Biomedical subjects

C E Aydin

Publications and source records attributed to C E Aydin.

10 recordsLinked to original sources

PubMed2001

A response to California's mandated nursing ratios.

PURPOSE: To explore the need for evidence-based health policy, as illustrated by the mandatory staffing bill passed by the California state legislature in 1999. DESIGN: Prospective data were collected from a voluntary sample of California acute care hospital representatives to describe selected patient safety and clinical outcomes and nurse staffing variables at the patient-care unit level. METHODS: Data for descriptive analysis were collected on hospital nurse staffing, patient falls, and pressure ulcers from 257 medical, surgical, medical-surgical combined, step-down, 24-hour observation units, and critical care patient care units in 38 California acute care hospitals from June 1998 to June 1999. FINDINGS: Nursing staffing ratios varied among the 257 units. RNs provided 91% of the nursing care in critical care units. Patients in medical-surgical units received 59% of their care from RNs, 11% from licensed vocational nurses, and 30% from other caregivers. Preliminary data showed no relationships between reported staffing ratios in these hospitals and the incidence of patient falls or hospital-acquired pressure ulcers. CONCLUSIONS: California Nursing Outcomes Coalition (CalNOC) data showed wide variations in staffing ratios, patient falls, and hospital-acquired pressure ulcers among nursing units and hospitals. These early findings indicate the need for additional research before determining minimal RN staffing requirements. Analysis of multiple sources of data may be necessary to determine safe staffing ratios and to provide evidence-based data for public policy.

Accidental Falls↗

PubMed1998

Computers in the consulting room: a case study of clinician and patient perspectives.

Few clinicians in the United States use computers during patient encounters and many still worry that computers will depersonalize their interactions with patients. This case study describes patient and clinician reactions to a computer-based health appraisal system. Findings showed no difference in any aspect of patient satisfaction between computer and non-computer groups. Use of a computer in the consulting room neither depersonalized nor enhanced patient satisfaction. Clinicians (in this case, nurse practitioners and physician assistants) were willing to use the system, which they perceived as having benefits for patient care, but were concerned about the increased time required for exams, effort required to learn the system while still interacting appropriately with the patient, increased monitoring of their performance, and other organizational issues. Clinicians who used the system showed a higher tolerance for uncertainty and communicated more frequently with each other and with others throughout the department. Implementation was slowed by the need to demonstrate the monetary value of the system.

Attitude of Health Personnel↗

PubMed1997

Evaluating the impact of health care information systems.

Evaluating the impact of computer-based medical information systems requires not only an understanding of computer technology but also an understanding of complex social and behavioral processes. This essay discusses the need for evaluation of health care information systems, a set of evaluation questions based on assumptions about the impact of technology on organizations, and recommendations for reducing barriers to the implementation of health care information systems.

Attitude to Computers↗

PubMed1997

Implementing computers in ambulatory care: implications of physician practice patterns for system design.

This paper presents pre-implementation data from the internal medicine division of a large physician group practice scheduled to implement an electronic medical record (EMR). Data were gathered through short-term participant observation and interviews. Findings indicate that (1) most physicians anticipate enough benefits to be willing to use the system; (2) computers must be accessible, easy to log into, and provide for physician movement and interrupted sessions; (3) many physicians are concerned about losing eye contact with patients; (4) it is unrealistic to expect even good typists to enter their own long notes; (5) staged implementation, with order entry introduced first, may help physicians adapt gradually; and (6) training should include protected time for instructional sessions for physicians, simulated patient encounters to help physicians adapt their practice patterns, and tutors available to answer questions in the clinical setting.

Ambulatory Care↗

PubMed1995

Computers in the examining room: the patient's perspective.

