Cin-Computers Informatics Nursing最新文献

This retrospective study of an electronic medical record database evaluated a modified training program aimed at improving documentation completion percentages in eight skilled nursing facilities across Tennessee, Ohio, Florida, and Wisconsin. The program involved a weeklong curriculum tailored to increase proficiency with the electronic medical record system, focusing on five key documentation forms: Admission Assessment, Morse Fall Risk Assessment, Braden Risk Assessment, Elopement Risk Assessment, and Weekly Skin Check. Data were collected between February 2023 and July 2023. A 3-month preimplementation phase served as the baseline control, representing the period prior to the nurses undergoing the modified training program. Data from the 3-month period after implementation was used for comparison. The sample included 47 nurses. Data analysis consisted of descriptive and inferential statistics, with two-tailed paired t tests showing significant mean improvements ( P  < .001) in documentation completion percentages ranging from 42% to 70% across all five forms. Although causality could not be inferred, significant improvements were observed following the training program.

The study aimed to determine the effects of game-based technology use in a first-aid lesson on knowledge and motivation. The study had a two-stage explanatory mixed-methods design. Quantitative data were collected as a randomized controlled trial. Qualitative data were collected through purposive sampling. A total of 202 nursing students were included and evaluated with a knowledge test and a teaching materials motivation questionnaire. A puzzle was applied to the intervention group before the first-aid lesson, and a Kahoot! was applied after the lesson. Four structured questions were asked to understand the students' thoughts about the game-based technology used. The students' pretest knowledge scores were similar. The mean posttest knowledge scores of the intervention group were significantly higher. However, the mean scores of the teaching materials motivation questionnaire were not high. The qualitative data analysis categorized students' opinions about the teaching materials as effective learning, enjoyable learning, and motivating learning. In conclusion, game-based technology methods in nursing practical lessons can enable students to apply the knowledge they learn in practice.

Digital health literacy is emerging as an important element in chronic illness management, yet its relationship with clinical outcomes remains unclear. Utilizing data from the ongoing EXpanding Technology-Enabled, Nurse-Delivered Chronic Disease Care trial, this cross-sectional, correlational study explored the association between digital health literacy, health literacy, and patient outcomes, specifically blood pressure and hemoglobin A 1c levels in 76 patients managing comorbid type 2 diabetes and hypertension. Results indicate patients had moderate digital health literacy, which was not significantly correlated with health literacy ( r  = 0.16, P  = .169). Both bivariate and covariate-adjusted regression models indicated that digital health literacy was not significantly associated with patient outcomes (all P  > .05, small effects). These findings suggest that although patients from diverse sociodemographic backgrounds may possess the digital health literacy to engage with digital health tools, this alone may not improve clinical outcomes. Although digital health literacy may not be directly related to improved clinical outcomes, future research should explore how digital health tools can be optimized to enhance patient engagement and address complex challenges in diverse populations managing chronic conditions.

Electronic health record support nurses' work in many ways; however, nursing documentation within the system has also been associated with burden and noncompliance with organizational and regulatory requirements. An increasing number of studies have analyzed nursing documentation burden and noncompliance, but no scoping review has been conducted that focuses on electronic health record-based strategies for improving nursing documentation. This scoping review aimed to identify electronic health record-based strategies for improving nursing documentation in hospital settings. The Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews guidelines were used, and databases MEDLINE, Web of Science, and CINAHL were searched on April 1, 2024. A total of 652 studies were retrieved, of which 25 were incoluded at the full-text level. Six documentation issues emerged across the studies, with 44% identifying documentation compliance as the main issue. Three electronic health record-based strategies, such as organizational change, end-user reminder system, and financial incentives, regulation, and policy, were identified. Six documentation improvement outcomes with findings were identified, with 52% of the studies' outcome demonstrating improved documentation compliance. This review identified electronic health record-based and supplemental strategies that concentrate on improving nursing documentation. More research is needed to identify how these strategies may affect other measures, such as patient care outcomes, accuracy and quality of nursing documentation, and costs associated with nursing time spent on documentation activities.

Maintaining adherence to a long-term lifestyle in heart failure patients is challenging, highlighting the importance of mobile health educational interventions from hospitalization to discharge. This study assessed the effects of mobile health interventions on heart failure patients during the transition from hospital to home through a systematic review and meta-analysis of randomized controlled trials using PubMed, EMBASE, and Scopus. Studies with mobile health interventions starting postdischarge were excluded. The Cochrane Risk of Bias Tool 2 and Grading of Recommendations, Assessment, Development, and Evaluations strategy were used to assess bias. The results indicated that mobile health interventions were not effective in reducing readmissions compared with conventional management after 30 days (relative risk, 1.04; 95% confidence interval, 0.87-1.24). No improvements were found in quality of life or self-care. However, a reduction in mortality was observed (relative risk, 0.64; 95% confidence interval, 0.42-0.9). The study showed that mobile health interventions can reduce mortality in heart failure patients and may reduce late readmissions and improve quality of life over a period longer than 6 months. Longer follow-up studies are necessary.

