PURPOSE: To evaluate completeness, granularity, multiple axial content, and clinical utility of the beta version of the ICNP in the context of standardized nursing care planning in a clinical setting. METHODS: An 35-bed acute care ward for infectious diseases at a Swedish university hospital was selected for clinical testing. A convenience sample of 56 patient records with data on nutrition and skin care was analyzed and mapped to the ICNP. FINDINGS: Using the ICNP terminology, 59%-62% of the record content describing nursing phenomena and 30%-44% of the nursing interventions in the areas of nutrition and skin care could be expressed satisfactorily. For about a quarter of the content describing nursing phenomena and interventions, no corresponding ICNP term was found. CONCLUSIONS: The ICNP needs to be further developed to allow representation of the entire range of nursing care. Terms need to be developed to express patient participation and preferences, normal conditions, qualitative dimensions and characteristics, nonhuman focus, and duration. PRACTICE IMPLICATIONS: The practical usefulness of the ICNP needs further testing before conclusions about its clinical benefits can be determined.
The aim of this survey was to test the applicability of the Nursing Interventions Classification (NIC) system for use in a future nursing information system for documenting nursing in an electronic patient record in Iceland. Also, the aim was to test the translation of NIC into Icelandic. In order to be applicable to nursing NIC needs to be sensitive enough to describe the work nurses do, differentiate between specialities in nursing, and be understandable to nurses. A sample of 198 nurses was asked to identify how often they used each of 433 NIC nursing interventions. Of the 36 most frequently used interventions half are within the physiological domain. Core nursing interventions were different between specialities, e.g. Analgesic Administration had a high mean score in surgical nursing, and Health Education in primary health care. anova for the 27 classes in NIC showed significant differences (p
To evaluate the clinical relevance of access targets for elective dental procedures performed under general anesthesia at The Hospital for Sick Children in Toronto, Ontario, by assessing incremental changes in the burden of dental disease over wait times for such procedures.
Children scheduled for elective dental procedures under general anesthesia were assigned a priority according to the dental diagnosis and the medical risk status. Each priority level was defined by a specific diagnostic code and access target (maximum acceptable wait time). The dental records of children who underwent dental procedures with general anesthesia between June 2005 and December 2008 were assessed retrospectively. A novel assessment scale was used to measure the cumulative burden of dental disease during the waiting period.
A total of 378 children (age range 10 months to 17 years) met the inclusion criteria. Statistically significant correlations were identified between disease burden and wait times for priority group IV (access target 90 days) (p=0.004), for the entire sample (p
This paper is a status report from a large-scale openEHR-based EPR project from the North Norway Regional Health Authority. It concerns the standardization of a regional ICT portfolio and the ongoing development of a new process oriented EPR systems encouraged by the unfolding of a national repository for openEHR archetypes. Subject of interest; the contextualization of clinical templates is governed over multiple national boundaries which is complex due to the dependency of clinical resources. From the outset of this, we are interested in how local, regional, and national organizers maneuver to standardize while applying OpenEHR technology.
To assess the usefulness of the controlled vocabularies of PubMed/MEDLINE and PsycINFO for finding articles on injury prevention and safety promotion (IPSP) topics and to identify specific indexing problems that can contribute to incomplete retrieval.
Professional reference librarians provided search strategies for finding articles relevant to five topics pertaining to the injury prevention field in the two bibliographic databases. The results of implementing these search strategies were compared with the results of a presumptive gold standard-serial textword searches on the same topics. The index terms assigned to the articles that were missed by the librarian strategies were examined.
The search products of the librarian-constructed search strategies identified 34-91% of the IPSP-relevant articles that were identified through serial textword searches of the two databases. Specific indexing issues were found to contribute to this loss.
Librarians bring expertise to searching, but irregular or incomplete indexing can limit the product of even well-constructed searches for articles on IPSP topics.
The ability of a cue-based system to accurately assert whether a disorder is affirmed, negated, or uncertain is dependent, in part, on its cue lexicon. In this paper, we continue our study of porting an assertion system (pyConTextNLP) from English to Swedish (pyConTextSwe) by creating an optimized assertion lexicon for clinical Swedish.
We integrated cues from four external lexicons, along with generated inflections and combinations. We used subsets of a clinical corpus in Swedish. We applied four assertion classes (definite existence, probable existence, probable negated existence and definite negated existence) and two binary classes (existence yes/no and uncertainty yes/no) to pyConTextSwe. We compared pyConTextSwe's performance with and without the added cues on a development set, and improved the lexicon further after an error analysis. On a separate evaluation set, we calculated the system's final performance.
Following integration steps, we added 454 cues to pyConTextSwe. The optimized lexicon developed after an error analysis resulted in statistically significant improvements on the development set (83% F-score, overall). The system's final F-scores on an evaluation set were 81% (overall). For the individual assertion classes, F-score results were 88% (definite existence), 81% (probable existence), 55% (probable negated existence), and 63% (definite negated existence). For the binary classifications existence yes/no and uncertainty yes/no, final system performance was 97%/87% and 78%/86% F-score, respectively.
We have successfully ported pyConTextNLP to Swedish (pyConTextSwe). We have created an extensive and useful assertion lexicon for Swedish clinical text, which could form a valuable resource for similar studies, and which is publicly available.
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Cites: J Am Med Inform Assoc. 2011 Sep-Oct;18(5):563-721515542
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Comprehensive wound documentation is an important tool in evaluating and planning patient care. The sublanguage used in ICUs may affect negatively to the wound care and thus to the healing process. We made a quantitative content analysis of nursing documentation of cardiac surgery adult patients (n=60) who had stayed over four days in the ICU. The sublanguage used in nursing documentation of wounds and ulcers in the ICU was unstructured with many words of colloquial language, misspellings and abbreviations. The documentation did not cover all aspects of proper wound care. The information technology could be helpful for nurses to document right things with plain language.