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PubMedDate not supplied

A survey study of pediatric nurses' use of information sources.

This survey study explored use of different information sources among a convenience sample of 113 bedside pediatric nurses. The study was guided by three interrelated concepts: types of information sources, levels of evidence, and computer skill. The Nursing Information Use Survey measured use of information sources, impact of information sources on nursing care, barriers to information, and expectations that a computerized clinical desktop or patient information management system would improve patient care. Significant correlations between use of interpersonal and non-computer-based information and non-computer- and computer-based information supported the conceptual model. Use of traditional, non-computer information sources such as textbooks and print-based journals was higher among baccalaureate, compared with diploma, prepared nurses. Nurses with greater computer and online searching skill used more computer-based information. Findings suggested that strategies to improve nurses' computer and information searching skills may promote use of higher-level evidence in planning nursing care.

Adult↗

PubMedDate not supplied

The use of personal digital assistants at the point of care in an undergraduate nursing program.

This study examined the relationships between the use of personal digital assistants and self-efficacy and the preparation for medication administration among second-year Bachelor of Science in Nursing students in a medical-surgical clinical environment. By using a controlled experimental method, the study attempted to support claims about the educational benefits of personal digital assistants which have generally been reported in more descriptive and anecdotal formats. The sample consisted of 36 students, of which two groups had personal digital assistants and two groups served as a control. The control groups were provided with paper resources equivalent to the software provided by the personal digital assistants. Findings showed a significant increase in self-efficacy in the groups with personal digital assistants.

Attitude of Health Personnel↗

PubMedDate not supplied

Computer courses in the undergraduate nursing curriculum in Turkey.

This study surveys computer courses in undergraduate nursing schools in Turkey. To accomplish this, the investigator gave an assignment to first-year students at the Ege University School of Nursing as part of a computer course in 2003-2004. The assignment consisted of having students use their computer skills and do research on the Internet to obtain information about computer classes at other Turkish nursing schools. The objective of this assignment was to correspond by e-mail with first-year students at these institutions. Because of this assignment, at least 70 contacts were established, and information has been exchanged between nursing students at 45 different universities in Turkey. This study shows that one method used by undergraduate nursing schools in Turkey to educate their students in modern nursing practices is to integrate computer courses in their curricula, thereby providing students important practical technology skills.

Adaptation, Psychological↗

PubMedDate not supplied

The N-CODES project moves to user testing.

For a technology to be implemented successfully, it must be thoroughly tested by the stakeholders who will use it in practice. This article reports on the user testing of the Nurse Computer Decision Support working prototype. Ten acute care nurses with varying levels of education and experience participated in the testing. The study's protocol consisted of a series of tasks requiring the participants to use the system while solving patient problems. Both quantitative and qualitative data on usability, ease of navigation, and nurse satisfaction were collected. The nurses ranked usability and ease of navigation highly. Nurses were excited about the system's clinical potential and felt that it would be useful to all practitioners regardless of experience. Testing the system in an actual clinical setting is the next step, but it is clear that the system has extraordinary potential to improve clinical decision making and patient outcomes.

Acute Disease↗

PubMedDate not supplied

Improving the human readability of Arden Syntax medical logic modules using a concept-oriented terminology and object-oriented programming expressions.

Medical logic modules are a procedural representation for sharing task-specific knowledge for decision support systems. Based on the premise that clinicians may perceive object-oriented expressions as easier to read than procedural rules in Arden Syntax-based medical logic modules, we developed a method for improving the readability of medical logic modules. Two approaches were applied: exploiting the concept-oriented features of the Medical Entities Dictionary and building an executable Java program to replace Arden Syntax procedural expressions. The usability evaluation showed that 66% of participants successfully mapped all Arden Syntax rules to Java methods. These findings suggest that these approaches can play an essential role in the creation of human readable medical logic modules and can potentially increase the number of clinical experts who are able to participate in the creation of medical logic modules. Although our approaches are broadly applicable, we specifically discuss the relevance to concept-oriented nursing terminologies and automated processing of task-specific nursing knowledge.

Attitude of Health Personnel↗

PubMedDate not supplied

Mapping of nursing records into the NIC and the ICNP in a Korean oriental-medicine hospital.

This study uses mapping methodology to examine the applicability of the Nursing Interventions Classification and the International Classification of Nursing Practice to nursing practice in a Korean Oriental-medicine hospital. Data were collected from the nursing records of 56 stroke patients in one unit, and intervention statements were mapped into NIC and ICNP. Of 147 unique nursing intervention statements extracted, 136 (92.52%) could be mapped into NIC and 99 (67.35%) statements could be completely mapped into ICNP. Using mapping methodology, this study validates that both NIC and ICNP would be useful for documenting nursing care in a Korean hospital, but it also identifies additional concepts that need to be represented in both of these standardized nursing languages. It is recommended that nurses be more careful in documenting their interventions and also that SNLs be developed further to more completely represent nursing practice.

Adult↗

PubMed2005

Cognitive Continuum Theory in nursing decision-making.

