Análise de conteúdo à parametrização portuguesa relacionada com o Processo Respiratório

Background: data sharing from clinical practice is crucial to support nurses' decision-making process, improve nursing outcomes, and increase the quality of care. In Portugal, International Classification for Nursing Practice is used to document care being necessary for the standardization of this process preventing information redundancy. Objectives: (1) to identify diagnoses and interventions used by Portuguese nurses related to Respiratory Process, (2) to suggest unified diagnoses and interventions syntaxes. Methodology: qualitative study with a content analysis. The sample included data regarding e-documentation of nursing diagnosis and interventions customized in the nursing public information system until 2019. Results: of the initial sample of 1502 diagnoses aroused 28 and from 2060 interventions emerged 73 as the most relevant. The main findings were: two areas of nursing attention, one related to respiratory function and the other to patient's learning abilities, diversity of diagnoses and interventions to express the same needs resulting from a variety of taxonomic misunderstandings, and lack of standardized language. Conclusions nursing documentation have two dimensions representing the complexity of nursing care. It also shows that using standardized language does not prevent information redundancy resulting in different diagnoses and interventions to express the same needs.Marco contextual: el cambio de datos resultantes de la práctica clínica es crucial para apoyar el proceso de toma de decisiones. Portugal, utiliza la CIPE para documentar la práctica clínica, siendo necesaria la estandarización de lo proceso evitando redundancia de información. Objetivos: (1) identificar diagnósticos e intervenciones utilizados por enfermeros portugueses relacionados con el Proceso Respiratorio, (2) sugerir sintaxis unificadas de diagnósticos e intervenciones. Metodología: diseño cualitativo con análisis de contenido. La muestra incluyó datos sobre documentación electrónica en el sistema de información pública de enfermería hasta 2019. Resultados: 1502 diagnósticos surgieron 28 y de 2060 intervenciones surtieron 73 como los más relevantes. Los principales hallazgos fueron: dos áreas de atención de enfermería, una relacionada con la función respiratoria y otra con las habilidades de aprendizaje del paciente, diversidad de diagnósticos e intervenciones para expresar las mismas necesidades resultantes de una variedad de malentendidos taxonómicos, falta de lenguaje estandarizado. Conclusión: los resultados muestran que la documentación de enfermería tiene dos dimensiones representando la complejidad del cuidado de enfermería. También muestra que el uso de un lenguaje estandarizado no evita la redundancia de información resultando en diferentes diagnósticos e intervenciones para expresar las mismas necesidades.Enquadramento: a partilha de dados da prática clínica é crucial para apoiar o processo de tomada de decisão, Em Portugal a CIPE é utilizada para documentar os cuidados de enfermagem sendo necessária a uniformização deste processo de forma a evitar redundância de informação. Objetivos: (1) identificar diagnósticos e intervenções utilizados por enfermeiros portugueses relacionados com o Processo Respiratório, (2) sugerir sintaxes unificadas de diagnósticos e intervenções. Metodologia: estudo qualitativo com análise de conteúdo análise de conteúdo. A amostra incluiu dados referentes à documentação eletrónica customizada no sistema público de informação de enfermagem até 2019. Resultados: da amostra inicial de 1502 diagnósticos emergiram 28 e de 2060 intervenções surgiram 73 como os mais relevantes. Os principais achados foram: duas áreas de atenção de enfermagem, uma relacionada com função respiratória e outra com habilidades de aprendizagem do cliente, diversidade de diagnósticos e intervenções para expressarem as mesmas necessidades decorrentes de equívocos taxonómicos e de falta de linguagem padronizada. Conclusão: os diagnósticos e intervenções de enfermagem possuem duas dimensões que representam a complexidade do cuidado de enfermagem. O uso de linguagem padronizada não impede a redundância de informações resultando em diagnósticos e intervenções diferentes para expressar as mesmas necessidades

