267 research outputs found
A nursing clinical information system for the assessment of the complexity of care
No full textBackground. The complexity of care can be described through a clinical nursing information system, in particular through the Professional Assessment Instrument -PAI-, encoding each health care activity in time units and analysing the relationship of observed time to patient characteristics in relation to the functional models of care needs. Design. Observational study Methods. Data were collected for 11 months in 2016-17 in four inpatient units of an Italian hospital using the Professional Assessment Instrument, and a survey grid to measure the time of the nursing activities delivered. All activities with a frequency of 20 or more have been included. The Work Sampling technique was used for time-tracking. Results. The sample included 2765 nursing activities. The mean times for each care activity were compared showing significant differences. A statistically significant correlation (Sperman's correlation coefficient) was observed both between the observed time and the level of illness severity and between time and functional models. Conclusion. Patient complexity, both in terms of illness severity and level of dependence, can be coded through a clinical nursing information system. This facilitates the classification and measurement of nursing care delivered, which includes the entire care process
Natural language processing and String Metric-assisted Assessment of Semantic Heterogeneity method for capturing and standardizing unstructured nursing activities in a hospital setting: a retrospective study
No full textBackground: Nurses record data in electronic health records (EHRs) using different terminologies and coding systems. The purpose of this study was to identify unstructured free-text nursing activities recorded by nurses in EHRs with natural language processing (NLP) techniques and to map these nursing activities into standard nursing activities using the SMASH method.
Study design: A retrospective study using NLP techniques with a unidirectional mapping strategy called SMASH.
Methods: The unstructured free-text nursing activities recorded in the Medicine, Neurology and Gastroenterology inpatient units of the Agostino Gemelli IRCCS University Hospital Foundation, Rome, Italy were collected for 6 months in 2018. Data were analyzed by three phases: a) text summarization component with NLP techniques, b) a consensus analysis by four experts to detect the category of word stems, and c) cross-mapping with SMASH. The SMASH method calculated the string comparison, similarity and distance of words through the Levenshtein distance (LD), Jaro-Winker distance and the cross-mapping's cut-offs: map [0.80-1.00] with < 13 LD, partial-map [0.50-0.79] with <13 LD and no map [0.0-0.49] with >13 LD.
Results: During the study period, 491 patient records were assessed. 548 different unstructured free-text nursing activities were recorded by nurses. 451 unstructured free-text nursing activities (82.3%) were mapped to standard PAI nursing activities, 47 (8.7%) were partial mapped, while 50 (9.0%) were not mapped. This automated mapping yielded recall of 0.95%, precision of 0.94%, accuracy of 0.91%, F-measure of 0.96. The F-measure indicates good reliability of this automated procedure in cross-mapping.
Conclusions: Lexical similarities between unstructured free-text nursing activities and standard nursing activities were found, NLP with the SMASH method is a feasible approach to extract data related to nursing concepts that are not recorded through structured data entry
Development and implementation of pediatric and neonatal nursing information system in a hospital setting: the pediatric PAI
No full textThe Professional Assessment Instrument (PAI) is a clinical nursing information system used in the adult inpatient units of the A. Gemelli university hospital in Rome (Italy). The PAI allows for the systematic collection of nursing care data in order to improve the quality of care. So far, few clinical nursing information systems have been developed in the neonatal and pediatric care setting. The aim of this study is to describe the development and implementation of a clinical nursing information system (PAIped) for the neonatal and pediatric care setting.
Methods: The Patient-and Family-Centered Care model was used to develop the contents of the PAIped. A web platform application was developed for the PAIped. The standard nursing terminology Clinical Care Classification System was used. A decisionmaking support system was developed within the PAIped to support nurses in making diagnoses and in selecting the most appropriate nursing interventions.
Results: A clinical nursing information system using a standard nursing terminology was developed in the pediatric and neonatal care setting. After a test phase, the PAIped was implemented in all the pediatric and neonatal inpatient units of the A. Gemelli university hospital.
