Interpretivism was the philosophical lens of choice given that it primarily seeks meaning and\ud insights, much in keeping with this research which looks for the meaningful issues of\ud Medical Record (MR) users and aims to gain insights into DTE issues of MR uses. So an\ud interpretive approach is used (Chapter 4). Users of MR are interviewed and Dooyeweerd’s\ud aspects are employed to analyse the transcripts and a selection of excerpts from papers\ud (Chapter 5).\ud Using the results of aspectual analysis of these texts, five quantitative and qualitative\ud comparisons are made of the following (Chapter.6)\ud \ud The comparison of hospitals\ud The comparison of paper and electronic records.\ud The comparison of nurses\ud The comparison of nationalities\ud The research has three main findings (Chapter 7).\ud 1-The meaningful DTE issues for medical record users are different from the meaningful\ud issues discussed in the literature.\ud 2-Aspectual analysis enables us to reveal, uncover and classify DTE issues that are\ud meaningful for medical record users.\ud 3- Each type of user tends to have a unique aspectual profile.\ud Chapter.8 discusses limitations of the research and how this research might contribute to\ud practice methodology and theory. The research contributes to practice of designing and\ud evaluating EMR systems. Furthermore the research could help to generate a theory of\ud medical records. Also the research offers a method for analysing DTE issues for other\ud researchers in other sectors.
23. Effective collaborative working between nurses in a multicultural setting in Saudi Arabia : barriers and solutions
- Author
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Al-Turki, RA, Hardiker, NR, and Brettle, AJ
- Abstract
Research Aim\ud The chief aim of this Saudi-based study is to provide an in-depth understanding of how nurses and nurse managers perceive culture and effective and ineffective collaborative working in a highly multicultural healthcare setting.\ud Methods\ud A qualitative case study approach was used. Eighteen semi-structured interviews were conducted to better understand how nurses and nurse managers perceive culture and how this impacts effective and ineffective collaborative working in a large hospital in Riyadh in the Kingdom of Saudi Arabia (KSA).\ud A literature review guided the development of an interview schedule, underpinned by the Purnell Competence Model (Purnell, 2002). The results of all interview data were collected, transcribed, and analysed inductively and deductively. \ud Principal Findings\ud Fourteen items in total from the in-depth semi-structured interview can help to identify the barriers and facilitators of multicultural nurses working together.\ud The Purnell Model proved its efficiency to be used for multicultural nurses’ collaboration in a Saudi hospital, but a further three themes emerged beyond the Purnell Model of Cultural Competence to better describe the current case study.\ud Conclusions \ud In order for optimal healthcare to be provided by multicultural nurses, it is essential that they collaborate effectively. This can be accomplished through appropriate practices, training, education, and research, as well as professional and self-awareness through cultural competence; publicising ethical guidelines and enacting regulation by the Ministry of Health in KSA.\ud \ud Importance and Relevance\ud This study is the first study to describe the barriers and facilitators of multicultural nurses working together in any context and specifically in a KSA context. There have been no studies into the barriers and facilitators in a Saudi context. Therefore, the academic contribution of this thesis will help to fill the gap in knowledge. A few studies have previously been conducted in Saudi Arabia, but these focus on barriers to nurse-patient relationships, rather than multicultural nurses working together. \ud The results of this thesis will inform the future multicultural nursing workforce collaboration strategies of the KSA Ministry of Health and ultimately impact on patient care through better working relationships.
24. Measurement of healthcare quality : a mixed-methods comparative study of accredited and non-accredited hospitals in Saudi Arabia
- Author
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Alasmari, A, Staniland, KM, and Hardiker, NR
- Subjects
health services administration ,education ,geographic locations ,health care economics and organizations - Abstract
Saudi Arabia was one of the first countries in the middle east to adopt an accreditation programme in its healthcare sector in forming the Central Board of Accreditation for Healthcare Institutions (CBAHI) in 2005. Even though accreditation has implied positive effects on quality of healthcare, as addressed in the literature, the literature search revealed a dearth of published studies concerned with the relationship between accreditation and improved quality of healthcare in Saudi Arabia.\ud \ud \ud The main aim of this research was to examine any potential differences in the quality of care provided by accredited and non-accredited Ministry of Health hospitals in Saudi Arabia.\ud \ud \ud A mixed-method approach was adopted with the intention of gathering both quantitative and qualitative data to answer the research objectives. Quantitative data was collected through extraction from the reports on quality of care indicators provided by the participating Ministry of Health hospitals. Qualitative data incorporated social and behavioural thinking regarding the quality of accredited and non-accredited hospitals. Qualitative data was collected through semi-structured interviews with senior hospital management of a selection of Ministry of Health hospitals.\ud \ud \ud A total of 88 MoH hospitals provided data, of which 46 were accredited and 42 were non-accredited. When quality of care indicators were compared between accredited and non-accredited hospitals, a significant difference was found in 12 separate quality of care indicators. The significant difference was that, the indicators in the accredited hospitals had a higher score, which showed that the quality of care in non-accredited hospitals was better.\ud \ud \ud Three themes emerged from the interview data: knowledge, practice, and attitude, with findings showing a similarity of perspective towards quality from both accredited and non-accredited hospital staff. Non-accredited hospital staff had a different attitude towards quality than accredited hospital staff.\ud \ud \ud Conclusion: This study clearly demonstrated the superiority of non-accredited hospitals in the overall results of the indicators under study. Moreover, the behaviour and attitude of the employee demonstrate that some of the hospitals members are not able to strike a balance between their basic duties as healthcare practitioners and their participation in quality initiatives.
