Visualization of Patterns in Public Health Nurse Intervention Data

Background

Standard intervention effectiveness research methods may mask the unique impact of the public health nurse (PHN). Recent studies of intervention data show that the PHN may contribute up to 17% of variability in client outcomes. Therefore, it is important to understand how PHN interventions or style vary in order to improve client outcomes. New methods for visualizing PHN intervention patterns offer opportunities to identify PHN intervention patterns. PHNs documented intervention data using the Omaha System, a standardized terminology. For visualization analysis, intervention data and D3 software were used to gemerate streamgraphs depicting a continuous flow of interventions over time for each patient. The purpose of this study was to identify intervention patterns that are unique for each nurse, and patterns that are shared across nurses.

 Method

There were 206 streamgraphs from documentation by 14 PHNs. These streamgraphs were visually inspected, given a shape name, annotated, and entered into an excel spreadsheet by the first author, and validated by the second author using an iterative process. Disagreements were resolved by consensus, and the frequency of occurrence of patterns by nurse and for the total sample was calculated.

 Results

Preliminary analysis found statistically significant associations for various patterns with length of service, and PHN. The final analysis will be completed by September 2014. 

Conclusions

Streamgraph patterns may demonstrate unique PHN styles and shared PHN approaches. Further research is needed to evaluate associations of these streamgraph intervention patterns with client characteristics and outcomes, and explore PHN styles and approaches used in diverse populations and settings.