Computers in nursing最新文献

Undergraduate nursing students (juniors) entering an upper division nursing program were asked to rate their overall computer skill, ability to use word processing, spreadsheet, presentation/graphics programs, and their ability to use the Internet and e-mail. Because of the number of students who rated themselves as not computer literate an intervention was planned. A graduate student, using a tutorial manual, worked with students for six 1.5-hour skill-enhancing sessions during their first semester. After the sessions students again rated their skill levels. An analysis of the before and after data showed a mean gain score of 5.5 points, with each skill showing a significant increase from the before to the after assessment.

This study analyzed nursing staff attitudes at three different time periods during and after implementation of a clinical information system (CIS). Nursing staff completed a 12-item questionnaire about their perceptions of a computer CIS after receiving training on the system, but before going "online." Participants then completed surveys after 1 month of use and again after 6 months of use of the system. There was a positive relationship between participants' perceptions of the CIS and the self-rating of their adaptability level (P < 0.013), their rating of the technical level of their unit (P < 0.012), and the number of years of experience in their job (P < 0.048). There was no relationship between nurses' perceptions of the CIS and their age or between nurses' perceptions and their personal computer experience. Although attitudes became less positive at each time interval, the attitude differences from preimplementation to 1 month later were not statistically significant, whereas the difference from 1 month to 6 months was statistically significant.

This article focuses on the educational theory underpinning computer-based simulation in professional education. An innovative computer-based physical simulation to facilitate student learning of assessment and palpation skills in midwifery has been developed to prototype stage and preliminary evaluations conducted. The learning experience explicitly builds on the learning and teaching theory--a "conversational framework"--developed by Laurillard. A template incorporating all the dimensions of the Laurillard framework in the learning experience is presented and discussed. It is argued that this template could have wider application especially in clinically based health science courses. The case-based learning environment allows the students to solve problems and make valid clinical judgments. Throughout the learning experiences, students effectively examine a pregnant woman while interrelating their experiences with the academic knowledge of the teacher (a world of "descriptions"). The structure for learning relies on a mechanism for identifying and addressing the misunderstandings students initially hold. The creation of situations of cognitive conflict in the student's world of action (Laurillard's concept of intrinsic feedback) is seen as central to the learning experience. Finally, the article will canvass the issues faced by a project team designing and developing a technology-based educational package around an educational theory.

This study was designed to determine the accuracy of computerized comprehensive nursing exams, HESI Exit Exams (E2s), in predicting registered nurse and practical nurse students success on the licensing exam. Schools of nursing that administered E2s during the academic year 1996-97 were surveyed to determine how many students (n = 2809) predicted by the E2 to pass the licensure exam had failed, and if the exam administration was monitored or proctored. Based on the findings of this study, the E2 was determined to be an accurate predictor of students' success on the licensing exam. However, it was significantly more accurate (P = .05) when the exam was monitored (99.49%) than unmonitored (96.82%). The E2 was determined to be highly predictive of students' success on the licensing exam for all groups tested: associate degree, baccalaureate, diploma, and practical nursing students.

Patient care using patient volume rather than acuity has been a long-standing problem in a cardiac catheterization laboratory in a central New Jersey Medical Center. The current pattern of staffing results in some of the nursing staff becoming unproductive from a patient care perspective. This recently has become a concern of the Vice President of Nursing who has the unpopular task of consolidating nursing positions. There is a very effective acuity measurement system, the Medicus Acuity System, in place for the various inpatient areas. This system also exists in the Emergency Department and is called EMERGE. The system collects and objectively weighs information regarding severity of patient needs or acuity. These data are collected daily and provide unit managers with information regarding hours of direct nursing care on their particular units. The information over time shows trends in direct care hours and allows these managers to target the average patient population. The system gives insight into units that require more and less nursing hours by hour of the day, day of the week, and month of the year. This makes overall housewide use of nursing personnel more patient-care appropriate and more financially sound, for example, in the summer months when acuity is shown to be higher. In today's managed care environment this author believes the practice of staffing units based on bed occupancy is now regarded as antiquated, inefficient, and impractical. This study investigated a modified version of the EMERGE tool and its ability to capture patient acuity as it relates to staffing in the cardiovascular laboratory (CVL). During the 5 days of data collection, 87 patients were cared for in the CVL. The modified EMERGE cards were completed on 54 of the 87 patients that week. This represented 62% of that total patient population. Each day data for 60% or more of the patients were entered into the study. The interrater reliability of the data collected was better than 98% each day with overall accuracy being 99.5%. This interrater reliability was based on the findings by the expert panel, who compared two or three (approximately 10%) of the actual nurses' notes to the matching EMERGE cards each day. More than 80% of the 54 patients were classified as Type 3, well above the Type 1 standard patient acuity category for the EMERGE system. Telemetry units with a majority of EMERGE Type 3 patients would require between 50 to 100 minutes of care per visit and would have a significant nursing workload. These units are where the CVL draws most of their patient population. In summary, this study reflects a growing trend in healthcare that requires justification of staffing through the productivity of workers. Acuity tools provide tangible and objective data about daily workload and productivity by measuring patient's needs. As managed care forces hospitals to cutt staff, acuity tools will become more important for evaluating productivity and retaining staff

