Nursing InformaticsThe Impact of Nursing Knowledge on

Health Care Informatics

Edited by

U. GerdinSwedish Institute for Health Services Development,

Stockholm, Sweden

M. Tallberg

Kuopio University, Kuopio, Finland

and

P. WainwrightDepartment of Nursing, Midwifery and Health Care,

University of Wales, Swansea, Wales, UK

IOSPress

UNIVERSITATSBiBLIOTHEKHANNOVER

TECHNISCHEINFORMATIONSBIBLIOTHEK

Ohmsha

Amsterdam • Berlin • Oxford • Tokyo • Washington, DC

Table of Contents

Foreword xvEditorial xviiGreetings from the Scientific Programme Committee xixA Message from the Chair, NI'97 Organising Committee xxiAcknowledgements xxiiiNF97 Committees xxv

PAPERS

Terminology and Classification

A Compositional Approach to Nursing Terminology, N. Hardiker and J. Kirby 3Nursing Intervention Intensity and Focus: Indicators of Process for Outcomes Studies,

S.J. Grobe, L.C. Hughes, L. Robinson, D.C. Adler, I. Nuamah and R. McCorkle 8Evaluating Standardized Coding and Classification Systems for Clinical Practice:

a Critical Review of the Nursing Literature in the United States, S.B. Henry andC.N. Mead 15

An Evaluation of the Utility of the Home Health Care Classification for CategorizingPatient Problems and Nursing Interventions from the Hospital Setting,W.L. Holzemer, SB. Henry, C. Dawson, K. Sousa, C. Bain and S.F. Hsieh 21

Strategies and Tools for Creating a Common Nursing Terminology within a LargeHealth Maintenance Organization, C.A. Zingo 27

The Danish National Health Classification System - Nursing InterventionsClassification - a Part of a Common Danish Health Care Classification, /. Madsenand S.A. Jytte Burgaard 32

Development of Nursing Informatics

New Challenges for Nursing Informatics, M.J. Ball, J. V. Douglas and B.J. Hoehn 39Important Considerations about Nursing Intelligence and Information Systems,

E.C. Bollard 44Effects of a Nursing Information System in 5 Dutch Hospitals, F. Eurlings,

A. van Asten, H. Cozijn, K. Klaassen, R. Stokman, R. van Valkenburg andE. van Gennip 50

Nursing Informatics in Germany: Hospitals on the Track, B. Schulz and S. Steeneck 56The International Classification for Nursing Practice: A Progress Report,

Dame J. Clark 62Developing Informatics as a Discipline, J.P. Turley 69

Monitoring and Management

Data Extraction and Archiving for Nursing Research Using a Bedside ClinicalInformation System, J. Saville, L. Goodwin and D. Bryars 11

Development of a Computerized Database for a Nursing Quality ManagementProgram, JM. Welton 82

Design & Implementation of an Automated Questionnaire, R.L. Carr, CD. Snowand R.A.J. Youngson 88

Patient Outcomes and Nurses'Classification Data, E.J. Halloran, JM. Welton,S.R Englebardt and M. W. Thorson 94

Health-Related Outcomes Management: Moving Forward Standing Still,J.S. Shamian, LM. Nagle and M.A. Catt 99

Improving Nursing Documentation to Include Outcomes of Care in ComputerizedInformation Systems, K.A. McCormick 105

Current Status of Informatics Education

Computer Literacy: Expected Learning Outcomes in Nursing Studies and the Reality,K. Saranto and H. Leino-Kilpi 113

Organizational Diagnosis of Computer and Information Learning Needs: The Processand Product, R. Nelson and B. Anton 118

The Information Age: The Status of Technology in Nursing Education Programs in theUnited States, B. Carty and P. Rosenfeld 125

The Current Status of Nursing Informatics in Undergraduate Nursing Programs:Comparative Case Studies between Sweden and Australia, J.L. Hardy,R. Lindqvist, M.-L. Kristofferzon and O. Dahlberg 132

Educating Clinicians

An Informatics Education for Improved Nursing by Introducing and Easy DataBase System, Y. Narita, R. Satou, H. Takahashi, K. Miura and Y. Takemoto 139

Education of Clinical Nurses in Nursing Documentation in Accordance with theVIPS-model, C. Bjorvell and I. Thorell-Ekstrand 145

Computerized Education in a Multi Hospital University Medical Center, M.R. Priceand R.R. Wieczorek 149

Understanding Surgery: Multimedia Comes to Theatre, S. Dakin, M. Garner andM. Plura 153

