RESUMO
PURPOSE: The purposes of this study were to apply data mining tool to nursing specific knowledge discovery process and to identify the utilization of data mining skill for clinical decision making. METHODS: Data mining based on rough set model was conducted on a large clinical data set containing NMDS elements. Randomized 1000 patient data were selected from year 1998 database which had at least one of the five most frequently used nursing diagnoses. Patient characteristics and care service characteristics including nursing diagnoses, interventions and outcomes were analyzed to derive the meaningful decision rules. RESULTS: Number of comorbidity, marital status, nursing diagnosis related to risk for infection and nursing intervention related to infection protection, and discharge status were the predictors that could determine the length of stay. Four variables (age, impaired skin integrity, pain, and discharge status) were identified as valuable predictors for nursing outcome, relived pain. Five variables (age, pain, potential for infection, marital status, and primary disease) were identified as important predictors for mortality. CONCLUSIONS: This study demonstrated the utilization of data mining method through a large data set with stan-dardized language format to identify the contribution of nursing care to patient's health.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomada de Decisões Assistida por Computador , Sistemas de Informação Hospitalar , Armazenamento e Recuperação da Informação , Meio-Oeste dos Estados Unidos , Registros de Enfermagem , Avaliação de Resultados em Cuidados de Saúde/métodos , Curva ROCRESUMO
The purpose of this study was to identify nursing care for elderly patients with dementia using Uniform Hospital Discharge Data Set (UHDDS) and Nursing Minimum Data Set (NMDS) of a community hospital in the United States Mid-west. The study sample included 222 elderly patients with dementia who were discharged in the year 1998. The findings were as follows. 1. The proportion of dementia in this study was 8.5% among total elderly patients. The most common associated disease was hypertension (n=40, 18.0%), followed by urinary tract infection (n=30, 13.5%). 2. The most frequent nursing diagnoses were altered health maintenance (n=158, 71.2%), knowledge deficit (n=150, 67.6%), potential for injury (n=119, 53.6%), potential for infection (n=102, 45.9%), pain (n=89, 40.1%), impaired physical mobility (n=78, 35.1%), and altered thought process (n=64, 28.8%). 3. The most frequent interventions were discharge planning (n=138, 62.1%), surveillance safety (n=86, 38.8%), fall prevention (n=78, 34.9%), teaching: disease process (n=74, 33.1%), learning facilitation (n=66, 29.5%), and infection protection (n=65, 29.3%). The results identified the need for continued work on the linkage of the nursing care elements, including nursing diagnosis, nursing intervention, and nursing-sensitive outcome, using the standardized languages.