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Signal Detection to Measure Allostatic Load.

Douglas C Howard1

  • 1Phi Epsilon, Clinical Program Manager, Office of the Medical Inspector, Department of Veterans Affairs, Washington, DC, USA.

Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing
|April 9, 2021
PubMed
Summary

The Troubled Outcome Risk (TOR) scale, developed using big data from electronic medical records (EMR), objectively measures patient allostatic load. This tool improved nursing surveillance, reducing hospital length of stay (LOS) and optimizing patient care.

Keywords:
Allostatic loadnursing surveillancenursing-sensitive indicatorssignal detection

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Area of Science:

  • Healthcare Informatics
  • Nursing Research
  • Big Data Analytics

Background:

  • Allostatic load assessment in hospitalized patients is complex.
  • Electronic Medical Records (EMR) offer vast data potential.
  • Objective measures are needed to guide nursing practice.

Purpose of the Study:

  • To develop and validate the Troubled Outcome Risk (TOR) scale for calculating allostatic load in hospitalized patients.
  • To leverage big data from EMR for enhanced patient assessment.
  • To improve nursing surveillance and patient outcomes through objective risk stratification.

Main Methods:

  • Retrospective and prospective observational studies were conducted.
  • Signal detection algorithms were applied to big data for scale development.
  • The TOR scale was implemented to guide nurse staffing decisions.

Main Results:

  • The retrospective study analyzed over 290,000 data points to establish TOR score interpretation standards.
  • The prospective study demonstrated the TOR scale's utility in objective patient allostatic load measurement.
  • Implementation led to a reduction in inpatient length of stay (LOS) by 0.3 days.

Conclusions:

  • The TOR scale provides an evidence-based, objective measure of patient allostatic load.
  • Utilizing EMR data through the TOR scale positively impacts nursing practice and patient outcomes.
  • The TOR scale facilitates a shift towards patient-need-based staffing.