Big data can help prepare nurses and improve patient outcomes by improving quality, safety, and outcomes
Article Category: Original Article
Data publikacji: 22 cze 2023
Zakres stron: 241 - 248
Otrzymano: 08 lis 2022
Przyjęty: 31 gru 2022
DOI: https://doi.org/10.2478/fon-2023-0026
Słowa kluczowe
© 2023 Muayyad Ahmad et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Figure 1.
EPHPP quality assessment tool for quantitative studies (n = 8).
| Domain | Stifter et al. |
Brennan and Bakken |
Remus |
Founds |
Gleason and Dennison Himmelfarb |
Procter and Wilson |
Hewner et al. |
Monsen et al. |
|---|---|---|---|---|---|---|---|---|
| Selection Bias | NA | NA | NA | NA | NA | NA | NA | NA |
| Study design | 1 | NA | NA | NA | NA | 2 | 1 | 1 |
| Control for confounders | NA | NA | NA | NA | NA | 2 | NA | NA |
| Blinding | NA | NA | NA | NA | NA | NA | NA | NA |
| Data collection methods | 1 | NA | NA | NA | NA | 2 | 2 | 2 |
| Withdrawals and drop-outs | NA | NA | NA | NA | NA | NA | NA | NA |
| Intervention integrity | NA | NA | NA | NA | NA | 2 | 1 | 2 |
| Analysis | NA | 2 | NA | NA | NA | NA | 1 | 1 |
Literature review matrix
| Study author | Title and year | Purpose | Additional description | Key findings | Recommendation\considerations |
|---|---|---|---|---|---|
| Janet Stifter, Yingwei Yao, Muhammad Kamran Lodhi, Karen Dunn Lopez, Ashfaq Khokhar, Diana J. Wilkie, Gail M. Keenan | Nurse Continuity and Hospital-Acquired Pressure Ulcer A Comparative Analysis Using an Electronic Health Record “Big Data” Set 2015 |
HANDS, an electronic nursing plan of care database, was used as the big data source. | The documentation system was used to collect data on nine units in four hospitals from 2005 to 2008. Two large community hospitals with medical-surgical and critical care units were included. |
All nine study units had poor nurse continuity (index = 0.21–0.42 [1.0 = optimal]). Nutrition, mobility, perfusion, hydration, skin problems, and age were linked to HAPUs (p.001). HAPU development was not significantly associated with patient characteristics, nurse continuity, or interactions between the two. -High variation in nurse continuity between patient episodes in HANDS data, offering rich potential for future study on nursing |
Nutrition, mobility, and perfusion are linked to HAPUs, but not nurse continuity. We found high variation in the degree of continuity between patient episodes in HANDS data, which offers rich potential for future study of nurse continuity and its effect on patient outcomes. This study used EHR big data containing nursing care plan documentation to examine a nurse-sensitive patient outcome. More research is needed, so hospital administrators can reorganize health care delivery systems to ensure safe, high-quality care for all hospitalized patients. |
| Patricia Flatley Brennan, Suzanne Bakken. | Nursing Needs Big Data and Big Data Needs Nursing 2015 | To use data science to improve patient outcomes. | Explore emerging federal big data initiatives and nursing informatics research exemplars to determine where nursing is poised to join the big data revolution. We reflect on big data initiatives. | Existing methods for analyzing large data sets are necessary but insufficient for nursing to join the big data revolution. The nursing SPS guides an ethical, principled approach to big data and data science. Implications for basic and advanced clinical nurses, nurse scientists who collaborate with data scientists, and nurse data scientists. | Big data and data science could benefit nursing clinicians and researchers. Big data can be used to improve comparative effectiveness surveillance, opportunity monitoring, adverse event identification, and public health surveillance. |
| Kelly T. Gleason, and Cheryl R. Dennison Himmelfarb | Big Data: Contributions, Limitations, and Implications for CVNs 2017 | Improve patient care and outcomes | Electronic health records, machine-generated data from cardiac monitors and ActiGraphs, social media including Facebook status updates and Twitter posts, and genome data are health care data sources. Big data analytics gives nurse scientists access to patient health data to answer clinical questions. |
Big data improves patient care. No major cost increases. Electronic health records make nurse documentation easier to analyze. |
Big data analytics can improve cardiovascular care. Big data allows researchers to study racial and ethnic minorities, among others. Nurses must continue to improve EHRs and mobile health technology. Nurses can include patient-reported outcomes in big data and use those data to develop an evidence base that helps patients and providers manage cardiovascular disease. |
| Monsen, Karen A.; Kelechi, Teresa J. McRae, Marion E. Mathiason, Michelle A. Martin, Karen S. | Data-driven discovery of novel patterns in archived clinical trial data 2018 | To illustrate the approach by exploring a large research data set with 95 variables (demographics, temperature measures, anthropometrics, and standardized instruments measuring quality of life and self-efficacy) using the Omaha System. | 2015–2017 annual deep dive study track work How will this understanding happen and how does nursing affect the trend of increasing access to data and information as sources improve in accuracy and timeliness? Develop professional curiosity, promote constructivist learning, and learn how to consider the context of care for patients. These data come from external systems that describe social determinants of health, such as a patient’s environment, economic status, community, transportation infrastructure, food access, climate, and pollution levels. Nurses need basic skills, especially with data (analytics). |
Reducing health disparities and improving providers’ ability to meet demand Recognize the nurse’s role in contextualized health care, which goes beyond EHR data. Develop a standard curriculum to teach nursing and interdisciplinary students to view, assess, and plan for the whole person (context). Obtain leadership buy-in to promote change to optimize collaborative care. This may involve expanding nursing activity, responsibility, and role. Strengthen nurse information skills for context-based collaborative care. Provide the nurse with big data manipulation and management, data science, data analytics, and visualization skills to enable collaborative eHealth. |
