Author Affiliations: Center for Innovations in Quality, Effectiveness and Safety (Mss Wong, Yang, and Knox, Mr SoRelle, and Drs Hysong, O'Mahen, and Petersen) and Patient Care Services (Dr Dorsey), Michael E. DeBakey Veterans Affairs Medical Center; and Section of Health Services Research, Department of Medicine, Baylor College of Medicine (Mss Wong, Yang, and Knox, Mr SoRelle, and Drs Hysong, O'Mahen, and Petersen), Houston, TX.
Comput Inform Nurs. 2023 Sep 1;41(9):679-686. doi: 10.1097/CIN.0000000000001003.
Healthcare systems and nursing leaders aim to make evidence-based nurse staffing decisions. Understanding how nurses use and perceive available data to support safe staffing can strengthen learning healthcare systems and support evidence-based practice, particularly given emerging data availability and specific nursing challenges in data usability. However, current literature offers sparse insight into the nature of data use and challenges in the inpatient nurse staffing management context. We aimed to investigate how nurse leaders experience using data to guide their inpatient staffing management decisions in the Veterans Health Administration, the largest integrated healthcare system in the United States. We conducted semistructured interviews with 27 Veterans Health Administration nurse leaders across five management levels, using a constant comparative approach for analysis. Participants primarily reported using data for quality improvement, organizational learning, and organizational monitoring and support. Challenges included data fragmentation, unavailability and unsuitability to user need, lack of knowledge about available data, and untimely reporting. Our findings suggest that prioritizing end-user experience and needs is necessary to better govern evidence-based data tools for improving nursing care. Continuous nurse leader involvement in data governance is integral to ensuring high-quality data for end-user nurses to guide their decisions impacting patient care.
医疗保健系统和护理领导者旨在做出基于证据的护士人员配备决策。了解护士如何使用和感知可用数据来支持安全人员配备，可以加强学习型医疗保健系统并支持循证实践，特别是考虑到新兴的数据可用性和数据可用性方面的特定护理挑战。然而，目前的文献对住院护士人员配备管理背景下数据使用和挑战的性质提供的见解很少。我们旨在调查退伍军人事务部的护士领导者如何根据数据来指导他们的住院人员配备管理决策，退伍军人事务部是美国最大的综合医疗保健系统。我们对来自五个管理层级的 27 名退伍军人事务部护士领导者进行了半结构化访谈，采用恒定性比较分析方法进行分析。参与者主要报告说，他们将数据用于质量改进、组织学习以及组织监测和支持。挑战包括数据碎片化、无法获得和不适合用户需求、缺乏对可用数据的了解以及报告不及时。我们的研究结果表明，优先考虑最终用户体验和需求对于改进护理服务的循证数据工具是必要的。持续让护士领导者参与数据治理对于确保高质量的数据供最终用户护士使用以指导影响患者护理的决策至关重要。
