Nursing Information System Research Articles

Web-Based Nursing Care Documentation for Students to Support Online Learning

Nursing care is the most critical element in nursing services, which aims to improve the patient’s health status. Ineffective and inefficient care documentation can impact the quality of nursing services. However, the increasingly advanced development of technology provides freedom for the health world to improve the quality of patient-centered services. Educational institutions have also used information technology in learning process activities. As prospective health professionals, students must be equipped with competencies to support their performance. In this study, a web-based nursing care information system was developed to assist students in documenting care activities. The website application was designed to increase student competency in nursing documentation activities to provide high-quality nursing services even though learning is online. The waterfall model approach was used in application design. The design stage started with analyzing application requirements, followed by system design and coding. Next, using a Likert-scale questionnaire, a usability test was performed on 15 beta users to assess the functionality of the application. The results showed that the nursing care website application was easy to use and that students felt satisfied. It is hoped that the website application can be made more attractive by including a decisional support system to make it easier for students to enforce nursing diagnoses on patients.

Exploring the Association between Complexity of Care, Medical Complexity, and Length of Stay in the Paediatric Setting Using a Nursing Minimum Data Set: A Study Protocol.

The complexity of care requires systematic documentation to fully understand its relationship with medical complexity and its impact on patient outcomes. The Nursing Minimum Data Set (NMDS) plays a crucial role by capturing essential nursing data, enabling a detailed analysis of care and its impact on outcomes, such as length of stay (LOS). However, despite its potential, the use of NMDS in paediatric care remains limited. This study aims to explore the association between nursing and medical complexities and LOS in paediatric patients. A descriptive, retrospective, monocentric study will be conducted. The data will be collected through a nursing information system (Professional Assessment Instrument (PAIped)) and the hospital discharge register of patients admitted to the paediatric department in 2022 in an Italian university hospital. Conclusions and Expected Results: The use of PAIped will allow for the description of the complexity of care and enable an analysis of its relationship with medical complexity and LOS.

Exploring the Impact of Medical Complexity on Nursing Complexity of Care in Paediatric Patients: A Retrospective Observational Study.

To explore the impact of medical complexity, defined by the number of chronic conditions, on the complexity of care, as described by the frequency of nursing diagnoses (NDs) and nursing actions (NAs), in paediatric patients. Retrospective observational study. This study was conducted in an Italian university hospital and involved the analysis of electronic health records for neonatal and paediatric patients who were consecutively admitted from January to December 2022. The sample was classified into three categories-non-chronic, single chronic and multimorbid patients-according to their clinical profiles. NDs recorded within the first 24 h from patient hospital admission and NAs performed throughout the hospital stay were counted for each group. Distinct variations in the prevalence and patterns of NDs and NAs were observed across different levels of medical complexity. A significant moderate positive correlation between the number of NDs and NAs was found. However, the frequency of NDs did not directly correlate with the number of chronic conditions. Conversely, a weak but significant negative correlation was identified between the quantity of NAs and the number of chronic conditions. While the frequency of NDs showed a stable but decreasing trend as the number of chronic conditions increased, a higher number of chronic conditions were associated with a lower quantity of NAs. We discovered a notable variation in the complexity of care across varying levels of medical complexity in paediatric patients. Our findings suggest that the complexity of care does not necessarily correspond to the degree of medical complexity. The observed negative relationship between the number of chronic conditions and the quantity of NAs underscores the need for further research to explore this unexpected finding and its implications for clinical practice. Without the adoption of standardised nursing terminologies, such as nursing diagnoses (NDs) and nursing actions (NAs), assessing the complexity of care in paediatric settings can be challenging. Integrating clinical nursing information systems that incorporate standardised NDs and NAs into electronic health records is crucial for accurately documenting and analysing the complexity of care and its relationship with medical complexity. In paediatric patients, the frequency of nursing diagnoses (NDs) at hospital admission is significantly associated with the quantity of nursing actions (NAs) delivered during hospitalisation. However, there is no correlation between the frequency of NDs and medical complexity, as defined by the number of chronic disorders. Specifically, the frequency of NDs decreases with increasing medical complexity, while the quantity of NAs is negatively associated with the number of chronic disorders. This indicates that the complexity of care cannot be inferred solely from medical complexity, and additional factors need to be explored. These findings enhance understanding of how complexity of care relates to medical complexity in paediatric patients. Insights into the prevalence and patterns of NDs and NAs can benefit nurses, managers, researchers and policymakers by informing clinical and organisational decision-making to ensure high-quality care. The study adhered to the RECORD Statement. Patients, service users, caregivers or public members were not directly involved in the design, conduct, analysis and interpretation of data or in writing this paper. Patients contributed only to data collection.

