Patient-level analysis of outcomes using structured labor and delivery data

  • Authors:

  • Eric S. Hall;Mollie R. Poynton;Scott P. Narus;Spencer S. Jones;R. Scott Evans;Michael W. Varner;Sidney N. Thornton

  • Affiliations:

  • Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA and Intermountain Healthcare, Salt Lake City, UT, USA;Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA and College of Nursing, University of Utah, Salt Lake City, UT, USA;Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA;Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA;Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA and Intermountain Healthcare, Salt Lake City, UT, USA;Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA;Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA and Intermountain Healthcare, Salt Lake City, UT, USA

  • Venue:
  • Journal of Biomedical Informatics
  • Year:
  • 2009

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Abstract

This paper presents methods for identifying and analyzing associations among nursing care processes, patient attributes, and patient outcomes using unit-level and patient-level representations of care derived from computerized nurse documentation. The retrospective, descriptive analysis included documented nursing events for 900 Labor and Delivery patients at three hospitals over the 2-month period of January and February 2006. Two models were used to produce quantified measurements of nursing care received by each patient. The first model considered only the hourly census of nurses and patients. The second model considered the size of nurses' patient loads as represented by computerized nurse-entered documentation. Significant relationships were identified between durations of labor and nursing care scores generated by the second model. In addition to the clinical associations identified, the study demonstrated an approach with global application for representing the amount of nursing care received at the individual patient level in analyses of patient outcomes.