A Theory-Based Approach for Identifying Nurse and Team Member Contributions in the Electronic Health Record

Electronic health records in nursing from 2000 to 2020: A bibliometric analysis

Background

Electronic health records (EHR) is the longitudinal data generated by patients in medical institutions and recorded by electronic medical information systems in the form of digital, which is also the most widespread application of big data in medicine. The purpose of this study was to explore the application of electronic health records in the field of nursing and determine the current research status and hotspots.

Methods

A bibliometric analysis of electronic health records in nursing was undertaken from 2000 to 2020. The literature comes from Web of Science Core Collection database. We used CiteSpace (version 5.7 R5; Drexel University), which is a Java-based software that especially visualized collaborative networks and research topics.

Results

A total of 2616 publications were included in the study. We found that publications increased year by year. The Journal of American Medical Informatics Association (n = 921) is the most cited. The United States (n = 1,738) has the most publications in this field. University Penn (n = 63) is the institution with the most publications. There is no influential cooperation network among the authors, of which Bates, David W (n = 12) have the largest number of publications. The relevant publications also focus on the fields of health care science and services, and medical informatics. In keywords, EHR, long-term care, mobile application, inpatient falls, and advance care planning has been researching hotspots in recent years.

Conclusion

With the popularization of information systems, the publications of EHR in the nursing field have increased year by year. This study provides the basic structure, potential cooperation, and research trends of EHR in the field of nursing from 2000 to 2020, and provides a reference for nurses to effectively use EHR to help clinical work or scientific researchers explore the potential significances of EHR.

A Theoretical Framework of Home-Based Professional Nursing Practice

The purpose of this article is to introduce a descriptive middle-range theoretical framework unique to professional nursing practice provided in the patient's home. The variety of care models provided in the home, ranging from nonskilled home maintenance service to hospital-at-home programs, reinforces the need to clearly define and describe home-based professional nursing practice. This framework includes six concepts (primacy of home, patient authority, patient self-management, caregivers as collaborators, interprofessional clinical team collaboration, nurse autonomy), and four relational statements of the concepts that describe the experience of patients in their homes and home-based providers. The four theoretical statements are: (1) The patient's beliefs, habits, and self-management actions in the home are shaped by the meaning of home and the physical home environment. (2) The patient has ultimate decision-making control and authority over his/her own health-related behaviors in the home. (3) Home-based care includes interprofessional teams to provide holistic care and maximize self-management ability. (4) The home-based nurse is autonomous when working in the home with the patient/caregiver and has primary responsibility for holistic assessment and intervention. Knowledge of this theoretical framework can help nurses maintain the integrity and purpose of the professional nurse's role in home-based care as well as provide guidance for nursing education and organizational structures. Recommendations for research to test and validate the framework are provided.