A Bridge Between Data and Language: The Swiss Nursing Information System Project

Abstract

BACKGROUNDA uniform system of representing and describing nursing practice is essential and should be constructed in such a way as to allow integration of improvements and refinements. After 2 years of theoretical developments, the framework for a national nursing information system, called NURSING data, became a reality. NURSING data is a national nursing project designed to shape nursing information systems to improve clinical information systems (records), improve management systems (cost and quality), provide a complement to the healthcare medical statistics, and give reliable information on the cost of nursing care.MAIN CONTENT POINTSAs a starting point, the NURSING data project worked on two preconditions: (a) the information system must be unified at the Swiss level and compatible at an international level, and (b) it must, as far as possible, be built from what exists and is used. The overall objective was to provide a representation of nursing practice through the use of statistical indicators, providing a helpful tool for decision making in the fields of health policy and health economics. In order to ensure the validity of results, the model needed to reflect practice. The construction of the model was achieved by moving between nursing practice itself and the highest level of abstraction possible from available statistical data. Additionally, the model needed to be compatible with current international work in the same field.Numerous nursing professionals in many different areas of practice were called to participate in order to guarantee the feasibility of the proposed solutions and to ensure the diffusion of information. A mixed group consisting of different partners in the healthcare field and professional nurses with expertise in information systems chooses and defines variables, while at the same time ensuring compatibility and conformity with preexisting federal health statistics. While waiting for the generalization of an internationally recognized terminology, it would appear necessary to formalize, in the Swiss context, the characteristics of each of these variables in the form of two standardized, accepted reference classifications for nursing phenomena and interventions. With this aim in mind, three working groups have been set up, one for each of the linguistic regions — French, German, Italian — to put forward two lists of terms (phenomena and interventions), which are at present undergoing assessment by a Delphi panel of volunteer nurses (about 50 from each linguistic region).CONCLUSIONSWhile some of this work is still in a developmental stage, the current NURSING Data project aims to produce a list of appropriate variables that describe the how and why of nursing in Switzerland (the Swiss Nursing Minimum Data Set) that takes into account the needs of the various partners; an accepted nursing classification for phenomena and interventions, adapted to the different areas of clinical practice for statistical use; and a validated system of data analysis, allowing different types of feedback according to specific needs (e.g., clinical, research, finance).