System Design

Nursing Information in Electronic Patient Records: Criteria Established in a DelphiStudy, W.T.F. Goossen, P.J.M.M. Epping and T.W.N. Dassen 161

System Design Challenges: The Integration of Controlled Vocabulary Use into DailyPractice, K. Douglas and M. Nubie 167

Using a Revised Model to Identify Information Requirements for Cardiac SurgeryPatients Operating Mobile Computing Technology, C.A. Gassert 172

The Wisecare Project and the Impact of Information Technology on NursingKnowledge, W. Sermeus, D. Hoy, N. Jodrell, A. Hyslop, T. Gypen, J. Kinnunen,J. Mantas, L. Delesie, J. Tansley, and J. Hofdijk 176

Informatics Curricula

Nursing Informatics in Nursing Education, V.K. Saba and J.B. Riley 185Nursing Informatics in a Registered Nurse Graduate Program, J. Aroian and

O. Breton 191The Role of Nurse Education in the Integration of Information in the Health Care

Environment, P.M. Procter 195Keeping Education in Health Informatics on the Right Track, C. N0hr, A. Bygholm

and O. Hejlesen 201

Implementation

Benefits Realisation in Maternity Information Systems, H.J. Betts andR. Gunn-Russell 209

Partners in Powersharing - The Role of Midwives in Information Technology,T. Carroll, M. Lavin, K. Muldoon, M. Williams and M.A. Kelly 215

Evaluation of Community Nursing Information Systems, A. Lang0en and T. Bjelland 220Using Reengineering to Improve "Customer Visit Processes", D. Salois-Swallow 223

Research Methods

Developing a Generic Health Status Measure for Use in a Computer-Based OutcomesInfrastructure, M.T. Lush, S.B. Henry, K. Foote andD.L. Jones 229

Description of a Comprehensive Research Project to Develop a Reference Model forNursing Information Systems, P.J.M.M. Epping and W.T.F. Goossen 235

Determining an Appropriate Clinical Problem for Expert System Development in theNeonatal Intensive Care Unit, T.L. Panniers 241

A Collaborative International Nursing Informatics Research Project: Predicting ARDSRisk in Critically 111 Patients, L. Goodwin, J. Saville, B. Jasion, B. Turner,J. Prather, T. Dobousek and S. Egger 247

Standards

Attention for Security now more Needed than Ever, E.S.P. Pluyter-Wenting 253Nursing Information and Data Set Evaluation Center, K. Marek, J. Kneedler,

R. Zielstorff, C. Delaney, P. Marr, C. Averill and D.K. Millholland 257Collection of Nursing Minimum Data Set (NMDS) Could Benefit from Medical

Encoding Experiences, P. Weber, C. Lovis, P.-A. Michel and R. Baud 263European Standardization in Healthcare Informatics and the Need for Increased

Involvement of Healthcare Professionals, K. Kajbjer 269A Conception of a Support System for Optimising the Organisation of Nursing Staff

from the Viewpoint of the Nursing Care Needs Structure, S. Tsuru, S. Shindob,Y. Takatanic and A. Seod 275

Knowledge and Decision Support Research

Exploring Nursing Knowledge by Using Digital Photography, B. McGuiness andR.Axford 281

'Shared Care' and Computer Assistance in Glaucoma Management, L. Martin 288A Knowledge-Based Decision Support System for Prevention and Treatment of

Pressure Ulcers, R.D. Zielstorff, G.O. Barnett, G. Estey, G. Hamilton, A. Vickery,E. Welebob, J.B. Fitzmaurice and C. Shahzad 291

Decision Support for Assessing Patient Preferences for Geriatric Care, CM. Ruland,D. Kresevic, P.F. Brennan and M. Lorensen 296

Computerized Decision Support Systems: Implications for Practice, B.J. Braden,C. Corritore and P. McNees 300

Thinking in Nursing Practice, M.E. Fonteyn 305

Patient Record Systems

Nursing Documentation in the Computer-Based Patient Record, K.P. Walker andCM. Prophet 313

The Patient Care Process: Pathways in Transition, M.A. Catt, L.M. Nagle andJ.S. Shamian 318

Nursing Process Redesign with the Implementation of a Computer Based PatientRecord in the Ambulatory Setting, J.A. Murphy and J.S. Ahlstrom 323

Nursing Process Documentation - Effects on Workload and Quality when Using aComputer Program and a Key Word Model for Nursing Documentation,S. Sahlstedt, H. Adolfsson, M. Ehnfors and B. Kails from 330

Functional Requirements for IT support for nursing information systems integrated inElectronic Healthcare Record Systems (EHCRS), P.-A. Lundgren and C. Wisser 337

