The present invention relates to a nursing information management system which operates as integrated with hospital information management systems being used in hospitals; focuses on increasing quality and productivity of health-care services and enhancing safety and satisfaction of patients/healthy individuals and employees; evaluates workload of optimal nursing care professionally by taking patient care requirements into consideration; does a cost-effective nurse workforce planning; and analysis effects thereof on indicators of nursing quality. Background of the Invention

Nursing is an essential human resource for patients/healthy individual and health system. One of the most important problems encountered by health-care executives is that planning of health-care workforce is not made such that it will meet the need of the facility. In literature it is emphasized that there is an important relationship between nature of health-care workforce and quality and efficiency of health-care services. Quality and efficiency of health-care services increase recognition and competitive power of facilities at national and international level. Therefore, providing right number of medical staff at the right time, in the right place and at the right knowledge and skill level in such a way that it will increase efficiency and productivity is extremely important.

Nurse workforce composes the largest share within health-care workforce. Therefore, nurse workforce planning is one of the priority issues for medical facilities. It is necessary to do optimum planning of nurse workforce in order that a medical facility can fulfil its strategic plans and objectives and achieves its goals. Today, computer-aided applications such as Excel care ^® , Ecare ^® , TrendCare ^® , GRASP , etc. are used for planning nurse workforce. It is known that nurse workforce can be planned by appropriate quality and quantity; efficiency and productivity, visibility of nursing services and documentation quality are increased and cost is reduced by use of these applications. Similarly; planning nurse workforce in a proper way is also important in terms of patient safety, satisfaction and reducing morbidity and mortality ratios.

Until today, many methods have been identified concerning how many nurses should be available in places such as country, hospital, etc. however none of these methods provided benefit in an optimal level (Barber and Lopez- Valcercel, 2010, p.2.). Due to the fact that number of employees having suitable quality and quantity for each shift can be determined by use of these applications, it is stated that there is a decrease in nursing costs and quality of care and documentation is increased (Duffield and et. al., 2006). But use of these applications also increases cost (Twigg and Duffield, 2009). Integration of nursing systems and health-care system will be ensured by means of this application recommended and cost-effective benefits will be provided in the long term for the ones utilizing health systems and health-care services of facilities upon the services performed by nurses are made apparent. The United States patent document no. US2006149589 discloses a system and a method for clinical workforce management interface. In the invention disclosed in the said document, the interface comprises an aggregate patient population profile (a unit wherein each patient is listed) and work-load capacity for those patients and also staff (doctors, nurses, etc.) assigned over a shift, 24 hours, or other period. In addition, the said interface includes capacities, skills, work programmes and information of available personnel. In addition to these, according to one application example of the invention disclosed in the document, any of the personnel (nurse or manager) can view or manipulate the tasks assigned to a patient. Whereas in another application example, patient-nurse ratios can be changed automatically and the personnel manager can be warned in case of an increase in these ratios. The invention disclosed in the said patent document is a limited application, calculating number of patient per nurse and receiving data about the staff are the data which can be obtained from currently-used applications. Whereas auto-calculation of nurse ratios is not a critical status and it can be easily achieved by a dividing operation.

The United States, patent document no. US2006095298 discloses a method for processing, renewing medical records of a patient, having work-flow and etc. The invention disclosed in the said document describes a system for management of a patent data and simplifying the work-flow of persons such as doctors, nurses, etc. and it comprises three modules. The first module is a module for information entry wherein work-flow, forms are created, the second module is a query module for making research from the database, and the third module is a billing module wherein billings are formed. In the invention disclosed in the said document, the modules may contain past day information or they may also renewed by current information. The said information may comprise daily notes, patient discharge processes, prescriptions, etc. It is also disclosed in the said document that a daily to do list can be made in form of a report about the patient. The invention disclosed in the said patent document is designed as an application containing limited information.

The Chinese utility model document no. CN202003399 discloses a decision-making support system for hospitals. In the invention disclosed in the said document, the decision-making support system comprises a hospital information system server, a laboratory information system server, a material resource server and a human resource server and the servers get in contact with user personal computers by connecting with a database. The decision-making support system builds a database in accordance with the data that it collects from different servers. It is mentioned in the said document that the data included in the sad document may comprise data such as medical fee data, number of employees, user data, treatment data. The application disclosed in the said patent document is data related to general hospital information system and focuses on nursing information management system and evaluates effects of variables such as nursing interventions, workforce plannings, shift plannings on cost effectiveness, quality indicators, etc. The United States patent document no. US2006253299 discloses a hospital information system. In the information system disclosed in the said document, information about the patient and implementation results are indicated on a flow chart and it is ensured that doctor's indications are monitored by nurses. Whereas it is mentioned in the document that the data input to the system can be updated real- timely in accordance with the disease change of condition and when false treatment is administered, for example, nurses can be warned. In addition, it is disclosed in the document that medical expenses can be created and billed. The invention disclosed in the said patent document is an application which focuses on doctor indication and medical applications.

