Implementation of the Austrian Nursing Minimum Data Set (NMDS-AT): A Feasibility Study

Abstract

BackgroundAn Austrian Nursing Minimum Data Set (NMDS-AT) has been developed to describe the diversity of patient populations and variability of nursing care based on nursing diagnoses, nursing interventions, and nursing outcomes. The aim of this study is to test the feasibility of using this NMDS-AT by assessing the availability of data needed for the NMDS-AT in routine nursing documentation, and to assess its reliability and usefulness.MethodsData were collected in a general hospital from patient records of 20 patients representing 457 patient days. Availability of needed data was assessed by two raters in a chart review based on an NMDS-AT form. The interrater reliability (n = 20) and intrarater reliability (n = 5) was assessed using Cohen’s kappa coefficient and intraclass correlation coefficient (ICC). Usefulness was assessed by verifying whether typical analysis questions can be answered by the documented NMDS-AT data.ResultsIn the 20 patient records, thirteen nursing diagnoses, 50 nursing interventions, and five nursing outcomes occurred, representing 68 (58.6 %) of the overall 116 data elements of the NMDS-AT. The data were found at different data sources (e.g., electronic nursing record or paper-based fever chart) and in various forms (e.g., standardized or free text).The interrater reliability of the thirteen nursing diagnoses showed kappa values (percentage of agreement) ranging from 0.35 (85 %) to 1.00 (100 %). The 50 nursing interventions showed ICCs ranging from 0.03 to 1.00. All nursing outcomes showed an ICC of 1.00. The intrarater reliability showed 100 % agreement. Performing typical analysis questions showed that the extracted NMDS-AT data are able to answer questions of clinical management, of policy makers, and of nursing science.ConclusionsThe NMDS-AT was found to be feasible: needed data was available in the analysed patient records, data extraction showed good reliability, and typical analysis could be performed and showed interesting results. Before the NMDS-AT can be introduced in healthcare institutions, the following challenges need to be addressed: 1. improve the quality of nursing documentation; 2. reduce fragmentation of documentation; 3. use a standardized nursing classification system; and 4. establish mappings between nursing classification systems and the NMDS-AT.

Prevalence of nursing diagnoses as a measure of nursing complexity in a hospital setting

“…Werley and Lang (1988) proposed the Nursing Minimum Data Set (NMDS) to achieve this aim. The NMDS represents a systematic record of essential standardized nursing data documenting all steps of the nursing process (Sermeus et al 1994, Ranegger et al 2015.…”

Designing a minimum data set of laboratory data for the electronic summary sheet of pediatric ward in Iran: A cross‐sectional study

“…Ringer and colleagues designed a nursing MDS by examining different minimum data sets, and combining these data sets. in a panel of experts, they developed a final list of these data for Australia 22 . Kelimstra and colleagues introduced an MDS for the pathology report of patients with neurological and endocrine diseases in the United States.…”

Nursing Information Flow in Long-Term Care Facilities

“…(1) information process flow challenges in relation to nursing practice; 6,7,14,[18][19][20] (2) information requirements for information quality; [21][22][23][24] and (3) communication demands for care collaboration. 5,12,15,17,[25][26][27] The need of comprehensive communication has been well addressed by the majority of reports as LTC care requires increased collaboration.…”