Biomedical subjects

Ting-Ting Lee

Publications and source records attributed to Ting-Ting Lee.

13 recordsLinked to original sources

PubMed2006

Adopting a personal digital assistant system: application of Lewin's change theory.

AIM: This paper reports a study exploring nurses' perceptions of adopting an information system using handheld computers (personal digital assistants) in their daily practice. BACKGROUND: Handheld computers have recently been used in nursing information systems for patient care, but few studies have explored their impact on users. By understanding clinicians' experiences of using this technology, strategies can be implemented to smooth the change process in adopting their use, thus achieving optimal patient outcomes. METHOD: A descriptive, exploratory approach was used to study nurses' perceptions of using personal digital assistants as part of a hospital information system. A purposive sample of 15 nurses participated in one-to-one, in-depth interviews from February to March 2004. Nurses' perceptions of the adoption process were analysed using Lewin's force field theory of change as a framework. FINDINGS: Nurses initially resisted using the personal digital assistant system (unfreezing stage), then came around to using it (moving stage), and finally adopted the system in their daily practice (re-freezing stage). However, an anticipatory stage also occurred and this could serve as a feedback mechanism to improve the system for current and future use. CONCLUSION: Educational programmes should be provided and strategic planning should be done in the early stage of implementing a policy to adopt new technology. In addition, the adoption process and learning period could be shortened by improving the system's content design. During this transition stage, dual charting should be used as a backup only for a limited time to avoid adding extra work to nurses' already heavy workload. Finally, the concept of confidentiality should be reinforced and stressed early in the educational programme to protect patient data, which can easily be accessed in computerized systems.

Adult↗

PubMed2006

Nurses' perceptions of their documentation experiences in a computerized nursing care planning system.

AIM: To explore how the content design of a computerized nursing care plan affects nurses' perceptions of their documentation experience, specifically in making care plans. BACKGROUND: Nurses' attitudes towards and experiences of computer use in daily practice have been studied. However, no studies have examined how using a computerized nursing care planning system affects nurses' perceptions of the documentation process. METHODS: A descriptive, exploratory qualitative approach was used to conduct one-on-one, in-depth interviews with 20 nurses. The major interview question was, 'What do you think the content of the computerized care plan provided in making care plans?' Data analysis was based on Miles and Huberman's data reduction, data display, and a conclusion verification process. FINDINGS: Nurses generally viewed the content of the computerized nursing care planning system as a reference to aid memory, a learning tool for patient care, and a vehicle for applying judgement to modify care plan content. CONCLUSIONS: Although computer technology is designed to streamline nurses' work, using a computerized care plan system can also enhance their knowledge, experience and judgement of descriptions of patient problems and care strategies. Thus, the effects of using technology on documentation behaviours or patterns may deserve further exploration. RELEVANCE TO CLINICAL PRACTICE: While computerized documentation systems have been used widely in patient care, little attention has been given to how the design of care plan content affects the documentation process. Electronic documentation systems can introduce nurses to new skills and knowledge that may improve care quality.

Adult↗

PubMed2006

A study of network education application on nursing staff continuing education effectiveness and staff's satisfaction.

The rapid development of computer technology pushes Internet's popularity and makes daily services more timely and convenient. Meanwhile, it also becomes a trend for nursing practice to implement network education model to break the distance barriers and for nurses to obtain more knowledge. The purpose of this study was to investigate the relationship of nursing staff's information competency, satisfaction and outcomes of network education. After completing 4 weeks of network education, a total of 218 nurses answered the on-line questionnaires. The results revealed that nurses who joined the computer training course for less than 3 hours per week, without networking connection devices and with college degree, had the lower nursing informatics competency; while nurses who were older, at N4 position, with on-line course experience and participated for more than 4 hours each week, had higher nursing informatics competency. Those who participated in the network education course less than 4 hours per week were less satisfied. There were significant differences between nursing positions before and after having the network education. Nurses who had higher nursing information competency also had higher satisfaction toward the network education. Network education not only enhances learners' computer competency but also improves their learning satisfaction. By promoting the network education and improving nurses' hardware/software skills and knowledge, nurses can use networks to access learning resources. Healthcare institutions should also enhance computer infrastructure, and to establish the standards for certificate courses to increase the learning motivation and learning outcome.

Computer-Assisted Instruction↗

PubMed2006

Nurses' perceptions of adopting a PDA system--application of Lewin's change theory.

PDAs have recently been used in nursing information systems, but few studies have explored their impact on users. The purpose of this study was to explore nurses' perceptions of PDAs. Lewin's theory was used for data analysis. Fifteen nurses participated in in-depth interviews. Results indicated that they initially resisted using the PDA (unfreezing stage), then came around to using it (moving stage), and finally adopted the system (re-freezing stage). An anticipatory stage was added as a feedback mechanism to improve the system. By understanding clinicians' experiences, strategies can be implemented to smooth this process and to achieve optimal nursing care.

Attitude to Computers↗

PubMed2005

Factors affecting the use of nursing information systems in Taiwan.

