Judith J Warren

University of Kansas | KU · School of Nursing

The aim of this chapter is to describe the history of big data and its characteristics—variety, velocity, and volume—and to serve as a big data primer. Many organizations are using big data to improve their operations and/or create new products and services. Methods for generating data, how data is sensed, and then stored, in other words data colle...

Possible futures for education, partnerships, research, and practice are presented as a result of our immersion in the world of big data and data science. We propose basic and sweeping changes in each of these areas, especially for nursing. Kuhn’s episodic model of scientific revolution where suddenly the discovery of a new path changes the way we...

This text reflects how the learning health system infrastructure is maturing and being advanced by health information exchanges (HIEs) with multiple organizations blending their data or enabling distributed computing. It educates the readers on the evolution of knowledge discovery methods that span qualitative as well as quantitative data mining, i...

The integration of Big Data from electronic health records and other information systems within and across health care enterprises provides an opportunity to develop actionable predictive models that can increase the confidence of nursing leaders' decisions to improve patient outcomes and safety and control costs. As health care shifts to the commu...

Background: There is wide recognition that, with the rapid implementation of electronic health records (EHRs), large data sets are available for research. However, essential standardized nursing data are seldom integrated into EHRs and clinical data repositories. There are many diverse activities that exist to implement standardized nursing langua...

The process of moving from the locally defined flowsheet ontology containing redundancy and jargon to one understandable by researchers is described. Over 250 million nursing flowsheet observations were imported into a data repository that uses the i2b2 framework. Focus groups were used to derive a new ontology model--18 templates were identified....

To create an interoperable set of nursing diagnoses for use in the patient problem list in the EHR to support interoperability. Queries for nursing diagnostic concepts were executed against the UMLS Metathesaurus to retrieve all nursing diagnoses across four nursing terminologies where the concept was also represented in SNOMED CT. A candidate data...

While nursing documentation in electronic medical record (EMR) flowsheets may represent the largest investment of clinician time with information systems, organizations lack tools to visualize and repurpose this data for research and quality improvement. Incorporating flowsheet documentation into a clinical data repository and methods to reduce the...

The Quality and Safety Education for Nurses (QSEN) project is a national initiative to transform nursing education to integrate quality and safety competencies. This article describes a two-year process to generate educational objectives related to quality and safety competency development in graduate programs that prepare advanced practice nurses...

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In our study, we described the experiences and behaviors of beginning nursing students learning the nursing process using a modified electronic health record. Eight students led by an experienced nursing instructor from a midwestern university comprised the criterion purposive sample. Data were obtained from observations of the group, interviews wi...

An overview of competencies and suggestions for educating healthcare terminologists is presented. This new role in healthcare informatics requires formal and informal education that pays particular attention to the adult learner. Knowledge of terminology and informatics standards development is critical, as well as knowledge about the use of termin...

Learning is no longer an internal individual activity but occurs through networks and connections. The aim of this project was to teach online health informatics students to use Web 2.0 tools and technologies to form networks and connections through experiential learning assignments. Web 2.0 tools and technologies were evaluated using a criteria ch...

Second Life is a massive, multiuser, virtual environment. The University of Kansas School of Nursing has introduced SL into the health informatics curriculum as a virtual environment for students and faculty to interact and communicate. Students have successfully completed course activities in SL. Informatics faculty continue to develop simulations...

High-fidelity simulation technology is a growing educational technology. Designing effective simulations requires the use of informatics tools such as UML modeling. This poster demonstrates the steps in modeling a simulation exercise.

Using standardized terminology within electronic health records is critical for nurses to communicate their impact on patient care to the multidisciplinary team. The universal requirement for quality patient care, internal control, efficiency and cost containment, has made it imperative to express nursing knowledge in a meaningful way that can be s...

Quality and Safety Education for Nurses (QSEN) addresses the challenge of preparing nurses with the competencies necessary to continuously improve the quality and safety of the health care systems in which they work. The QSEN faculty members adapted the Institute of Medicine(1) competencies for nursing (patient-centered care, teamwork and collabora...

By incorporating a clinical information system in the education curriculum as a teaching platform, the University of Kansas School of Nursing teaches nurses and other health professional students how to assess, plan, document and manage care in an electronic medium that develops healthcare informatics competencies. The outcomes of this integrated t...

As new directions and priorities emerge in health care, nursing informatics leaders must prepare to guide the profession appropriately. To use an analogy, where a road bends or changes directions, guideposts indicate how drivers can stay on course. The AMIA Nursing Informatics Working Group (NIWG) produced this white paper as the product of a meeti...

Simulated e-Health Delivery System (SEEDS) uses a clinical information system (CIS) to teach students how to process data from virtual patient case studies and work with information technology. SEEDS was developed in response to the Institute of Medicine recommendation that students be taught about information systems in order to improve quality pa...

Rigour is needed in the construction of health terminologies to avoid introducing ambiguity and error into clinical records. When two large scale terminologies (SNOMED RT and Clinical terms Version 3) were merged to form SNOMED CT) a number duplicate and ambiguous concepts were introduced. The SNOMED nursing working group was tasked with producing...

