Publications by authors named "Karen Monsen"

Background:  Multitasking, defined as performing two or more interventions simultaneously, increases the cognitive burden of clinicians. This may, in turn, lead to higher risk of medication and procedural errors. Time motion study (TMS) data for nurses in nursing homes revealed an extensive amount of multitasking while managing medications.

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This poster presentation describes innovative use of the Omaha System, a standardized terminology, into public health nurses' (PHNs) workflow and electronic records within a local health department's Childhood Lead Poisoning Prevention Program. The Omaha System facilitated the tracking of evidence-based interventions and client outcomes, showing a significant improvement in record completeness (from 33% pre-implementation to 84% post-implementation) and client outcomes in health care supervision, growth and development, and nutrition. Outcome data analysis revealed improvement across all post-implementation records from initial assessments to interim assessments for Health care supervision (p<.

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Article Synopsis
  • The work of public health nurses (PHNs) in mental health assessment and intervention is complex, making it hard to evaluate how their efforts improve client outcomes.* -
  • This study analyzed data from over 4,000 clients to compare traditional propensity scoring methods with energy-balancing weights (EBWs) for adjusting differences in baseline characteristics among those receiving PHN interventions.* -
  • Results showed that while EBWs were more effective in balancing client characteristics, clients who received more diverse and frequent PHN interventions had consistently improved outcomes in knowledge, behavior, and mental health over time.*
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Background: Public Health Nurses (PHN) caring for vulnerable populations amid systemic inequality must navigate complex situations, and consequently they may experience serious moral distress known to be detrimental to PHN wellbeing.

Objective: Given PHN awareness of social inequities, the study aimed to determine if PHNs were motivated to enact social change and engage in social and political action to address inequality.

Design And Sample: A survey of 173 PHNs was conducted in fall 2022.

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Objective: To honor the legacy of nursing informatics pioneer and visionary, Dr. Virginia Saba, the Friends of the National Library of Medicine convened a group of international experts to reflect on Dr. Saba's contributions to nursing standardized nursing terminologies.

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Objective: Theory-based research of social and behavioral determinants of health (SBDH) found SBDH-related patterns in interventions and outcomes for pregnant/birthing people. The objectives of this study were to replicate the theory-based SBDH study with a new sample, and to compare these findings to a data-driven SBDH study.

Materials And Methods: Using deidentified public health nurse-generated Omaha System data, 2 SBDH indices were computed separately to create groups based on SBDH (0-5+ signs/symptoms).

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Background: Indigenous nurses are underrepresented in the nursing workforce. Important strategies have been developed to increase the diversity of the future nursing workforce; however, unique cultural needs of Indigenous students must be addressed to provide holistic support while maintaining and strengthening cultural identity.

Method: The Niganawenimaanaanig (We Take Care of Them) Indigenous Nursing Education Model was developed based on the Medicine Wheel and previous diverse nursing education models.

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Health Level 7®'s (HL7) Fast Healthcare Interoperability Resources® (FHIR®) is leading new efforts to make data available to healthcare clinicians, administrators, and leaders. Standardized nursing terminologies were developed to enable nursing's voice and perspective to be visible within the healthcare data ecosystem. The use of these SNTs has been shown to improve care quality and outcomes, and to provide data for knowledge discovery.

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Objective: To characterize patterns in whole-person health of public health nurses (PHNs).

Design And Sample: Survey of a convenience sample of PHNs (n = 132) in 2022. PHNs self-identified as female (96.

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In COVID-19 survivors, symptom burden is a significant and multifaceted personal and societal challenge. The Omaha system is a standardized terminology used by researchers and clinicians for documentation and analysis of meaningful data for whole-person health. Given the urgent need for a standardized symptom checklist specific to the long COVID population, the purpose of the present study was to identify long COVID symptoms from the published literature (native symptoms) and map those to the Omaha system signs/symptoms terms.

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Background: Meaningful data to determine safe and efficient nursing workload are needed. Reasoning a nurse can accomplish a finite number of interventions and location changes per hour, examination of time pressure using time motion study (TMS) methods will provide a comparable indication of safe and efficient workload for an individual nurse.

