Computers in nursing最新文献

In this article two recent developments in the German health care system are outlined. On one side, an increasing economic pressure and legal changes on the German health care system lead to growing computerization in German hospitals. On the other side, a shift from functional to holistic nursing is observed. The question is raised if within the paradigm of holistic nursing computer support is an adequate way to organize and design work. The newly developed German care information system, PIK (Pflegedienst im Krankenhaus--Nursing service in hospital), serves as an example for a program that is structured according to the nursing process. On the grounds of this exemplification it is argued that within the concept of "technology as an option" not only is the design of a program important but also its basic work organization and design. The authors come to the conclusion that computer support of holistic nursing is possible. However, it is shown that some aspects of nursing (for example, intuitive knowledge, which has been identified as an integral part of expert nursing) cannot be formalized and thus cannot be supported by computer systems.

The authors describe recent developments in the German health care system. A taking stock of the current state of hospital information system implementations in Germany leads to the conclusion that up to now no integrated hospital information system can be found, but that the awareness for the necessity of such a system is growing. Anticipated challenges and risks of care information systems are examined on grounds of an exemplification by the German care information system PIK (Pflegedienst im Krankenhaus--Nursing service in hospital). With regard to the shift from functional to holistic nursing in Germany it is argued that the consequences of the implementation of a care information system are intertwined closely with the nursing model.

This study examined the use of an interactive computer classroom (ICC) compared with a traditional lecture/discussion format (LD) for a nursing management course taught from fall semester 1994 through fall semester 1996. The ICC was structured around a group systems support software, a tool previously used in business settings for group decision-making activities. Structured learning activities allowed all students to participate simultaneously and anonymously. Data were collected during the second and final semesters of the study. The outcomes included academic performance, measured by course exams; class participation, measured by direct observation; and attendance records. The control group was a concurrent management course taught with the same objectives and evaluated by identical examinations. The examination scores and the frequency of class participation of the ICC group were significantly higher than those measures of the LD group. There was no significant difference in class attendance. Evaluation forms with open-ended questions were completed by the ICC students and revealed that the students believed that the process enhanced application and understanding. The negative aspects of the ICC experience were the need for increased preparation time for faculty and the students' lack of tolerance when technical difficulties caused delays.

The Rural Partnership Linkage for Cancer Care project is a program of advanced practice nursing care made available to rural cancer patients to provide education, symptom management, referral, and support within their communities. The advanced practice nurses used a computerized clinical information system (CCIS) to record care. In this article the CCIS is described, the software and hardware requirements are discussed, and the outcomes and value of the system are discussed. The CCIS is a relational database run on laptop computers that includes screens for standard recording of demographics, physical exam, symptoms, and treatments. The advanced practice nurses track patient symptoms over time, noting which treatments are successful in resolving or reducing the problems. Information from patient visits is selected by help menus for inclusion into referral forms, reports of patient care, and discharge summaries. Reports can be faxed or mailed to distant sites. The research team uses the combined data set to examine symptom patterns, nursing diagnosis, and treatments that result in improved physical and psychological functioning and symptom resolution. Rural cancer patients and their families benefit from care management, participation in research, and communication of patient health status in an integrated and timely fashion made possible by the CCIS.

A research survey was conducted on a stratified random sample of National League for Nursing accredited diploma, associate, baccalaureate, and master programs to determine the status of computer and information technology in nursing education. Fifty-five percent (n = 190) of the 347 selected schools responded. Compared with national statistics, all programs (diploma, associate, and higher degree) were proportionately represented. Findings indicated that schools have almost universal access to computers and educational software. However, further data analysis indicated that a majority of schools lacked a coordinated plan for technology implementation and were underfinanced for technology and related personnel. In addition, less than one third of the schools addressed nursing informatics (the information of nursing) in the curriculum and only 19 schools indicated that nursing informatics was offered as a separate course. Successful strategies for the implementation of computer and information technology are presented based on the findings.

This article addresses the development of the initial course in the first completely online doctoral program in nursing. Synchronous and asynchronous methods of distance education were assessed. Planning focused at the university, school, and course levels. University planning involved the technical infrastructure, registration, student services, and library services. School planning examined administrative commitment and faculty commitment and willingness. Course planning focused on marketing, precourse information, time frame, modular design, planned interaction, and professor availability and support. Implementation issues centered on getting students connected, learning the software, changing instructional methods, and managing chats. Traditional methods of evaluating student learning and course evaluation were supplemented with the development of qualitative and quantitative tools to gather data for making administrative decisions. The Dean and faculty agreed that the internet was an effective method of delivering content in the initial Health Policy course. The Dean and faculty agreed to continue the PhD program online for one cohort and continue to evaluate student progress and faculty and student satisfaction.

Values clarification for nursing practice is one of the most challenging aspects of nursing education. Use of electronic meeting software has been demonstrated to be effective in overcoming typical barriers to student growth. Inhibitions related to fear of censorship are overcome by anonymity of the system. Monopolizing by dominant members is controlled when the ability to speak in parallel exists. Overall, this application of electronic meeting software in the classroom demonstrated involvement of all students in an innovative approach to understand the effect of personal values on health policy development in a graduate nursing course.

Much of what has been written about computer use in nursing has been technocentric in nature. Nursing literature has focused on the intricacies of the technology, computer literacy, nurses' attitudes to computers and information systems, the implementation of these systems and, to a lesser degree, nursing information and its application in a computerized environment. Little, if any, attention has been given to the underlying cognitive processes required to use information technologies effectively. Can nursing stand accused of concentrating too heavily on the technology of information rather than on the cognitive processes involved in the acquisition, management, and use of information? This discussion will focus on the utilization of cognitive tools to facilitate the higher order thinking skills required for the effective use of information technologies. The concept of cognitive tools and cognitive residues will be defined. The role of these concepts within the broader context of nursing informatics will be illustrated using examples of how computer-based cognitive tools have been implemented in one undergraduate nursing program.