Requirements of tools and techniques to support the entry of structured nursing data

Abstract

The benefits of structured data are widely accepted within the nursing informatics community. However, despite the existence of structured data in the form of well-established nursing terminologies, computer-based nursing record systems are yet to achieve widespread adoption and few of the potential benefits have yet to be realized. In this paper we argue the need for tools and techniques to support the entry of structured nursing data into computer-based systems. In the absence of a generally accepted solution, we build on preliminary work carried out at the 2002 Nursing Terminology Summit and analyze the results of other studies in order to identify a preliminary set of requirements or desiderata for such tools and techniques. These requirements are centered on: how structured data is presented to users for selection; how to mediate between a variety of conceptual structures--terminologies, information models, user interface models and models of the clinical process; and how to reduce the considerable modeling burden through reuse of modeling constructs. Further applied research is needed with the ultimate goal of developing a general solution that will benefit nurses, other professionals and ultimately their patients.