25. Interpretive Description in Computerized Ontology Development: Rigour.
- Author
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Block LJ, Wong ST, Hardiker NR, Hung L, and Currie LM
- Subjects
- Humans, Vocabulary, Controlled, Biological Ontologies
- Abstract
This poster presents the use of Interpretive Description in ontology development. The methods selected attended to the need for quality and rigour.
- Published
- 2024
- Full Text
- View/download PDF
26. Reinterpreting the Nursing Record for an Electronic Context: Development Principles.
- Author
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Hardiker NR, Dowding D, Dykes PC, and Sermeus W
- Subjects
- United Kingdom, Focus Groups, United States, Documentation, Humans, Nursing Informatics, Electronic Health Records, Nursing Records
- Abstract
The full potential for electronic health record systems in facilitating a positive transformation in care, with improvements in quality and safety, has yet to be realised. There remains a need to reconceptualise the structure, content and use of the nursing component of electronic health record systems. The aim of this study was to engage and involve a diverse group of stakeholders, including nurses and electronic health record system developers, in exploring together both issues and possible new approaches to documentation that better fit with practice, and that facilitate the optimal use of recorded data. Three focus groups were held in the UK and USA, using a semi-structured interview guide, and a common reflexive approach to analysis. The findings were synthesised into themes that were further developed into a set of development principles that might be used to inform a novel electronic health record system specification to support nursing practice.
- Published
- 2024
- Full Text
- View/download PDF
27. Going Beyond Surface Language: An Exploratory Evaluation of Nursing Ontology Mappings.
- Author
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Block LJ and Hardiker NR
- Subjects
- Natural Language Processing, Humans, Terminology as Topic, Systematized Nomenclature of Medicine, Standardized Nursing Terminology
- Abstract
A range of approaches have been used to develop and evaluate terminology mapping. In seeking to enhance existing methods this exploratory feasibility study examined a small subset of existing equivalency mappings between the International Classification for Nursing Practice and SNOMED CT. To identify potential inconsistencies in allocation, comparisons were made for each concept in each equivalency mapping, through a manual review of a) compositionality and specificity of asserted and inherited relationships, and b) ancestors through to root. There were similarities and several differences across the mappings which were both structural and definitional in nature. In order to demonstrate practical utility, the approach piloted in the present study might benefit from scaling up and a degree of automation. However, the study has demonstrated it is both feasible and potentially useful when evaluating terminology mapping to go beyond the surface language of mapped terms, and to consider the deeper definitional features of the underlying concepts.
- Published
- 2024
- Full Text
- View/download PDF
28. Interactions that support older inpatients with cognitive impairments to engage with falls prevention in hospitals: An ethnographic study.
- Author
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Mcvey L, Alvarado N, Zaman H, Healey F, Todd C, Issa B, Woodcock D, Dowding D, Hardiker NR, Lynch A, Davison E, Frost T, Abdulkader J, and Randell R
- Subjects
- Humans, Aged, Hospitals, Qualitative Research, Anthropology, Cultural, Inpatients, Cognitive Dysfunction
- Abstract
Aims: To explore the nature of interactions that enable older inpatients with cognitive impairments to engage with hospital staff on falls prevention., Design: Ethnographic study., Methods: Ethnographic observations on orthopaedic and older person wards in English hospitals (251.25 h) and semi-structured qualitative interviews with 50 staff, 28 patients and three carers. Findings were analysed using a framework approach., Results: Interactions were often informal and personalised. Staff qualities that supported engagement in falls prevention included the ability to empathise and negotiate, taking patient perspectives into account. Although registered nurses had limited time for this, families/carers and other staff, including engagement workers, did so and passed information to nurses., Conclusions: Some older inpatients with cognitive impairments engaged with staff on falls prevention. Engagement enabled them to express their needs and collaborate, to an extent, on falls prevention activities. To support this, we recommend wider adoption in hospitals of engagement workers and developing the relational skills that underpin engagement in training programmes for patient-facing staff., Implications for Profession and Patient Care: Interactions that support cognitively impaired inpatients to engage in falls prevention can involve not only nurses, but also families/carers and non-nursing staff, with potential to reduce pressures on busy nurses and improve patient safety., Reporting Method: The paper adheres to EQUATOR guidelines, Standards for Reporting Qualitative Research., Patient or Public Contribution: Patient/public contributors were involved in study design, evaluation and data analysis. They co-authored this manuscript., (© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
