Information Content Across Types of Nurse Cognitive Artifacts.

Acute care nurses commonly use personalized cognitive artifacts to organize information during a shift. The purpose of this content analysis is to compare information content across three formats of cognitive artifacts used by acute care nurses in a medical oncology unit: hand-made free-form, preprinted skeleton, and EHR-generated. Information contained in free-form and skeleton artifacts is more tailored to specific patient context than the NSR. Free-form and skeleton artifacts provide a space for synthesizing information to construct a "story of the patient" that is missing in the NSR. Future design of standardized handoff tools will need to take these differences into account for successful adoption by acute care nurses, including tailoring of information by patient, not just unit type, and allowing a space for nurses to construct a narrative describing the patients "story."

[Therapeutic Nursing in Neurological (Early-)Rehabilitation: A Grounded Theory Study]. / Therapeutische Pflege in der neurologischen (Früh-)Rehabilitation: Eine Grounded-Theory-Studie.

PURPOSE: What is therapeutic nursing? This question is gaining relevance in the context of the billing of services in the DRG system (DRG=Diagnosis-Related Groups), because in paragraph 8-552 of the operations and procedures coding system (OPS), it is explicitly stated that therapeutic care must be carried out by specially trained personnel. To date, empirical results on therapeutic nursing in neurological early rehabilitation are sparse. The objective of the study is to develop a theory of therapeutic care in neurological early rehabilitation. MATERIALS AND METHODS: The study is based on the method of grounded theory. Open participatory observations (n=92) and episodic interviews (n=10) with nursing professionals and nursing auxiliaries were conducted in 5 inpatient rehabilitation clinics. RESULTS: The theory of therapeutic nursing includes 6 categories: (1) nursing care, (2) observation/perception, (3) communication, (4) autonomy and individual needs of patients and their relatives, (5) multi-professional team and (6) prerequisites. DISCUSSION: The results indicate which aspects are included in therapeutic nursing and the necessary prerequisites for delivering therapeutic nursing. Against this background, continuing education programs reveal conspicuous gaps in the area of knowledge transfer and application in practice. CONCLUSIONS: The results of the study should be taken into consideration and integrated in nursing education, both at the basic level and in continuing education.

Harmonizing Nursing Terminologies.

In this paper, the authors report on a study aimed at harmonising two nursing terminologies, the Clinical Care Classification (CCC) and the International Classification for Nursing Practice (ICNP®). As the electronic health record evolves and the need for interoperability extends beyond local and national borders, a degree of standardisation across healthcare terminologies become essential. Harmonising across terminologies results in a) increased consensus relating to domain content and b) improvements in the terminologies involved. Findings from this study suggest that there is much overlap of content in nursing terminologies. The continued harmonisation between nursing terminologies and other healthcare terminologies are recommended to achieve international interoperability.

[Catalogues of therapeutic nursing activities in neurological early rehabilitation]. / Leistungskataloge der aktivierend-therapeutischen Pflege in der neurologischen Frührehabilitation.

Under the German DRG-system, hospital-based rehabilitation of still critically ill patients becomes increasingly important. The code for early neurological rehabilitation in the DRG-system's (Diagnosis Related Groups) list of operations and procedures requires an average daily therapeutic intensity of 300 min, part of which is being contributed by therapeutic nursing. As therapeutic aspects are integrated in other nursing activities, it is difficult to separate its time consumption. This problem is pragmatically resolved by catalogues of therapeutic nursing activities which assign plausible amounts of therapeutic minutes to each activity. The 4 catalogues that are used most often are described and compared. Nursing science has not focused yet on therapeutic nursing.

Information model for learning nursing terminology.

Standardized terminologies are introduced in healthcare with the intention of improving information quality, which is important for enhancing the quality of healthcare itself. The International Classification for Nursing Practice (ICNP®) is a unified language system that presents an ontology for nursing terminology; it is meant for documentation of nursing diagnoses, nursing interventions and patient outcomes. This paper presents an information model and an application for teaching nursing students how to use ICNP to assist in the planning of nursing care. The model is an integration of ICNP and our catalog ontology, patient journal ontology, and ontology defining task sets. The application for learning nursing terminology offers descriptions of patient situations and then prompts the student to supply nursing statements for diagnoses, goals and interventions. The nursing statements may be selected from catalogues containing premade solutions based on ICNP, or they may be constructed directly by selecting terms from ICNP.

