The power of nursing notes: UK study on patient survival

The sentiments left in nursing notes are good indicators of whether ICU patients will survive, a UK study has found.

Researchers at the University of Waterloo looked at the notes from over 27,000 ICU patients and examined how sentiments related to 30-day mortality and survival.

They said nursing notes have not been widely used in prediction models for clinical outcomes, despite containing rich information. And Associate Professor Joel Dubin said while physiological information collected in the first 24 hours of a patient’s ICU stay is useful for predicting 30-day mortality, it might be important to focus on more than the objective components of a patient’s health status.

Dubin said there is some added predictive value to including nursing notes in the mix.

For the study, the researchers used a publicly available ICU database containing patient data between 2001 and 2012.

It then looked at adjectives in the text to establish positive, neutral or negative statements. Some examples of words that stuck out when the team used an open-source sentiment analysis algorithm were "pleasant" and "grim".

Dubin and colleagues then explored the relationship between the sentiment and 30-day mortality while controlling for gender, type of ICU and simplified acute physiology score.

The researchers said there was a clear difference between the patients with the most positive messages who experienced the highest survival rates and those with the most negative messages who experienced the lowest survival rates. They added that sentiments of clinicians can serve as a predictor of patient outcomes in the ICU.

“Mortality is not the only outcome that nursing notes could potentially predict,” said Dubin. “They might also be used to predict readmission or recovery from infection while in the ICU.”

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