29. Practices of falls risk assessment and prevention in acute hospital settings: a realist investigation.
- Author
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Randell R, McVey L, Wright J, Zaman H, Cheong VL, Woodcock DM, Healey F, Dowding D, Gardner P, Hardiker NR, Lynch A, Todd C, Davey C, and Alvarado N
- Subjects
- Humans, Risk Assessment, England, State Medicine, Hospitals, Aged, Accidental Falls prevention & control
- Abstract
Background: Falls are the most common safety incident reported by acute hospitals. The National Institute of Health and Care Excellence recommends multifactorial falls risk assessment and tailored interventions, but implementation is variable., Aim: To determine how and in what contexts multifactorial falls risk assessment and tailored interventions are used in acute National Health Service hospitals in England., Design: Realist review and multisite case study. (1) Systematic searches to identify stakeholders' theories, tested using empirical data from primary studies. Review of falls prevention policies of acute Trusts. (2) Theory testing and refinement through observation, staff interviews ( n = 50), patient and carer interviews ( n = 31) and record review ( n = 60)., Setting: Three Trusts, one orthopaedic and one older person ward in each., Results: Seventy-eight studies were used for theory construction and 50 for theory testing. Four theories were explored. (1) Leadership: wards had falls link practitioners but authority to allocate resources for falls prevention resided with senior nurses. (2) Shared responsibility: a key falls prevention strategy was patient supervision. This fell to nursing staff, constraining the extent to which responsibility for falls prevention could be shared. (3) Facilitation: assessments were consistently documented but workload pressures could reduce this to a tick-box exercise. Assessment items varied. While individual patient risk factors were identified, patients were categorised as high or low risk to determine who should receive supervision. (4) Patient participation: nursing staff lacked time to explain to patients their falls risks or how to prevent themselves from falling, although other staff could do so. Sensitive communication could prevent patients taking actions that increase their risk of falling., Limitations: Within the realist review, we completed synthesis for only two theories. We could not access patient records before observations, preventing assessment of whether care plans were enacted., Conclusions: (1) Leadership: There should be a clear distinction between senior nurses' roles and falls link practitioners in relation to falls prevention; (2) shared responsibility: Trusts should consider how processes and systems, including the electronic health record, can be revised to better support a multidisciplinary approach, and alternatives to patient supervision should be considered; (3) facilitation: Trusts should consider how to reduce documentation burden and avoid tick-box responses, and ensure items included in the falls risk assessment tools align with guidance. Falls risk assessment tools and falls care plans should be presented as tools to support practice, rather than something to be audited; (4) patient participation: Trusts should consider how they can ensure patients receive individualised information about risks and preventing falls and provide staff with guidance on brief but sensitive ways to talk with patients to reduce the likelihood of actions that increase their risk of falling., Future Work: (1) Development and evaluation of interventions to support multidisciplinary teams to undertake, and involve patients in, multifactorial falls risk assessment and selection and delivery of tailored interventions; (2) mixed method and economic evaluations of patient supervision; (3) evaluation of engagement support workers, volunteers and/or carers to support falls prevention. Research should include those with cognitive impairment and patients who do not speak English., Study Registration: This study is registered as PROSPERO CRD42020184458., Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129488) and is published in full in Health and Social Care Delivery Research ; Vol. 12, No. 5. See the NIHR Funding and Awards website for further award information.
- Published
- 2024
- Full Text
- View/download PDF
30. Nursing Informatics' Contribution to One Health.
- Author
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Peltonen LM, O'Connor S, Conway A, Cook R, Currie LM, Goossen W, Hardiker NR, Kinnunen UM, Ronquillo CE, Topaz M, and Rotegård AK
- Subjects
- Humans, Delivery of Health Care, Nursing Informatics, One Health, Medical Informatics
- Abstract
Objectives: To summarise contemporary knowledge in nursing informatics related to education, practice, governance and research in advancing One Health., Methods: This descriptive study combined a theoretical and an empirical approach. Published literature on recent advancements and areas of interest in nursing informatics was explored. In addition, empirical data from International Medical Informatics Association (IMIA) Nursing Informatics (NI) society reports were extracted and categorised into key areas regarding needs, established activities, issues under development and items not current., Results: A total of 1,772 references were identified through bibliographic database searches. After screening and assessment for eligibility, 146 articles were included in the review. Three topics were identified for each key area: 1) education: "building basic nursing informatics competence", "interdisciplinary and interprofessional competence" and "supporting educators competence"; 2) practice: "digital nursing and patient care", "evidence for timely issues in practice" and "patient-centred safe care"; 3) governance: "information systems in healthcare", "standardised documentation in clinical context" and "concepts and interoperability", and 4) research: "informatics literacy and competence", "leadership and management", and "electronic documentation of care". 17 reports from society members were included. The data showed overlap with the literature, but also highlighted needs for further work, including more strategies, methods and competence in nursing informatics to support One Health., Conclusions: Considering the results of this study, from the literature nursing informatics would appear to have a significant contribution to make to One Health across settings. Future work is needed for international guidelines on roles and policies as well as knowledge sharing., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
- Published
- 2023
- Full Text
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31. Mapping of Wound Infection Concepts.
- Author
-
Block LJ, Ronquillo C, Hardiker NR, Wong ST, and Currie LM
- Subjects
- Humans, Wound Infection diagnosis
- Abstract
Wound infection is a serious health care complication. Standardized clinical terminologies could be leveraged to support the early identification of wound infection. The purpose of this study was to evaluate the representation of wound infection assessment and diagnosis concepts (N=26) in SNOMED CT and ICNP, using a synthesized procedural framework. A total of 13/26 (50%) assessment and diagnosis concepts had exact matches in SNOMED CT and 2/7 (29%) diagnosis concepts had exact matches in ICNP. This study demonstrated that the source concepts were moderately well represented in SNOMED CT and ICNP; however, further work is necessary to increase the representation of diagnostic infection types. The use of the framework facilitated a systematic, transparent, and repeatable mapping process, with opportunity to extend.
