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  1. Involving Students in Omaha System Partnership Research: A View from Istanbul, Turkey Selda Secginli, PhD, Assistant Professor, Istanbul University, Nursing Faculty, Public Health Nursing Department, Istanbul, Turkey June 26, 2012 11th International Congress on Nursing Informatics

  2. Agenda 1. Omaha System 2. Omaha System Partnership 3. Researchs in Omaha System Partnership 4. Omaha System Partnership Benefits 5. Questions

  3. Today EHR which focus on the individual, computer-based, and easily accessible when neededhas become a core in health information systems

  4. OmahaSystemwas designed to berelatively; Simple Hierarchical Multidimensional Computer-compatible Used by my faculty team for more than ten years

  5. Known Benefits of Partnership Studies • An optimal environment in which to enhance practice, evaluate programs, measure outcomes, and improve population health • Opportunities for shared knowledge and skills • Provide new ways of working • Generate new knowledge using large data sets.

  6. Threecomponents of theOmaha System Partnership for Knowledge Discovery and Health Care Quality 1. multidisciplinary scientific teams of researchers with experience in advanced data analysis and data mining techniques 2. affiliate members from TurkeytocontributeOmahaSystem data and work together with the scientific team onresearchprojects 3. a warehouse of de-identified clinical Omaha System data including client problems, signs/symptom, interventions, and knowledge, behavior, andstatus outcomes

  7. OmahaSystemPartnership

  8. Researches from Turkey in the Partnership I- Using the Omaha System to Describe Health Problems, Interventions, and Outcomesin Home care inIstanbul, Turkey: A Student Informatics Research Experience (under review) II- Attitudes of Health Professionals Towards Electronic Health Recording in Primary Health Care Settings: A Questionnaire Survey (under writing)

  9. Using the Omaha System to Describe Health Problems, Interventions, and Outcomesin Home care in Istanbul, Turkey: A Student Informatics Research Experience Co Principal Investigators: Erdogan S, Secginli S. et al. Istanbul University, Nursing Faculty Purpose: To provide hands-oninformatics experience to nursing students; to identify the frequency and type ofhome care clients' health problems, nursinginterventions, and outcomes using the Omaha System

  10. Table of Contents • Introduction • Methods • Results • Discussion • Conclusions

  11. Home Care Services in Turkey • In 2010, Turkish governmentincluded home care services in the HealthTransformation Program for the purpose of mainlyenable medical care and rehabilitation of the bedridden clients to beperformed at home. • Homecareservicesare not integratedtothehealthcareandsocialcaresytems of thecountry, andare not coveredbygovernmenthealthinsuranceheldby 90% of thepopulation. • Fewprivatesectorprovidersandmunicipalitiesofferedtheseserviceswhicharegenerallylimitedtothelargercities.

  12. Table of Contents • Introduction • Methods • Results • Discussion • Conclusions

  13. Approval was obtained from theuniversity institutional review board, 2011/ 393-462 and municipal health services and home health centers directors • A software based on Omaha System was used for documentation. Students received trainingin use of the Omaha System, software program, home visits, and family assessment • 159 students visited the clients at home with nurses and did face-to-face interviews in the households

  14. Table of Contents • Introduction • Methods • Results • Discussion • Conclusions

  15. SampleandOmahaSystemProblems • The mean age was 66.13 years (SD=18.65) • Two-third of the clients had no education/low education (66%) • Data were collected from 598 clients • Clients received 8657 interventions for 2267 problems • Skin, Neuro-musculo- skelatal function, Personal care, and Nutrition were the mostcommon problems

  16. The Ten MostProblemsandTheInterventionCategories

  17. TheInterventionCategoriesandTheMostFrequentTargets • Theintervention categories were: Teaching,guidanceand counseling (47%), Treatments and procedures (22%), Surveillance (22%) and the Case management (9%) • The most frequent targets were: Dressing change/wound care (776), sign/symptoms-physical (770),skin care (623), positioning (563) and continuity of care (520)

  18. InterventionsCategoryAccordingToThe OmahaSystemDomains

  19. AverageKnowledge, BehaviourandStatusFinal Ratings

  20. Table of Contents • Introduction • Methods • Results • Discussion • Conclusions

  21. Some Points to Discuss- I • Three of the 42 Omaha system problems were not addressed within this population (exceptionswith Sexuality, Pregnancy, and Postpartum) • Home care services (including nursing studentand educator visits) may positively affect client knowledge, behavior, and status related to the identified health problems

  22. Some Points to Discuss- II • The evidence-based care plan of the most common home careproblems identified in this study have developed • The developed evidence-based care plans could be used in future studies of home care intervention effectiveness • The integration of information technology within the curriculum enabled the educators to meet informationtechnology requirements as a component of home care practicum experience

  23. Limitations • Observational data sets, especially systematic bias that may be introduced through use of students in data collection • Inability to randomize clients, and thus inability to attribute causation of outcomes to the interventions ofstudents and educators • Study findings may not begeneralizable to a broader population and limited comparisons due to the lack ofrelevant literature on similar programs and settings in Turkey

  24. Table of Contents • Introduction • Methods • Results • Discussion • Conclusions

  25. This study mainly demonstrated that 1- Using the Omaha System provides a foundation for evidence-based nursing education in home care and informatics. 2- Omaha System is an useful datacollection tool for evaluating problems, interventions, and outcomes in home care, 3- A positive teaching and learning tool for baccalaureate nursing education.

  26. Acknowledgements • Municipality home care teams • Undergraduate nursing students • Department research assistants • Florence Nightingale Nursing Schools and Hospitals Foundation

  27. OmahaSystemPartnershipBenefits- I • Built a support network by identifying people involved with information technology in my university and let them know about the Project • Dissemination of tools to other researchers

  28. OmahaSystemPartnershipBenefits- I • Stimulates nurses in home health care team in professional thinking. And the health care teams gained awareness of the importance of nursing documentationand the use of a standardized nursing terminology • Students employed nursing informatics at the basic practice level to improve health care delivery and outcome evaluation

  29. OmahaSystemPartnershipBenefits- II • Gave better insight on delivered care and improved documentation and practice quality • Scientific publications • A poster was submitted for the 2nd International Public Health Nursing Conference in Minnesota in October 2011

  30. Omaha System Partnershıp Benefits- III • Presentation of Omaha System outcomes at national and international professional meetings

  31. Omaha System Partnershıp Benefits- III • A scientific program with international visitors from America and Holland in the faculty

  32. Omaha System Partnershıp Benefits- III • Foremost, helped us to recognize once that it was very important to embrace new practice models for nursing students such as informatics. And a new course “Nursing Informatics” is going to start in the faculty next year

  33. Roadmap ? • Future research in Omaha System Partnership • in collaborationwith • The health care teams and postgraduate students • Build a support network by identifying more people from Turkey involved with information technology in other universities and let them know about the Partnership Project • Disseminate our partnership outcomes and share our experiences especially in other nursing schools in Turkey

  34. Thank you for your attention Sabrınız için teşekkürler secginli@istanbul.edu.tr s.secginli@gmail.com