In this study, the author discusses the effect of nurse shift schedules on circadian rhythm and some important ergonomics criteria. The author also reviews and compares different nurse shift scheduling methods via the criteria of flexibility, fairness, continuity in shift assignments, nurses' preferences, and ergonomics principles. In this article, a primary shift rotation system is proposed to provide better continuity in shift assignments to satisfy nurses' preferences. The primary shift rotation system is modeled as a zero-one linear goal programming (LGP) problem. To generate the shift assignment for a unit with 13 nurses, the zero-one LGP model takes less than 3 minutes on average, whereas the head nurses spend approximately 2 to 3 hours on shift scheduling. This study reports the process of implementing the primary shift rotation system.

The implementation of nontraditional healthcare delivery increases the need for information technology innovation, not only in use of computer-based patient records, but also in enabling infrastructures to support health information exchange. This is very apparent in mobile health clinics where care is provided to vulnerable community populations at locations far removed from academic and tertiary care settings. Several challenges of designing a computerized system for the University of Maryland School of Nursing's Wellmobile will be addressed in this article, as well as possible solutions to these challenges. It is the authors' belief that implications for further study will become apparent as these constraints and challenges are described.

The role of community-based cancer support groups (CSGs) in helping people cope with cancer is well known. Recently, online CSGs have become a viable alternative to traditional CSGs. The purposes of this study were to determine if categories of responses on Internet cancer support groups (ICSGs) differ when the majority of the participants were of a single gender, and whether response categories seen on gender-specific ICSGs were different than those on ICSGs used equally by men and women. A line-by-line analysis of postings on prostate, breast, and mixed ICSGs were analyzed and responses categorized. Four categories (information giving/seeking; encouragement/support; personal opinion; and personal experience) accounted for approximately 80% of responses across the groups. Information giving/seeking was ranked first in the prostate group, and personal experience took priority in the breast group. Men were more than twice as likely to give information and women more than twice as likely to give encouragement and support. One category (prayer), identified in the mixed group, was lacking in the prostate and breast groups, and an activism category was added to the prostate group. Categorical responses differed by gender (chi 2 = 79.40, P < .0001). Attention should be given to facilitating the entry of underserved groups into ICSGs. Future research should explore the relationship between ICSG membership and variables such as depression, survival time, and quality of life.

This study was conducted to explore the use of interactive videodisc instruction (IVDI) with cooperative learning strategies. Baccalaureate students in their junior year were assigned to one of three types of groups based on prenursing grade point average: homogeneous average achievement, homogeneous high achievement, and heterogeneous mixed achievement students. Groups of three to five students viewed a lesson related to auscultation of heart sounds using IVDI and were videotaped throughout the lesson. There were no significant differences among the groups in their interaction frequencies, cooperativeness, or achievement on the group posttest completed immediately after viewing the lesson. Homogeneous high achievement students scored significantly higher than the other two groups on the individual posttests given 2 weeks after viewing the lesson. However, all three groups had very low scores. Several themes emerged related to management of the lesson. A majority of the students without previous IVDI experience had difficulty accessing and proceeding through the lesson: fill-in-the-blank questions posed by the lesson often were frustrating to the students, students in groups had difficulty reading the touch screen monitor, a large number of students attempted to locate the cardiac valves on themselves or other group members, and male students tended to distance themselves from each other. In this study, students needed more orientation to the computer equipment and to cooperative learning strategies. When using IVDI with inexperienced students, faculty should be certain that technical assistance is available throughout the lesson.