Content Analysis of Nursing Integumentary Diagnoses and Interventions: Firsts Step Towards a Wound Healing Information Model
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Abstract
Wound care specialists are essential to meet the growing need to prevent and treat acute and chronic wounds affecting millions worldwide. Information systems with clinical decision support become essential by collecting, codifying, and storing knowledge, and returning information on-screen to the nurse.Goals: This study aims to identify opportunities for semantic interoperability improvement through the analysis of all diagnoses and interventions used in a public Health Information System related to the integumentary system. Methods: A qualitative descriptive study of nursing diagnoses and interventions data. We selected the Portuguese national Health Information System for data analysis since it was recognized for the progress in terms of information and communications technologies used in the health sector. All nursing diagnoses, interventions, and their relationships available for selection in clinical practice regarding wound healing were analyzed. We performed this research in two phases: (1) Content analysis of nursing diagnoses and interventions, revised by two external experts, and (2) Focus group with Health Information Systems and terminologies experts to discuss and implement contributions to a wound healing clinical model.Results: We matched 66 diagnoses, 171 interventions, and 318 relationships to the integumentary system. Nursing interventions were centered on three action types: performing, determining, and informing. We found unexpected inconsistencies regarding the association between teaching actions and missing knowledge-centered diagnoses. The focus group added an essential perspective on interventions from other domains becoming essential to wound healing. Conclusions: Nurses use standardized language to describe nursing concepts in daily practice. Semantic interoperability is still questionable by persistent changes based on opinions instead of scientific knowledge, with no known public rules or procedures. A qualitative approach allowed for improvements in the concepts used to represent clinical practice and the sentences construction validity.
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Atkin, L., & Tickle, J. (2018). Best practice statement leg ulceration pathway: revision required to reflect new evidence. Wounds UK, 14(4).
Bahr, S. J., & Weiss, M. E. (2019). Clarifying model for continuity of care: a concept analysis. International journal of nursing practice, 25(2), e12704.
Bardin, L. (1977). Análise de conteúdo (Vol. 70).
Batista da Cunha, J., Alves Dutra, R. A., Magela Salomé, G., & Masako Ferreira, L. (2018). Computational system applied to mobile technology for evaluation and treatment of wounds. Revista de Enfermagem UFPE, 12(5). https://doi.org/10.5205/1981-8963- V12I5A230677P1263-1272-2018
Bezemer, T., De Groot, M. C., Blasse, E., Ten Berg, M. J., Kappen, T. H., Bredenoord, A. L., Van Solinge, W. W., Hoefer, I. E., & Haitjema, S. (2019). A human (e) factor in clinical decision support systems. Journal of medical Internet research, 21(3), e11732. https://doi.org/10.2196/11732
Cruz, I., Bastos, F., Pereira, F., Silva, A., & Sousa, P. (2016). Analysis of the Nursing Documentation in–Building a Clinical Data Use in Portugal Model of Nursing Centered on the Management of Treatment Regimen. Nursing Informatics 2016: EHealth for All: Every Level Collaboration–From Project to Realization, 225, 407. https://doi.org/10.3233/978-1-61499- 658-3-407
European Observatory on Health Systems and Policies. (2018). Health System Review - Portugal, Phase1 Final Report. https://www.sns.gov.pt/wp-content/uploads/2018/04/PortugalReviewReport_Printers_03April2018-2.pdf
Gonçalves, P., Sequeira, C., & Silva, M. (2019). Content analysis of nursing diagnoses in mental health records in Portugal. International nursing review, 66(2), 199-208. https://doi.org/10.1111/inr.12493
Gruber, T. (1993). What is an Ontology.
International Council of Nurses. (2017). International Classification for Nursing Practice. Retrieved 2021/01/23 from https://www.icn.ch/what-we-do/projects/ehealth-icnptm/icnp-browser
International Organization for Standardization. (2014). Health informatics — Categorial structures for representation of nursing diagnoses and nursing actions in terminological systems (ISO 18104).