AIM: This paper reports a study to test a proposed model of factors (demographic variables, computer experience and perceived technology characteristics) influencing the efficient use of a computerized nursing care planning system by hospital clinical nurses. BACKGROUND: Although nursing information systems have been used in health care institutions, little research has explored the efficiency of computer use in nurses' daily practice. METHOD: A secondary data analysis was applied to focus on clinical nurses' daily computer use. The original data were collected from a medical centre in Taiwan to establish the reliability and validity of a scale to evaluate computerized nursing care plan systems. RESULTS: Younger nurses with more education, less computer knowledge and less usage pressure, and who perceived that they had less usage benefit, more education training and usability regarding system use, spent less time on the computerized nursing care plan. CONCLUSION: The results can be used for further organization of education programmes and as a reference for training strategies. Further examination and analysis of item content are suggested.

Adult↗

PubMed2005

Nursing diagnoses: factors affecting their use in charting standardized care plans.

AIMS AND OBJECTIVES: The purpose of this study was to explore factors that may affect nurses' use of nursing diagnoses in charting standardized nursing care plans in their daily practice. BACKGROUND: Care plans have been viewed as providing a structured approach to the assessment, planning and delivery of patient care. Nonetheless, the challenge for many institutions is to help professional nursing staff refine their understanding of nursing diagnoses and charting skills, to identify patient problems and propose appropriate care plans. METHOD: Twelve clinical nurses working at a medical center in Taiwan underwent one-on-one in-depth interviews from May to July 2000. Data analysis was based on Miles and Huberman's data reduction, data display, and a conclusion verification process to investigate the charting process. FINDINGS: Nurses tended to match patient conditions to the designated nursing diagnoses, be unfamiliar with statements of related factors, use objective data to describe patient conditions, ignore descriptions of nursing goals, dutifully check interventions without always executing them, and choose the same evaluation to meet hospital requirements. CONCLUSIONS: These findings suggest that using educational programmes for enhancing nurses' ability to use nursing diagnoses and exploring the process of diagnostic reasoning would improve the quality of patient documentation. RELEVANCE TO CLINICAL PRACTICE: The trend in health care is to focus on chart audit to reveal indicators of quality of care. Therefore, the experience of nurses in this study could be applied to in-service training programmes by institutions that are replacing traditional, manually written care plans with a standardized care planning system, thus helping other nurses through this transition process.

Attitude of Health Personnel↗

PubMed2005

Nurses' concerns about using information systems: analysis of comments on a computerized nursing care plan system in Taiwan.

AIMS AND OBJECTIVES: The purpose of this study was to pursue a deeper understanding of nurses' perceptions of a computerized nursing care plan as written in comments on a survey. BACKGROUND: Studies have examined nurses' perceptions of computer use, but comments written on surveys of computerized nursing care planning have never been reported and the pattern and meaning of such feedback have not been systematically analysed. DESIGN: Of 738 nurses in Taiwan who completed a two-part survey to evaluate a computerized nursing care plan, 202 responded on part II to an open-ended question about overall perceptions of a nursing information system. METHODS: A sample of 10 questionnaires with comments was subjected to qualitative content analysis. Key words and phrases were identified, then grouped into categories, which were used to code the remaining respondents' comments. Another 20 were used to pilot test these coding categories. The final coding categories were applied to all 202 questionnaires with comments for data analysis. RESULTS: Nurses were concerned about inconvenient access to computers; reduced work efficiency; inability to individualize patient care and nursing specialty deficiencies; poor content design, system function, and system integration; using the system as a policy requirement; and privacy and legal issues. CONCLUSIONS: Hardware availability, content design and user training/education programmes are critical issues that affect nurses' use of computers in their daily practice. RELEVANCE TO CLINICAL PRACTICE: These comments can be applied in strategic planning and staff development programmes to further use of information systems in patient care.

Adult↗

PubMed2005

Assembly of severe acute respiratory syndrome coronavirus RNA packaging signal into virus-like particles is nucleocapsid dependent.

The severe acute respiratory syndrome coronavirus (SARS-CoV) was recently identified as the etiology of SARS. The virus particle consists of four structural proteins: spike (S), small envelope (E), membrane (M), and nucleocapsid (N). Recognition of a specific sequence, termed the packaging signal (PS), by a virus N protein is often the first step in the assembly of viral RNA, but the molecular mechanisms involved in the assembly of SARS-CoV RNA are not clear. In this study, Vero E6 cells were cotransfected with plasmids encoding the four structural proteins of SARS-CoV. This generated virus-like particles (VLPs) of SARS-CoV that can be partially purified on a discontinuous sucrose gradient from the culture medium. The VLPs bearing all four of the structural proteins have a density of about 1.132 g/cm(3). Western blot analysis of the culture medium from transfection experiments revealed that both E and M expressed alone could be released in sedimentable particles and that E and M proteins are likely to form VLPs when they are coexpressed. To examine the assembly of the viral genomic RNA, a plasmid representing the GFP-PS580 cDNA fragment encompassing the viral genomic RNA from nucleotides 19715 to 20294 inserted into the 3' noncoding region of the green fluorescent protein (GFP) gene was constructed and applied to the cotransfection experiments with the four structural proteins. The SARS-CoV VLPs thus produced were designated VLP(GFP-PS580). Expression of GFP was detected in Vero E6 cells infected with the VLP(GFP-PS580), indicating that GFP-PS580 RNA can be assembled into the VLPs. Nevertheless, when Vero E6 cells were infected with VLPs produced in the absence of the viral N protein, no green fluorescence was visualized. These results indicate that N protein has an essential role in the packaging of SARS-CoV RNA. A filter binding assay and competition analysis further demonstrated that the N-terminal and C-terminal regions of the SARS-CoV N protein each contain a binding activity specific to the viral RNA. Deletions that presumably disrupt the structure of the N-terminal domain diminished its RNA-binding activity. The GFP-PS-containing SARS-CoV VLPs are powerful tools for investigating the tissue tropism and pathogenesis of SARS-CoV.

