# Advancing Nursing Data Integration Through a Nursing Minimum Dataset for the Conceptual and Technical Development of a “Fall Prevention” Data Module: Development Study

## TL;DR

This study develops a standardized nursing dataset for fall prevention in long-term care to improve data usability for research and AI.

## Contribution

A nursing minimum dataset for fall prevention, using standardized terminology for AI and research in long-term care.

## Key findings

- A fall prevention module was developed with 8 basic and 11 extension modules for LTC nursing data.
- Expert input and surveys helped prioritize fall risk factors, interventions, and outcomes for the dataset.
- The dataset uses FHIR standards to enable interoperable and cross-sector data sharing in nursing care.

## Abstract

In aging populations, the demand for care, including care delivery in long-term care (LTC) facilities, is increasing. This situation highlights the need to optimize care processes through continuous scientific evaluation. The use of artificial intelligence (AI) has the potential for use in nursing research, but it experiences a lack of standardization and structuring of nursing data. Although solutions such as standardized nursing terminologies exist, their use in practice has thus far not been widespread and is often associated with high documentation costs.

This paper presents the conceptual and technical development of a nursing minimum dataset that focuses on a specific “fall prevention” use case. The aim of this work was to improve data standardization and usability for research and AI-based analysis in LTC settings.

A representation of the “fall prevention” use case was developed using literature analyses, co-design workshops, and a quantitative survey (n=158). Technical indexing was conducted by translating the results into the technical terminology of the Health Level Seven International Fast Healthcare Interoperability Resources standard.

The “fall prevention” use case was developed as part of a German nursing minimum dataset for long-term residential care with 8 basic modules (patient or client demographics) and 11 extension modules (nursing care elements). The module of the “fall prevention” use case includes fall risk factors, interventions, and outcomes. The literature analysis included 4 international fall guidelines and 17 practice and transfer documents established in German LTC. In total, 12 experts from the fields of management, quality management, technical application support, nursing service management, department management, and members of the PFLIP (Pflege-Kerndatensatz und Intersektorales Pflegedaten-Repository [Nursing Minimum Data Set and Intersectoral Nursing Data Repository]) research project participated in the workshops. A total of 158 people participated in the quantitative survey, the majority of whom were female (117/158, 74%), with 63% (100/158) working directly in nursing care and an average of 24.9 years of professional experience, mainly in LTC (63/158, 40%), outpatient care (37/158, 23%), and hospitals (14/158, 9%). The relevant content, in the sense of a minimum set of items, was identified and prioritized in collaboration with nursing experts and translated into a Fast Healthcare Interoperability Resources–based implementation guide.

This approach addresses the lack of structured nursing data for AI and research and can serve as an example for interoperable, cross-sector solutions in global LTC.