- Published
- 2021
- Full Text
- View/download PDF
32. Facilitating the Implementation of Standardized Care Plans in Municipal Healthcare.
- Author
-
Østensen E, Hardiker NR, and Hellesø R
- Subjects
- Delivery of Health Care, Humans, Norway, Documentation, Nursing Records
- Abstract
Standardized care plans have the potential to enhance the quality of nursing records in terms of content and completeness, thereby better supporting workflow, easing the documentation process, facilitating continuity of care, and permitting systematic data gathering to build evidence from practice. Despite these potential benefits, there may be challenges associated with the successful adoption and use of standardized care plans in municipal healthcare information practices. Using a participatory approach, two workshops were conducted with nurses and nursing leaders (n = 11) in two Norwegian municipalities, with the objective of identifying success criteria for the adoption and integration of standardized care plans into practice. Three themes were found to describe the identified success criteria: (1) "facilitating system level support for nurses' workflow"; (2) "engaged individuals creating a culture for using standardized care plans"; and (3) "developing system level safety nets." The findings suggest success criteria that could be useful to address to facilitate the integration of standardized care plans in municipal healthcare information practice and provide useful knowledge for those working with implementation and further development of standardized care plans., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
- Full Text
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33. Use of standardized terminologies in clinical practice: A scoping review.
- Author
-
Fennelly O, Grogan L, Reed A, and Hardiker NR
- Subjects
- Delivery of Health Care, Documentation, Electronic Health Records, Health Personnel, Humans, Standardized Nursing Terminology
- Abstract
Aim: To explore the use and impact of standardized terminologies (STs) within nursing and midwifery practice., Introduction: The standardization of clinical documentation creates a potential to optimize patient care and safety. Nurses and midwives, who represent the largest proportion of the healthcare workforce worldwide, have been using nursing-specific and multidisciplinary STs within electronic health records (EHRs) for decades. However, little is known regarding ST use and impact within clinical practice., Methods: A scoping review of the literature was conducted (2019) across PubMed, CINAHL, Embase and CENTRAL in collaboration with the Five Country Nursing and Midwifery Digital Leadership Group (DLG). Identified studies (n = 3547) were reviewed against a number of agreed criterion, and data were extracted from included studies. Studies were categorized and findings were reviewed by the DLG., Results: One hundred and eighty three studies met the inclusion criteria. These were conducted across 25 different countries and in various healthcare settings, utilising mainly nursing-specific (most commonly NANDA-I, NIC, NOC and the Omaha System) and less frequently local, multidisciplinary or medical STs (e.g., ICD). Within the studies, STs were evaluated in terms of Measurement properties, Usability, Documentation quality, Patient care, Knowledge generation, and Education (pre and post registration). As well as the ST content, the impact of the ST on practice depended on the healthcare setting, patient cohort, nursing experience, provision of education and support in using the ST, and usability of EHRs., Conclusion: Employment of STs in clinical practice has the capability to improve communication, quality of care and interoperability, as well as facilitate value-based healthcare and knowledge generation. However, employment of several different STs and study heterogeneity renders it difficult to aggregate and generalize findings., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
34. Introducing standardised care plans as a new recording tool in municipal health care.
- Author
-
Østensen E, Hardiker NR, Bragstad LK, and Hellesø R
- Subjects
- Community Health Services organization & administration, Electronic Health Records organization & administration, Humans, Norway, Nurses psychology, Qualitative Research, Nursing Records standards, Patient Care Planning standards
- Abstract
Aims and Objectives: To explore how nurses use standardised care plans as a new recording tool in municipal health care, and to identify their thoughts and opinions., Background: In spite of being an important information source for nurses, care plans have repeatedly been found unsatisfactory. Structuring and coding information through standardised care plans is expected to raise the quality of recorded information, improve overviews, support evidence-based practice and facilitate data aggregation. Previous research on this topic has mostly focused on the hospital setting. There is a lack of knowledge on how standardised care plans are used as a recording tool in the municipal healthcare setting., Design: An exploratory design with a qualitative approach using three qualitative methods of data collection. The study complied with the Consolidated Criteria for Reporting Qualitative Research., Methods: Empirical data were collected in three Norwegian municipalities through participant observation and individual interviews with 17 registered nurses. In addition, we collected nursing records from 20 electronic patient records., Results: Use of standardised care plans was influenced by the nurses' consideration of their benefits. Partial implementation created an opportunity for nonuse. There was no consensus regarding how much information to include, and the standardised care plans could become both short and generic, and long and comprehensive. The themes "balancing between the old and the new care planning system," "considering the usefulness of standardised care plans as a source of information" and "balancing between overview and detail" reflect these findings., Conclusions: Nurses' use of standardised care plans was influenced by the plans' partial implementation, their views on usefulness and their personal views on the detail required in a care plan., Relevance to Clinical Practice: The structuring of nursing records is a fast-growing trend in health care. This study gives valuable information for those attempting to implement such structures in municipal health care., (© 2020 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)