Nursing is highly skilled in the science of care, the application of justified interventions to meet diagnostic needs, and the ability to record such care in system-designed tools like the EHR. There is much discussion about using medical and social determinants of health data to plan post-acute care for patients. Nurses understand the importance of considering the whole patient, but many lack the data science and analytics skills to turn oceans of data into continents of knowledge. Thought leaders will map the path to co-create eHealth. Reduce health and social care costs |
| P.M. Procter and M.L. Wilson | eHealth, Nursing, and Big Data 2018 | Explore the changing influence of big data, specifically population and social determinants of health data, on co-created eHealth in a nursing domain over the past 3 years. |
2015–2017 annual deep dive study track How will this understanding happen and how does nursing affect the trend of increasing access to data and information as sources improve in accuracy and timeliness? Develop professional curiosity, promote constructivist learning, and learn how to consider the context of care for patients. This data comes from external systems that describe social determinants of health, such as a patient’s environment, economic status, community, transportation infrastructure, food access, climate, and pollution levels. Nurses need basic skills, especially with data (analytics). |
Reduce health inequalities and improve providers’ ability to meet demand Acknowledge the nurse’s professional curiosity in contextualized care that goes beyond EHR medical data. Prepare nursing and inter-disciplinary students in an academic setting to view, assess, and plan for the whole person in their population (context). Get leadership buy-in for change to optimize collaborative care; identify motivators. It may include a broader view of reimbursable nursing activity, responsibility, and role. Improve nurse information skills and contextbased collaborative care. Give the nurse information on big data manipulation and management, data science, data analytics, and visualization so she can activate collaborative eHealth. |
Nursing is highly skilled in the science of care, the application of justified interventions to meet diagnostic needs, and the ability to record such care in system-designed tools like the EHR. There is much discussion about using medical and social determinants of health data to plan post-acute care for patients. Nurses understand the importance of considering the whole patient, but many lack the data science and analytics skills to turn oceans of data into continents of knowledge. Thought leaders will map the path to co-create eHealth. Reduce health and social care costs |
| Sandra Founds | Big data and precision health require systems biology in nursing. 2017 | To discuss systems biology, big data, and precision health from a nursing perspective. | This update discusses systems biology, big data, and precision health from a nursing perspective. | Expanding technology and data sources, viewed from the perspective of systems biology, create opportunities for nursing in the era of big data and precision health. Systems biology helps nurse scientists and clinicians model biological and behavioral components with big data. Nurse scientists and clinicians should collaborate to synthesize big data and systems biology in clinical decision support applications and to integrate databases and platforms. In the era of comics, big data, and precision health, nursing can lead in education, research, and practice by teaching and upholding ethical standards. |
Systems biology can guide nurses and other clinicians in the acquisition, management, and modeling of multiomics data from people in health and illness in their environments. Nurses can help translate systems biology for precision health and advocate for patient engagement. Nursing research, education, and practice can incorporate systems biology to create and apply omics and big data to strengthen holistic precision health for all. |
| Sally Remus | CNEs and Big Data: Opportunities 2017 |
To connect CNE informatics competency and nursing knowledge development to big data. | Informatics competency and EBPs | CNEs with informatics skills can use Big data to develop nursing knowledge as eHealth project sponsors. Informatics-savvy CNEs are the new digital age transformational leaders who can advocate for nurses in 21st-century health systems. Transformational CNEs with informatics competency will position nurses and the nursing profession to achieve its future vision, where nurses are perceived as knowledge workers, providing leadership for safe, quality care and demonstrating nursing’s unique contributions to fiscal health through clinically relevant, EBPs. |
CNEs with informatics skills can write nursing’s big data script. Harnessing big data will position nurses and the nursing profession to achieve its future vision, where nurses are seen as knowledge workers providing leadership for safe, quality care and demonstrating nursing’s unique contributions to fiscal health through clinically relevant EBPs. |
| Sharon Hewner Suzanne S. Sullivan, Guan Yu. | Implementing best practice for transitional care using innovative technology and big data reduces ER visits and hospitalizations. 2018 | To improve post-discharge utilization value by identifying high-risk patients who could benefit from rapid nurse outreach to assess social and behavioral determinants of health and reduce inpatient and ED visits. | The intervention was applied to chronically ill discharged patients before and after comparisons. Nurses give a phone alert. This project evaluated health-related outcomes and nursing care value in the year before and the year of intervention using binomial regression to account for rare events. | The nurse care coordinator reduced inpatient and emergency visits by 25% and increased outpatient visits by 27%. | Frontline nurses pose questions and identify opportunities to use big data to support EBP and solve health care problems. Coordination of care must go beyond single settings and include social factors. To influence health care policy and research, nurses must demonstrate the tangible and intangible value of nursing care. |