Nurses' acceptance of nursing information systems: Amulti-center cross-sectional study in China.

In China, nursing information systems (NIS) implementation can face numerous barriers to acceptance, including the attitudes of potential users. However, few studies have evaluated this acceptance. The aim of this study was to explain the acceptance of NIS utilizing a survey based on unified theory of acceptance and use of technology. A multi-center cross-sectional study utilizing an online survey was conducted. SPSS AMOS was used to conduct a structural equation modelling analysis. This research followed the STROBE Checklist. A total of 3973 Nurses participated in the study between January 2023 and March 2023. The acceptance of NIS among nurses was overall moderate to high. The proposed model has been rigorously tested and validated using empirical data, ensuring its credibility and dependability. Performance expectancy (PE), social influence (SI), and attitude significantly and positively affected intentions to use NIS. Effort expectancy (EE) did not show any significant effects in the sample. Facilitating conditions (FCs) was found to have a negative relationship with the intention to use NIS. There was a statistically significant difference BI between the different age groups, working years, and computer training experience. The model demonstrates a good fit with the observed data. This study identified PE, SI, and attitude as facilitators of nurses' intentions to use NIS. The findings about EE indicates that the ease of using NIS does not seem to be a concern among nurses. Moreover, high FC might be perceived as indicative of a complex system or extensive usage, that can lead to increased workload and reduced behavioural intention (BI). The significant differences in BI among various demographic groups highlight the need for more studies understanding the preferences and barriers faced by different, levels of experience and training backgrounds. No patient or public contribution.

Application Progress of Nursing Information System in China

This paper introduces and summarizes the development background and function, application status and development limitations of nursing informatization, aiming to provide reference for nursing staff to further understand the relevant content of nursing informatization, better apply nursing informatization to clinical practice, and provide reference for clinical nursing informatization in China.

Design and Development of a Fully Intelligent Nursing Information System Based on International Standard Nursing Terminology.

Design and develop a Clinical Care Classification (CCC) nursing information system aligned with nursing terminology CCC, emphasizing standard procedures and a responsibility-based nursing model to enhance efficiency and quality of care. Conduct thorough investigation into clinical nursing informatics needs, analyze existing system shortcomings, utilize Microsoft.net for development, integrate standard nursing procedures and clinical operating protocols into system functions. Structure database based on bed characteristics, implant CCC Nursing Terminology and clinical nursing knowledge base. Successfully design and develop CCC Nursing Information System featuring patient list, nurse assignment, nursing evaluation, diagnosis, goals, plan, interventions, special care, shift handover, record query, workload statistics, and intelligent guidance based on patient assessment and nursing elements. The CCC Nursing Information System advances standard nursing procedures in clinical practice, promoting standardization and responsibility-based holistic care. It harnesses big data to enhance system intelligence.

Next-Generation Intelligent Care Opportunities

Nursing information systems are becoming increasingly prevalent in our medical institutions. However, changes in the social environment and imbalances between the demands of caregivers and care recipients mean that current nursing information systems are inadequate in terms of quality and operational needs. This article was written to provide insights into opportunities to leverage technology to further promote care quality by applying a "data, information, knowledge, and wisdom" system development structure to develop intelligent technology products that equitably meet the needs of patients, caregivers, and nursing processes. Applied in clinical settings, these products should help satisfy patient needs and facilitate nursing work.