- Published
- 2020
- Full Text
- View/download PDF
35. Reinterpreting the nursing record for an electronic context.
- Author
-
Hardiker NR, Dowding D, Dykes PC, and Sermeus W
- Subjects
- Data Collection, Decision Making, Electronic Health Records, Health Personnel, Humans, Nursing Records
- Abstract
Background: This article seeks to facilitate the re-imagining of nursing records purposefully within an electronic context. It questions existing approaches to nursing documentation, critically examines existing nursing record systems and identifies new requirements., Methods: A comprehensive literature review was conducted to identify themes, that might meaningfully contribute to a new approach to nursing record systems development, around four key interrelated areas - standards, decision making, abstraction and summarization, and documenting. Studies were analyzed using narrative synthesis to provide a critical analysis of the current 'state of the art', and recommendations for the future., Results: Included studies collectively described aspects of current best practice, both in terms of nursing record systems themselves, and how nurses and other health professionals contribute to and engage with those systems. A number of cross-cutting themes identified more novel approaches taken by nurses to systems development: going back to basics in determining purpose; firming up informatics foundations; nuancing or tailoring to suit different requirements; and engagement, involvement and participation., Conclusion: There is a paucity of research that specifically focuses on the nature of the electronic nursing record and its impact on patient care processes and outcomes. In addition to further research in these areas, there is a need: to reinterpret nurses as knowledge workers rather than as 'data collectors'; to agree on the application in practice of appropriate standards and terminologies; and to work together with system developers to change the ways in which data are captured and care is documented., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
36. Nurses' information practice in municipal health care-A web-like landscape.
- Author
-
Østensen E, Bragstad LK, Hardiker NR, and Hellesø R
- Subjects
- Adult, Female, Health Information Systems, Humans, Male, Middle Aged, Patient Safety, Qualitative Research, Information Dissemination, Nurses, Public Health standards
- Abstract
Aim: To uncover the characteristics of nurses' information practice in municipal health care and to address how, when and why various pieces of information are produced, shared and managed., Background: Nursing documentation in the electronic patient record has repeatedly been found unsatisfactory. Little is known about how the information practice of nurses in municipal health care actually is borne out. In order to understand why nursing documentation continues to fail at living up to the expected requirements, a better understanding of nurses' information practice is needed., Design: A qualitative observational field study. The study complied with the Consolidated Criteria for Reporting Qualitative Research., Methods: Empirical data were collected in three Norwegian municipalities through participant observations and individual interviews with 17 registered nurses on regular day shifts. The data were analysed through thematic content analysis., Results: Nurses' information practice in municipal health care can be described as complex. The complexity is reflected in four themes that emerged from the data: (1) web of information sources, (2) knowing the patient and information redundancy, (3) asynchronous information practice and (4) compensatory workarounds., Conclusions: The complex and asynchronous nature of nurses' information practice affected both how and when information was produced, recorded and shared. When available systems lacked functions the nurses wanted, they created compensatory workarounds. Although electronic patient record was an important part of their information practice, nurses in long-term care often knew their patients well, which meant that a lot of information about the patients was in their heads, and that searching for information in the electronic patient record sometimes seemed redundant., Relevance to Clinical Practice: This study provides contextual knowledge that might be valuable (a) in the further development of information systems tailored to meet nurses' information needs and (b) when studying patient safety in relation to nurses' information practice., (© 2019 John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
37. Visibility of Community Nursing Within an Administrative Health Classification System: Evaluation of Content Coverage.
- Author
-
Block LJ, Currie LM, Hardiker NR, and Strudwick G
- Subjects
- Humans, Nursing classification, World Health Organization organization & administration
- Abstract
Background: The World Health Organization is in the process of developing an international administrative classification for health called the International Classification of Health Interventions (ICHI). The purpose of ICHI is to provide a tool for supporting intervention reporting and analysis at a global level for policy development and beyond. Nurses represent the largest resource carrying out clinical interventions in any health system. With the shift in nursing care from hospital to community settings in many countries, it is important to ensure that community nursing interventions are present in any international health information system. Thus, an investigation into the extent to which community nursing interventions were covered in ICHI was needed., Objective: The objectives of this study were to examine the extent to which International Classification for Nursing Practice (ICNP) community nursing interventions were represented in the ICHI administrative classification system, to identify themes related to gaps in coverage, and to support continued advancements in understanding the complexities of knowledge representation in standardized clinical terminologies and classifications., Methods: This descriptive study used a content mapping approach in 2 phases in 2018. A total of 187 nursing intervention codes were extracted from the ICNP Community Nursing Catalogue and mapped to ICHI. In phase 1, 2 coders completed independent mapping activities. In phase 2, the 2 coders compared each list and discussed concept matches until consensus on ICNP-ICHI match and on mapping relationship was reached., Results: The initial percentage agreement between the 2 coders was 47% (n=88), but reached 100% with consensus processes. After consensus was reached, 151 (81%) of the community nursing interventions resulted in an ICHI match. A total of 36 (19%) of community nursing interventions had no match to ICHI content. A total of 100 (53%) community nursing interventions resulted in a broader ICHI code, 9 (5%) resulted in a narrower ICHI code, and 42 (23%) were considered equivalent. ICNP concepts that were not represented in ICHI were thematically grouped into the categories family and caregivers, death and dying, and case management., Conclusions: Overall, the content mapping yielded similar results to other content mapping studies in nursing. However, it also found areas of missing concept coverage, difficulties with interterminology mapping, and further need to develop mapping methods., (©Lorraine J Block, Leanne M Currie, Nicholas R Hardiker, Gillian Strudwick. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.06.2019.)