To provide culturally competent care for racial/ethnic minorities, it is important to provide information and coaching/support in the languages that users can understand. However, issues in using multiple languages, especially in culturally tailored technology-based intervention research among racial/ethnic minority cancer survivors, have rarely been discussed. The purpose of this article is to discuss the issues in using four different languages among Asian American breast cancer survivors with depressive symptoms in a culturally tailored technology-based intervention study for cancer pain management and make suggestions for future technology-based intervention research using multiple languages. Research diaries written by the research team members, the recordings of biweekly research team meetings, and postings on Microsoft Teams were analyzed using content analysis. The issues included: (1) difficulties in recruiting eligible translators for multiple languages; (2) differences in selecting words by translators' traits; (3) difficulties in ensuring conceptual equivalence in measurements; (4) necessary contextual translation based on cultural understanding; (5) avoiding words with stigma; and (6) required multiple repeated steps. These methodological and conceptual issues need to be considered in future culturally tailored technology-based intervention research among racial/ethnic minorities, especially Asian American breast cancer survivors.

The use of electronic health records challenges the nurse-patient relationship. Collaborative documentation could help to change this. The aim of this review was to provide a synthesis of current knowledge on the impacts, as well as barriers and facilitators of collaborative electronic documentation in nursing settings. A mixed-methods systematic review was conducted. The search was conducted in November 2022. The study used thematic analysis for qualitative data and descriptive analysis for quantitative data. Data integration was performed using a convergent integrated approach according to the Joanna Briggs Institute methodology. The methodological quality of the included studies was critically appraised using the Mixed-Methods Appraisal Tool. A total of 17 studies were included. Study types were qualitative (n = 10), quantitative (n = 2), and mixed methods (n = 5). Multiple implementation practices were identified in different types of nursing settings. The facilitators and barriers were related to characteristics of nurses, patients, technology, and organization. Education and organizational support were identified to be essential in successful implementation. Collaborative documentation could be a way to overcome the challenges in nursing process associated with electronic documentation, as it can save nurses' time and improve patient experience. Implementation needs to be carried out with end-user patients and nurses.

Remote monitoring has been proposed to provide new opportunities to monitor pregnancy in the home environment and reduce the number of follow-up visits to the maternity clinic. Still, the integration of remote monitoring into the pregnancy care process has not been achieved. This descriptive qualitative study aimed to explore pregnant women's and healthcare professionals' perceptions of integrating remote monitoring into pregnancy monitoring process. A convenience sample of 10 pregnant women and 11 healthcare professionals participated in the focus group interviews. The data were analyzed with reflexive thematic analysis. The results comprised a four-step pregnancy monitoring process organizing the issues to consider when integrating remote monitoring into these steps. According to pregnant women and healthcare professionals, remote pregnancy monitoring should allow a holistic assessment to ensure the well-being of the pregnant woman and the fetus. Clear criteria for monitoring should guide the adaptation of monitoring to the identified monitoring needs. Ideally, remote monitoring could enable more personalized maternity care, supporting the monitoring-related decision-making of both pregnant women and healthcare professionals and facilitating the early detection of pregnancy complications. However, integration of remote monitoring would require significant restructuring of current pregnancy care processes.

This study investigated the effects of a nurse-led Omaha System-based mobile health application on physical, psychosocial, and cognitive symptoms and quality of life in patients with COVID-19 followed at home. This randomized control trial was conducted on 60 patients followed at home (30 in each intervention and control group). The intervention group received a nurse-led Omaha System-based mobile health application named COVOS, and the control group received usual care. Compared with the control group, the physical symptoms of the intervention group were significantly reduced at all follow-ups (first, second, and third months; P  < .05). Psychosocial symptoms (depression, anxiety, stress) were significantly reduced, respectively, in the intervention group at all follow-ups: first and third months and second and third months ( P  < .05). Cognitive symptoms were significantly reduced in the first month in the intervention group ( P  = .014). Similarly, the physical component score of quality of life significantly improved in the first month, and the mental component score of quality of life significantly improved in the second and third months ( P  < .05) in the intervention group. Results suggest that the COVOS had the potential to reduce effectively the physical, psychosocial, and cognitive symptoms of patients with COVID-19 and improve the quality of life of patients with COVID-19 followed at home.