DESIGN AND EXPLORATION OF NEW MODELS FOR SECURITY AND PRIVACY-SENSITIVE COLLABORATION SYSTEMS

Collaboration has been an area of interest in many domains including education, research, healthcare supply chain, Internet of things, and music etc. It enhances problem solving through expertise sharing, ideas sharing, learning and resource sharing, and improved decision making. To address the limitations in the existing literature, this dissertation presents a design science artifact and a conceptual model for collaborative environment. The first artifact is a blockchain based collaborative information exchange system that utilizes blockchain technology and semi-automated ontology mappings to enable secure and interoperable health information exchange among different health care institutions. The conceptual model proposed in this dissertation explores the factors that influences professionals continued use of video- conferencing applications. The conceptual model investigates the role the perceived risks and benefits play in influencing professionals’ attitude towards VC apps and consequently its active and automatic use

Operationalizing the DataGauge Framework in a Health Information Exchange Utilizing Hepatitis C Data

This project aims to implement the DataGauge framework in a health information exchange (HIE) setting as a proof of concept. The modified DataGauge framework, described by Diaz-Garelli et al. (2019), is utilized to test its functionality and applicability with any dataset. The specific objective of the project is to determine the number of hepatitis C-positive tests within the HIE. The implementation involved multiple iterations following the DataGauge framework\u27s steps for data extraction and analysis. Five iterations were conducted, resulting in both successful and failed queries based on the validity of the data standards. The findings revealed that the HIE, in this case, did not have complete access to the clinical data required to answer the initial question about the number of hepatitis C-positive patients; rather, the HIE only received information from patients who consented to share their health data and were approved by their physicians. To address this limitation, a recommendation is proposed based on Guerrero et al.\u27s (2019) workflow. The recommendation suggests granting an intermediary actor (referred to as the analyst) access to all clinic data, regardless of patient consent status. The analyst would then gather and deidentify the relevant clinical data, with explicit permission from the clinic, and provide it to the Rio Grande Valley HIE (RGV HIE). This approach would enable the RGV HIE to legally access non-participant data through deidentified datasets or aggregated count/sum data, while ensuring compliance and collaboration. By implementing this recommended process, the RGV HIE can enhance its preparedness for future clinical questions, grants, partnerships, and public health emergencies. Moreover, this model can be applied to other data warehouses and HIEs nationwide

Doctor of Philosophy

dissertationControlled clinical terminologies are essential to realizing the benefits of electronic health record systems. However, implementing consistent and sustainable use of terminology has proven to be both intellectually and practically challenging. First, this project derives a conceptual understanding of the scope and intricacies of the challenge by applying informatics principles, practical experience, and real-world requirements. Equipped with this understanding, various approaches are explored and from this analysis a unique solution is defined. Finally, a working environment that meets the requirements for creating, maintaining, and distributing terminologies was created and evaluated

Terveystaltio- ja potilaskertomusjärjestelmien yhteentoimivuus

Tämä työ tutkii, miten terveystaltio- ja potilaskertomusjärjestelmien yhteentoimivuutta voidaan parantaa. Tutkielman lähtökohtana on, että nykyisillä standardeilla ja terveystiedon mallinnusratkaisuilla on mahdollista edistää yhteentoimivuutta sen eri tasoilla. Työssä tutustutaan terveystaltio- ja potilaskertomusjärjestelmiin ja näiden järjestelmien välisessä yhteentoimivuudessa esiintyviin ongelmiin. Yhteentoimivuuteen liittyvien ongelmien ratkaisemiseksi käydään läpi erilaisia standardeja ja mallinnusratkaisuja, joiden käyttöä arvioidaan järjestelmien välisessä tiedonvaihdossa. Tutkielman tuloksena on, että nykyisillä standardeilla ja mallinnusratkaisuilla voidaan parantaa terveystaltio- ja potilaskertomusjärjestelmien perustason, rakenteellisen tason ja osittaisen semanttisen tason yhteentoimivuutta