- Published
- 2019
- Full Text
- View/download PDF
38. Identifying Principles for the Construction of an Ontology-Based Knowledge Base: A Case Study Approach.
- Author
-
Jing X, Hardiker NR, Kay S, and Gao Y
- Abstract
Background: Ontologies are key enabling technologies for the Semantic Web. The Web Ontology Language (OWL) is a semantic markup language for publishing and sharing ontologies., Objective: The supply of customizable, computable, and formally represented molecular genetics information and health information, via electronic health record (EHR) interfaces, can play a critical role in achieving precision medicine. In this study, we used cystic fibrosis as an example to build an Ontology-based Knowledge Base prototype on Cystic Fibrobis (OntoKBCF) to supply such information via an EHR prototype. In addition, we elaborate on the construction and representation principles, approaches, applications, and representation challenges that we faced in the construction of OntoKBCF. The principles and approaches can be referenced and applied in constructing other ontology-based domain knowledge bases., Methods: First, we defined the scope of OntoKBCF according to possible clinical information needs about cystic fibrosis on both a molecular level and a clinical phenotype level. We then selected the knowledge sources to be represented in OntoKBCF. We utilized top-to-bottom content analysis and bottom-up construction to build OntoKBCF. Protégé-OWL was used to construct OntoKBCF. The construction principles included (1) to use existing basic terms as much as possible; (2) to use intersection and combination in representations; (3) to represent as many different types of facts as possible; and (4) to provide 2-5 examples for each type. HermiT 1.3.8.413 within Protégé-5.1.0 was used to check the consistency of OntoKBCF., Results: OntoKBCF was constructed successfully, with the inclusion of 408 classes, 35 properties, and 113 equivalent classes. OntoKBCF includes both atomic concepts (such as amino acid) and complex concepts (such as "adolescent female cystic fibrosis patient") and their descriptions. We demonstrated that OntoKBCF could make customizable molecular and health information available automatically and usable via an EHR prototype. The main challenges include the provision of a more comprehensive account of different patient groups as well as the representation of uncertain knowledge, ambiguous concepts, and negative statements and more complicated and detailed molecular mechanisms or pathway information about cystic fibrosis., Conclusions: Although cystic fibrosis is just one example, based on the current structure of OntoKBCF, it should be relatively straightforward to extend the prototype to cover different topics. Moreover, the principles underpinning its development could be reused for building alternative human monogenetic diseases knowledge bases., (©Xia Jing, Nicholas R Hardiker, Stephen Kay, Yongsheng Gao. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 21.12.2018.)
- Published
- 2018
- Full Text
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39. WITHDRAWN: Nursing record systems: effects on nursing practice and healthcare outcomes.
- Author
-
Urquhart C, Currell R, Grant MJ, and Hardiker NR
- Subjects
- Humans, Professional Practice, Randomized Controlled Trials as Topic, Nursing, Nursing Records, Outcome and Process Assessment, Health Care
- Abstract
Background: A nursing record system is the record of care that was planned or given to individual patients and clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice., Objectives: To assess the effects of nursing record systems on nursing practice and patient outcomes., Search Methods: For the original version of this review in 2000, and updates in 2003 and 2008, we searched: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE, EMBASE, CINAHL, BNI, ISI Web of Knowledge, and ASLIB Index of Theses. We also handsearched: Computers, Informatics, Nursing (Computers in Nursing); Information Technology in Nursing; and the Journal of Nursing Administration. For this update, searches can be considered complete until the end of 2007. We checked reference lists of retrieved articles and other related reviews., Selection Criteria: Randomised controlled trials (RCTs), controlled before and after studies, and interrupted time series comparing one kind of nursing record system with another in hospital, community or primary care settings. The participants were qualified nurses, students or healthcare assistants working under the direction of a qualified nurse, and patients receiving care recorded or planned using nursing record systems., Data Collection and Analysis: Two review authors (in two pairs) independently assessed trial quality and extracted data., Main Results: We included nine trials (eight RCTs, one controlled before and after study) involving 1846 people. The studies that evaluated nursing record systems focusing on relatively discrete and focused problems, for example effective pain management in children, empowering pregnant women and parents, reducing loss of notes, reducing time spent on data entry of test results, reducing transcription errors, and reducing the number of pieces of paper in a record, all demonstrated some degree of success in achieving the desired results. Studies of nursing care planning systems and total nurse records demonstrated uncertain or equivocal results., Authors' Conclusions: We found some limited evidence of effects on practice attributable to changes in record systems. It is clear from the literature that it is possible to set up the randomised trials or other quasi-experimental designs needed to produce evidence for practice. Qualitative nursing research to explore the relationship between practice and information use could be used as a precursor to the design and testing of nursing information systems.
