Modeling the distribution of Nursing Effort using structured Labor and Delivery documentation

Open issues in intelligent personal health record--an updated status report for 2012

To improve the capability and usability of the personal health record (PHR) as a tool to empower consumers in the management of their own health, we have proposed the concept of an intelligent PHR (iPHR) and built a prototype iPHR system with four functions. These four functions use various health knowledge and computer science techniques to automatically provide users with personalized healthcare information to facilitate their well-being. This paper discusses several open issues in iPHR, including two enhancements to an existing function and two potential new functions. The two enhancements are for automatically compiling relevant self-care activities for each health issue and automatically identifying contraindicated self-care activities, respectively. One potential new function is personalized search for individual healthcare providers. Another potential new function is personalized local search for health-related services to help maintain patients in their homes. We include some preliminary thoughts on how to address these open issues with the hope to stimulate future research work on iPHR.

Consequences of nursing procedures measurement on job satisfaction

BACKGROUND

Job satisfaction among nurses has consequences on the quality of nursing care and accompanying organizational commitments. Nursing procedure measurement (NPM) is one of the essential parts of the performance-oriented system. This research was performed in order to determining the job satisfaction rate in selected wards of Baqiyatallah (a. s.) Hospital prior and following the NPM.

MATERIALS AND METHODS

An interventional research technique designed with an evaluation study approach in which job satisfaction was measured before and after NPM within 2 months in selected wards with census sampling procedure. The questionnaire contained two major parts; demographic data and questions regarding job satisfaction, salary, and fringe benefits. Data analyzed with SPSS version 13.

RESULTS

Statistical evaluation did not reveal significant difference between demographic data and satisfaction and/or dissatisfaction of nurses (before and after nursing procedures measurement). Following NPM, the rate of salary and benefits dissatisfaction decreased up to 5% and the rate of satisfaction increased about 1.5%, however the statistical tests did not reveal a significant difference. Subsequent to NPM, the rate of job value increased (P = 0.019), whereas the rate of job comfort decreased (P = 0.033) significantly.

CONCLUSIONS

Measuring procedures do not affect the job satisfaction of ward staff or their salary and benefits. Therefore, it is suggested that the satisfaction measurement compute following nurses' salary and therefore benefits adjusted based on NPM. This is our suggested approach.

Patient-level analysis of outcomes using structured labor and delivery data

This paper presents methods for identifying and analyzing associations among nursing care processes, patient attributes, and patient outcomes using unit-level and patient-level representations of care derived from computerized nurse documentation. The retrospective, descriptive analysis included documented nursing events for 900 Labor and Delivery patients at three hospitals over the 2-month period of January and February 2006. Two models were used to produce quantified measurements of nursing care received by each patient. The first model considered only the hourly census of nurses and patients. The second model considered the size of nurses' patient loads as represented by computerized nurse-entered documentation. Significant relationships were identified between durations of labor and nursing care scores generated by the second model. In addition to the clinical associations identified, the study demonstrated an approach with global application for representing the amount of nursing care received at the individual patient level in analyses of patient outcomes.

Generating nurse profiles from computerized labor and delivery documentation

This paper presents methods for generating nurse profiles using computerized documentation. NuProGen (Nurse Profile Generator), a custom-built knowledge discovery tool, enabled profile generation by calculating the numbers of various complicated patient cases (including high body mass index, bleeding, and multiple gestation) managed by each of 91 Labor and Delivery nurses at a single Intermountain Healthcare facility during the 3-month study period of January through March 2007. The tool identified patterns of documentation recorded by each nurse, as well as nursing care patterns associated with each of the three patient conditions examined in the study. Individual nurse profiles supported identification of expert and novice nurses corresponding to the management of specific conditions. A discussion of the benefits provided by available nurse profile data is also presented.