ASSOCIATION BETWEEN HEALTH LITERACY AND NURSING DEPENDENCY IN HEART FAILURE PATIENTS: A RETROSPECTIVE STUDY

Abstract Background Approximately 6.7 million Americans over 20 years of age have heart failure (HF) and 33% of the US adult population without known symptomatic HF is at–risk for HF. To understand self–care protocols, patients should understand and use health information and literature suggests a positive relation between health literacy (HL) and self–care. Health literacy (HL) is a potential risk factor for health outcomes and can be defined as “personal knowledge and competencies obtained through daily activities, social interactions and across generations”. However, even though HL has gained international relevance, it remains underestimated in most world countries. Moreover, HL is poorly measured in hospitalized HF patients and its relationship with nursing dependency is still poorly studied. We aimed to describe HL levels by analyzing the relationship between HL and nursing dependency. Methods A retrospective design was used by selecting 608 adult patients with HF consecutively admitted in cardiovascular and internal medicine units of an Italian university hospital across 1 year. Single Item Literacy Screener (SILS) was used to measure HL and was systematically reported on electronic health records; nursing diagnoses were collected from the clinical nursing information system to measure nursing dependency. Results The mean age of the sample was 75.50 ± 13.06. HL levels were low (SILS >2) in approximately 26% of the hospitalized patients (n=159; 26.2%). A mean of 4.1 ± 3.4 nursing diagnosis per patient was identified. A significant difference was observed between patients with adequate HL (n=449) and low HL (n=159) in terms of nursing diagnoses (mean 2.76 ± 20.3 VS mean 8.69 ± 2.79; p< .001, respectively). A statistically significant linear association (Spearman’s correlation coefficient) was observed between the HL score and the number of NDs. Conclusion HL was associated with the number of NDs in HF patients. Understanding the relationship between HL and nursing dependency can allow the planning of targeted interventions to improve the patient’s health outcomes, representing a key element for public health.

Machine learning-based speech recognition system for nursing documentation – A pilot study

PurposeConsidering the significant workload of nursing tasks, enhancing the efficiency of nursing documentation is imperative. This study aimed to evaluate the effectiveness of a machine learning-based speech recognition (SR) system in reducing the clinical workload associated with typing nursing records, implemented in a psychiatry ward. MethodsThe study was conducted between July 15, 2020, and June 30, 2021, at Cheng Hsin General Hospital in Taiwan. The language corpus was based on the existing records from the hospital nursing information system. The participating ward's nursing activities, clinical conversation, and accent data were also collected for deep learning-based SR-engine training. A total of 21 nurses participated in the evaluation of the SR system. Documentation time and recognition error rate were evaluated in parallel between SR-generated records and keyboard entry over 4 sessions. Any differences between SR and keyboard transcriptions were regarded as SR errors.Findings: A total of 200 data were obtained from four evaluation sessions, 10 participants were asked to use SR and keyboard entry in parallel at each session and 5 entries were collected from each participant. Overall, the SR system processed 30,112 words in 32,456 s (0.928 words per second). The mean accuracy of the SR system improved after each session, from 87.06% in 1st session to 95.07% in 4th session. ConclusionThis pilot study demonstrated our machine learning-based SR system has an acceptable recognition accuracy and may reduce the burden of documentation for nurses. However, the potential error with the SR transcription should continually be recognized and improved. Further studies are needed to improve the integration of SR in digital documentation of nursing records, in terms of both productivity and accuracy across different clinical specialties.

