w ebinar 1 nursing databases 101: from inception to analysis

Webinar 1Nursing Databases 101:

From Inception to Analysis

Andrea Baumann RN, PhDJaspreet Ahuja, MSc.

Nursing Health Services Research Unit (NHSRU) McMaster University

Leveraging Data to Make Better Decisions - An

Overview of DatabasesWebinar Series

Date: Thursday October 18, 2012Time: Noon- 1:00PM (EST)

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Introduction• Target audience

• Overview of webinar series

• Types of data

• Discussion of a database

• Example from the Pan American Health Organization

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Types of Data

Primary data - collected to answer a specific research question.

Secondary data – collected by some other user.

Administrative data – secondary data collected for non-research purposes but may used to answer specific research questions.

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Source: Wunsch, H., Harrison, D., Rowan, K. (2005). Health Services Research in critical care using administrative data. Journal of Critical Care, 20: 264-269. 3

Primary Databases

• Result from individual research projects

• Include many variables and/or themes

• Can be standardized for use by other investigators to ask different questions

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Secondary Databases• Housed at the provincial, national and

international level

• Include data from a variety of administrative databases

• Agreement on general indicators

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Indicators“…standardized measures by which to compare

health status and health system performance and characteristics among different jurisdictions in Canada…through quality comparative information.”

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Source: Canadian Institute for Health Information (CIHI). (2012). Health Indicators Interactive Tool. Retrieved: http://www.cihi.ca/CIHI-ext-portal/internet/EN/SubTheme/health+system+performance/indicators/cihi010653

Health Administrative Databases• Housed in healthcare organizations

• Include data such as human resources, finances, payroll, illness and long term disability

• Stored in a “data warehouse”

• Uploaded to the Ministry of Health and Long-Term Care as part of an accountability agreement (varies from province to province)

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Challenges in Database Development• Standardizing data

• Compatible versions of software

• De-identifying personal information

• Access and transferability

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Source: Data, Data Everywhere: Access and Accountability? (2011). ed. C. M. Flood. Montreal and Kingston: Queen’s Policy Study Series.

Provincial Databases• Institute for Clinical Evaluative Sciences (ICES)*

– Health services data; Population and demographic data; Disease cohort/registry data; Care provider, facility, geography, coding and other data

• Ministry of Health and Long-Term Care– Health Professions Database; Management Information Systems (MIS)

• College of Nurses of Ontario– Provincial nursing regulatory database

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*Source: Institute for Clinical Evaluative Sciences (ICES). 2012. Retrieved from: http://www.ices.on.ca/webpage.cfm?site_id=1&org_id=26&morg_id=0&gsec_id=5314&item_id=5322 9

National Databases• Canadian Institute for Health Information

• Statistics Canada

• Canadian Association of Schools of Nursing and Canadian Nurses Association

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International Databases• Organization for Economic Development and

Development (OECD)

• International Labour Organization (ILO)

• World Health Organization (WHO)

• Pan American Health Organization (PAHO)

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PAHO • What does PAHO have in HHR?• How do they develop databases ?• What does PAHO want to create ?

Two examples:1. An international database developed using national

databases 2. The creation of a schools of nursing directory database

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12Source: Pan American Health Organization/World Health Organization (2012). Retrieved from: http://new.paho.org/hq/index.php?option=com_content&view=article&id=91&Itemid=220&lang=en

PAHO- Example 1

Migration of Nurses from Latin America and the Caribbean countries to Canada:

- Nursing education acquired from source country

- Focus on numbers of those practicing in Canada

- Using existing data/literature

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Using CIHI Database• CIHI Nursing Database

• Data on 3 regulated nursing professions in Canada:» Registered Nurses (RNs)

» Licensed Practical Nurses (LPNs)

» Registered Psychiatric Nurses (RPNs)

• What does this database contain?

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14Source: Canadian Institute for Health Information (CIHI). (2012). Spending and Health Workforce. http://www.cihi.ca/CIHI-ext-portal/internet/EN/TabbedContent/spending+and+health+workforce/workforce/nurses/cihi010673

Data Methodology• How is this data collected?– Methodology– Primary or Secondary ?

• Data Dictionary

• Challenge: Details of data collected were not necessarily available in reports

– “Canadian” vs ”Foreign”

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15Source: Canadian Institute for Health Information (CIHI). (2012). Spending and Health Workforce. http://www.cihi.ca/CIHI-ext-portal/internet/EN/TabbedContent/spending+and+health+workforce/workforce/nurses/cihi010673

What to do ?• Coping with challenges and making decisions

• 2 options

– Data Request from CIHI

– Use available data till 2006

• Consider time vs. how recent is the data ?

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ILO Report: Canadian Context• ILO – International Labor Organization

• Report on Mobility of Health Professionals– Compiles CIHI data to demonstrate trends and

patterns in migration

• Primary or Secondary data ?

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PAHO Example 22). Schools of Nursing Directory

-primary data collection

– Questionnaire• Identification• Contact Information• Undergraduate and/or Graduate Program• Scientific Journal• Research Groups

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Challenges & Limitations• Accuracy

• Up to date data

• Dependent on time availability

• Cost

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Challenges & Limitations

• Data indicators; no common agreement– Among provinces

– Even bigger challenge when comparing project comparing countries

– Terms: RPN’s, LPNs & RNs are not consistent

– Need for a common nursing data dictionary ?

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Main Messages• Different types of data

• Development of provincial and national databases are on-going

• Need for data is increasing

• Many challenges including a common understanding

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Questions?

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Leveraging Data to Make Better Decisions - An

Overview of DatabasesWebinar Series

Upcoming Webinar SessionsWebinar 2: How to Access and Use Secondary Databases (Nov 19, 2012)

Webinar 3: Collecting and Storing Your Data (Dec 12, 2012)

Webinar 4: Development of a New Graduate Nurse Employment Database (Jan 21, 2013)

Webinar 5: Applications and Analysis of a Secondary Database

(Feb 20, 2013)

Webinar 6: Understanding How to Work with HOBIC (March 2013)

Webinar 7: Development of a Longitudinal Qualitative Database

(March 2013)

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Contact InformationAndrea Baumann, PhD

Scientific Director Nursing Health Services Research Unit

McMaster University

Michael DeGroote Centre for LearningMDCL 3500

(905) 525-9140 ext. 22581baumanna@mcmaster.ca

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