The Chinese patent ^' document no. CN103455963 discloses a nursing system wherein a wireless handheld terminal is used for a specific disease. The said system comprises a wireless handheld terminal, a hospital information system treatment platform, a hospital management platform which are connected to one another by means of a network. Whereas the wireless handheld terminal and the hospital information system treatment platform comprise a nursing evaluation module, forms, schemes and nursing information. A nurse can reach the disease data that s/he demands and the treatment methods suitable for this disease by means of the database included in the hospital information system by using the wireless handheld terminal and administers necessary treatment method in a healthy way. The said application aids the ¹ nurses to decide on nursing administrations to be applied to the patient and to have information about treatment methods intended for the disease. The said application is a theatrical basis and it will be able to make contribute for the nurses to develop their individual skills.

Summary of the Invention

An objective of the present invention is to realize a nursing information management system which makes nursing service visible and can evaluate the effect of this on quality and productivity directly, wherein optimal number of nurse necessary for safe health-care in health facilities is determined, which can be used as a human resources planning tool, and wherein a control and evaluation mechanism is created by providing integration of this with automation system.

Another objective of the present invention is to realize a nursing information management system which has a nursing documentation module wherein electronic medical records included within the scope of clinical decision support and clinical information systems giving warning and alert based on the data input by the nurse about the patient are created. Another objective of the present invention is to realize a nursing information management system which can be integrated with other systems being used in hospitals such as hospital information management system and wherein all aspects of nursing systems are transferred to a single medium. Another objective of the present invention is to realize a nursing information management system wherein a sound database is created for nursing services.

Another objective of the present invention is to realize a nursing information management system wherein turnout of employment, exhaustion and absence ratio of nurses are reduced; nurse satisfaction is increased and time management is used effectively.

Another objective of the present invention is to realize a nursing information management system wherein planning of a nurse workforce specific to clinics is done; which enables to carry out strategic planning of nursing resources and determines number of nurses who work by shift systems in clinics at optimum level.

Another objective of the present invention is to realize a nursing information management system wherein nursing activities such as direct or indirect nursing activities, activities related to a unit and individual activities are determined; nurse work-load and workforce analysis are calculated by using patient classification system and determining dependence levels of patients; and which ensures data analysis of clinical activities.

Another objective of the present invention is to realize a nursing information management system which enables to evaluate workload level of optimal nursing care professionally by data analysis and workforce analysis of clinical activities.

Another objective of the present invention is to realize a nursing information management system wherein cost-effective planning' s are done in a facility by use of nurse workforce at optimum level, and which provides guidance to budget planning.

Another objective of the present invention is to realize a nursing information management system which provides an administrative resource for nurses and hospital executives for determining quality standards of nursing care and patient safety problems (such as adverse events, falls, pressure sores, mortality etc) and for taking the necessary precautions.

Another objective of the present invention is to realize a nursing information management system which enables to ensure patient safety, to provide patient- centred care and to increase patient satisfaction.

Another objective of the present invention is to realize a nursing information management system which provides a database for communication by comparisons in recruitment of nurse personnel, local, regional, national and international nursing; and decision-makers at different levels.

Detailed Description of the Invention

"A nursing information management system" realized to fulfil the objectives of the present invention is shown in the figure attached, in which: Figure 1 is a schematic block diagram of the inventive system.

The components illustrated in the figure are individually numbered, where the numbers refer to the following:

1. System

2. Management database

3. Registration database

4. Registration interface

5. Decision support module

6. Query unit

The inventive nursing information management system (1) working integrally together with information management systems used in health facilities such as hospital comprises:

- At least one management database (2) which is integrated with information management systems being used in hospitals and comprises system inputs;

- at least one registration database (3) wherein electronic medical records such as all kinds of practice records, physical, psychological and social identification and nursing care practices for nursing activities are kept;

- at least one registration interface (4) which is used for creating records on the registration database (3) and accessed over web-based and/or mobile platforms;

- at least one decision support module (5) which comprises clinical practice guidelines, gives warning and alert to the registration database (3) based on the data input by the nurse about the patient; and

- at least one query unit (6) wherein reporting and graphics are created over web and/or by means of mobile platforms based on the data input to the registration database (3); indicates nursing costs, quality indicators; does shift planning, nurse assignment according to clinics and planning of number of nurse necessary. In a preferred embodiment of the invention, the management database (2) is used as integrated with hospital management information systems; and patient identity information, doctor order information and nurse information are kept on thereof. In the inventive nursing information management system (1), the registration database (3) comprises information which can be used by nurses; exist in literature and also data which can be input by nurses instantly. The said registration database (3) contains information such as records of nursing practice (such as medicine, enema, cold-hot application, etc.); physical, psychological and social diagnostic information; nursing care practices; nursing admission notes; risk assessment notes; professional patient classification scale; nurse profile information within itself.

