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首页> 外文学位 >Early referral for nurse case management services in hospitalized adults: Electronic health record decision support.
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Early referral for nurse case management services in hospitalized adults: Electronic health record decision support.

机译：住院成人护士病例管理服务的早期转诊：电子病历决策支持。

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摘要

Background: Patients with complex needs should be identified early to mobilize appropriate referral to nurse case management (NCM) services for discharge planning facilitated by the use of electronic health record (EHR) decision-support processes.Objectives: To explore NCM service referral in a pre- and post-decision support EHR application using the EHR nursing admission history of adult hospitalized patients. Nurse case managers' priority concerns for referred patients were also examined.Method: Retrospective data of hospitalized cardiopulmonary medical and surgical patients were obtained from the health care record using electronic and manual data collection methods in pre- and post-decision support periods in 2008 from a midwestern United States city.Results: There were significantly more NCM service referrals in the post- decision support group suggesting that the addition of auto-referral in the nursing admission history enhanced nurse decision-support. Drug use and use of community equipment and service prior to admission positively predicted nurse-referral for NCM services in the post-decision support period. Advanced age, overall functional status, drug use and community equipment and service use positively predicted auto-referral to NCM services. Cognitive deficit was a significant predictor for auto-referral to NCM services in the post-decision support group when the auto-referral variables were not included in the logistic regression model. The priority concerns identified by case managers for NCM referred patients included home care agency use, post-discharge placement services, power of attorney documentation completion, insurance and financial concerns, and oxygen and other home equipment and service needs.Conclusions: The assessments of patients' needs, using the nursing admission history and a discharge screening tool, could improve NCM referral. Nurse-referral continues to be a valuable complement to EHR auto-referral for NCM services. Auto-referral for NCM services increased when patient factors were used to trigger EHR automatic NCM referral. Further research into the variables of functional status, cognitive status, drug use, community equipment and service and age to predict the need for NCM services is recommended.
机译：背景：应尽早确定具有复杂需求的患者，以动员适当的转介到护士病例管理（NCM）服务以通过电子健康记录（EHR）决策支持程序促进出院计划。决策前和决策后支持使用成人住院患者的EHR护理入院史进行EHR应用。方法：从2008年的决策前和决策后支持期，通过电子和手工数据收集方法，通过医疗记录收集住院的心肺内科和外科患者的回顾性数据。结果：决策后支持小组中的NCM服务转诊明显增加，这表明在护理入院史中增加了自动转诊，这增强了护士的决策支持。入院前的药物使用以及社区设备和服务的使用在决策后的支持期内积极预测NCM服务的护士转诊。高龄，总体功能状况，药物使用以及社区设备和服务使用情况会积极预测自动推荐给NCM服务。当自动转诊变量未包括在逻辑回归模型中时，认知缺陷是决策后支持组自动转诊NCM服务的重要预测指标。案例管理员针对NCM推荐的患者确定的优先考虑事项包括家庭护理机构的使用，出院后安置服务，授权书完成，保险和财务问题以及氧气和其他家庭设备和服务的需求。结论：对患者的评估使用护理入院历史和出院筛查工具的需求可以改善NCM推荐。护士转诊仍然是NCM服务的EHR自动转诊的宝贵补充。当使用患者因素触发EHR自动NCM转诊时，NCM服务的自动转诊增加。建议对功能状态，认知状态，药物使用，社区设备和服务以及年龄等变量进行进一步研究，以预测是否需要NCM服务。

著录项

  • 作者

    Greene, Maureen T.;

  • 作者单位

    The University of Wisconsin - Milwaukee.;

  • 授予单位 The University of Wisconsin - Milwaukee.;
  • 学科 Information Technology.Health Sciences Nursing.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 167 p.
  • 总页数 167
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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