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Following assessment, a nursing diagnosis is the next step in the nursing process. It begins after the nurse has collected and recorded the patient data. The purpose of diagnosing is to identify how the client responds to actual or potential health processes, identify factors that bestow or that cause health problems, the etiologies, and identify resources or strengths the individual, group, or community can draw on to prevent or resolve problems.
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Exploring Reasons for Delayed Start-of-Care Nursing Visits in Home Health Care: Algorithm Development and Data

Maryam Zolnoori1, Jiyoun Song1, Margaret V McDonald2

  • 1School of Nursing, Columbia University, New York, NY, United States.

JMIR Nursing
|December 30, 2021
PubMed
Summary
This summary is machine-generated.

Delayed home health care nursing visits, often due to access issues or patient requests, can be reduced by improving intake procedures and patient education. Addressing these delays is crucial for better patient outcomes.

Keywords:
NLPclassificationclinical informaticsclinical notesdelayed start-of-care nursing visiteHealthhome carehome healthcare servicesnatural language processingnursingnursing note

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Area of Science:

  • Health Services Research
  • Nursing Informatics
  • Natural Language Processing

Background:

  • Delayed start-of-care nursing visits in home health care (HHC) are linked to adverse patient outcomes, including hospitalization.
  • Reasons for these delays have not been previously studied due to reliance on unstructured clinical notes.

Purpose of the Study:

  • To develop and validate a natural language processing (NLP) algorithm for identifying reasons for delayed HHC nursing visits from clinical notes.
  • To describe the common reasons for delayed visits in a large HHC patient cohort.

Main Methods:

  • An NLP algorithm was created and tested using free-text nursing notes from the Visiting Nurse Service of New York (VNSNY).
  • Data from 48,497 new HHC episodes initiated in 2019 were analyzed.

Main Results:

  • The NLP algorithm achieved a precision of 0.8, recall of 0.75, and F-score of 0.77.
  • One-third (33.5%) of HHC episodes experienced delayed start-of-care visits.
  • Top reasons included no answer at the door/phone (46.3%), patient/family requests (35.5%), and administrative/scheduling issues (18.2%).

Conclusions:

  • Home health care organizations should investigate and enhance strategies to mitigate delays in initiating nursing visits.
  • Interventions like patient/caregiver education on timely care importance and streamlined intake processes are recommended.