Omaha Systém Dotaz Zobrazit nápovědu
2nd ed. reprinted 484 s.
Hepatopankreatobiliární nemoci patří k častým onemocněním v gastroenterologii. Problematika implementace standardizované terminologie Omaha systému v České republice nebyla dosud zkoumána. Cílem výzkumu bylo identifikovat problémy, intervence a výsledky klientů s vybraným gastroenterologickým onemocněním podle Omaha systému v klinické praxi ošetřovatelství. Výzkum byl realizován pomocí kvantitativní metody za použití formuláře dokumentace Omaha systému se souhlasem autorky. Výzkumný vzorek tvořilo 23 klientů s hepatopankreatobiliárním onemocněním. Počet dokumentovaných potíží dle schématu klasifikace problémů byl od 3 do 10, z čehož 10 % v environmentální doméně, 20 % v psychosociální doméně, 40 % ve fyziologické doméně a 30 % v doméně chování ve vztahu ke zdraví. Celkem bylo realizováno 274 intervencí. Průměrný počet intervencí byl 11,9 u jednoho klienta. Při mapování propojení problémů a intervencí bylo nejvíce intervencí z kategorie léčba a terapeutické postupy (35,4 %) a surveillance (31,8 %). Poměrně nízké zastoupení naznačují intervence v kategorii edukace, vedení a poradenství (18,2 %) a case management (14,6 %). Intervence v kategorii léčba a terapeutické postupy dominovaly u problému bolest (35,5 %), trávení – hydratace (45,3 %), kůže (93,8 %) a krevní oběh (62,9 %). Case management se uplatňoval u problému užívání látek (50 %) a u problému výživa (31,7 %). Při porovnání iniciálních hodnot výsledků problémů s finálními hodnotami bylo výrazné zlepšení vědomostí a stavu u jednotlivých problémů. Výsledky výzkumu prezentují pilotní zkušenosti s uplatněním Omaha systému u vybrané komunity klientů. Nejčastější problémy klientů s hepatopankreatobiliárním onemocněním dle schématu klasifikace problémů Omaha systému byly z fyzilogické domény a z domény chování ve vztahu ke zdraví. Problémy byly častěji propojeny s intervencemi z kategorie léčba a terapeutické postupy a surveillance, nižší frekvence byla zaznamenána u intervencí z kategorie edukace, vedení a poradenství a case management. Použitím škály pro hodnocení výsledků problémů bylo zjištěno zlepšení vědomostí a stavu u jednotlivých problémů. Pro budoucí výzkum doporučujeme ověření složek Omaha systému na větším počtu respondentů.
Hepatic pancreatic biliary diseases are very common in gastroenterology. The issue of implementing the standardized terminology of the Omaha system in the Czech Republic has not been studied so far. The goal of the study was to identify the problems, interventions and the results of clients with a chosen gastroenterology problem according to the Omaha system in clinical nursing practice. The study used the quantitative method of documentation forms of the Omaha system with the author’s permission. The studied sample group was composed of 23 clients who had a hepatic pancreatic biliary disease. The number of documented difficulties according to the Problem Classification Scheme was from 3 to 10, where 10% covered the environmental domain, 20% covered the psychological domain, 40% covered the physiological domain and 30% covered the domain of health-related behaviour. In total, there were 274 interventions. The average number of interventions was 11.9 per client. While mapping the interconnections of problems and interventions, most interventions occurred in the category of treatments and procedures (35.4%) and surveillance (31.8%). A very low number of interventions occurred in the category of teaching, guidance, and counseling (18.2%), and case management (14.6%). The intervention in treatments and procedures category dominated in pain problem (35.5%), digestion – hydration (45.3%), skin (93.8%) and circulation (62.9%). Case management was used in substance use (50%) and nutrition (31.7%). After comparing the initial results to the final results, there was significant improvement in the knowledge and status regarding individual problems. The results of the study present the pilot experience with the implementation of the Omaha system in a selected group of clients. The most common problems of clients with hepatic pancreatic biliary disease were in the physiological domain and the health-related behaviour domain according to the Problem Classification Scheme of the Omaha system. More frequently, the problems were associated with the interventions in the treatments and procedures and surveillance categories. The interventions were less frequent in teaching, guidance, and counseling and case management. Using a Problem Rating Scale for Outcomes, an improvement in knowledge and status in individual problems was found. For future studies, we recommend verifying the components of the Omaha system using a larger number of respondents.
- Klíčová slova
- Hepatopankreatobiliární nemoci, hodnotící škály, kvalita ošetřovatelské péče, Omaha systém, schéma klasifikace problémů, schéma intervencí, plán ošetřovatelské péče,
- MeSH
- gastroenterologie MeSH
- hodnotící studie jako téma MeSH
- nemoci jater MeSH
- nemoci slinivky břišní MeSH
- nemoci žlučových cest MeSH
- ošetřovatelská péče MeSH
- referenční standardy MeSH
Objectives: Nurse coaching is an important strategy for improving the health of populations. Effective interventions for nurse coaching (NC) practice, fair value outcome measurements, and standardization of terms have yet to be determined. As healthcare systems adopt electronic medical records and as nurse coaching practice evolves, it is important to capture and identify NC interventions. The long-term goal is to improve patient-centered practice by using standardized interface terminology and to examine the feasibility of using the Omaha System to represent NC practice. The three aims were to evaluate content validity of NC case studies, test accuracy of NC graduates identifying Omaha System terms for NC interventions, and explore the feasibility of analyzing NC case study data. Design: This survey research evaluated NC case studies that were developed for this study by the first author and mapped to Omaha System intervention terms. Sample: Surveys were emailed to 400 graduates of two nurse coach education programs. Nurse Coaches self-reported little to no experience using standardized terminologies for documentation. Measures: The Omaha System was used to describe the interventions found in the NC case studies. Results: Across the three case studies, 95.7% of NCs agreed that the case studies were realistic, and 89.3% agreed that they would use similar interventions; NCs identified Omaha System interventions for the case studies accurately 84.3% of the time, and feasibility of analyzing NC practice data was demonstrated through use of case study data in aggregate. Conclusion: The Omaha System has potential for use as a NC documentation tool and should be considered for development of a standardized, evidence-based guideline for NC practice.