Monitoring and Evaluating Benefits of an Automated Patient Care, P. Welychka 343

Teaching and Training Strategies I

Information Technology in Nursing: a Project Examining Educational Applications ofthe Internet and World Wide Web, L.G. McKenna and R.M. Ribbons 351

Using the Internet as a Teaching Strategy: Informatics at Work, J.E. Thiele 356Self-Study Program on HTML Browser - Application to Clinical Nursing General 360Remarks Course, N. Ochiai, Y. Sota and H. EzumiThe Nightingale Tracker™: Information Technology for Community Nursing

Education, V.L. Elfrink, K.S. Martin and L.S. Davis 364

Cognitive Skills

Innovation in Nursing Education: Development of Computer-Assisted Thinking,M. Kanai-Pak, R. Hosoi, C. Arai, Y. Ishii, M. Seki, Y. Kikuchi, K. Kabasawa andK Sato 371

Database Issues in Object-Oriented Clinical Information Systems Design, S.C. Chuand J.B. Thorn 376

Data Mining: A Strategy for Knowledge Development and Structure In NursingPractice, L.R. Eriksen, J.P. Turley, D. Denton and S. Manning 383

Facilitating Higher Order Thinking Skills in Nurse Education: A Prototype Databasefor Teaching Wound Assessment and Management Skills, R.M. Ribbonsand LG. McKenna 389

Nursing Language

Implementation of Standardized Nursing Languages (NIC, NOC) in On-line CarePlanning and Documentation, CM. Prophet, G.G. Dorr, T.D. Gibbs andA.A. Porcella 395

A National Framework for District Nurses' Uniform Documentation Patient Records,/. Rising, M. Ehnfors, L. Abrahamsson, A. Borgstrom, B.M. Forsgren andS. Hellstrom 401

A Comparative Study of Nursing Diagnosis Systems Using Neural Networks andExpert Systems, J.A. Kim 404

The VIPS Model - Implementation and Validity in Different Areas of Nursing Care,A. Ehrenberg, M. Ehnfors and I. Thorell-Ekstrand 408

Teaching and Training Strategies II

The Learning Collaboratory: A Knowledge-Building Environment for NursingEducation, D.J. Skiba 413

Training Strategy For Nursing Staff In Using Computers In Hospitals - A MalaysianViewpoint -, S.B. Mohamad, L. Coote and V Lane 418

Education and Training in Health Informatics the IT EDUCTRA Project, A. Hasman 424

Curriculum and Faculty Development

Expanding Nursing Informatics Knowledge Through Curriculum Development:A Collaborative Faculty Practice Model, B.E. Carter and B. McGuiness 431

Conquering Technophobia: Preparing Faculty for Today, PL. Richard 437E-discourse and Continuing Professional Education: the Fusion of Nursing

Knowledge and Informatics to Close the Theory-Practice Gap, P.J. Murray 442

Evaluation

Nurses' MEDLINE Usage and Research Utilization, PL Prin and M.E. Mills 451A Comparison of Network Use by Academic and Clinical Sites, D. Anthony 457Nurses' Perceptions of the Impact of a Computerized Information System on a

Critical Care Unit, A.L. Lyness, M. Hravnak and D. Martich 463Implementation of a Patient Management System in a Children's Hospital,

L.A. Westbrooke and R.L. Carr 469

Teaching and Training Strategies III

Advances in Digital Video for Electronic Media, J.A. McAfooes AllVideo Conferencing in Group Training of Psychiatric Nurses, 5. Bergvik and

D. Gammon 481Development of a CAI program entitled "Introduction to Nursing Process".

Requirement for Nursing Education in Japan, Y. Muranaka, R. Fujimura,K. Yamashita, Y. Furuhashi, S. Yamamoto and K. Arita 487

A Simulation Program that Teaches Clinical Decision Making in Nursing,K. Hjelm-Karlsson and H. Stenbeck 492

Nursing Resource Management

Transforming Resource Utilization Data into Information, LM. Nagle and K. Miller 499An Information Processing System for Scheduling of Nurse Assignments by Head

Nurses, I.S. Kim and S.W Hong 503Development of A Computerized Patient Classification and Staffing System,

H.A. Park and J.H. Park 508Workload Measurement in the ICU, K. 0yri 512

Communication

The ComputerLink Projects: A Decade of Experience, P.F. Brennan 521Reducing Nurses' Workload Using a Computerized Nursing Support System Linked

to the Hospital Information System, C. Ito, I. Satoh, H. Michiya, Y. Kitayama,K. Miyazaki, S. Ota, H. Satoh, T. Sakurai, H. Shirato and K. Miyasaka 527

