Clinical Informatics and Its Usefulness for Assessing Risk and Preventing Falls and Pressure Ulcers in Nursing Home Environments

摘要

Nursing homes have lagged in the development and use of technology and clinical informatics. This paper describes a practical model of translating clinical informatics research into practice. The Minimum Data Set (MDS) assessment data collected by nursing homes nationwide is translated into knowledge-based information that supports continuous quality improvement. It does so by providing timely Web-based reports alerting staff to the likelihood of an adverse outcome, along with individualized resident risk profiles to guide preventive care plan development. The adverse outcomes addressed in this study falls and pressure ulcers are associated with considerable morbidity and mortality and represent serious quality of care issues for the elderly nursing home population. These events are usually preventable yet contribute significantly to the growing costs of health care, insurance, and liability. This paper describes the risk reports and how nursing home staffs are using them, barriers to use of clinical informatics, measurable changes in processes, outcomes and quality of care, and implications for other Web-based decision- support systems in long term care settings.