Riitta Danielsson-Ojala

Characteristics of Finnish and Swedish intensive care nursing narratives: a comparative analysis to support the development of clinical language technologies

BackgroundFree text is helpful for entering information into electronic health records, but reusing it is a challenge. The need for language technology for processing Finnish and Swedish healthcare text is therefore evident; however, Finnish and Swedish are linguistically very dissimilar. In this paper we present a comparison of characteristics in Finnish and Swedish free-text nursing narratives from intensive care. This creates a framework for characterising and comparing clinical text and lays the groundwork for developing clinical language technologies.MethodsOur material included daily nursing narratives from one intensive care unit in Finland and one in Sweden. Inclusion criteria for patients were an inpatient period of least five days and an age of at least 16 years. We performed a comparative analysis as part of a collaborative effort between Finnish- and Swedish-speaking healthcare and language technology professionals that included both qualitative and quantitative aspects. The qualitative analysis addressed the content and structure of three average-sized health records from each country. In the quantitative analysis 514 Finnish and 379 Swedish health records were studied using various language technology tools.ResultsAlthough the two languages are not closely related, nursing narratives in Finland and Sweden had many properties in common. Both made use of specialised jargon and their content was very similar. However, many of these characteristics were challenging regarding development of language technology to support producing and using clinical documentation.ConclusionsThe way Finnish and Swedish intensive care nursing was documented, was not country or language dependent, but shared a common context, principles and structural features and even similar vocabulary elements. Technology solutions are therefore likely to be applicable to a wider range of natural languages, but they need linguistic tailoring.AvailabilityThe Finnish and Swedish data can be found at: http://www.dsv.su.se/hexanord/data/.

Registered Nurses’ Experiences with the Medication Administration Process

Background. Registered nurses (RNs) have a role in the medication administration process (MAP) multiple times per day in a hectic hospital environment. This requires a great deal from the RNs in order to accomplish the demanding task of avoiding adverse drug events. However, the process has not been widely studied from the nurses’ perspective. Aim. The aim of this study was to describe the different stages of MAP from the RNs’ perspective. Methods. A qualitative descriptive research design, with a purposive sample involving thematic interviews of 20 RNs and questions to them in a paper form, was conducted in two medical units. Data was analyzed by using deductive content analysis. Results. The results revealed that RNs confront numerous problems such as equivocal prescriptions, problems with information technology (IT), unavailability or incompatibility of the medicines, a substantial amount of generic substitutions, and changing medicine brands. Disruptions and distraction run through each stage of the MAP, excluding prescribing. The RNs desire support in all stages of the MAP. Conclusion. There are areas to improve in each stage of the MAP from the RNs perspective. Real-time and ubiquitous documentation, along with software including the data and knowledge required in medication management, is needed.

Can IT health-care applications improve the medication tray-filling process at hospital wards? An exploratory study using eye-tracking and stress response

Filling medication trays and dispensing them at hospital wards is a painstaking, time-consuming and tedious task involving searching for medication in large shelves, double checking in the daily filled tray that the appearance, amount and concentration of each medication corresponds to the prescription, as well as analysing the timing conditions, among other details. Finally, if needed, finding equivalent compounds containing no secondary effects is also crucial, as well as being aware of the dynamically changing treatments in patients located, e.g., in surgery wards. Once the tray is filled, similar concerns and checks need to be done before dispensing the medication to the patient. We conducted a pilot in two university hospital wards using eye-tracking glasses and stress response to assess the tasks that take time the most and are most meticulous or stressing for the nurses. The aim is to use the findings to implement a mobile application that helps saving time and proneness to errors daily in such complex nursing procedures.

Mobile dictation for healthcare professionals

We demonstrate a mobile dictation application utilizing automatic speech recognition for healthcare professionals. Development was done in close collaboration between human-technology interaction and nursing science researchers and professionals working in the area. Our work was motivated by the need for improvements in getting spoken patient information to the next treatment steps without additional steps. In addition, we wanted to enable truly mobile spoken information entry, i.e., dictation can take place on the spot. In order to study the applicability we conducted a small-scale Wizard-of-Oz evaluation in a real hospital environment with real nurses. Our main focus was to gather subjective expectations and experiences from the actual nurses themselves. The results show true potential for our mobile dictation application and its further development.