The relationship of skilled clinical charting in the home on the outcomes of home healthcare patients.

摘要

This quantitative research study explored the relationship between the percentage of point-of-care (POC) in-home charting of skilled clinical services and outcomes. Specifically, the research questioned, "Is the percentage of in-home charting using POC software associated with a patient experiencing an adverse event?" POC percentages were measured using PalmWyse(TM) software. Home healthcare patients' outcomes were measured by the presence or absence of one or more adverse event as defined by the Outcomes and Assessment Information Set. The study utilized 2009 data from 3 agencies contained in the HealthWyse database. A binary logistic regression analysis of 28,136 clinical visits (2,060 episodes) explored the relationship between the percentage of in-home charting using POC software and adverse events. Results of the binary logistic regression for all 3 agencies combined produced a statistically significant result (p = .001), suggesting that when using POC software, for every 1% increase in the average of in-home charting of clinical documentation, patients were 1.02 times more likely not to experience an adverse event. When the individual analyses for Agency A, Agency B, and Agency C were completed, the results of the binary logistic regressions for Agency A and Agency C produced statistically significant results (p = .045 and p = .001, respectively). The study supported, for Agency A and Agency C when using POC software, for every 1% increase in the average of in-home charting, patients were 1.01 and 1.04 times more likely, respectively, not to experience an adverse event. For Agency B, data analysis did not produce significant findings (p = .251). The combination of results supports the need for further research of POC technology benefits in the home.