Analysis of the information ability of nurses in county hospitals in northern Henan province: a survey

ObjectiveTo investigate the status quo of nursing information ability of nurses in county-level hospitals and analyze its influencing factors.MethodsIn June 2022, a total of 303 on-the-job clinical nurses from 3 county-level hospitals in Hebi City, Henan Province were selected as subjects by convenience sampling method. General data questionnaire and self-rating nursing information ability scale were used to investigate them.ResultsThe total score of nursing information ability of 303 nurses in county hospitals of Hebi City, Henan Province was (77.72 ± 18.76). There were statistically significant differences in the scores of nursing information ability among different ages, working years, positions, education, marriage, monthly income, whether they had learned computer-related knowledge and skills, and whether they had participated in the learning or training of nursing information system (all p < 0.05).Multiple linear regression analysis showed that age, years, position, monthly income and whether they had learned computer-related knowledge and skills were the main influencing factors of nursing information ability of county-level nurses (all p < 0.05).ConclusionsThe nursing information ability of nurses in county-level hospitals in northern Henan is at a medium level. The government or society should provide training and guidance on nursing information ability, so as to provide more opportunities for nurses in county-level hospitals to participate in and learn nursing information technology to improve their ability.

Analysis of Intensive Care Unit Nursing Clinical Judgment and Selection of Nursing Diagnosis for Cerebral Hemorrhage.

Few nursing informatics studies focus on selecting nursing diagnoses for critical patients. The absence of data about nursing clinical judgment in the care of patients with cerebral hemorrhage greatly hinders research progress in evidence-based care. A stratified, retrospective study analyzed 115 electronic "intelligent" nursing information system nurse assessments and nursing diagnoses. Data were documented from April 2019 to November 2020 for critically ill patients admitted with cerebral hemorrhage in a 10-bed medical ICU at a 1500-bed tertiary facility, Henan Honliv Hospital, in Henan Province, China. In the selection of nursing diagnoses among nurses of stratified competencies (novice to expert), novice and experienced nurses were found to have significant variances in selecting nursing diagnoses for critically ill patients with cerebral hemorrhage. Novice nurses more frequently selected the Activity Intolerance Risk diagnosis as an initial diagnosis ( P = .025). Experienced nurses selected the Fluid Volume Excess Risk diagnosis more frequently ( P = .003). Consequently, nursing information systems are important in evaluating professional practice. The access to structured, standardized nursing data for the complete nursing process enables nurse managers to comprehensively analyze the nursing care given to patients, the distribution of patient nursing diagnoses, and the status of patient care risks.

Effects of different types of interference on nurses' working memory: An ERP study.

To explore the effects of different types of interference on nurses' working memory, and the role of attention control. A repeated measures design. A single-factor, four-level within-subjects design was adopted. Thirty-one nurses completed a delay-recognition task with four blocks in September 2020: Interrupting Stimulus (stimuli requiring attention), Distracting Stimulus (stimuli to-be-ignored), No Interference and Passively View. Behavioural responses of the participants and EEG data were recorded. MATLAB 21b and EEGLAB 21b were used for electroencephalogram data preprocessing and data extraction. Firstly, when nursing information system was used as task material, the accuracy rate and false alarm rate of primary tasks under interruption condition was statistically significantly different with that of distraction and no interference condition. There is a statistically significant difference in electroencephalogram measurement between correct and wrong response under interruption. Secondly, the role of attention control was different under interruption and distraction. There was a statistically significant positive correlation between the average amplitude distraction attention control index and task accuracy, and statistically significant negative correlation between the latency interruption attention control index and the accuracy of working memory task. There were different effects of interruptions and distractions on nurses' working memory and the role of attention control were also different. Measures can be designed according to these results to reduce the negative impact of interference on nurses, so as to improve work efficiency and reduce patient risk. This study has implications for clinical nursing during human-computer interaction. Resumption of the speed of the target information after an interruption affected task performance. Therefore, interventions should be designed to reduce the time needed for nurses to extract task information after an interruption, such as providing key clues in the information system interface. Registered nurses participated in the study as subjects.