- Published
- 2018
- Full Text
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40. ICNP.
- Author
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Østensen E, Bragstad LK, Hardiker NR, and Hellesø R
- Subjects
- Humans, Norway, Terminology as Topic, Vocabulary, Controlled, Electronic Health Records, Standardized Nursing Terminology
- Abstract
The International Classification for Nursing Practice (ICNP
® ) terminology was in 2016 implemented in three Norwegian municipalities through the introduction of five standardized care plans in the Electronic Patient Record (EPR) system. This poster provides results from an exploratory, qualitative study, investigating how nurses in these municipalities applied the care plans into their daily informational work.- Published
- 2018
41. Embedding Nursing Interventions into the World Health Organization's International Classification of Health Interventions (ICHI).
- Author
-
Fortune N, Hardiker NR, and Strudwick G
- Subjects
- Humans, World Health Organization, Nursing Informatics, Nursing Process classification, Vocabulary, Controlled
- Abstract
Objective: The International Classification of Health Interventions, currently being developed, seeks to span all sectors of the health system. Our objective was to test the draft classification's coverage of interventions commonly delivered by nurses, and propose changes to improve the utility and reliability of the classification for aggregating and analyzing data on nursing interventions., Materials and Methods: A 2-phase content mapping method was used: (1) three coders independently applied the classification to a dataset comprising 100 high-frequency nursing interventions; (2) the coders reached consensus for each intervention and identified reasons for initial discrepancies., Results: A consensus code was found for 80 of the 100 source terms; for 34% of these, the code was semantically equivalent to the source term, and for 64% it was broader. Issues that contributed to discrepancies in Phase 1 coding results included concepts in source terms not captured by the classification, ambiguities in source terms, and uncertainty of semantic matching between "action" concepts in source terms and classification codes., Discussion: While the classification generally provides good coverage of nursing interventions, there remain a number of content gaps and granularity issues. Further development of definitions and coding guidance is needed to ensure consistency of application., Conclusion: This study has produced a set of proposals concerning changes needed to improve the classification. The novel method described here will inform future health terminology and classification content coverage studies., (© The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com)
- Published
- 2017
- Full Text
- View/download PDF
42. The use of computerized clinical decision support systems in emergency care: a substantive review of the literature.
- Author
-
Bennett P and Hardiker NR
- Subjects
- Decision Making, Computer-Assisted, Emergency Service, Hospital, Humans, Decision Support Systems, Clinical, Emergency Medical Services
- Abstract
Objectives: : This paper provides a substantive review of international literature evaluating the impact of computerized clinical decision support systems (CCDSSs) on the care of emergency department (ED) patients., Material and Methods: : A literature search was conducted using Medline, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase electronic resources, and gray literature. Studies were selected if they compared the use of a CCDSS with usual care in a face-to-face clinical interaction in an ED., Results: : Of the 23 studies included, approximately half demonstrated a statistically significant positive impact on aspects of clinical care with the use of CCDSSs. The remaining studies showed small improvements, mainly around documentation. However, the methodological quality of the studies was poor, with few or no controls to mitigate against confounding variables. The risk of bias was high in all but 6 studies., Discussion: : The ED environment is complex and does not lend itself to robust quantitative designs such as randomized controlled trials. The quality of the research in ∼75% of the studies was poor, and therefore conclusions cannot be drawn from these results. However, the studies with a more robust design show evidence of the positive impact of CCDSSs on ED patient care., Conclusion: This is the first review to consider the role of CCDSSs in emergency care and expose the research in this area. The role of CCDSSs in emergency care may provide some solutions to the current challenges in EDs, but further high-quality research is needed to better understand what technological solutions can offer clinicians and patients., (© The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com)
- Published
- 2017
- Full Text
- View/download PDF
43. Understanding the use of standardized nursing terminology and classification systems in published research: A case study using the International Classification for Nursing Practice(®).
- Author
-
Strudwick G and Hardiker NR
- Subjects
- Humans, Publishing, Research, Standardized Nursing Terminology
- Abstract
Background: In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown., Purpose: This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study., Methods: A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature., Results: Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice., Conclusions: Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
44. Harmonizing Nursing Terminologies.
- Author
-
Coenen A, Paese F, Saba V, Jansen K, Hardiker NR, and Kim TY
- Subjects
- Internationality, Machine Learning, Practice Patterns, Nurses' classification, Natural Language Processing, Nursing Care classification, Nursing Process classification, Nursing Records classification, Terminology as Topic, Vocabulary, Controlled
- Abstract
In this paper, the authors report on a study aimed at harmonising two nursing terminologies, the Clinical Care Classification (CCC) and the International Classification for Nursing Practice (ICNP®). As the electronic health record evolves and the need for interoperability extends beyond local and national borders, a degree of standardisation across healthcare terminologies become essential. Harmonising across terminologies results in a) increased consensus relating to domain content and b) improvements in the terminologies involved. Findings from this study suggest that there is much overlap of content in nursing terminologies. The continued harmonisation between nursing terminologies and other healthcare terminologies are recommended to achieve international interoperability.
