Christina Baker1, Figaro Loresto2, Kaci Pickett3,4, Sadaf Sara Samay5, Bonnie Gance-Cleveland1. 1. College of Nursing, University of Colorado, Aurora, Colorado, United States. 2. Department of Research, Innovation, and Professional Practice, Children's Hospital Colorado, Aurora, Colorado, United States. 3. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, United States. 4. Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, United States. 5. Department of Research Informatics and Analytics, Children's Hospital Colorado, Aurora, Colorado, United States.
Abstract
BACKGROUND AND OBJECTIVES: School-aged children with chronic conditions require care coordination for health needs at school. Access to the student's accurate, real-time medical information is essential for school nurses to maximize their care of students. We aim to analyze school nurse access to medical records in a hospital-based electronic health record (EHR) and the effect on patient outcomes. We hypothesized that EHR access would decrease emergency department (ED) visits and inpatient hospitalizations. METHODS: This retrospective secondary data analysis was conducted using EHR data 6 months pre- and post-school nurse access to students' hospital-based EHR. The main outcome measures were the ED visits and inpatient hospitalizations. RESULTS: For the sample of 336 students in the study, there was a 34% decrease in ED visits from 190 visits before access to 126 ED visits after access (p <0.01). Inpatient hospitalizations decreased by 44% from 176 before access to 99 after access (p <0.001). The incident rate of ED visits decreased (IRR: 0.66; 95% CI: 0.53-0.83; p = 0.00035), and hospitalizations decreased (IRR: 0.56; 95% CI: 0.44-0.72; p <0.0001) from pre to post access. These findings suggest school nurse access to medical records is a positive factor in improving school-aged patient outcomes. CONCLUSION: School nurse access to medical records through the hospital-based EHR may be a factor to improve patient outcomes by utilizing health information technology for more efficient and effective communication and care coordination for school-aged children with chronic medical conditions. Thieme. All rights reserved.
BACKGROUND AND OBJECTIVES: School-aged children with chronic conditions require care coordination for health needs at school. Access to the student's accurate, real-time medical information is essential for school nurses to maximize their care of students. We aim to analyze school nurse access to medical records in a hospital-based electronic health record (EHR) and the effect on patient outcomes. We hypothesized that EHR access would decrease emergency department (ED) visits and inpatient hospitalizations. METHODS: This retrospective secondary data analysis was conducted using EHR data 6 months pre- and post-school nurse access to students' hospital-based EHR. The main outcome measures were the ED visits and inpatient hospitalizations. RESULTS: For the sample of 336 students in the study, there was a 34% decrease in ED visits from 190 visits before access to 126 ED visits after access (p <0.01). Inpatient hospitalizations decreased by 44% from 176 before access to 99 after access (p <0.001). The incident rate of ED visits decreased (IRR: 0.66; 95% CI: 0.53-0.83; p = 0.00035), and hospitalizations decreased (IRR: 0.56; 95% CI: 0.44-0.72; p <0.0001) from pre to post access. These findings suggest school nurse access to medical records is a positive factor in improving school-aged patient outcomes. CONCLUSION: School nurse access to medical records through the hospital-based EHR may be a factor to improve patient outcomes by utilizing health information technology for more efficient and effective communication and care coordination for school-aged children with chronic medical conditions. Thieme. All rights reserved.
Authors: Hylke M Snieder; Sarah Nickels; Melanie Gleason; Arthur McFarlane; Stanley J Szefler; Mandy A Allison Journal: J Sch Health Date: 2017-12 Impact factor: 2.118
Authors: Robert F Lemanske; Sujani Kakumanu; Kathleen Shanovich; Nicholas Antos; Michelle M Cloutier; Donna Mazyck; Wanda Phipatanakul; Shirley Schantz; Stanley Szefler; Renee Vandlik; Paul Williams Journal: J Allergy Clin Immunol Date: 2016-09 Impact factor: 10.793