Nursing Information System pada Pelayanan Kesehatan

This study aims to determine how to implement the nursing information system in health services in hospitals. The research method used was a literature study on ten journals related to the Nursing Information System. The results showed that the effectiveness of NIS found that NIS can reduce the workload of nurses and increase client satisfaction. NIS makes hospital nurses more efficient in nursing care, increasing client satisfaction. In conclusion, electronic nursing documentation can make nurse performance more effective. However, nurses must have informatics and English skills to adapt quickly in this era.&#x0D; &#x0D; Keywords: Hospital Health, Nursing Electronic Documentation, Nursing Information System, Services

Mobile nursing care plan information system for nursing service in hospitals.

The COVID-19 pandemic has greatly affected the health sector, especially the speed of healthcare services in hospitals, such as nursing care. This is caused by the low ratio between the number of resources available and the number of cases handled, which leads to suboptimal services. One of the solutions to this problem is to implement a digital (mobile) nursing care information system. Therefore, this study aims to produce a digital (mobile) nursing information system model that is suitable for hospitals. The research and development (RnD) method used in this study was carried out in three stages, namely, analysis of information system needs, preparation of the model design, and trial of Mobile Nursing Care Plan Information System (MNCPIS). The design was prepared with the Framework for Application of System Technique (FAST). A total of 148 nurses were selected as respondents using a simple random sampling approach. Data were then collected through interviews, focus group discussions, and questionnaires. Furthermore, MNCPIS was assessed with system requirements analysis using the Performance, Information, Economic, Control/Security, Efficiency, and Service (PIECES) framework. The t-test results indicate that MNCPIS was more effective and appropriate compared to the conventional (manual) types. This was indicated by all the variables measured in the MNCPIS component, including assessment, nursing diagnosis and evaluation, planning, and implementation. Based on these findings, the model can be developed as a nursing care information system to improve the quality assurance of services rendered by nurses. A mobile plan information system can be implemented in the nursing care department in hospitals to ensure satisfaction and quality assurance for the services provided in hospitals.

A New Portable Home Nursing Care Support System with Scheduling and Flexible Real-time Routing Mechanism

&lt;p&gt;With the rapid growth of the elderly population, the need for long-term medical care continues to increase, and reliance on medical and institutional nursing care services is limited. Long-term nursing care at home is a kind of home care service which provides continuous nursing care after discharge from the hospital and is an alternative long term care choice that can relieve the hospital from the pressure of too many long-term care beds. Therefore, how to integrate limited medical resources and create a mobile home care model that attracts more manpower willing to devote themselves to the long-term care service and can upgrade the value of nursing information system has always need a breakthrough in the medical information field. This research is built upon the mobile computing technology to construct a new portable home nursing care support system. The result shows that this mobile home nursing care support mechanism can help patients and their families maintain good quality of life and dignified living. At the same time, caregivers are provided with intelligent guide and medical information support during their implementation of home care medical measures, thereby excluding redundant non-professional medical details and improve the quality of home health care service.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Retracted: Application of Intelligent Nursing Information System in Emergency Nursing Management.

[This retracts the article DOI: 10.1155/2021/3998830.].

Transition to a new nursing information system embedded with clinical decision support: a mixed-method study using the HOT-fit framework

BackgroundNursing information systems embedded with standardized nursing language and clinical decision support have been increasingly introduced in health care settings. User experience is key to the adoption of health information technologies. Despite extensive research into the user experience with nursing information systems, few studies have focused on the interaction between user, technology and organizational attributes during its implementation. Guided by the human, organization and technology-fit framework, this study aimed to investigate nurses’ perceptions and experiences with transition to a new nursing information system (Care Direct) 2 years after its first introduction.MethodsThis is a mixed-method study using an embedded design. An online survey was launched to collect nurses’ self-reported use of the new system, perceived system effectiveness and experience of participation in system optimization. Twenty-two semi structured interviews were conducted with twenty nurses with clinical or administrative roles. The quantitative and qualitative data were merged using the Pillar Integration Process.ResultsThe average score of system use behavior was 3.76 ± 0.79. Regarding perceived system effectiveness, the score of each dimension ranged 3.07–3.34 out of 5. Despite large variations in approaches to participating in system optimization, nurses had generally positive experiences with management and technical support. Eight main categories emerged from the integrated findings, which were further condensed into three themes: perceptions on system content, structure, and functionality; perceptions on interdisciplinary and cross-level cooperation; and embracing and accepting the change.ConclusionsEffective collaboration between clinicians, administrators and technical staff is required during system promotion to enhance system usability and user experience. Clear communication of organizational missions to staff and support from top management is needed to smooth the system implementation process and achieve broader system adoption.