International Organization for Standardization. (2015). Health informatics - Detailed clinical models, characteristics and processes (ISO/TS 13972:2015).
Itulua-Abumere, F. (2015). Outlines of Focus Group: Exploring the potentials of focus group research method/ perspective for practical research purposes whilst indicating the limitations and advantages of the method. https://doi.org/10.13140/RG.2.1.4509.8966
Ivins, N., Clask, M., & Fallon, M. (2018). An initiative to improve wound management within community services across one Clinical Commissioning Group in England. Wounds UK, 14(5).
Lindholm, C., & Searle, R. (2016). Wound management for the 21st century: combining effectiveness and efficiency. International wound journal, 13, 5-15. https://doi.org/doi.org/10.1111/iwj.12623
Lozano-Rubí, R., Carrero, A. M., Balazote, P. S., & Pastor, X. (2016). OntoCR: A CEN/ISO-13606 clinical repository based on ontologies. Journal of biomedical informatics, 60, 224-233. https://doi.org/https://doi.org/10.1016/j.jbi.2016.02.007
Lumbers, M. (2018). Wound debridement: choices and practice. British Journal of Nursing, 27(15), S16-S20. https://doi.org/10.12968/bjon.2018.27.15.s16
Neves, H., & Parente, P. (2019). A nursing clinical data model for neuromuscular processes: content analysis of the Portuguese nursing customization. Ciencia & saude coletiva, 24, 1609- 1616. https://doi.org/10.1590/1413-81232018245.04462019
Nussbaum, S. R., Carter, M. J., Fife, C. E., DaVanzo, J., Haught, R., Nusgart, M., & Cartwright, D. (2018). An economic evaluation of the impact, cost, and medicare policy implications of chronic nonhealing wounds. Value in Health, 21(1), 27-32. https://doi.org/10.1016/j.jval.2017.07.007
Ordem dos Enfermeiros. (2018). OE celebra parceria com Escola Superior de Enfermagem do Porto. Retrieved 2021/01/21 from https://www.ordemenfermeiros.pt/noticias/conteudos/oe-celebra-parceria-com-escola-superior-de-enfermagem-do-porto/
Paiva, A., Cardoso, A., Sequeira, C., Morais, E., Bastos, F., & Pereira, F. (2014). Análise da parametrização nacional do Sistema de Apoio à Prática de Enfermagem-SAPE®. Escola Superior de Enfermagem do Porto, Porto. http://hdl.handle.net/10400.26/31982
Queirós, C., Silva, M. A. T. C. P., Cruz, I., Cardoso, A., & Morais, E. J. (2021). Nursing diagnoses focused on universal self?care requisites. International nursing review. https://doi.org/10.1111/inr.12654
Samuriwo, R., & Dowding, D. (2014). Nurses’ pressure ulcer related judgements and decisions in clinical practice: a systematic review. International journal of nursing studies, 51(12), 1667- 1685. https://doi.org/10.1016/j.ijnurstu.2014.04.009
Strickler, J. (2017). Florence Nightingale: Lighting the way for the future of nursing. Nursing, 47(12), 43-45. https://doi.org/10.1097/01.nurse.0000526887.95058.3b
WOCN Task Force. (2018). Wound, Ostomy, and Continence Nursing: Scope and Standards of WOC Practice, 2nd Edition: An Executive Summary. J Wound Ostomy Continence Nurs, 45(4), 369-387. https://doi.org/10.1097/WON.0000000000000438
Woo, K., Conceição de Gouveia Santos, V. L., & Alam, T. (2018). Optimising quality of life for people with non-healing wounds. Wounds International, 9(3), 6-14. http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=131918860&lang=pt- br&site=ehost-live
World Health Organization. (2017, 2017/07/04). International Classification for Nursing Practice (ICNP). Retrieved 2020/02/18 from https://www.who.int/classifications/icd/adaptations/icnp/en/