College of Nursing, University of Colorado, Aurora, Colorado, United States.
Department of Research, Innovation, and Professional Practice, Children's Hospital Colorado, Aurora, Colorado, United States.
Appl Clin Inform. 2022 Aug;13(4):803-810. doi: 10.1055/a-1905-3729. Epub 2022 Jul 20.
School-aged children with chronic conditions require care coordination for health needs at school. Access to the student's accurate, real-time medical information is essential for school nurses to maximize their care of students. We aim to analyze school nurse access to medical records in a hospital-based electronic health record (EHR) and the effect on patient outcomes. We hypothesized that EHR access would decrease emergency department (ED) visits and inpatient hospitalizations.
This retrospective secondary data analysis was conducted using EHR data 6 months pre- and post-school nurse access to students' hospital-based EHR. The main outcome measures were the ED visits and inpatient hospitalizations.
For the sample of 336 students in the study, there was a 34% decrease in ED visits from 190 visits before access to 126 ED visits after access ( <0.01). Inpatient hospitalizations decreased by 44% from 176 before access to 99 after access ( <0.001). The incident rate of ED visits decreased (IRR: 0.66; 95% CI: 0.53-0.83; = 0.00035), and hospitalizations decreased (IRR: 0.56; 95% CI: 0.44-0.72; <0.0001) from pre to post access. These findings suggest school nurse access to medical records is a positive factor in improving school-aged patient outcomes.
School nurse access to medical records through the hospital-based EHR may be a factor to improve patient outcomes by utilizing health information technology for more efficient and effective communication and care coordination for school-aged children with chronic medical conditions.
患有慢性病的学龄儿童在学校需要医疗协调以满足其健康需求。获取学生准确、实时的医疗信息对于学校护士最大限度地照顾学生至关重要。我们旨在分析医院电子病历（EHR）中学校护士对医疗记录的访问情况及其对患者结局的影响。我们假设 EHR 访问将减少急诊部（ED）就诊和住院。
本回顾性二次数据分析使用 EHR 数据，在学校护士获得学生医院 EHR 之前和之后的 6 个月进行。主要结局指标是 ED 就诊和住院。
在研究的 336 名学生样本中，ED 就诊从访问前的 190 次就诊减少到访问后的 126 次就诊，减少了 34%（<0.01）。住院减少了 44%，从访问前的 176 次减少到访问后的 99 次（<0.001）。ED 就诊的发生率降低（IRR：0.66；95%CI：0.53-0.83；=0.00035），住院也降低（IRR：0.56；95%CI：0.44-0.72；<0.0001），从访问前到访问后。这些发现表明，学校护士通过医院 EHR 访问医疗记录是改善学龄期患者结局的积极因素。
学校护士通过医院 EHR 访问医疗记录，可能是通过利用健康信息技术改善患者结局的一个因素，以实现对患有慢性病的学龄儿童进行更高效和有效的沟通和医疗协调。