Animals↗

PubMed2005

[Analyzing a nursing information system in terms of Lewin's change theory].

The ever increasing are of information technology has deeply influenced, indeed changed our lives. Under its impact, healthcare institutions have constantly changed to improve the quality of patient care. Enterprise management has become a major focus of hospitals, and the development of nursing information systems has accelerated in line with this worldwide trend. The purpose of this study is to apply Lewin's change theory in analyzing a nursing information system, as well as to explore issues regarding challenges that such systems will present to managers and staff and the strategies that can be applied in order to set up the infrastructure for future nursing information systems.

Information Systems↗

PubMed2004

Standardized care plans: experiences of nurses in Taiwan.

BACKGROUND: Nursing care plans have been viewed as structured plans of action for patient care. Studies have investigated the outcomes or effectiveness of using different types of care plans, but have seldom reported nurses' perceptions of using care plans in daily practice. AIMS AND OBJECTIVES: The purpose of this study was to explore nurses' experiences using a standardized care plan. DESIGN: Nineteen clinical nurses at a teaching hospital in Taiwan were interviewed one-on-one and in depth from April to June 2000. Data analysis was based on Miles and Huberman's data reduction, data display, and a conclusion verification process to identify themes and concepts that represented nurses' experiences using a care plan. RESULTS: The following themes emerged from the interview data: being reminded of care procedures, time-saving in making care plans, time-consuming in making shift reports, undesirable content design, and paperwork-oriented/not patient-centered. CONCLUSION: With the considerable amounts of money spent on education and training to meet nurses' needs, a careful examination of nurses' experiences in using care plans, should assist in care plan development and lead to observable effects on patient care. RELEVANCE TO CLINICAL PRACTICE: Nursing documentation reflects nurses' observations, assessments, and interventions. It is expected that better use of standardized care plans will enhance nurses' access to appropriate and accurate information in decision-making, thus improving the charting process and care quality.

Adult↗

PubMed2004

Nurses' adoption of technology: application of Rogers' innovation-diffusion model.

This qualitative study applied Everett Rogers' innovation-diffusion model to analyze nurses' perceptions toward using a computerized care plan system. Twelve nurses from three respiratory intensive care units in Taiwan voluntarily participated in a one-on-one, in-depth interview. Data were analyzed by constant comparative analysis. The content that emerged was compared with the model's five innovation characteristics (relative advantage, compatibility, complexity, trialability, and observability), as perceived by new users. Results indicate that Rogers' model can accurately describe nurses' behavior during the process of adopting workplace innovations. Related issues that emerged deserve further attention to help nurses make the best use of technology.

Adaptation, Psychological↗

PubMedDate not supplied

Evaluation of computerized nursing care plan: instrument development.

With the increasingly popular use of information technology in patient care, the need for reliable instrumentation to evaluate information systems has become critical. This article describes the psychometric testing of a scale developed to evaluate a computerized nursing care plan (CNCP) system. A review of the literature generated a 44-item questionnaire, which was then administered to a convenience sample of 729 hospital nurses in Taiwan. Factor analysis (principal component analysis with varimax rotation) and item analysis were applied to establish the scale's construct validity and reliability. Twenty-two items selected from the original 44-item pool were grouped into 6 major constructs: patient care, nursing efficiency, professionalism, usage benefit, education and training, and usability. The alpha coefficient was 0.85. The statistical results showed that nurses generally valued using the CNCP system. Further psychometric analysis of the scale is suggested in other nursing populations, for subscale development and to refine item wording.

Adult↗

PubMedDate not supplied

Nursing administrators' experiences in managing PDA use for inpatient units.

The adoption of information technology in patient care has become a trend in healthcare organizations. The impact of this technology on end users has been widely studied, but little attention has been given to its influence from a management perspective. The purpose of this study was to explore nurse managers' perceived experiences in implementing a policy to adopt personal digital assistant technology. A descriptive, exploratory qualitative approach (one-on-one, in-depth interviews) was used to collect data from 16 nurse managers of inpatient units at a medical center in Taiwan. Interview data were analyzed according to Miles and Huberman's data reduction, data display, and conclusion verification process. The results revealed that nurse managers experienced the limitations of technology, training issues, doctors' obstructive influence, role conflict, and improvement of future personal digital assistant use. These results can be used to improve strategic organizational planning and in-service training programs to implement information systems.

Adult↗