The rise of evidence-base practice (EBP) as a standard for care delivery is rapidly emerging as a global phenomenon that is transcending political, economic and geographic boundaries. Evidence-based nursing (EBN) addresses the growing body of nursing knowledge supported by different levels of evidence for best practices in nursing care. Across all...

The SNOMED" micro CTGFN (Convergent Terminology Group for Nursing) is a working group reporting to the SNOMED International Editorial Board. They are charged with ensuring a terminology supportive of nursing's requirement for describing patient care. The strategies utilized for nursing content follow.

We evaluated the usefulness of two models for integrating nursing diagnosis concepts into SNOMED Clinical Terms (CT). First, we dissected nursing diagnosis term phrases from two source terminologies (North American Nursing Diagnosis Association Taxonomy 1 (NANDA) and Omaha System) into the semantic categories of the European Committee for Standardi...

A jointly funded partnership between the school of nursing at a large midwestern university and a premier health care information technology supplier represents a pioneering event for education and for the health care information technology industry. The impetus for this partnership arose from Institute of Medicine reports published in late 1999 an...

Goal statements are a significant component of structures that support the process of health care delivery such as practice guidelines, standards of care, critical pathways, disease management plans, patient education plans, and nursing care plans. Although these structures are increasingly computer-based, there has been little attention to the for...

Representing nursing judgements in the electronic health record The naming of nursing phenomena and representing the phenomena in a standardized manner suitable for encoding in computer-based systems is a challenge for the nursing profession at the national and the international level. Considerable progress has been made in the development of class...

The American Nurses Association has long recognized the need for nursing to participate in the development of national healthcare data sets and standardized terminologies suitable for implementation in computer-based systems. In 1989, the American Nurses Association Steering Committee on Databases to Support Clinical Nursing Practice was establishe...

We evaluated the utility of the CEN Categorical Structure for Nursing Diagnoses as a terminology model for integrating nursing diagnosis concepts into SNOMED. First, we dissected nursing diagnosis term phrases from two source terminologies (North American Nursing Diagnosis Association (NANDA) Taxonomy 1 and Omaha System) into the semantic categorie...

The Nursing Terminology Summit has used collaborative processes to bring about significant changes in the development of terminology standards for nursing. This paper draws on agendas, reports, notes, and other documents from the Summit, in addition to the authors' own experience as Organizer, Steering Committee, and participants, to provide a brie...

In her Editorial ("Word for Word," July), editor-in-chief Diana Mason argues for a simpler diagnostic language. Although the example she criticizes ("alteration in oxygenation related to ...") has never been a North American Nursing Diagnosis Association (NANDA) diagnosis, her point is clear: make nursing language practical. This argument possesses...

Challenged with the need to provide graduate education in nursing informatics across the state of Nebraska, an innovative curriculum was developed. This curriculum is integrated with other system-focused specialties (community health nursing and nursing administration) to form a Health Systems Nurse Specialist (HSNS) Program. The delivery of this c...

Patient falls rate was modeled using a statistical model with a known distribution. Simulated data was generated and used to prepare management data that can be used to evaluate this quality indicator. This methodology provided a view of how the data could behave over a number of simulated management scenarios. Various data reporting periods and re...

Delivery of state-of-the-art patient care requires new models to foster the development of professional nurses and integrate practice, research, and education. The Chief Nursing Officer of University Hospital/Associate Dean of the College of Nursing at a tertiary health science center positioned doctorally prepared nurses in clinical practice setti...

Delivery of state-of-the-art patient care requires new models to foster the development of professional nurses and integrate practice, research, and education. The Chief Nursing Officer of University Hospital/Associate Dean of the College of Nursing at a tertiary health science center positioned doctorally prepared nurses in clinical practice setti...

The Research Nurse Intern program at the University of Nebraska Medical Center is designed to support the development of research-based nursing practice and to foster the professional development of staff nurses. The activities of the 2-year program are based on a model that blends research dissemination and utilization with the change process. The...

Evaluation of new patient care delivery models often focuses on their impact on the role of the staff nurse and the introduction of a variety of assistive personnel. This article examines the effects of patient-centered care models on the roles of nurse and non-nurse managers. Interviews with 26 managers approximately 6 months after models have bee...

Efforts to develop an International Classification for Nursing Practice (ICNP) were initiated nearly a decade ago. To update nurses on progress, below is a critical review of the ICNP using the Computer-based Patient Record Institute (CPRI) Features Framework and a discussion of its relevance to current US efforts: 1) the activities of the American...

Building on the work of previous authors, the Computer-based Patient Record Institute (CPRI) Work Group on Codes and Structures has described features of a classification scheme for implementation within a computer-based patient record. The authors of the current study reviewed the evaluation literature related to six major nursing vocabularies (th...

The International Classification for Nursing Practice (ICNP) is a collaborative project under the auspices of the International Council of Nurses. The alpha version is available online for comment in preparation for the release of the beta version in 1999. The authors answer the most-frequently asked questions about the ICNP and encourage nurses in...

