HIT Support for Safe Nursing Care

描述（由申请人提供）：为了加强安全文化并减少医院单位的错误，来自高风险行业的经验可以提高卫生信息技术（HIT）支持的护士护理计划和记录保存的有效性。这一为期三年的项目支持护理规划过程，使围绕该过程的活动标准化和结构化，并使其在一个单位的护士之间、在不同单位之间以及在不同的卫生保健机构之间可转移。该研究的核心假设是，重新设计的hit支持的护理计划过程通过发展护士之间更大的“集体意识”、“正念”和“谨慎的相互联系”来促进信息流动，从而形成一种安全文化。本研究涉及AHRQ目标5，即关于HIT价值的知识的创造和传播，以及关于HIT在各种卫生保健环境中的益处的新知识和证据的创造。该项目的具体目标是：1)证明HIT可以成功实施，以支持护士在一个动态的护理计划过程中，包括单位内和跨医疗保健环境的护理计划和提供；2)证明由hit支持的护理规划过程能带来更强的安全文化。五家医疗机构的八个护理单位（第一年四个单位，第二年四个单位）将完成护理计划培训，并在实时条件下实施动手自动化护理数据系统（HANDS）护理计划流程，以测试沟通的标准化和改进以及安全文化的增强。数据分析和解释将为未来在全国范围内实时实施的长期目标提供信息，从而实现跨学科整合，并为电子健康记录（E.H.R.）的执行提供信息。

DESCRIPTION (provided by the applicant): To enhance safety culture and reduce errors in hospital units, lessons from high-risk industries can increase effectiveness of health information technology (HIT)-supported nurse care-planning and record-keeping. This three-year project supports the care planning process by standardizing and structuring the activities surrounding it, and making it transferable between nurses on one unit, between units, and among health care settings. The central hypothesis is that the reengineered HIT-supported care planning process leads to a safety culture through the development of greater "collective mind," "mindfulness," and "heedful interrelating" among nurses across time and settings by to facilitate information flow. This study addresses AHRQ Objective 5, relating to the creation and diffusion of knowledge regarding the value of HIT, and to the creation of new knowledge and evidence regarding the benefits of HIT in various health care settings. The specific aims of this project are: 1) to demonstrate that HIT can be successfully implemented to support nurses in a dynamic care planning process encompassing both the planning and provision of care within units and across healthcare settings; and 2) to demonstrate that a HIT-supported care planning process leads to a stronger safety culture. A convenience sample of eight nursing units (four units in year one, four units in year two) in five healthcare organizations will complete the care planning training and implement the Hands-on Automated Nursing Data System (HANDS) care planning process under real-time conditions to test standardization and improvement in communication and enhancement of a safety culture. Data analysis and interpretation will inform the long-range goal of a future real-time implementation in settings across the country, leading to interdisciplinary integration and informing execution of an Electronic Health Record (E.H.R.).