Developing a professional-practice-model-based nursing organizational informatics competency model

BackgroundThe development of nursing informatics started late in China. There is an urgent need to develop a clinical practice model that can guide nursing managers in constructing an organizational nursing informatics competency. ObjectiveThe objective of this study was to develop a nursing organizational informatics competency model based on the Professional Practice Model (PPM) and to provide a reference for training in clinical nursing informatics in hospitals. MethodsA multidisciplinary team in the hospital was first formed as the working group, consisting of nurses trained with the TIGER (Technology Informatics Guiding Education Reform) Taiwan model and had practical experience in system development. We used an exploration map to help build the prototype of the hospital nursing informatics competency model. Then, a final model was constructed by experienced out-of-hospital experts using the Delphi method. The final model was determined according to the validity analysis. ResultsTen hospital stakeholders were invited to form the multidisciplinary working team to develop the prototype organizational PPM model. Two rounds of Delphi were conducted to twelve experienced nurses' informatics experts outside the hospital by e-mail. The results showed that the questionnaire return rate was 100 %, the expert authority coefficient was 0.84, the general validity of the two rounds of content was 92.46 % and 100 %, respectively, and the coefficient of variation of all items was < 0.3. The final model included five categories, including management strategy and leadership, organizational structure and operation, improvement of the environment for nursing information practice, cultivation of core competence in nursing information, and project management of the nursing information system, with 61 elements in total. ConclusionsWe propose this model to help hospital nursing managers to establish a plan of action to build up organizational clinical informatics competency.

Nurses' knowledge of and attitude to nursing information systems.

The use of a nursing information system (NIS) provides significant benefit to the nurses in the management of real-time patient data and contributes to improving the operational effectiveness of nursing services. To assess the knowledge of, attitude towards and use of an NIS. A prospective cross-sectional study was carried out among 230 hospital nurses in India, using a validated questionnaire including demographic characteristics, and questions on knowledge of, attitude towards and use of an NIS. The study found that more than 70% of nurses had good computer skills and knowledge about the information system. About 75% of the nurses reported that the NIS could be a tool to support them in improving patient care, and medical documentation, although 42% claimed that the use of NIS depersonalises nursing care. Seventy-one per cent of the nurses expressed the need for formal education and training on using an NIS during and after their nursing education. Training and demonstration of NISs during nurse education would improve nurses' knowledge, build confidence and positive attitudes, and enhance the acceptability and sustainability of NISs in healthcare settings.

Design and Implementation of Model-Driven Development for Nursing Information System.

Current healthcare industries are more focusing on quality, efficiency, and safety. Nursing information systems are among the key components of healthcare information systems; they can help nurses to use data more effectively while managing their nursing activities, allowing them to improve patient care and develop their knowledge. According to clinical various needs and various hospitals, so as to develop a flexible Nursing Information System, this study based on the MVC, Object-Oriented Programming is used to develop the web interface, and web service is used to exchange data with HIS. This design and implements a flexible Nursing Information System which is applied and summarized clinically on the function of acquiring clinical data from the different clinical requirements and showing the web pages and different kinds of forms from the device browser. Under the software development environment of high variability, high complexity, and high customization in the medical industry, a scalable and maintainable nursing information system is realized through the MVC architecture and the Master-Detail data table design, which can meet the needs of different organizations.