Discovering health knowledge in the BC nurse practitioners encounter codes.

Integrating the Nurse Practitioner (NP) role into clinical practice settings is new in British Columbia (BC), Canada. Encounter codes are unique numeric codes assigned to specific types of patient care services performed by NPs. In this study we apply knowledge discovery techniques to analyze the encounter codes extracted from the BC Ministry of Health database to understand the most common practice activities carried out by NPs and what diseases patients sought care for from NPs. The analysis produced important information about NPs' practice patterns. This work leads to a better understanding of NP practice patterns in BC.

[Therapeutic nursing: a systematic review]. / Therapeutische Pflege und Rehabilitation: Eine systematische Literaturübersicht.

BACKGROUND: For some years therapeutic service catalogues have been established in medical rehabilitation which have broadened our previous understanding of nursing actions. Currently, therapeutic nursing plays a prominent role in neurological early rehabilitation because the operations and procedures coding system (OPS) 8-552 within the DRG-System (Diagnosis Related Groups) states that therapeutic nursing must be carried out by specially trained nursing personnel. This requirement leads to inconsistencies in nursing practice and the medical service of the health insurance (MDK) since a definition of therapeutic nursing is lacking. A previous review of therapeutic nursing in 2003 focused primarily on the development of the therapeutic nursing role, but not on therapeutic nursing itself. The following article contains the first systematic review of the current state of research regarding a definition of therapeutic nursing. For this purpose, a systematic study was conducted to examine if there are, nationally or internationally, any definitions of therapeutic nursing and to identify what the therapeutic aspects of nursing are. METHODS: The research included following database; Medline, Cinahl and Embase. Additionally, a research by hand of several German journals as well as textbooks and specialized literature was carried out. RESULTS: 5 studies were selected which define the term "therapeutic nursing". Among these are one review, one primary study, one theoretical discussion and one dissertation. Further twenty four studies were identified which do not define the term, but are closely related to the subject, and use or characterize the term in various contexts. CONCLUSIONS: The publications examined provided indications of duties, interventions and roles nurses should perform, but not how to carry these out, nor what is therapeutic about the nursing. At the same time, the low number of studies reveals that therapeutic nursing has barely been examined and demonstrates the lack of theoretically grounding through nursing science.

Going beyond patient classification systems to create an evidence-based staffing methodology.

The Department of Veterans Affairs developed a nationally standardized nurse staffing methodology, using an evidence-based process. We present an overview, linking an integrative review of recent literature on patient classification systems, interdisciplinary expert panel consultation, operational feasibility assessment, and frontline manager involvement. This resulted in 7 candidate indicators for inclusion in unit-specific staffing models. Adaptable to all healthcare settings, this process goes beyond traditional patient classification systems.

Clasificación de las evidencias por su diseño y utilidad. La investigación secundaria cualitativa / Classification of evidences according to their design and utility. The bibliographic qualitative research

Este trabajo propone un esquema de clasificación de las pruebas cualitativas en base al diseño y a su utilidad. Por su diseño, las evidencias se pueden clasificar en cuatro niveles, en cuyos extremos están la meta síntesis cualitativa y el estudio de caso. Por su utilidad, las pruebas se clasifican en virtud de su capacidad para dar respuesta a un problema relevante. También se realidad una aproximación a la investigación secundaria cualitativa (revisión sistemática y meta análisis cualitativo), definida aquí como la síntesis de varios estudios cualitativos tras la lectura crítica y la clasificación de sus hallazgos, es decir, tras el análisis estructurado de investigaciones que tratan sobre un mismo problema. Por tanto, la lectura crítica y la clasificación de los hallazgos cualitativos son la base de la investigación secundaria cualitativa (AU)

This paper proposes a classificatory scheme of proofs according to their design and utility. As far as design is concerned, proofs can be classified according to their potential to account for a significant problem. The paper also deals with the secondary qualities investigation (systematic revision and qualitative met analysis), which is here defined as the synthesis arising from a number of qualitative studies after the critical reading and classification of their (..) (AU)