PANELS

Perspectives on the Design and Implementation of an Electronic Medical Record forObstetrics Practice, HM. Nadel and C. Schifiliti 535

Learning by Sharing in Nursing Informatics: CARING and WINI, C.J. Bickford,K. Smith and S.K. Newbold 536

The Internet in Nursing Education: World-wide Linkages of Nursing Students,Faculty, and Resources, F.P. Brennan, H. Springer, D. Skiba, M. Conrick andM.C. Griffith 537

Linking Clinical Variables with Health-Related Quality of Life: Challenges forComputer-Based Systems, S.B. Henry, W.L. Holzemer, M. Costantino, M. Lush,CM Mead and K. Sousa 538

Nursing Interventions Classification (NIC): Use of a Standardized NursingNomenclature in an Automated Clinical Information System, P.W. Foley Dalyand P. Button 539

International Nursing Language and Health Care Informatics, S.J. Grobe,Dame J. Clark, W.L. Holzemer, W. Sermeus and A. Thoroddsen 540

WORKSHOPS

Educational Technologies and Distance Learning: An On-line Demonstration,CD. Parker and V.T. Laidlow 543

Medication Charting Sailing into Automation, M. Thompson and A. Walker 544The Benefits of Open Healthcare Information Systems for Nursing, A. van der Werff 545Integration of Information Systems with Care Delivery Models to Provide Patient

Focused, Resource Efficient, Outcome Effective Nursing Care, J.A. Murphy 546Creating a Virtual Resource for Health Informatics Teaching: the GHIFT project,

J. Murphy 547Nursing Informatics Education in Europe, J. Mantas , F. Eurlings,

E. Pluyter Wenting and W. Sermeus 548Data Format: Influence on Patient Records and Decision Making, C.B. Thompson 549Automating Clinical Documentation. The Dr. Spock Guide to Prenatal Care,

M. Douglas 550

ACTION: Assisting Carers using Telematics Interventions to meet Older Person'sNeeds, L. Magnusson, H. Berthold, L. Brito, M. Chambers, T. Daly and D. Emery 551

Writing for Publication: A Way to Share Health Care Information Knowledge,B.J. Brown, B. Henry, N. Casey and K. Wilskman 552

The Paperless Hospital, K. Arvedson, B. Sjoberg and U. Hertin 553Development and Implementation of a Ward Information System Using a Wireless

Pen-based Computer Strategy for a Change, E. van der Velde, J. Heijman andP. Polise-de Boer 554

The Development of a Nursing Information Reference Model, P.J.MM. Eppingand W.T.F. Goossen 555

Preparing Nursing Information Systems through Education, /. Moisil 556

SCIENTIFIC DEMONSTRATIONS

Computerized Classroom Presentation with Keypad Questions as Compared toTraditional Classroom Lecture, C. Cooper, S. Gerth, K. Lewis, D. Maxwelland P. Tymchyshyn 559

A Virtual Conference for World-wide Health Workers, J. Hovel 560Creating Web Pages with HTML, M. McClees 561The Braden System, B. Braden, N. Bergstrom and P. McNees 562Using Computerized Clinical Standards for Quality Assurance, M.R. Price and

R.R. Wieczorek 563The NIGHTINGALE project, J. Manias and P. Dounavis 564

POSTERS

Hospital and Community Systems

Computer-based Patient Classification System Used for Nursing Cost Allocation,P. Partanen, E. Toyry and P. Savolainen 567

Nursing Informatics in Finnish University Hospitals - State of the Art, S. Salantera,K. Saranto and O. Ponkala 568

Getting the Right System: The CHIPS Experience, G.C. Clough 569A Common Concept Model for the Swedish Health Care System, L. Jernberg,

A. Hedin, T. Lundmark, H.C. Lenner, H. Svedberg, S.B. Wallin andS.A. Sandstrom 570

Growing Use of the Computer by Nurses on a General Ward, W. Roelofs,R.J.A. Sloos and H.B.J. Nieman 571

Nursing Knowledge Has an Impact in Innovation of Information Systems for thePrimary Health Care - Networking as a Tool, T. J0rgensen 572

A Community Nursing Record with Computer support, T. Holm, C. Magnusson,B. Andersson B, H. Berthold H, B. Fransson B, C. Johansson, S. Johansson andK. Liner 573

Hospital Information System: a Nursing Evaluation, I.C.K.O. Cunha, F.F. Fakih,M.C.F. Reichert, L.S. Lestingi, A.L.B. Barros and H.F. Marin 574