CompuHx* is an Interactive Health Appraisal System (IHAPS) used in the examining room at Kaiser-Permanente's San Diego Department of Preventive Medicine to record patient information, assist in diagnosis, and provide a legible summary of findings. The purpose of the present project was to examine the impact of computer use in the examining room on patient satisfaction with the Health Appraisal experience. Survey results showed no significant differences in patient satisfaction between patients whose examiners used CompuHx and those whose examiners did not. These findings indicate that, in the eyes of the patients surveyed, clinician use of a computer in the examining room did not depersonalize their relationship with the clinician, nor did it enhance satisfaction with the thoroughness of the exam or confidence in the examiner's findings.

Attitude to Computers↗

PubMed1994

Professional agendas and computer-based patient records: negotiating for control.

Professional groups approach the computer implementation process as an opportunity both to protect and enhance their ability to perform their work and to negotiate for arrangements that will further their professional agendas. The article examines and compares the professional agendas and negotiating positions of pharmacy and laboratory departments as examples of professional groups involved in the implementation of order entry systems. Findings showed a stronger stance taken by the pharmacy departments in both institutions to exercise as much control as possible over the order entry process. This stance is influenced by both task issues and professional agendas. Understanding the link between these professional agendas and the issues that arise during computer implementation can help guide similar negotiations as institutions adopt computer-based patient record systems.

Hospital Departments↗

PubMed1994

Transforming information use in preventive medicine: learning to balance technology with the art of caring.

CompuHx* is an Interactive Health Appraisal System (IHAPS) used in the examining room to record patient information, assist in diagnosis, and provide a legible summary of findings. This paper describes Phase I of a longitudinal study in which 22 examiners (five system users and 17 non-users) responded to detailed surveys and interviews about the system. Findings indicated that both users and non-users had mixed feelings about the system's ease of use and impact on their jobs, but agreed that it would have value for their practice. Underlying their acceptance of the system was a common concern for maintaining a caring relationship with patients and not allowing computer technology to depersonalize the examining room. Examiners also expressed concerns about the implementation process.

Artificial Intelligence↗

PubMed1992

Bringing social worlds together: computers as catalysts for new interactions in health care organizations.

In this case study, computer systems are explored as catalysts for new interactions between departments in health care organizations. Hypotheses investigated changes in the extent to which members of different departments (1) exchange information and (2) understand each other's work following implementation of an integrated medical information system. Analyses showed that communication-based forms of involvement in implementation (communicating with systems personnel and trainers, communicating about new ways to use the system, and receiving support from supervisors for doing so) were overwhelmingly more important than either general participation or computer use in predicting increases in interdepartmental interaction. Changes in tasks and roles also led to new, informal, face-to-face contacts to support computer system use, as well as greater administrative control over the organization as a whole. In addition, results of interviews and observations over the two-year study period illustrate the importance of work group identification in predicting changes accompanying computerization.

Appointments and Schedules↗

PubMed1989

Occupational adaptation to computerized medical information systems.

This paper explores the effects of computerized medical information systems on the occupational communities of health care professionals in hospitals. Interviews were conducted with informants from the pharmacy and nursing departments at two hospitals currently using medical information systems for communicating physicians' medication orders from the nursing station to the pharmacy. Results showed changes in tasks for both pharmacy and nursing, resulting in increased interdependence between the two departments. This interdependence was accompanied by improved communication and cooperation, providing an opportunity to encourage better working relationships between departments. The use and maintenance of the common computerized data base became a superordinate goal for the two groups, with the computer system itself as the topic of communication.

Adaptation, Psychological↗

PubMedDate not supplied

Hospital nursing benchmarks: the California Nursing Outcomes Coalition project.

The California Nursing Outcomes Coalition (CalNOC) project is an initiative that has become the largest ongoing nursing quality measurement repository in the nation. Launched in 1996 by California nursing leaders concerned with trends in hospital care, CalNOC has created reliable quality benchmark data to define patient safety thresholds in California. This article describes CalNOC's effort, which aligns with the strategy of the National Quality Forum for measuring and reporting healthcare quality. By tracing the evolution of the CalNOC project and its future potential, we hope to encourage other grassroots efforts to build the database repositories needed for healthcare quality measurement in the 21st century.

American Nurses' Association↗