The elements of the Nursing Minimum Data Set (NMDS) were collected manually from 188 medical records in eight acute care facilities. These eight facilities represent 54 per cent of the beds in South Dakota. The purpose of the study was to describe discharge destination, nursing diagnoses, nursing interventions, and nursing resource utilization for patients with fractured femur with pinning. The sample was primarily female (69.1 per cent), with a mean age of 78.5 years. Most (84.0 per cent) patients were transferred to another facility, with 46.2 per cent going to extended care facilities. The most frequent nursing diagnoses were comfort (89.9 per cent) and physical mobility (59.6 per cent). Interventions were classified using the 16-category classification scheme developed by Werley and Lang. The most frequently recorded types of interventions were in the category of monitoring and/or surveillance (16.7 per cent of 7,555 interventions), whereas emotional support and/or counseling was much less frequent (3.0 per cent of 7,555). Discharge planning was the most frequent nursing intervention in the category of coordination and collaboration of care (54.8 per cent of 188 patients). Documentation systems have been structured to accommodate technical tasks on flow sheets, for example. Nursing resource utilization was the most difficult, and also presently the least meaningful, NMDS element to collect because each facility has different staffing, different patient classification systems, and no prescribed method for collecting these data. Manual data collection is time-consuming and expensive and therefore not recommended.
Bibliographical noteFunding Information:
*Education Specialist, Nursing Projects, Education and Development Center, SiouxV alleyH ospital, Sioux Falls, SD. "~Associate Professor, College of Nursing, The University of Iowa, IowaC ity, IA. ~:Collaborative Care Nurse Researcher, St. Joseph's Hospital, Milwaukee,W I. Supported in part by the American Organization of Nurse Executivesw ith a grant through the AmericanN urses Foundation, 1993-1994. Address correspondencea nd reprint requests to Ms Karpiuk: Sioux ValleyH ospital, Educationa nd DevelopmentC enter, 1100 S EuclidA ve, Box 5039, Sioux Falls, SD 57117-5039. Copyright © 1997 by W.B. SaundersC ompany 8755-7223/97/1302-0007503.00/0 HE INTENSITY and complexity of nursing care T required for comprehensive quality patient care continues to increase. Concurrently, information systems have been implemented to capture and process data to meet the demands for quality, comprehensive, and appropriate nursing care. Most information systems and approaches, however, have used nonnursing data sets to address nurses' work. These approaches have assumed that nursing care evolves from medical orders rather than recognizing that nurses have their own information on which to base clinical judgments.
- Acute care
- Fractured femur with pinning
- Manual data collection
- Nursing Minimum Data Set
- South Dakota Statewide Project