Zarbano, Jonna J

Abstract Objectives The primary objective of this research is to assess the content coverage of nursing data within a publicly available common data model (CDM), focusing on how nursing data, documented in flowsheets, are represented within the model. Materials and Methods This mapping study was informed by previous evaluation studies and serves as a framework for evaluating information resources, including to guide development and implementation. The overall research process consists of 4 steps: (1) identify a CDM; (2) define evaluation criteria; (3) map nursing flowsheet data; and (4) apply evaluation criteria. Results Overall, 65.5% (n = 1170) of the flowsheet concepts were mapped to Systematized Nomenclature of Medicine—Clinical Terms (SNOMED CT) and Logical Observation Identifiers Names and Codes (LOINC) target codes and 56.0% (n = 1831) of the flowsheet values were mapped to SNOMED CT and LOINC target codes. The flowsheet concepts had a higher average mapping time per concept/reviewer (1.19 min) as compared to the average mapping time per value/reviewer (0.64 min). Discussion This mapping study demonstrated the progress and ongoing challenges of mapping nursing data to a national common data model. However, the ability to use nursing data at scale in a national CDM remains limited until more comprehensive mapping is completed. Conclusion This mapping study identifies a significant gap in integrating nursing data into a national common data model, highlighting an opportunity to enhance patient care through improved real-time insights and evidence-based nursing practices. Addressing this gap can help shape policies that prioritize the inclusion of nursing data. Additionally, aligning nursing data at scale can advance research, increase efficiency, and optimize nurse-sensitive patient outcomes.

Background After an increase of central line–associated bloodstream infections (CLABSIs) at our community hospital in 2021, a case-control study suggested that patients with CLABSIs were 3.0 times more likely to have missed daily chlorhexidine gluconate (CHG) bathing than patients without CLABSIs. Objective To increase the rate of daily CHG bathing in hospitalized patients with central lines and subsequently reduce the number of CLABSIs. Methods Our pre-post intervention was launched on September 2022 and consisted of enhancements to the electronic health record (EHR) to simplify the identification of overdue CHG bathing instances to increase compliance, and therefore decrease the CLABSI rate at our hospital. A workflow was implemented Monday–Friday utilizing these EHR enhancements for active surveillance to engage frontline nursing staff and address gaps in care in real time. Results After the initiative was implemented, adherence to daily CHG bathing increased from 94.9% to 95.3%, with a considerable disparity between weekdays (97.6%) and weekends (89.3%). After weekend data were excluded, the post-intervention increase in the adherence rate was statistically significant ( p = .003). Discussion This initiative underscored the importance of involving health care informatics partners and showed how technology can bridge gaps in health care quality. Outreach and reminders effectively improved CHG bathing adherence by emphasizing the importance of consistent communication and follow-up.