Cross-Mapping Study of Nursing Practice Terms from a Brazilian Hospital Database.
| Autor: | Gonçalves LS; Nursing Undergraduate and Graduate Program Professor, UFPR, Brazil., Andreatta D; Nursing Undergraduate Program Student, UFPR, Brazil., Schamne FK; Master in Nursing Science Program Student, UFPR, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | Studies in health technology and informatics [Stud Health Technol Inform] 2020 Jun 16; Vol. 270, pp. 1233-1234. |
| DOI: | 10.3233/SHTI200378 |
| Abstrakt: | Objective: To perform a cross-mapping study between nursing documentation from a Electronic Health Record (EHR) of a Brazilian hospital and four nursing terminology systems. Method: Descriptive, quantitative and retrospective study. Results: The EHR presents a total of 247 anamnesis / physical examination terms, 75 nursing diagnoses, and 205 nursing interventions terms to nurses make their choice. Conclusion: Authors strongly recommend that attempts in building more usable and friendly EHRs for clínical care practice documentation consider classification systems structures in their development, to ensure complete, safe, evidence-based and comparable registries. |
| Databáze: | MEDLINE |
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