The nursing profession has developed a number of classification systems. What can HIM professionals learn from the processes and results? This article presents an overview of the major nursing classification systems and examines some of the national efforts to standardize nursing data elements.

Clinically useful problem lists are essential to the CPR. Providing a terminology that is standardized and understood by all clinicians is a major challenge. UNMC has developed a lexicon to support their problem list. Using a just-in-time coding strategy, the lexicon is maintained and extended prospectively in a dynamic clinical environment. The te...

The Health Systems Nurse Specialist (HSNS) curriculum was developed in response to the changing needs in community health and administration graduate nursing education within Nebraska. These two specialties were integrated around a common focus of practicing within health care systems. One of the essential competencies of this specialty is the abil...

Detection and treatment of nutritional disorders has surfaced as a major health concern for older persons. This article explores how one clinical nurse specialist (CNS) used advanced practice knowledge and skills to develop a nutritional screening program for an elderly population served by a nursing clinic. A study was conducted to determine the p...

To compare three potential sources of controlled clinical terminology (READ codes version 3.1, SNOMED International, and Unified Medical Language System (UMLS) version 1.6) relative to attributes of completeness, clinical taxonomy, administrative mapping, term definitions and clarity (duplicate coding rate). The authors assembled 1929 source concep...

Patient and family education is an important component of the organ transplant programs at the University of Nebraska Medical Center. The Medical Center is in the process of planning a new transplant center which will employ the family-centered, educationally-intensive cooperative care concept. This approach was chosen as the model for the delivery...

Patient outcomes are becoming markers of health care effectiveness and quality. The CNS is uniquely positioned to influence outcomes evaluation within nursing. One way to accomplish this is through recommendations on the selection and use of appropriate patient assessment tools within the patient database. Recommendations of the CNS should be based...

PATIENT OUTCOMES ARE becoming markers of health care effectiveness and quality. The CNS is uniquely positioned to influence outcomes evaluation within nursing. One way to accomplish this is through recommendations on the selection and use of appropriate patient assessment tools within the patient database. Recommendations of the CNS should be based...

A valid taxonomy legitimizes the elements that make up the taxonomy and increases trust in its generalizability and predictability. There is a concern that the NANDA Taxonomy is not a valid taxonomic structure. Despite on-going work to validate individual nursing diagnoses, there is little research that focuses on validation of groups of diagnoses...

This article is a discussion of the research trends concerning noncompliance, ethical concerns about noncompliance with prescribed treatment of chronic disease, requirements for ethical practice concerning noncompliance and chronic illness, and needed research about the relationship between noncompliance and coping with chronic disease. Questions a...

A number of persistent issues in the nursing diagnosis community have challenged the ability of one nursing diagnosis taxonomy to account for nursing's practice. The North American Nursing Diagnosis Association (NANDA) Taxonomy Committee, charged with the preparation of one taxonomy for all, has struggled with some of these issues and has initiated...

In the process of placing diagnoses into Taxonomy I, certain inconsistencies became apparent. Inadequate definition of both diagnoses and human response patterns, lack of defining characteristics, and inconsistency in the levels of abstraction within the taxonomic hierarchy made the task of assigning a diagnosis to a taxonomic pattern difficult. Am...

Taxonomic development in nursing, although still in its infancy, is progressing. Taxonomy development has moved beyond subjective placement of diagnoses into categories based on an "expert" opinion alone. The taxonomy of nursing diagnoses is entering a new era whereby the assumptions and classification rules for Taxonomy I--Revised are being invest...

In order to effectively organize the use of nursing time during clinic check-in, we designed a forward chaining rule based program for nursing history taking, problem tracking, and documentation. The program consists of a medical logic module trigger engine which identifies relevant rules for nursing history, an interactive question manager for nur...

The ambulatory office setting is increasingly becoming a central focus of patient care. The nursing staff are integral to patient care management in this environment. They are frequently the heaviest users of medical records and are generally early advocates of well designed computer records systems. As our implementation of a Computer Stored Ambul...

In the early 1970s the need for a precise and computerizable language of nursing phenomena was identified. This need stimulated the formation of the National Conference Group for the Classification of Nursing Diagnoses. The group began the work of identifying nursing diagnoses and developing a taxonomic structure for their classification. Based on...

In this study, the professional and bureaucratic role conceptions and role deprivation of students participating in a preceptorship program were compared to those in a traditional faculty-supervised clinical group. The role conceptions and role deprivation of nursing faculty and preceptors were also examined. One hundred eighteen students in a two-...

A taxonomy of nursing diagnoses improves communication within the domain of nursing practice. The author contends that use of this tool throughout the health care delivery system could lead to improved management of nursing care. Improvements could be made in identification of staffing requirements, justification of third party payments, developmen...

This author describes how she developed a stress-management program for critical care clinical nurse specialists, and suggests many strategies that can be used in the development of all critical care staffs.

Thesis (Ph. D.)--University of Hawaii, 1987. Includes bibliographical references (p. [226]-233). Photocopy.

"DA8729426." Thèse (Ph. D.)--University of Hawaii, 1987. Microfiche du manuscrit dactylographié.