Involving Students in Omaha System
Partnership Research:
A View from Istanbul, Turkey
Selda Secginli, PhD,
Assistant Professor,
Istanbul University, Nursing Faculty,
Public Health Nursing Department,
Istanbul, Turkey
June 26, 2012
1
11th International Congress on Nursing Informatics
Agenda
1. Omaha System
2. Omaha System Partnership
3. Researchs in Omaha System Partnership
4. Omaha System Partnership Benefits
5. Questions
2
Today
Quality
Technology
Information
EHR which focus on the individual, computer-based,
and easily accessible when needed has become a core
in health information systems
3
Omaha System was designed to be relatively;
Simple
Hierarchical
Multidimensional
Computer- compatible
Used by my faculty team for more than
ten years
Known Benefits of Partnership Studies

An optimal environment in which to enhance practice,
evaluate programs, measure outcomes, and improve
population health

Opportunities for shared knowledge and skills

Provide new ways of working

Generate new knowledge using large data sets.
5
Three components of the Omaha System Partnership
for Knowledge Discovery and Health Care Quality
1. multidisciplinary scientific teams of researchers with experience in advanced data
analysis and data mining techniques
2. affiliate members from Turkey to contribute Omaha
System data and work together with the scientific team
on research projects
3. a warehouse of de-identified clinical Omaha System data including client problems,
signs/symptom, interventions, and knowledge, behavior, and status outcomes
6
Omaha System Partnership
7
Researches from Turkey in the Partnership
I- Using the Omaha System to Describe Health
Problems, Interventions, and Outcomes in Home
care in Istanbul, Turkey: A Student Informatics
Research Experience (under review)
II- Attitudes of Health Professionals Towards
Electronic Health Recording in Primary Health Care
Settings: A Questionnaire Survey (under writing)
8
Using the Omaha System to Describe Health
Problems, Interventions, and Outcomes in
Home care in Istanbul, Turkey:
A Student Informatics Research Experience
Co Principal Investigators: Erdogan S, Secginli S. et al.
Istanbul University, Nursing Faculty
Purpose: To provide hands-on informatics experience to
nursing students; to identify the frequency and type of
home care clients' health problems, nursing interventions,
and outcomes using the Omaha System
9
Table of Contents

Introduction

Methods

Results

Discussion

Conclusions
10
Home Care Services in Turkey

In 2010, Turkish government included home care services
in the Health Transformation Program for the purpose of
mainly enable medical care and rehabilitation of the
bedridden clients to be performed at home.

Home care services are not integrated to the health care
and social care sytems of the country, and are not covered
by government health insurance held by 90% of the
population.

Few private sector providers and municipalities offered
these services which are generally limited to the larger
cities.
11
Table of Contents

Introduction

Methods

Results

Discussion

Conclusions
12



Approval was obtained from the university institutional
review board, 2011/ 393-462 and municipal health
services and home health centers directors
A software based on Omaha System was used for
documentation. Students received training in use of the
Omaha System, software program, home visits, and
family assessment
159 students visited the clients at home with nurses
and did face-to-face interviews in the households
Table of Contents

Introduction

Methods

Results

Discussion

Conclusions
14
Sample and Omaha System Problems

The mean age was 66.13 years (SD=18.65)

Two-third of the clients had no education/low education (66%)

Data were collected from 598 clients

Clients received 8657 interventions for 2267 problems

Skin, Neuro-musculo- skelatal function, Personal care, and
Nutrition were the most common problems
The Ten Most Problems and The Intervention
Categories
The Intervention Categories
and The Most Frequent Targets

The intervention categories were:
Teaching, guidance and counseling (47 %),
Treatments and procedures (22 %), Surveillance (22 %)
and the Case management (9 %)

The most frequent targets were:
Dressing change/wound care (776), sign/symptomsphysical (770), skin care (623), positioning (563) and
continuity of care (520)
Interventions Category According To The
Omaha System Domains
Average Knowledge, Behaviour and Status
Final Ratings
Table of Contents

Introduction

Methods

Results

Discussion

Conclusions
20
Some Points to Discuss- I

Three of the 42 Omaha system problems were not
addressed within this population (exceptions with Sexuality,
Pregnancy, and Postpartum)

Home care services (including nursing student and
educator visits) may positively affect client knowledge,
behavior, and status related to the identified health
problems
21
Some Points to Discuss- II

The evidence-based care plan of the most common
home care problems identified in this study have
developed

The developed evidence-based care plans could be
used in future studies of home care intervention
effectiveness

The integration of information technology within the
curriculum enabled the educators to meet information
technology requirements as a component of home care
practicum experience
22
Limitations

Observational data sets, especially systematic bias that may
be introduced through use of students in data collection

Inability to randomize clients, and thus inability to attribute
causation of outcomes to the interventions of students and
educators

Study findings may not be generalizable to a broader
population and limited comparisons due to the lack of
relevant literature on similar programs and settings in Turkey
23
Table of Contents

Introduction

Methods

Results

Discussion

Conclusions
24
This study mainly demonstrated that
1- Using the Omaha System provides a foundation for
evidence-based nursing education in home care and
informatics.
2- Omaha System is an useful data collection tool for
evaluating problems, interventions, and outcomes in home
care,
3- A positive teaching and learning tool for baccalaureate
nursing education.
Acknowledgements

Municipality home care teams

Undergraduate nursing students

Department research assistants

Florence Nightingale Nursing Schools and Hospitals
Foundation
26
Omaha System Partnership
Benefits- I

Built a support network by identifying people involved
with information technology in my university and let
them know about the Project

Dissemination of tools to other researchers
27
Omaha System Partnership
Benefits- I

Stimulates nurses in home health care team in
professional thinking. And the health care teams gained
awareness of the importance of nursing documentation
and the use of a standardized nursing terminology

Students employed nursing informatics at the basic
practice level to improve health care delivery and
outcome evaluation
28
Omaha System Partnership
Benefits- II

Gave better insight on delivered care and improved
documentation and practice quality

Scientific publications

A poster was submitted for the 2nd International Public
Health Nursing Conference in Minnesota in October 2011
29
Omaha System Partnershıp
Benefits- III

Presentation of Omaha System outcomes at national and
international professional meetings
30
Omaha System Partnershıp
Benefits- III

A scientific program with international visitors from
America and Holland in the faculty
31
Omaha System Partnershıp
Benefits- III

Foremost, helped us to recognize once that it was very
important to embrace new practice models for nursing
students such as informatics. And a new course “Nursing
Informatics” is going to start in the faculty next year
32
Roadmap ?
Future research in Omaha System Partnership
in collaboration with
 The health care teams and postgraduate students
 Build a support network by identifying more people from
Turkey involved with information technology in other
universities and let them know about the Partnership Project
Disseminate our partnership outcomes and share our
experiences especially in other nursing schools in Turkey
33
Thank you for your attention
Sabrınız için teşekkürler
secginli@istanbul.edu.tr
s.secginli@gmail.com