Decision Support and Knowledgebase

The Beginning of a Knowledge Build-up, Interaction, and Partaking ResponsibilityModel in Health Care Concerning Patient Development, S. Weitner S andM. Hedstrom 577

A Prototype of a Medical Decision Support System for Patients with Ulcus CrurisVenosum, E. Blomstrom and K. Wikell 578

Computerized Interviewing to Enhance Decision Making of Nurse PractitionerStudents, N.K. Meehan 579

Decision Support System in Nursing Diagnoses During Prenatal Care, S.M.O. Barros,H.F. Marin and A.M. Silva 580

Internet and Videoconferencing Education

Using Nursing Resources on the Internet, M.A. Silva and M.H. Lopes 583The Development of a Practice Based Nursing Home Page, DM. Goldsmith,

R.H. Chapman, J. Wandel, P.J. Reiley and C. Safran 584A Small Intranet for Teaching how to Use Internet, K. Yamanouchi, %

M. Nakano and M. Nojiri 585 |The Nursing Department of the Brazilian Virtual Hospital, M.H.B. Lopes, |

A. Olimpio, C. Severing do Couto, JM. Teixeira, M.A.S. Silva, M.G.P. Baquerizo, \M. Gallego, S.S. Moromizato, V.R.T.K. Bezerra, S.H. Cardoso and IR.M.E. Sabbatini 586 ,

Application of the Internet for Nursing Education, Y. Majima 587 t

Education

The First Report about the NICE Project - Nursing Informatics and Computer AidedEducation, P. Kokol and V. Brumec 591

"Novum Media" a Centre for Developing Distance Education in Medicine andNursing within a Health Care Region, M. Fundin 592

Distance Education in Nursing via a Computer Conference, /. Olausson,K. Hjelm-Karlsson and G. Gustafsson 593

The SIP Project - A Push for Technological Innovation in Nursing Education inDenmark, R. Kolbcek 594

A CD-ROM-based Educational Tool for Teenagers with Diabetes, H. V. Jorgensen,J.B. Knudsen and S. Sander 595

Development of a Prototype of an Education System in Prenatal Hygiene,K.G.B. Lopes and H.F. Marin 596

Educational Program on First Aid, I.Y. Whitaker, N. Granitoff, V.C.S. Goncalves,C.L. Pereira, JM. Lee, EM. Salvador, AM. Melo, M.P. Ramos, M.S. Ancao,D. Sigulem and H.F. Marin 597

Methods and Attitudes

Teaching Method and Evaluation of Information Education in Shimane NursingCollege, H. Ezumi, Y. Sota and N. Ochiai 601

A Centre for Informatics in Nursing and Caring, O. Sundin and S. Johansson 602

Representing Heterogeneous Viewpoints of Healthcare Professionals, M. Schoop 603COACH - Canadian Nursing Informatics Group Maintaining Momentum, P. Jeselon,

H. Clement, P. Welychka and S. Salois-Swallow 604

Documentation and Classification

An Innovative Home Health Care Classification System for Continuity of Care,V.K. Saba 607

Concepts for Nursing Practice: a Swedish Model for Nursing Documentation, theVIPS Model, Compared to Other Classifications, M. Thunberg, M. Ehnfors,E. Hamrin 608

Refining and Evaluating a Nursing Diagnosis Taxonomy, M. Rosenberg andC. Delaney 609

Intensive Course in Nursing Documentation in Accordance with the VIPS Model,C. Bjorvell and I. Thorell-Ekstrand 610

Development of an Evaluation Plan for Determining the Effectiveness of aComputerized Critical Care Flowsheet, J. Cuddigan, J. Warren, K. Azevedo,R. Halbach, K. Davis and J.H. Sisson 611

GRADUATE STUDENT POSTERS

A Plan for Enterprise Integration, authored by: KG. Charters 615Toward a Decision Support Framework for Preventing, Detecting and Minimizing

Errors in Nursing, authored by: M. Costantino 616The Relationship between Health Status Scores on Hospital Admission and the Care

Planned by the Nurse, authored by: M.T Lush 617Nursing Documentation in Pediatric-Nursing Care, authored by: G. Engvall 618Individual Health Promotion Program (IHHP), authored by: P. Hernandez 619Adoption of a Computer Mediated Communication Network, authored by: K. Smith 620Computer Anxiety Among Graduate Nursing Students, authored by: MM. Gillespie 621Development and Use of Clinical Guidelines in Public Health Care, authored by:

K. Nordstrand 622

Author Index 623

Subject Index 627