Olga Šušteršič

Toward the design of a nursing ontology system.

The unambiguous and consistent representation of the healthcare domain is the foundation of modernized healthcare (eg, electronic medical records). However, the nursing domain often fails to meet this requirement. In this article, we address this challenge by presenting a three-stage methodological approach that can be used to (1) capture knowledge in a nursing domain; (2) design a nursing ontology, composed of data models linked with terminology concepts in a multirelational property graph; and (3) implement and (4) evaluate the ontology. Through the feasibility, development, and evaluation phases of our methodological approach, we modeled a nursing domain (ontology) and the indices that partition the domain into an efficient, searchable space, where the solution to a nursing problem is seen as abstractly defined traversals through its graph vertices and edges. Thus, the use of the three-phase ontology development process and multirelational property graph was sufficiently comprehensive for achieving the representation of a nursing domain ontology and its instantiation.

A Model for Risk Assessment in Health Care Using a Health Care Failure Method and Effect Analysis

Abstract Objective: The purpose of this research is to track and reduce risks so as to prevent errors within the process of health care. The aim is to design an organizational information model using error prevention methods for risk assessment. Method: In order to assess the risk of errors, the Health Care Failure Mode and Effect Analysis is used. To determine the causes of the errors, the Root Cause Analysis is used. Results: Results of the process analysis following corrective measures shows that the risk assessment of individual error causes reduced by73.6 percent. Re-evaluation of the risks to the whole process shows that the overall risk score was decreased by 45.5 percent. The proposed model has a significant impact on professional attention, communication and information, critical thinking, experience and knowledge. The average impact of information communication technology on the reduction of medication administration errors is 56 percent. These findings represent an increase in the quality of care. Conclusions: The results of our research are theoretically and practically useful and verifiable in other environments, if the level of the organizational culture and the culture of recording errors in combination with the precise recording of data to assess the risk of errors in the process. The model provides a standardized data format that can be used for the purpose of defining factors for the occurrence of errors, for developing a base of knowledge for learning from mistakes and for continuous verification and adaptation to changes in the environment in order to prevent errors. Izvleček Namen: Namen raziskave je zmanjševanje tveganj in posledično preprečevanje napak v procesu zdravstvene oskrbe. Cilj raziskave je oblikovanje organizacijsko-informacijskega modela preprečevanja napak z uporabo metod za ocenjevanje tveganj v kliničnem okolju. Metode: Za ocenitev tveganj za nastanek napak v procesu zdravstvene oskrbe smo uporabili metodo analize mogočih napak in njihovih posledic, prilagojeno za zdravstvo. Za ugotovitev vzrokov za nastanek napak smo uporabili metodo analize temeljnih vzrokov. Rezultati: Izsledki analize v kliničnem okolju kažejo, da je z uvedbo korektivnih ukrepov ocena tveganj posameznih vzrokov zmanjšana za 73,6 %. Opazen je vplivi na celoten proces in se je skupna ocena tveganj zmanjšala za 45,5 %. Predlagan model pomembno vpliva na strokovno pozornost, komunikacijo in informiranje, kritično razmišljanje ter na izkušnje in znanje. Povprečen vpliv informacijsko-komunikacijske tehnologije na pravilno izvajanje postopka aplikacije zdravil je 56-odstoten. S tem se je zvišala kakovost zdravstvene oskrbe. Zaključek: Izsledki raziskave so teoretično in praktično uporabni in preverljivi v drugih okoljih, če le stopnja organizacijske kulture in kulture evidentiranja napak izpolnjuje zahteve po natančnem evidentiranju podatkov za ocenitev tveganj za nastanek napak v procesu zdravljenja. Model omogoča standardiziran zapis podatkov, ki se lahko uporablja v namen opredelitve dejavnikov za nastanek napak, izgradnjo baze znanj za učenje iz napak ter za kontinuirano verifikacijo in prilagajanje organizacije spremembam v okolju s ciljem preprečevanja napak.