Linkages Between Nursing Care and Improved Patient Outcomes
Linkages Between Nursing Care and Improved Patient Outcomes
Nurse informaticists have long recognized both the barriers and the potential of health IT for capturing and using clinical data (Zielstorff et al., 1995). This article underscores the complexity of building linkages between nursing care and improved patient outcomes and the need for eMeasures and health IT to achieve this goal. The recent AARA and MU legislation creates an opportunity for nurses to advocate for indicators and for health IT systems that facilitate scalable approaches to capturing clinical data at the point of care and for reusing those data to populate nursing sensitive indicators.
While this legislation establishes standards to promote adoption of terminologies that will likely expand data reuse and improve interoperability of systems, it is not a panacea. Prerequisites for health IT systems that will build linkages between nursing care and patient outcomes include an informatics infrastructure where eMeasures are widely available and adopted. In addition, nursing content standards are needed for use in electronic systems (e.g., fall and pressure ulcer risk assessment scales) and standard terminologies to encode that content. The MU standards are basic requirements and are not focused on representing nursing care (ANA, 2013). Adoption of standards that support representation of nursing care and patient outcomes that are sensitive to that care are needed to achieve a scalable approach to build linkages between these variables.
Achieving an informatics infrastructure to support a health system that routinely builds linkages between nursing care and patient outcomes requires a concentrated effort. A focus is needed on transforming nursing indicators into eMeasures and building usable health IT systems that support nursing practice and produce structured, coded data to populate eMeasures. While there has been some progress to identify and operationalize indicators of nursing sensitive care (ANA, 2013; The Joint Commission., 2009), to date none of these indicators are designated as eMeasures. Further, very few rigorous studies have been conducted to measure the impact of health IT on nursing practice and patient outcomes. Additional research is needed to establish the types of systems associated with improved process and outcome indicators and determine how to integrate them into the workflow to capture and use clinical data as a byproduct of nursing care.
Conclusion
Nurse informaticists have long recognized both the barriers and the potential of health IT for capturing and using clinical data (Zielstorff et al., 1995). This article underscores the complexity of building linkages between nursing care and improved patient outcomes and the need for eMeasures and health IT to achieve this goal. The recent AARA and MU legislation creates an opportunity for nurses to advocate for indicators and for health IT systems that facilitate scalable approaches to capturing clinical data at the point of care and for reusing those data to populate nursing sensitive indicators.
While this legislation establishes standards to promote adoption of terminologies that will likely expand data reuse and improve interoperability of systems, it is not a panacea. Prerequisites for health IT systems that will build linkages between nursing care and patient outcomes include an informatics infrastructure where eMeasures are widely available and adopted. In addition, nursing content standards are needed for use in electronic systems (e.g., fall and pressure ulcer risk assessment scales) and standard terminologies to encode that content. The MU standards are basic requirements and are not focused on representing nursing care (ANA, 2013). Adoption of standards that support representation of nursing care and patient outcomes that are sensitive to that care are needed to achieve a scalable approach to build linkages between these variables.
Achieving an informatics infrastructure to support a health system that routinely builds linkages between nursing care and patient outcomes requires a concentrated effort. A focus is needed on transforming nursing indicators into eMeasures and building usable health IT systems that support nursing practice and produce structured, coded data to populate eMeasures. While there has been some progress to identify and operationalize indicators of nursing sensitive care (ANA, 2013; The Joint Commission., 2009), to date none of these indicators are designated as eMeasures. Further, very few rigorous studies have been conducted to measure the impact of health IT on nursing practice and patient outcomes. Additional research is needed to establish the types of systems associated with improved process and outcome indicators and determine how to integrate them into the workflow to capture and use clinical data as a byproduct of nursing care.
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