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Related Concept Videos

Flow Sheet01:17

Flow Sheet

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Flowsheets are valuable tools in nursing documentation. They enable healthcare professionals to efficiently record and monitor various patient assessments and measurements in a consolidated format.
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Related Experiment Video

Updated: Nov 12, 2025

Design and Analysis for Fall Detection System Simplification
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Information Models Offer Value to Standardize Electronic Health Record Flowsheet Data: A Fall Prevention Exemplar.

Kay S Lytle1, Bonnie L Westra2, Luann Whittenburg3

  • 1Alpha Alpha & Beta Nu, Chief Nursing Information Officer, Duke University Health System, Durham, NC, USA.

Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing
|March 15, 2021
PubMed
Summary
This summary is machine-generated.

Standardizing electronic health record (EHR) data with information models (IMs) enables better quality improvement and big data research. This study developed a fall prevention IM from actual EHR data, improving data comparability across healthcare organizations.

Keywords:
Big datadata exchangeelectronic health recordsinformation modelssecondary use

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Area of Science:

  • Health Informatics
  • Nursing Informatics
  • Data Standardization

Background:

  • Rapid electronic health record (EHR) implementation led to data standardization issues, hindering secondary data use.
  • Nurses and healthcare organizations struggle with usable documentation data output from EHR systems.
  • Lack of standardized data limits quality improvement initiatives and big data research in healthcare.

Purpose of the Study:

  • To describe a method for standardizing EHR flowsheet documentation data using information models (IMs).
  • To support data exchange, quality improvement, and big data research through standardized EHR data.
  • To validate a fall prevention IM using EHR flowsheet metadata from multiple organizations.

Main Methods:

  • A consensus-based, qualitative, descriptive approach identified essential fall prevention data concepts.
  • Retrospective, observational study mapped and analyzed nursing flowsheet metadata from eight health systems using FloMap software.
  • Iterative refinement involved subject matter experts, published evidence, and current documentation standards.

Main Results:

  • Analyzed EHR data represented 6.6 million patients, 27 million encounters, and 683 million observations.
  • The fall prevention IM was refined, adding five classes, reducing concepts by 14 (to 43), and adding 157 value set items.
  • The final IM included 11 fall risk screening tools and a fall event details class with 14 concepts.

Conclusions:

  • Iterative refinement and validation of the fall prevention IM enable semantic exchange and comparison of fall prevention data.
  • This method standardizes flowsheet data as coded data for information exchange and big data research.
  • Standardized IMs within EHRs can expand interoperability of nurse-sensitive data, requiring collaboration with EHR vendors and policymakers.