Data Mining Nursing Care Plans of End-of-Life Patients: A Study to Improve Healthcare Decision Making

Authors

  • Fadi Almasalha PhD,

    1. Fadi Almasalha, PhD, is an Assistant Professor at The Applied Science Private University, Amman, Jordan, Dianhui Xu, PhD, is a System Software Engineer at Litepoint Company, Sunnyvale, California, Yu-C. Chen, PhD, is a Software Engineer for Pixar Animations Studios, Emerville, California, Gail M. Keenan, RN, PhD, is an Associate Professor in the College of Nursing*, Ashfaq Khokhar, PhD, is a Professor in the Department of Electrical and Computer Engineering*, Yinwei Yao, PhD, is an Associate Clinical Professor in the College of Nursing*, Andy Johnson, PhD, is an Associate Professor in the Department of Computer Science*, Rashid Ansari, PhD, is a Professor in the Department of Engineering*, and Diana J. Wilkie, RN, PhD, is a Professor in the College of Nursing, University of Illinois at Chicago in Chicago, Illinois.
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  • Dianhui Xu PhD,

    1. Fadi Almasalha, PhD, is an Assistant Professor at The Applied Science Private University, Amman, Jordan, Dianhui Xu, PhD, is a System Software Engineer at Litepoint Company, Sunnyvale, California, Yu-C. Chen, PhD, is a Software Engineer for Pixar Animations Studios, Emerville, California, Gail M. Keenan, RN, PhD, is an Associate Professor in the College of Nursing*, Ashfaq Khokhar, PhD, is a Professor in the Department of Electrical and Computer Engineering*, Yinwei Yao, PhD, is an Associate Clinical Professor in the College of Nursing*, Andy Johnson, PhD, is an Associate Professor in the Department of Computer Science*, Rashid Ansari, PhD, is a Professor in the Department of Engineering*, and Diana J. Wilkie, RN, PhD, is a Professor in the College of Nursing, University of Illinois at Chicago in Chicago, Illinois.
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  • Gail M. Keenan RN, PhD,

    Corresponding author
    1. Fadi Almasalha, PhD, is an Assistant Professor at The Applied Science Private University, Amman, Jordan, Dianhui Xu, PhD, is a System Software Engineer at Litepoint Company, Sunnyvale, California, Yu-C. Chen, PhD, is a Software Engineer for Pixar Animations Studios, Emerville, California, Gail M. Keenan, RN, PhD, is an Associate Professor in the College of Nursing*, Ashfaq Khokhar, PhD, is a Professor in the Department of Electrical and Computer Engineering*, Yinwei Yao, PhD, is an Associate Clinical Professor in the College of Nursing*, Andy Johnson, PhD, is an Associate Professor in the Department of Computer Science*, Rashid Ansari, PhD, is a Professor in the Department of Engineering*, and Diana J. Wilkie, RN, PhD, is a Professor in the College of Nursing, University of Illinois at Chicago in Chicago, Illinois.
      gmkeenan@uic.edu or ashfaq@uic.edu, with a copy to the Editor: journal@nanda.org
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  • Ashfaq Khokhar PhD,

    1. Fadi Almasalha, PhD, is an Assistant Professor at The Applied Science Private University, Amman, Jordan, Dianhui Xu, PhD, is a System Software Engineer at Litepoint Company, Sunnyvale, California, Yu-C. Chen, PhD, is a Software Engineer for Pixar Animations Studios, Emerville, California, Gail M. Keenan, RN, PhD, is an Associate Professor in the College of Nursing*, Ashfaq Khokhar, PhD, is a Professor in the Department of Electrical and Computer Engineering*, Yinwei Yao, PhD, is an Associate Clinical Professor in the College of Nursing*, Andy Johnson, PhD, is an Associate Professor in the Department of Computer Science*, Rashid Ansari, PhD, is a Professor in the Department of Engineering*, and Diana J. Wilkie, RN, PhD, is a Professor in the College of Nursing, University of Illinois at Chicago in Chicago, Illinois.
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  • Yingwei Yao PhD,

    1. Fadi Almasalha, PhD, is an Assistant Professor at The Applied Science Private University, Amman, Jordan, Dianhui Xu, PhD, is a System Software Engineer at Litepoint Company, Sunnyvale, California, Yu-C. Chen, PhD, is a Software Engineer for Pixar Animations Studios, Emerville, California, Gail M. Keenan, RN, PhD, is an Associate Professor in the College of Nursing*, Ashfaq Khokhar, PhD, is a Professor in the Department of Electrical and Computer Engineering*, Yinwei Yao, PhD, is an Associate Clinical Professor in the College of Nursing*, Andy Johnson, PhD, is an Associate Professor in the Department of Computer Science*, Rashid Ansari, PhD, is a Professor in the Department of Engineering*, and Diana J. Wilkie, RN, PhD, is a Professor in the College of Nursing, University of Illinois at Chicago in Chicago, Illinois.
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  • Yu-C. Chen PhD,

