{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T13:08:51Z","timestamp":1789650531245,"version":"4.0.0"},"reference-count":32,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nurs. Rep.","Nursing Reports"],"abstract":"<jats:p>Background\/Objectives: Nursing-sensitive outcomes are key indicators of nursing care quality and safety. Digitalization of clinical documentation enables prospective surveillance using routine data, but real-world evidence on integrated digital, clinical record-based approaches remains limited. This pilot study assessed the feasibility of using routinely collected digital data, combined with ward-level indicators, to support nursing-sensitive outcome surveillance and to preliminarily identify factors associated with these outcomes during hospitalization. Methods: An observational pilot study was conducted at a 400-bed Italian university hospital over two months (November 2025\u2013January 2026) across ten wards. Clinical variables, including the Blaylock Risk Assessment Screening Score (BRASS) and ward-level indicators, were extracted from the electronic medical record system. The exploratory composite endpoint of documented nursing-sensitive outcomes was modeled using multivariable logistic regression with cluster-robust standard errors and Cox proportional hazards regression. Results: A dataset comprising 1552 hospitalizations and 20,415 patient-days was assembled, with 100% completeness for socio-demographic data and 93% for BRASS. The cumulative event rate of nursing-sensitive outcomes was 7.35% (6.08 per 1000 patient-days at risk; 5.58 per 1000 total patient-days). Pressure injuries were the most frequent event (n = 67), followed by falls (n = 39) and physical restraint (n = 14). In the adjusted models, the BRASS (OR = 1.12 per point, 95% CI 1.08\u20131.15; HR = 1.10, 95% CI 1.07\u20131.13) and admission to the hospital from the emergency department (OR = 4.41, 95% CI 3.02\u20136.45; HR = 3.46, 95% CI 2.48\u20134.83) were independently associated with nursing-sensitive outcome occurrence. In a 48 h landmark analysis restricted to hospitalized patients still event-free on day 2, the BRASS association was attenuated (OR 1.07, 95% CI 1.04\u20131.10). Conclusions: An integrated, digital, clinical record-based approach proved feasible for prospective nursing-sensitive outcome surveillance and supports the design refinements planned for longitudinal analyses.<\/jats:p>","DOI":"10.3390\/nursrep16090338","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:41:35Z","timestamp":1789645295000},"page":"338","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of Using Digital Clinical Records to Identify Factors Associated with Nursing-Sensitive Outcomes During Hospitalization: A Pilot Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Ivana","family":"Finiguerra","sequence":"first","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Michela","family":"Gianino","sequence":"additional","affiliation":[{"name":"Department of Public Health and Pediatrics, University of Turin, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Vacchelli","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Demasi","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lusi","family":"Pappalardo","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Albanese","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Binello","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Borghin","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Cappello","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Cavagnini","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Durante","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Ferraris","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Gorgonzola","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Munaro","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Russo","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Tedino","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit for Health Professions, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Minniti","sequence":"additional","affiliation":[{"name":"Strategic Hospital Directorate, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Di Gioia","sequence":"additional","affiliation":[{"name":"Strategic Hospital Directorate, San Luigi Gonzaga University Hospital, 10043 Orbassano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1097\/00006199-200603001-00012","article-title":"Nursing-Sensitive Outcomes Data Collection in Acute Care and Long-Term-Care Settings","volume":"55","author":"Doran","year":"2006","journal-title":"Nurs. 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