HIT Support for Safe Nursing Care

描述(由申请人提供)：为了加强安全文化和减少医院单元中的错误，来自高危行业的经验可以提高健康信息技术(HIT)支持的护士护理规划和记录保存的有效性。这个为期三年的项目支持护理规划进程，使其周围的活动标准化和结构化，并使其可在一个单位、单位之间和卫生保健环境中的护士之间转移。中心假设是，重新设计的HIT支持的护理计划流程通过在护士之间发展更大的“集体意识”、“专注力”和“留心相互联系”来促进信息流动，从而产生安全文化。这项研究涉及AHRQ目标5，涉及创造和传播关于HIT价值的知识，以及创造关于HIT在各种医疗保健环境中的益处的新知识和证据。该项目的具体目标是：1)证明可以成功地实施HIT，以支持护士在动态护理规划过程中提供支持，该动态护理规划过程包括在单位内和整个医疗保健环境中规划和提供护理；以及2)证明HIT支持的护理规划过程可以带来更强大的安全文化。五个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)的便利样本将完成护理规划培训，并在实时条件下实施动手自动化护理数据系统(HANDS)护理规划流程，以测试沟通的标准化和改进以及安全文化的加强。数据分析和解释将为未来在全国各地的环境中实时实施的长期目标提供信息，导致跨学科整合，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.).