Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan:133:104016.
doi: 10.1016/j.ijmedinf.2019.104016. Epub 2019 Oct 31.

Identifying nurses' concern concepts about patient deterioration using a standard nursing terminology

Min-Jeoung Kang  1 , Patricia C Dykes  2 , Tom Z Korach  2 , Li Zhou  2 , Kumiko O Schnock  2 , Jennifer Thate  3 , Kimberly Whalen  4 , Haomiao Jia  5 , Jessica Schwartz  6 , Jose P Garcia  2 , Christopher Knaplund  6 , Kenrick D Cato  6 , Sarah Collins Rossetti  7
Affiliations

Identifying nurses' concern concepts about patient deterioration using a standard nursing terminology

Min-Jeoung Kang et al. Int J Med Inform. 2020 Jan.

Abstract

Objectives: Nurse concerns documented in nursing notes are important predictors of patient risk of deterioration. Using a standard nursing terminology and inputs from subject-matter experts (SMEs), we aimed to identify and define nurse concern concepts and terms about patient deterioration, which can be used to support subsequent automated tasks, such as natural language processing and risk predication.

Methods: Group consensus meetings with nurse SMEs were held to identify nursing concerns by grading Clinical Care Classification (CCC) system concepts based on clinical knowledge. Next, a fundamental lexicon was built placing selected CCC concepts into a framework of entities and seed terms to extend CCC granularity.

Results: A total of 29 CCC concepts were selected as reflecting nurse concerns. From these, 111 entities and 586 seed terms were generated into a fundamental lexicon. Nursing concern concepts differed across settings (intensive care units versus non-intensive care units) and unit types (medicine versus surgery units).

Conclusions: The CCC concepts were useful for representing nursing concern as they encompass a nursing-centric conceptual framework and are practical in lexicon construction. It enabled the codification of nursing concerns for deteriorating patients at a standardized conceptual level. The boundary of selected CCC concepts and lexicons were determined by the SMEs. The fundamental lexicon offers more granular terms that can be identified and processed in an automated fashion.

Keywords: Expression of concern; Information storage and retrieval; Standardized nursing terminology.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTERESTS

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Structure of terminology set used in research
Figure 2.
Figure 2.
Nursing concern scores for CCC concepts stratified by setting
Figure 3.
Figure 3.
Distribution of CCC concept counts
Figure 4.
Figure 4.
Hemodynamic and respiratory section of the entity and seed term matrix
See this image and copyright information in PMC

References

    1. Törnvall E, Wilhelmsson S. Nursing documentation for communicating and evaluating care. Journal of clinical nursing 2008;17(16):2116–24 - PubMed
    1. Association AN. ANA’s Principles for Nursing Documentation Guidance for Registered Nurses. American Nurses Association, 2010.
    1. Penoyer DA, Cortelyou-Ward KH, Noblin AM, et al. Use of electronic health record documentation by healthcare workers in an acute care hospital system. Journal of healthcare management 2014;59(2):130–44 - PubMed
    1. Cioffi J. Recognition of patients who require emergency assistance: a descriptive study. Heart & Lung: The Journal of Acute and Critical Care 2000;29(4):262–68 - PubMed
    1. Cioffi J. Nurses’ experiences of making decisions to call emergency assistance to their patients. Journal of advanced nursing 2000;32(1):108–14 - PubMed

Publication types