Computers in nursing最新文献

Internet technology is helping to reshape patient education. An illustration of this is provided by data from a two-stage pilot study involving 100 senior citizens who received instruction on how to conduct health information searches on the Internet. The goals were to enable the seniors to assume an active role in their health care and to share their information with family and friends. In a Train-the-Trainer approach, 20 trainers received instruction on searching for health information on the Internet, and subsequently trained 100 senior citizen trainees. The study was conducted from October 1997 to June 1998. The average age of the senior trainees was 69. Most had a college education. The study results reveal a positive impact of the training on senior trainee confidence in using the computer and the Internet, conducting health information searches online, and sharing health care information with their physicians, families, and friends. Some gender and educational differences were noted. In a 90-day posttraining follow-up, 66% of the trainees continued to use the Internet, with 47% of them using it to search for health information. Two thirds of those who searched for health information on the Internet talked about it with their physicians, with more than half reporting they were more satisfied with their treatment as a result of their searches and subsequent discussion with their physicians. These findings are relevant to patient education in the nursing curricula of nursing students and nurse practitioners. Some suggestions are given to improve the effectiveness of the training program.

This article describes the methods used, problems encountered, and solutions that were generated while integrating Web-based instruction (WBI) into a Master of Science in Nursing Leadership and Case Management, and a Post-Master's Case Management certificate distance education program taught via video-conferencing. The writer describes the use of computer-mediated communication to enhance collaboration between and among students at 11 video-conferencing sites. The integration of WBI to support collaboration was successful because students and faculty could complete their academic activities in the locations and times that were most convenient to them. The tools that WBI provided were instrumental in helping students submit collaborative work that faculty often identified as far exceeding their expectations.

As electronic applications are used increasingly in healthcare, nurses are being challenged to adopt them. Electronic mail (e-mail) is an electronic tool with general as well as healthcare uses. E-mail use may be an opportunity to learn a tool that requires skills similar to those used in other applications. This study aimed to identify barriers and facilitators that impact nurses' use of e-mail in the workplace. Data for this study were gathered using focus group methodology. Content analysis identified and labeled factors into seven major categories. Specific factors identified were generally consistent with those previously described in the literature as affecting use of computers in general. However, there were several additional factors identified that were not reported in other previous studies: lack of face-to-face communication, individual writing skills, recency of any educational experience, volume of mail received, password integrity, and technical support. Findings from this study provide information for any individual involved in introducing or updating an e-mail system in a healthcare environment.

Colleges are challenged to provide students with diverse teaching-learning experiences. Educators who introduce new teaching-learning experiences must evaluate the outcomes of these experiences. Three faculty members instituted a new multimedia computer-based assignment for undergraduate nursing students enrolled in a pediatric clinical course and then evaluated their knowledge and satisfaction. Students were asked to design a computer program about peripherally inserted central catheters, and to complete tests and summaries. During two semesters, 45 students participated in the assignment. As compared to another group of students who were asked to participate in a pencil and paper independent study assignment, these students were more satisfied with their computer assignment. Students in both groups, however, produced thought-provoking work and improved their knowledge base about central catheters. In many ways, the results support the use of a computer assignment.

Nurses in primary healthcare (PHC) clinics carry a heavy administrative burden, much of which can be computerized. Advantages and disadvantages of computerization and issues related to patient records and other requirements of computerized systems are well documented. However, not much attention has been given to users' needs in PHC environments in developing countries. Users in township areas have very specific needs because of a lack of previous exposure to computers and a reluctance to change working habits. Some general software requirements that system developers should consider are discussed.

The implementation of the computerized protocol for mechanical ventilation management should be considered successful. Of the 11 sites, only 4 encountered major difficulties. One site could be considered an implementation failure. At this site the protocol software, which was loaded onto the existing computerized patient documentation system, did not initially function smoothly and it severely affected the trust at the clinical site. At the other three sites system usage was minimal due to time requirements of the study rather than a failure to accept the decision support system. Implementation methods suggested by authors such as Whitten and Bentley were found to be successful. Methods of particular use included obtaining buy-in of key personnel, contacting and working with IS personnel early in the project, providing adequate training and reference materials for clinical and support personnel, and providing extra training for some users, thereby creating a "super-user" role. Finally, factors for success of a clinical trial to evaluate a decision support system are slightly different from those for successful use of the system. Time necessary for research functions such as patient screening and recruitment must be considered at the outset and planned for accordingly.

There are no multidisciplinary operational models to guide nursing informaticists and clinical system users in the design and implementation of computer-supported multidisciplinary care. The Patient-Centered Informatics Model is offered as just such a pragmatic guide. It fuses earlier work with new concepts and allows a visual depiction of crucial elements-influencing factors such as regulations and healthcare delivery models, system attributes such as healthcare delivery methods, knowledge base and supporting technology and categories of results of application processing. The model can help users and executives organize their thinking about the design, implementation, and evaluation of clinical systems in complex settings.

Ready access to research results is essential if nurses are to keep current with the scientific knowledge available to guide practice. Sigma Theta Tau International has supported the development of a software system that facilitates ongoing storage of information from research reports and can be used to gain online access to continually updated databases of research results called "knowledgebases." One such experimental knowledgebase, the Sleep Promotion Knowledgebase, includes studies of correlates of poor sleep in adults as well as sleep interventions and outcomes. The authors describe the creation of the Sleep Promotion Knowledgebase using arcs BUILDER to store information about research reports and the scientific findings they contain. The use of arcs MAPPER to examine sleep promotion interventions also is described. The strengths and limitations of the software system are identified, and the potential uses of arcs to disseminate sleep research results are discussed.