Suggest a data mining project for your practice. Which information would you like to have about your practice area that could be extracted using data mining strategies?

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Suggest a data mining project for your practice. Which information would you like to have about your practice area that could be extracted using data mining strategies?

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In Crossing the Quality Chasm, the Institute of Medicine (IOM) Committee on Quality of Health Care in America identified the critical role of information technology in designing a health system that produces care that is safe, effective, patient-centered, timely, efficient, and equitable. Specifically highlight was the role of informatics in promoting patient safety and enabling evidence-based practice (EBP), 2 significant aspects for assuring healthcare quality. First, described were the components of an informatics infrastructure for patient safety and EBP. Second, the role of informatics in 4 areas: 1) information access; 2) communication among members of the healthcare team; 3) automated surveillance for real-time error detection and prevention; and 4) standardization of practice patterns. Last, some challenges for nursing and for informatics in the future and provide key recommendations for education, practice, policy, and research.

A scenario of how the various aspects of information infrastructure can be highlighted on the task of improving patient care through EBP. Consider a patient who is admitted to an inpatient medical service and is found to require a surgical procedure. The resident caring for the patient enters a progress note, complete with problem list and preoperative orders, into the hospital’s electronic medical record system. Because the system recognizes through a set of rules that one of the problems entered was a surgical procedure, it matches the procedure against a set of guidelines for preoperative patient care. The system notes that preoperative antibiotics are recommended for this particular procedure (based on a recent automated survey of local patterns of antibiotic resistance in bacterial infections in the hospital) and generates a reminder, alerting the physician to the fact that antibiotics have not been ordered. He or she subsequently orders an antibiotic. Later in the day, based on a creatinine level indicative of mild renal insufficiency, the system sends a message recommending that the antibiotic dose be reduced using the resident’s preferred notification method, his or her handheld device. The resident reads the message, chooses a more appropriate dose, and transmits the revised order to the hospital system.

The nurse who is reviewing the preoperative orders on his or her to do list is notified by the system of the change in dose order as is the pharmacy-dispensing system. Additionally, because he or she is not familiar with the operative procedure, the nurse selects an icon to initiate an EBP search to retrieve information regarding the most effective preoperative teaching method for the procedure in a patient with similar characteristics as the hospitalized patient. The search, which is tailored by clinical data from the information system, retrieves a teaching plan that is subsequently implemented and evaluated. Following the procedure, the teaching plan and key postoperative indicators related to effectiveness of the plan are added to the hospital’s library of preoperative teaching plans and related computer-based instructional materials where it can be accessed in the future using a case-based reasoning algorithm.

Although this scenario is not typical in today’s healthcare organization, it reflects implementation of existing rather than future methods and technologies that form an informatics infrastructure for patient safety and EBP.

Course content is taken from NURS I630 developed by Josette Jones, Indiana University Indianapolis.

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Activities for This Lesson
Forum 5.
Suggest a data mining project for your practice. Which information would you like to have about your practice area that could be extracted using data mining strategies?

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