In a preferred embodiment of the invention, there are data concerning whether there is a particular condition of the patient which is input depending on observation and follow-ups of the nurse such as patient's history and family history, vital findings, allergies, contact isolation, pressure sore, restriction characteristics, etc. in the registration database (3).

The registration database (3) comprises standard nursing practice protocols in a preferred embodiment. The registration database (3) comprises standard protocols, tele-health applications, patient information, education and counselling forms and tools which are prepared considering international criteria for each nursing initiative and practice. In a preferred embodiment of the system, nursing care plans and assessments are input to the registration database (3) by using the registration interface (4). Considering the said data and individual need of the patient; planning, practice and assessment of nursing cares are ensured in accordance with NANDA nursing diagnostics.

In a preferred embodiment, the registration database (3) comprises forms which are recorded previously ^" and filled up over the registration interface (4). The said forms are forms such as description of nursing process, pain description, nurse observation, fluid monitoring, patient transfer, etc. The said forms being kept in the registration database (3) are the forms which must be filled up as required by legislation and hospital policy. In addition to this, there are undesirable event notification forms.

In a preferred embodiment, the interface (4) which can be accessed over web and/or mobile platforms is used in order to generate data on the registration database (3). In a preferred embodiment, nurses perform data entry to the registration database (3) in order that necessary actions are taken by the clinical decision support module (5) and/or necessary information are retrieved by the query unit (6) upon the information about the patient are recorded over the interface (4) other than existing information. In a preferred embodiment of the invention, the clinical decision support module (5) comprises clinical practice guidelines or health-care protocols and gives warning and alert to the registration database (3) based on the data input by the nurse about the patient. In the inventive nursing information management system (1), reports and graphics are retrieved by means of the query unit (6) query unit (6) based on the records input to the registration database (3). The query unit (6) queries information from the registration database (3) such as the patient report wherein there are actions taken for the patient during hospitalization; number of patient during shifts based on the dependency level; nurse work-load; nursing initiatives; etc. and information about practices demanded within appointed hours such as working hours and carried out by the nurse.

In a preferred embodiment, the query unit (6) calculates nursing care costs by using information such as number of nurses working in clinics, number of in-patients, working hours of nurses, etc. which are kept in the registration database (3). In another preferred embodiment, the query unit (6) makes a score calculation for the related clinic and/or hospital based on quality indicators such as mortality rate, rate of falling patients, length of stay in hospital, repeating hospitalization rate, compliance to hand hygiene and infection rate, pressure ulcer rate, etc. which are kept in the registration database (3) and arise from heavy work- load and wrong planning. With doing a right nursing workforce planning by means of the inventive nursing information management system (1), loss of workforce and quality of care which results from making the existing workforce to work by wrong time and wrong workload is avoided and this also affects calculation of score.

In another preferred embodiment, the query unit (6) does an optimal nurse planning according to the existing workforce shifts based on information such as number of nurse, nurse profile, number of patient, etc. included in the registration database (3). Thus; it is ensured that lists of overtime and compulsory shift are made, a fair shift change system is adjusted, nurses are employed in clinics suitable to the competencies, numbers of over shift are reduced, and nurse's monthly shift changes whereby they can plan their social activities are planned and practiced.

In addition, the query unit (6) does planning of nurse appointment in accordance with clinics based on area of expertise, certificates, experience periods, competencies and work-load of clinics of existing workforce. Besides, the query unit (6) determines and plans number of optimal nurse throughout shift, clinics and hospital. The query unit (6) makes calculation considering variables such as patient-nurse ratio, dependency levels of patients, the time spent for a patient by a nurse, working periods of nurses, number of annual leaves of a nurse, bed occupancy ratio, characteristic of the clinic worked for calculating numbers of patient that should be per nurse, in other words calculating number of nurse. The calculation made is compared to international patient-nurse ratio and evaluated by the query unit (6). The query unit (6) reports undesirable events and/or comes through results such as graphic/report as output by using data such as falling, infection ratios, sentinel event, repeating processes, IV complications, bedsore, patient transfer ratios, number of operation which are included in the registration database (3) wherein electronic medical records are kept.

With the inventive nursing information management system (1), nursing services are made more visible, cost-effective and efficient. Besides; a more productive and knowledge-based method model is ensured by providing an efficient method. Quality of workforce is measured, necessary improvements are made and work quality is enhanced in accordance with the existing work-load by means of the nursing information management system (1). In addition to this, losses of workforce and quality of care which results from matching the personnel with wrong time and wrong workload is avoided by using the existing workforce in the most correct way. Also, a far and transparent performance evaluation can be made by making cost accounting with the inventive nursing information management system (1). Furthermore, clinical mistakes for patient and employee safety resulting from heavy work-load and wrong planning are prevented by the inventive system (1).