- Klíčová slova
- klasifikační systémy, recenzovaný článek, klasifikační systém OMAHA,
- MeSH
- ošetřovatelství MeSH
- Klíčová slova
- ošetřovatelské terminologie,
- MeSH
- mezinárodní klasifikace nemocí MeSH
Objectives: The goals of this study were to examine the feasibility of using ontology-based text mining with CaringBridge social media journal entries in order to understand journal content from a whole-person perspective. Specific aims were to describe Omaha System problem concept frequencies in the journal entries over a four-step process overall, and relative to Omaha System Domains; and to examine the four step method including the use of standardized terms and related words. Design: Ontology-based retrospective observational feasibility study using text mining methods. Sample: A corpus of social media text consisting of 13,757,900 CaringBridge journal entries from June 2006 to June 2016. Measures: The Omaha System terms, including problems and signs/symptoms, were used as the foundational lexicon for this study. Development of an extended lexicon with related words for each problem concept expanded the semantics-powered data analytics approach to reflect consumer word choices. Results: All Omaha System problem concepts were identified in the journal entries, with consistent representation across domains. The approach was most successful when common words were used to represent clinical terms. Preliminary validation of journal examples showed appropriate representation of the problem concepts. Conclusions: This is the first study to evaluate the feasibility of using an interface terminology and ontology (the Omaha System) as a text mining information model. Further research is needed to systematically validate these findings, refine the process as needed to advance the study of CaringBridge content, and extend the use of this method to other consumer-generated journal entries and terminologies.
Objectives: The goals of this study were to examine relationships among health literacy and outcomes for sub-populations identified within a large, multi-dimensional Omaha System dataset. Specific aims were to extract sub-populations from the data using Latent Class Analysis (LCA); and quantify the change in knowledge score from pre- to post-intervention for common sub-populations. Design: Data-driven retrospective study using statistical modeling methods. Sample: A set of admission and discharge cases, captured in the Omaha System, representing 65,468 cases from various health care providers. Measures: Demographic information and the Omaha System terms including problems, signs/symptoms, and interventions were used as the features describing cases used for this study. Development of a mapping of demographics across health care systems enabled the integration of data from these different systems. Results: Knowledge scores increased for all five sub-populations identified by latent class analysis. Effect sizes of interventions related to health literacy outcomes varied from low to high, with the greatest effect size in populations of young at-risk adults. The most significant knowledge gains were seen for problems including Pregnancy, Postpartum, Family planning, Mental health, and Substance use. Conclusions: This is the first study to demonstrate positive relationships between interventions and health literacy outcomes for a very large sample. A deeper analysis of the results, focusing on specific problems and relevant interventions and their impact on health literacy is required to guide resource allocation in community-based care. As such, future work will focus on determining correlations between interventions for specific problems and knowledge change post-intervention.
Objectives: Public health nurse (PHN) perceptions of using standardized care plans to translate evidence-based guidelines into family home visiting practice have not been examined. The purpose of this study was to evaluate PHN experience and awareness of cognitive processes while using evidence-based care plans in family home visiting practice. Design: This qualitative study used content analysis of PHN interviews. Sample: A purposive sample of PHNs in a local public health agency who were experienced in the use of care plans in electronic documentation. Measures: The qualitative study utilized content analysis methods. Semi-structured interviews examined their cognitive experience transitioning from usual practice care plans to evidence-based care plans. Interviews were transcribed and analyzed using a thematic analysis approach. Themes were developed and revised following several reviews of the transcripts. Results: Four themes from PHN interviews revealed a complex dynamic process of knowledge management: 1. PHN thinking is separate from the care plan. 2. PHN thinking is supported by the care plan. 3. PHN thinking is stimulated by the care plan. 4. PHN documentation distress is minimized when the care plan matches PHN thinking. Conclusion: While using the evidence-based FHV care plan, PHN cognitive processes were related to their own knowledge and expertise, their individual clients, and the entire client population or program. Evidence-based care plans supported and stimulated PHN thinking about evidence-based interventions and their application in practice. A good fit of the care plan knowledge schemata with a PHN’s own knowledge schemata may decrease documentation distress. Further research is needed to evaluate the impact of using evidence-based care plans in other disciplines and settings.
komunitní péče
- Klíčová slova
- klasifikace ošetřovatelských intervencí, klasifikační systémy, Omaha Systém, ošetřovatelství založené na důkazech,
- MeSH
- komplexní management jakosti MeSH
- medicína založená na důkazech MeSH
- ošetřovatelská péče MeSH
- řízení veřejného zdraví MeSH
- služby domácí péče pracovní síly trendy využití MeSH
- standardizovaná ošetřovatelská terminologie MeSH
- zajištění kvality zdravotní péče metody normy MeSH
- zdravotní sestry MeSH