- Published
- 2015
45. Toward a Global eHealth Observatory for Nursing.
- Author
-
Bartz CC, Hardiker NR, and Coenen A
- Subjects
- Databases, Factual, Models, Organizational, Education, Nursing organization & administration, Health Information Systems organization & administration, Internet organization & administration, Nursing classification, Nursing organization & administration, Telemedicine organization & administration
- Abstract
This poster summarizes a review of existing health observatories and proposes a new entity for nursing. A nursing eHealth observatory would be an authoritative and respected source of eHealth information that would support nursing decision-making and policy development and add to the body of knowledge about professional nursing and client care outcomes.
- Published
- 2015
46. Integration of an OWL-DL knowledge base with an EHR prototype and providing customized information.
- Author
-
Jing X, Kay S, Marley T, and Hardiker NR
- Subjects
- Humans, Information Management, Software, Electronic Health Records, Knowledge Bases, Programming Languages, Systems Integration
- Abstract
When clinicians use electronic health record (EHR) systems, their ability to obtain general knowledge is often an important contribution to their ability to make more informed decisions. In this paper we describe a method by which an external, formal representation of clinical and molecular genetic knowledge can be integrated into an EHR such that customized knowledge can be delivered to clinicians in a context-appropriate manner.Web Ontology Language-Description Logic (OWL-DL) is a formal knowledge representation language that is widely used for creating, organizing and managing biomedical knowledge through the use of explicit definitions, consistent structure and a computer-processable format, particularly in biomedical fields. In this paper we describe: 1) integration of an OWL-DL knowledge base with a standards-based EHR prototype, 2) presentation of customized information from the knowledge base via the EHR interface, and 3) lessons learned via the process. The integration was achieved through a combination of manual and automatic methods. Our method has advantages for scaling up to and maintaining knowledge bases of any size, with the goal of assisting clinicians and other EHR users in making better informed health care decisions.
- Published
- 2014
- Full Text
- View/download PDF
47. Challenges associated with the secondary use of nursing data.
- Author
-
Hardiker NR, Sermeus W, and Jansen K
- Subjects
- Belgium, Information Storage and Retrieval standards, Information Storage and Retrieval statistics & numerical data, Medical Record Linkage standards, Nursing Assessment classification, Nursing Assessment statistics & numerical data, Nursing Care classification, Practice Guidelines as Topic, Terminology as Topic
- Abstract
There is a prevailing 'collect once, use many times' view of clinical data and its secondary use. This study challenges this view through an assessment of the degree to which the International Classification for Nursing Practice (ICNP) might be used to provide raw data for the Belgian Nursing Minimum Data Set (B-NMDS). A mapping exercise identified exact matches between ICNP and B-NMDS for just 8% of B-NMDS care descriptions; no matches at all for 23%; possible broader matches in ICNP for 55%; possible narrower matches for 8%; and a possible broader and narrower match for 1%. Refining ICNP content and developing and implementing purposive data sets or catalogues that accommodate both ICNP concepts and B-NMDS care descriptions would lay the foundations for the potential re-use of primary ICNP-encoded data in populating the B-NMDS. One unexpected result of the study was to re-affirm the utility of ICNP as a reference terminology.
- Published
- 2014
48. Nursing at the forefront of eHealth.
- Author
-
Hardiker NR, Coenen A, and Bartz CC
- Subjects
- International Council of Nurses, Nursing trends, Telemedicine trends
- Published
- 2012
- Full Text
- View/download PDF
49. Advancing nursing practice through social media: a global perspective.
- Author
-
Barry J and Hardiker NR
- Subjects
- Confidentiality, Governing Board, Humans, Organizational Policy, Privacy, Professional Misconduct, Risk, Social Change, Nursing organization & administration, Nursing trends, Nursing Informatics organization & administration, Nursing Informatics trends, Risk Management, Social Media
- Abstract
Social media has been used globally as a key vehicle for communication. As members of an innovative profession, many nurses have embraced social media and are actively utilizing its potential to enhance practice and improve health. The ubiquity of the Internet provides social media with the potential to improve both access to health information and services and equity in health care. Thus there are a number of successful nurse-led initiatives. However, the open and democratising nature of social media creates a number of potential risks, both individual and organisational. This article considers the use of social media within nursing from a global perspective, including discussion of policy and guidance documents. The impact of social media on both healthcare consumers and nurses is reviewed, followed by discussion of selected risks associated with social media. To help nurses make the most of social media tools and avoid potential pitfalls, the article conclusion suggests implications appropriate for global level practice based on available published guidance.
- Published
- 2012
50. Guidance on Evaluating Options for Representing Clinical Data within Health Information Systems.
- Author
-
Hardiker NR and Hynes B
- Abstract
The health information system PlunketPlus is a clinical initiative of Plunket (the Royal New Zealand Plunket Society) with a goal of further improving the health outcomes for children in New Zealand. The success of PlunketPlus depends heavily on how data is represented within the system. The purpose of the study described in this paper was to use PlunketPlus as a case study to inform the development of guidance on evaluating options for representing clinical data within health information systems, with a particular focus on automating existing informational processes. It has been possible to take some of the lessons learned to inform the development of initial more generic guidance that might be applicable across a range of domains. This paper concludes with a description of how Plunket applied the guidance as part of the development of PlunketPlus.
- Published
- 2012
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