Methods: An observer shadowed 11 nurses at a 250-bed nursing home in the Southeastern United States and recorded 160 h of observations using TimeCaT, web-based TMS data recording software.

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Background: Improved health among older women remains elusive and may be linked to limited knowledge of and interventions targeted to population subgroups. Use of structured community nurse home visit data exploring relationships between client outcomes, phenotypes, and targeted intervention approaches may reveal new understandings of practice effectiveness.

Materials And Methods: Omaha System data of 2363 women 65 years and older with circulation problems receiving at least 2 community nurse home visits were accessed.

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Objective: Numerous studies indicate that the social determinants of health (SDOH), conditions in which people work, play, and learn, account for 30%-55% of health outcomes. Many healthcare and social service organizations seek ways to collect, integrate, and address the SDOH. Informatics solutions such as standardized nursing terminologies may facilitate such goals.

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Objective: This study aimed to identify phenotypes of nutritional needs of home-visited clients with low income, and compare overall changes in knowledge, behavior, and status of nutritional needs before and after home visits by identified phenotypes.

Materials And Methods: Omaha System data collected by public health nurses from 2013 to 2018 were used in this secondary data analysis study. A total of 900 low-income clients were included in the analysis.

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Bone marrow suppression is the most common side effect of chemotherapy that may lead to discontinuation for treatment pertaining to patients during the therapy course. Acupuncture may relieve bone marrow suppression with regulation hematopoietic function during chemotherapy. The purpose of this study is to evaluate the effectiveness of acupuncture in relieving chemotherapy-induced bone marrow suppression and determine the effects of acupuncture on bone marrow function.

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Background: Clinical judgment is a critical nursing competency. Unfolding case study is a pedagogy used to develop clinical judgment. The Omaha System is an accepted taxonomy for standardizing nursing documentation.

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Objectives: In this study we aimed to describe and compare groups formed by a rules-based algorithm to prospectively identify clients at risk of poor outcomes in order to guide tailored public health nursing (PHN) intervention approaches.

Design: Data-driven methods using standardized Omaha System PHN documentation.

Sample: Clients ages 13-40 who received PHN home visiting services for both the Caretaking/parenting and Mental health problems (N = 4109).

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Nurses' attitudes toward information security can influence the hospital's information resources management and development. This study investigated the relationships between nurses' information security policy compliance, information competence, and information security attitudes, which are factors that influence information security behavior. Data were collected during September 2020.

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Objectives: Generate national estimates of the public health nursing workforce's (1) demographic and work characteristics and (2) continuing education learning needs in the United States.

Design: Secondary data analysis of the 2018 National Sample Survey of Registered Nurses.

Sample: Total 7352 of the 50,273 survey respondents were categorized as public health nurses (PHNs), representing an estimated 467,271 national workforce.

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Demands on long-term services and supports for older adults are growing, although geriatric workforce shortages have persisted for decades. Methods to define and quantify practice of licensed nurses in nursing homes are needed for work optimization within limited nurse resources available in nursing homes. This study aimed to refine and validate observable nursing interventions for nursing homes, using the Omaha System.

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Nursing home experts and informatics nurses collaborated to develop guidelines for nursing homes that revealed partnership principles in action during the COVID-19 pandemic. This article describes efforts to define interprofessional nursing home staff roles within the partnership-based COVID-19 Response Guideline, and to examine changes in nursing practice compared to the pre-pandemic practice of nurses. The qualitative process of identification of nursing home staff roles revealed the extensive scope of interprofessional partnership needed to respond to the pandemic.

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Data visualization techniques are useful for examining large multidimensional data sets. In this exploratory data analysis (EDA) study, we applied a visualization pattern detection and testing process to deidentified data to discover patterns in whole-person health for adults 65 and older. Whole-person health examines a person's environmental, psychosocial, and physical health, as well as their health-related behaviors; and assesses their strengths, challenges, and needs.

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