    1. Fadi Almasalha, PhD, is an Assistant Professor at The Applied Science Private University, Amman, Jordan, Dianhui Xu, PhD, is a System Software Engineer at Litepoint Company, Sunnyvale, California, Yu-C. Chen, PhD, is a Software Engineer for Pixar Animations Studios, Emerville, California, Gail M. Keenan, RN, PhD, is an Associate Professor in the College of Nursing*, Ashfaq Khokhar, PhD, is a Professor in the Department of Electrical and Computer Engineering*, Yinwei Yao, PhD, is an Associate Clinical Professor in the College of Nursing*, Andy Johnson, PhD, is an Associate Professor in the Department of Computer Science*, Rashid Ansari, PhD, is a Professor in the Department of Engineering*, and Diana J. Wilkie, RN, PhD, is a Professor in the College of Nursing, University of Illinois at Chicago in Chicago, Illinois.
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  • Andy Johnson PhD,

    1. Fadi Almasalha, PhD, is an Assistant Professor at The Applied Science Private University, Amman, Jordan, Dianhui Xu, PhD, is a System Software Engineer at Litepoint Company, Sunnyvale, California, Yu-C. Chen, PhD, is a Software Engineer for Pixar Animations Studios, Emerville, California, Gail M. Keenan, RN, PhD, is an Associate Professor in the College of Nursing*, Ashfaq Khokhar, PhD, is a Professor in the Department of Electrical and Computer Engineering*, Yinwei Yao, PhD, is an Associate Clinical Professor in the College of Nursing*, Andy Johnson, PhD, is an Associate Professor in the Department of Computer Science*, Rashid Ansari, PhD, is a Professor in the Department of Engineering*, and Diana J. Wilkie, RN, PhD, is a Professor in the College of Nursing, University of Illinois at Chicago in Chicago, Illinois.
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  • R. Ansari PhD,

    1. Fadi Almasalha, PhD, is an Assistant Professor at The Applied Science Private University, Amman, Jordan, Dianhui Xu, PhD, is a System Software Engineer at Litepoint Company, Sunnyvale, California, Yu-C. Chen, PhD, is a Software Engineer for Pixar Animations Studios, Emerville, California, Gail M. Keenan, RN, PhD, is an Associate Professor in the College of Nursing*, Ashfaq Khokhar, PhD, is a Professor in the Department of Electrical and Computer Engineering*, Yinwei Yao, PhD, is an Associate Clinical Professor in the College of Nursing*, Andy Johnson, PhD, is an Associate Professor in the Department of Computer Science*, Rashid Ansari, PhD, is a Professor in the Department of Engineering*, and Diana J. Wilkie, RN, PhD, is a Professor in the College of Nursing, University of Illinois at Chicago in Chicago, Illinois.
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  • Diana J. Wilkie RN, PhD

    1. Fadi Almasalha, PhD, is an Assistant Professor at The Applied Science Private University, Amman, Jordan, Dianhui Xu, PhD, is a System Software Engineer at Litepoint Company, Sunnyvale, California, Yu-C. Chen, PhD, is a Software Engineer for Pixar Animations Studios, Emerville, California, Gail M. Keenan, RN, PhD, is an Associate Professor in the College of Nursing*, Ashfaq Khokhar, PhD, is a Professor in the Department of Electrical and Computer Engineering*, Yinwei Yao, PhD, is an Associate Clinical Professor in the College of Nursing*, Andy Johnson, PhD, is an Associate Professor in the Department of Computer Science*, Rashid Ansari, PhD, is a Professor in the Department of Engineering*, and Diana J. Wilkie, RN, PhD, is a Professor in the College of Nursing, University of Illinois at Chicago in Chicago, Illinois.
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  • Author Disclosure Statement: Rights to HANDS® are owned by HealthTeam IQ, LLC, a company owned and managed by Gail Keenan. She has a conflict management plan with the University of Illinois to assure scientific integrity of research related to HANDS.

  • Authors who are also affiliated to University of Illinois at Chicago in Chicago, Illinois.

gmkeenan@uic.edu or ashfaq@uic.edu, with a copy to the Editor: journal@nanda.org

Abstract

PURPOSE:  To reveal hidden patterns and knowledge present in nursing care information documented with standardized nursing terminologies on end-of-life (EOL) hospitalized patients.

METHOD:  596 episodes of care that included pain as a problem on a patient's care plan were examined using statistical and data mining tools. The data were extracted from the Hands-On Automated Nursing Data System database of nursing care plan episodes (n = 40,747) coded with NANDA-I, Nursing Outcomes Classification, and Nursing Intervention Classification (NNN) terminologies. System episode data (episode = care plans updated at every hand-off on a patient while staying on a hospital unit) had been previously gathered in eight units located in four different healthcare facilities (total episodes = 40,747; EOL episodes = 1,425) over 2 years and anonymized prior to this analyses.

RESULTS:  Results show multiple discoveries, including EOL patients with hospital stays (<72 hr) are less likely (p < .005) to meet the pain relief goals compared with EOL patients with longer hospital stays.

CONCLUSIONS:  The study demonstrates some major benefits of systematically integrating NNN into electronic health records.

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