Nurses use data, too!: Difference between revisions

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Tracey, an HSC MICU, discusses with her colleagues that there are some patients who return to the ICU from the ward after they develop complications with their tracheostomies. They wonder why it might be that some of these patients have complications while others don’t, and whether any specific nursing care is part of the cause. The HSC ICU data collector hears them talk and joins the conversation. She knows that the database collects information on when ICU patients are intubated, which diagnoses they have that might cause their intubation, and which

diagnoses are causing a patient to be admitted to an ICU. She also knows that the Internal Medicine wards are included in the database, and that therefore information related to complications on the wards is available. By linking the data together, they will be able to find out if one of the reasons for readmission to ICU is related to tracheostomy complications from the sending ward. They look at the CCMDB wiki to find out that the database indeed already reports on re-admissions and their causes for all patients.

Tracey and the data collector email Julie, the statistician for the database, to find out if the information could be filtered to only include patients with tracheostomies. Julie replies that it would be possible to limit the readmission report to only patients with a tracheostomy from the sending ward.

[[File:Cuffed inflated tracheotomy tube.png|thumb]] Tracey and the data collector email Julie, the statistician for the database, to find out if the information could be filtered to only include patients with tracheostomies. Julie replies that it would be possible to limit the readmission report to only patients with a tracheostomy from the sending ward.

After some further conversation, they decide that they will extract the following information from the database:

 List and Frequencies of diagnoses for tracheostomy patients who were re-admitted, and for trach patients who were not readmitted for the last 5 years

* List and Frequencies of diagnoses for tracheostomy patients who were re-admitted, and for trach patients who were not readmitted for the last 5 years

 A list of patients with a trach who have been re-admitted to ICU after having been discharged in the last 5 years, including

* A list of patients with a trach who have been re-admitted to ICU after having been discharged in the last 5 years, including

* The full list of diagnoses, and diagnosis type (admit, complication, comorbid) and the part of the stay where the dx was coded (ie during ICU admission or during med ward stay)

** The full list of diagnoses, and diagnosis type (admit, complication, comorbid) and the part of the stay where the dx was coded (ie during ICU admission or during med ward stay)

* Time between discharge from ICU and re-admission

** Time between discharge from ICU and re-admission

* Patient age

** Patient age

 counts of patients with tracheostomy from the sending Medicine ward and return

* counts of patients with tracheostomy from the sending Medicine ward and return

 back to ICU for the past 5 years

* back to ICU for the past 5 years

 do the above at STB ICMS and check if the same pattern was observed

* do the above at STB ICMS and check if the same pattern was observed

Two weeks later Tracey receives her data. When she reviews it she notices that, as expected, a lot of the re-admissions had mucus plugs related to trach care on the wards. However, she also finds out that patients with some pre-existing diagnoses are more likely to develop the mucus plugs than others. Tracey presents this finding at her next team meeting, and they decide inform the wards which patients are especially susceptible to trach problems, and need special attention.

The same approach could have been used for

 any phenomenon that need identification of causes and relationships to the outcomes

* any phenomenon that need identification of causes and relationships to the outcomes

===Before and after – introducing new wound care products===

@@ Line 53: / Line 53: @@
 Tracey, an HSC MICU, discusses with her colleagues that there are some patients who return to the ICU from the ward after they develop complications with their tracheostomies. They wonder why it might be that some of these patients have complications while others don’t, and whether any specific nursing care is part of the cause. The HSC ICU data collector hears them talk and joins the conversation. She knows that the database collects information on when ICU patients are intubated, which diagnoses they have that might cause their intubation, and which
 diagnoses are causing a patient to be admitted to an ICU. She also knows that the Internal Medicine wards are included in the database, and that therefore information related to complications on the wards is available. By linking the data together, they will be able to find out if one of the reasons for readmission to ICU is related to tracheostomy complications from the sending ward. They look at the CCMDB wiki to find out that the database indeed already reports on re-admissions and their causes for all patients.
-Tracey and the data collector email Julie, the statistician for the database, to find out if the information could be filtered to only include patients with tracheostomies. Julie replies that it would be possible to limit the readmission report to only patients with a tracheostomy from the sending ward.
+[[File:Cuffed inflated tracheotomy tube.png|thumb]] Tracey and the data collector email Julie, the statistician for the database, to find out if the information could be filtered to only include patients with tracheostomies. Julie replies that it would be possible to limit the readmission report to only patients with a tracheostomy from the sending ward.
 After some further conversation, they decide that they will extract the following information from the database:
- List and Frequencies of diagnoses for tracheostomy patients who were re-admitted, and for trach patients who were not readmitted for the last 5 years
+* List and Frequencies of diagnoses for tracheostomy patients who were re-admitted, and for trach patients who were not readmitted for the last 5 years
- A list of patients with a trach who have been re-admitted to ICU after having been discharged in the last 5 years, including
+* A list of patients with a trach who have been re-admitted to ICU after having been discharged in the last 5 years, including
-* The full list of diagnoses, and diagnosis type (admit, complication, comorbid) and the part of the stay where the dx was coded (ie during ICU admission or during med ward stay)
+** The full list of diagnoses, and diagnosis type (admit, complication, comorbid) and the part of the stay where the dx was coded (ie during ICU admission or during med ward stay)
-* Time between discharge from ICU and re-admission
+** Time between discharge from ICU and re-admission
-* Patient age
+** Patient age
- counts of patients with tracheostomy from the sending Medicine ward and return
+* counts of patients with tracheostomy from the sending Medicine ward and return
- back to ICU for the past 5 years
+* back to ICU for the past 5 years
- do the above at STB ICMS and check if the same pattern was observed
+* do the above at STB ICMS and check if the same pattern was observed
 Two weeks later Tracey receives her data. When she reviews it she notices that, as expected, a lot of the re-admissions had mucus plugs related to trach care on the wards. However, she also finds out that patients with some pre-existing diagnoses are more likely to develop the mucus plugs than others. Tracey presents this finding at her next team meeting, and they decide inform the wards which patients are especially susceptible to trach problems, and need special attention.
 The same approach could have been used for
- any phenomenon that need identification of causes and relationships to the outcomes
+* any phenomenon that need identification of causes and relationships to the outcomes
 ===Before and after – introducing new wound care products===