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: 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.
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
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.
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.
Objective: Conduct and evaluate system-level evidence-based practice intervention for deep vein thrombosis (DVT) prevention. Design: One group post-intervention survey evaluation. Setting: A mother-baby unit in a tertiary hospital. Interventions/measurement: Educating nurses, implementing an evidence-based deep vein thrombosis (DVT) prevention guideline in the mother-baby unit, and recommending policy changes. Outcomes were measured using Omaha System Knowledge, Behavior, and Status scales (1 = lowest – 5 = highest) for nurse DVT knowledge and practice behavior, and implementation of policy recommendations. Results: Twenty nurses (80%) completed the evaluation survey. The nurses reported that their knowledge increased significantly (3.70 vs. 4.40; p < 0.001). Behavior was variable in DVT guideline adherence. After training, most nurses (65%) usually or always assessed women for DVT risk, and some (35%) usually or always applied compression boots for DVT. The majority of nurses (70%) reported that women refused compression boots. Nurses who did not usually or always assess patients were statistically less likely to apply boots (p = 0.022). The nurses who reported discomfort with the procedure (30%) were statistically less likely to apply stockings (p = 0.028). Policy implementation to support evidence-based DVT prevention increased significantly (p = 0.008). Conclusion: Comprehensive evidence-based interventions resulted in practice and system change to prevent DVT. Nurses‘ knowledge about DVT prevention increased and some nurses consistently assessed for DVT and applied compression boots. The facility supported the implementation of the guideline and implemented unit/facility policy changes.
- Klíčová slova
- edukace pacienta, intervence sestry, praxe založná na důkazech,
- MeSH
- klid na lůžku MeSH
- komplikace těhotenství MeSH
- kompresivní punčochy MeSH
- medicína založená na důkazech MeSH
- těhotenství MeSH
- vzdělávání pacientů jako téma MeSH
- žilní trombóza ošetřování prevence a kontrola terapie MeSH
- Check Tag
- těhotenství MeSH
