Reliability of a Canadian database for primary care nursing services' clinical and administrative data

Abstract

Background: The use of electronic clinical and administrative data can be an advantageous source of information for assessing nursing performance in primary care. In Québec (Canada), the I-CLSC electronic database could be used to measure performance indicators. However, little is known about the reliability of the data contained in this database. The objective of this study was to assess the reliability of the clinical and administrative data contained in the I-CLSC electronic database based on the data entered in medical records.

Methods: We used a longitudinal design for this study. A sample of 100 patients who had experienced 107 episodes of wound care were randomly selected from all patients who had two or more consultations during the year 2015. The paper records were used as reference. We collected data regarding eight nursing sensitive indicators from both sources. We assessed the concordance between the electronic data and the paper records by measuring inter-rater agreement.

Results: Six of the eight indicators showed a percentage agreement ≥ 85%, and kappa scores between 0.7 and 1.00 (p < 0.001), indicating high to perfect levels of agreement between the two data sources. Two indicators presented fair kappa scores.

Conclusion: This database provides reliable data relating to the organization of care but shows lower reliability for specific acts performed by nurses in primary care. This existing database can be used to assess, manage and improve certain dimensions of nursing performance in primary care.

Keywords: Clinical and administrative data; Concordance; Electronic database; Medical record; Nursing management; Primary care; Reliability.