Conclusion: The development and implementation of the PAIped in the A. Gemelli university hospital allowed the monitoring of nursing care processes and accurate nursing documentation
Case management of patients with chronic cutaneous ulcers: Care pathways and collaborative problem solving (Article) [Gestione manageriale del paziente portatore di ulcere cutanee croniche: I percorsi clinico assistenziali nell'ottica del problem solving]
No full text[Educational interventions in patients with heart failure: a review of the literature]
No full textPatient education is recognized as a central component of heart failure care and reduces hospital readmissions. Nurses have an important role in providing patient education and modifying self-care behaviors. The aim of this article is to examine characteristics of educational interventions for heart failure patients, their measured outcomes and the role of nurses in providing education. We conducted a literature review of the last 10 years and considered 30 articles. Multisession motivational interventions, repeated over time and with different follow-up interventions seem to produce the best results. However, some aspects remain controversial
HEALTH LITERACY AS A MEASURE OF NURSING COMPLEXITY OF CARE IN A DEPARTMENT OF CARDIOVASCULAR MEDICINE
No full text
Il Self-care nei pazienti con scompenso cardiaco riduce le ri-ospedalizzazioni
No full textPREMESSA E SCOPI:
Lo Scompenso Cardiaco è una patologia cronica con un rilevante impatto sociale ed economico. In Italia l’1,1% della popolazione è affetta da SC ma questa percentuale è destinata ad aumentare a causa dell’invecchiamento della popolazione. Diversi studi internazionali hanno dimostrato che se i pazienti con SC effettuano un efficace self-care, si riducono i loro accessi in pronto soccorso come pure il numero di ricoveri impropri. Questo fenomeno è ancora poco esplorato in Italia.
Lo scopo di questo studio è stato di indagare la relazione tra abilità di self-care nel paziente con SC, deterioramento cognitivo, comorbilità e frequenza dei ricoveri ospedalieri nell’ultimo anno.
MATERIALI E METODI:
E’ stato utilizzato un disegno descrittivo retrospettivo per studiare 659 pazienti seguiti in 16 ambulatori di Cardiologia distribuiti in varie regioni italiane. Sono stati esclusi dallo studio i pazienti che negli ultimi tre mesi avevano avuto una Sindrome Coronarica Acuta. Ai pazienti veniva chiesto di riferire la frequenza dei ricoveri ospedalieri dell’ultimo anno e poi venivano studiati con i seguenti strumenti: Self-Care of Heart Failure Index (SCHFI) (che misura tre dimensioni del self-care: self-care maintenance, self-care management e self-care confidence), Mini Mental State Examination, Charlson Comorbidity Index, Barthel Index. Inoltre venivano raccolti anche dati socio demografici, la classe NYHA, e la durata della malattia.
RISULTATI:
I pazienti avevano un’età media di 72,63 anni (SD 11,70) ed erano equamente distribuiti nelle quattro classi NYHA. I punteggi del SCHFI andavano da 55 a 63 su 100 nelle tre scale (il punteggio ideale è > 70). Applicando un modello di regressione statistica con le variabili studiate solo la self-care maintenance e la comorbilità erano predittori della frequenza dei ricoveri ospedalieri. Inoltre, confrontando i pazienti che avevano avuto almeno un ricovero nell’ultimo anno con quelli che non non erano mai stati ricoverati, questi ultimi avevano livelli significativamente più alti alle tre scale del self-care rispetto ai primi (p<0.02).
CONCLUSIONI: I risultati di questo studio confermano come sia importante educare il paziente con SC ad un efficace self-care che si dimostra, insieme alla comorbilità essere un predittore dei ricoveri ospedalieri
Gli interventi educativi per i pazienti con scompenso cardiaco: una sintesi della letteratura
No full textPatient education is recognized as a central component of heart failure care and reduces hospital readmissions. Nurses have an important role in providing patient education and modifying self-care behaviors. The aim of this article is to examine characteristics of educational interventions for heart failure patients, their measured outcomes and the role of nurses in providing education. We conducted a literature review of the last 10 years and considered 30 articles. Multisession motivational interventions, repeated over time and with different follow-up interventions seem to produce the best results. However, some aspects remain controversial
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