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[A synthesis of patient problems: a first step to the nursing minimum data set]
1DESMAP, L.SC. Hosp., Infirmier en soins généraux, Adjoint a la direction des soins responsable du systeme d'information des soins, Centre Hospitalier Universitaire Vaudois, affilié School of Nursing, University of Minnesota. alain.junger@chuv.ch
Recherche En Soins Infirmiers
|May 24, 2012
Summary
This study introduced nursing data into hospital statistics, identifying 15 key nursing problems impacting workload and patient stay. Analysis revealed differences based on nurse demographics, paving the way for improved healthcare funding models.
Area of Science:
- Healthcare Management
- Nursing Informatics
- Health Economics
Context:
- Switzerland's 2012 adoption of the SwissDRG hospital funding system, based on the German Diagnosis Related Group model.
- The SwissDRG system's limited consideration of nursing care, as it primarily groups by diagnoses and treatments.
- The need to integrate nursing data into hospital statistics for more comprehensive analysis.
Purpose:
- To introduce nursing data into medical statistics, presenting it in a diagnostic format.
- To identify and rank nursing problems based on their impact on hospital workload and patient length of stay.
- To explore the feasibility of using web questionnaires for large-scale nursing management surveys.
Summary:
- A web questionnaire surveyed 293 nursing managers at the University Hospital of Lausanne, yielding 95 responses across clinical specialties.
- Identified 15 significant nursing problems, with analysis using Relative Importance test (RIDITs) revealing demographic variations (sex, length of service).
- The study validates web questionnaires for data collection and RIDITs for analyzing small sample group differences.
Impact:
- Demonstrates a viable method for incorporating nursing data into hospital statistical systems.
- Provides a foundation for refining hospital funding models to better reflect nursing contributions.
- Highlights the potential for further research in pediatrics and obstetrics to expand nursing data integration.
Related Concept Videos
01:10Documentation of Nursing Diagnosis
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
01:24Data Reporting and Recording
Reporting and recording are crucial in data documentation. The timely, thorough, and accurate documentation of facts is essential when recording patient data. Failure to record findings during an assessment or interpretation of a problem will result in loss of information and make the patient document unreliable. The reader is left with general impressions if the information is not specific. A recording is documenting data of the individual's health information in a traceable, secure, and...
01:29Nursing Assessment
The two sources for collecting information are primary and secondary. After gathering information, interpretation and validation help to complete the data. The purpose of assessment is to establish data with the initial information, to interpret data about the patient's perceived needs and health problems, and to respond to these problems identified.
The nurse collects all aspects of the patient's health in the initial assessment, establishing priorities for ongoing focused assessments and...
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01:29Data Collection II
The nursing history captures and records the patient's health status, so that a care plan evolves to meet the patient's individual needs. The nursing health history is a part of the initial assessment. A comprehensive history covers all health dimensions and plays a significant role in the assessment process. A comprehensive history includes the patient's biographical information, reasons for seeking health care, expectations, present and past health history, medications, and family,...
01:05Data Collection III
The physical assessment examines the patient for objective data that defines the patient's condition, and aids in formulating the nursing care plan. The purpose of physical assessment is a health status appraisal, which includes identifying health problems, and establishing a database for nursing intervention.
The principles to begin the physical assessment include conducting a comprehensive or problem-related history in a quiet, well-lit room, emphasizing privacy and comfort for the patient.
The principles to begin the physical assessment include conducting a comprehensive or problem-related history in a quiet, well-lit room, emphasizing privacy and comfort for the patient.
01:30Data Collection I
Data collection gathers information needed to make accurate judgments about a patient's present condition. During a health history interview, subjective data is collected from the patient, their caregivers, or family members, and objective data is collected through observations and physical assessment. Patients are the primary source of subjective data. Thus information gathered from patients through interviews, observations, and physical examination is primary data. Secondary sources of data...