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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, 201211th International Congress on Nursing Informatics

Agenda

4.

2. Omaha System Partnership

5. Questions

3. Researchs in Omaha System Partnership

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Omaha System Partnership Benefits

1. Omaha System

Today Today

3

EHR which focus on the individual, computer-based,

and easily accessible when needed has become a core

in health information systems

Computer- compatible

Hierarchical

Used by my faculty team for more than ten years

Simple

Multidimensional

Omaha System was designed to be relatively;

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.

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Three components of the Omaha 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 Turkey to contribute Omaha

System data and work together with the scientific team

on research projects

3. a warehouse of de-identified clinical Omaha System data including client problems,

signs/symptom, interventions, and knowledge, behavior, and status outcomes

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Omaha System PartnershipOmaha System Partnership

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Researches from Turkey in the Partnership

I- Using the Omaha System to Describe Health Problems, Interventions, and Outcomes in Home care in Istanbul, 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)

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Using the Omaha System to Describe Health Problems, Interventions, and Outcomes in

Home care in Istanbul, Turkey: A Student Informatics Research Experience

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Co Principal Investigators: Erdogan S, Secginli S. et al. Istanbul University, Nursing Faculty

Purpose: To provide hands-on informatics experience to nursing students; to identify the frequency and type of home care clients' health problems, nursing interventions, and outcomes using the Omaha System

Table of Contents

IntroductionMethods

Results

Discussion

Conclusions

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Home Care Services in Turkey

In 2010, Turkish government included home care services

in the Health Transformation Program for the purpose of

mainly enable medical care and rehabilitation of the

bedridden clients to be performed at home.

Home care services are not integrated to the health care

and social care sytems of the country, and are not covered

by government health insurance held by 90% of the

population.

Few private sector providers and municipalities offered

these services which are generally limited to the larger

cities. 11

Table of Contents

Introduction

MethodsResults

Discussion

Conclusions

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Approval was obtained from the university 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 training in 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

Table of Contents

Introduction

Methods

ResultsDiscussion

Conclusions

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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

most common problems

Sample and Omaha System Problems

The Ten Most Problems and The Intervention Categories

The intervention categories were:

Teaching, guidance and 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)

The Intervention Categories and The Most Frequent Targets

Interventions Category According To The Omaha System Domains

Average Knowledge, Behaviour and Status

Final Ratings

Table of Contents

Introduction

Methods

Results

DiscussionConclusions

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Some Points to Discuss- I

Three of the 42 Omaha system problems were not addressed within this population (exceptions with Sexuality, Pregnancy, and Postpartum)

Home care services (including nursing student and educator visits) may positively affect client knowledge, behavior, and status related to the identified health problems

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Some Points to Discuss- II

The evidence-based care plan of the most common home care problems 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 information technology requirements as a component of home care practicum experience

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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 of students and

educators

Study findings may not be generalizable to a broader

population and limited comparisons due to the lack of

relevant literature on similar programs and settings in Turkey

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Table of Contents

Introduction

Methods

Results

Discussion

Conclusions

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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 data collection tool for

evaluating problems, interventions, and outcomes in home

care,

3- A positive teaching and learning tool for baccalaureate

nursing education.

Acknowledgements

Municipality home care teams

Undergraduate nursing students

Department research assistants

Florence Nightingale Nursing Schools and Hospitals

Foundation

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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

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Omaha System Partnership Benefits- I

Stimulates nurses in home health care team in

professional thinking. And the health care teams gained

awareness of the importance of nursing documentation

and the use of a standardized nursing terminology

Students employed nursing informatics at the basic

practice level to improve health care delivery and

outcome evaluation

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Omaha System Partnership Benefits- I

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

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Omaha System Partnership Benefits- II

Presentation of Omaha System outcomes at national and international professional meetings

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Omaha System Partnershıp Benefits- III

A scientific program with international visitors from America and Holland in the faculty

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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

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Omaha System Partnershıp Benefits- III

Roadmap ?

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Future research in Omaha System Partnership

in collaboration with

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

secginli@istanbul.edu.tr

s.secginli@gmail.com

Thank you for your attention

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