AIM: The purpose of this paper is to analyse and evaluate Cognitive Continuum Theory and to provide evidence for its relevance to nurses' decision-making. BACKGROUND: It is critical that theories used in nursing are evaluated to provide an understanding of their aims, concepts and usefulness. With the advent of evidence-based care, theories on decision-making have acquired increased significance. METHOD: The criteria identified by Fawcett's framework has been used to analyse and evaluate Hammond's Cognitive Continuum Theory. Findings. There is empirical evidence to support many of the concepts and propositions of Cognitive Continuum Theory. The theory has been applied to the decision-making process of many professionals, including medical practitioners and nurses. Existing evidence suggests that Cognitive Continuum Theory can provide the framework to explain decision-making in nursing. CONCLUSION: Cognitive Continuum Theory has the potential to make major contributions towards understanding the decision-making process of nurses in the clinical environment. Knowledge of the theory in nursing practice has become crucial.

Humans↗

PubMed2005

Developing and validating a nursing website evaluation questionnaire.

AIM: The aim of this paper is to report on the development and validation of an evaluation questionnaire for nursing websites. BACKGROUND: Increasing numbers of the general public and health care professionals are using the Internet to access health and health care-related information. The quality of such websites, therefore, needs to be evaluated. METHODS: A total of 24 websites in the United States and Taiwan, including websites in 13 leading schools and 11 hospitals, were selected as test websites. A total of 120 participants with Master's degrees in either nursing or mechanical engineering were invited to examine the 24 websites using a nursing website evaluation questionnaire. A 32-item questionnaire was developed, covering overall impression, download and switch speed, accessibility and convenience, web page content, service function and compatibility with common browsers. Participants were requested to connect to the specific websites and browse the contents before filling in the questionnaire. The results were arranged into 12 different sequences and prepared on a CD using Macromedia Dreamweaver. Data were analysed using Cronbach's alpha, Guttman split-half reliability and factor analysis. FINDINGS: Internal consistency was good, with a Cronbach's alpha of 0.93 in Part I and a KR-20 (Kuder Richardson) of 0.85 in Part II. Four factors given in Part I were identified as content truth, accessibility and convenience, speed and connection, and overall impression. CONCLUSION: The nursing website evaluation questionnaire had good construct validity and internal consistency.

Adult↗

PubMed2006

Promotion of evidence-based practice by professional nursing associations: literature review.

AIM: This paper reports a literature review examining the activities of professional nursing associations in the promotion of evidence-based practice. BACKGROUND: Professional nursing associations can play a role in the implementation and achievement of evidence-based practice as such associations aim to develop and further educate nurses professionally, build professional networks representing the interests of nurses and the nursing profession, influence the government and policymakers, and support and protect the basic values of nurses. The exact role of professional nursing associations in the promotion of evidence-based practice is as yet unclear, along with just how the role of such associations can be expanded and which strategies can be used to promote evidence-based practice among members. METHOD: A literature and Internet search was undertaken using the PUBMED, CINAHL, SCIRUS, INVERT, and the Cochrane databases using the terms evidence-based practice(s)* or EBP*, which were then combined with Nursing Society*, Nursing Organization*, Nursing Organisation*, Nursing Association* or Nursing Council*. Other sources included a Google search of the Internet, and the sites of various members of the International Council of Nurses. Publications in English, French or German from 1993 to 2004 were used, and the Internet search was conducted on 17 July 2003. RESULTS: Sixty nursing associations described the dissemination of evidence-based practice using one or more types of activities (179 activities in total). All of these activities were of a voluntary nature, with a predominant focus (132/179 activities) on intrinsic motivation of nurses. More specifically, most of the activities were aimed at nurses' competences and attitudes in relation to evidence-based practice. CONCLUSION: Professional nurses' associations are active in promoting evidence-based practice among their nurse members, but only those focusing on changing competences and attitude by addressing intrinsic motivation are well used. Other types of activities deserve to be explored, including behaviour-oriented approaches, approaches using structural, social or financial influence measures and perhaps methods based on 'involuntary involvement'.

Evidence-Based Medicine↗

PubMed2005

Geography and nursing: convergence in cyberspace?

During the last 3 years the interface between geography and nursing has provided fertile ground for research. Not only has a conceptual emphasis on space and place provided nurse researchers with a robust and subtly different way to deconstruct and articulate nursing environments, but also their studies have provided a much needed focus on certain areas of health-care, and in particular clinical practice, not currently prioritized by health geographers. We argue that, as something that is forcing fundamental re-considerations of the nature of both nursing and geography, cyberspace is a particularly important phenomenon that lies comparatively under-researched at this interface. To encourage some interest in researching nursing and cyberspace through a geographical lens, and at least to showcase a range of potentially useful and transportable concepts, we provide an overview of some of the key debates pertaining to cyberspace developed by human geographers, and make some initial and tentative connections to nursing.

Delivery of Health Care↗

PubMed2006

Writing place: a comparison of nursing research and health geography.

The concept of 'place', and general references to 'geographies of ...' are making gradual incursions into nursing literature. Although the idea of place in nursing is not new, this recent spatial turn seems to be influenced by the increasing profile of the discipline of health geography, and the broadening of its scope to incorporate smaller and more intimate spatial scales. A wider emphasis within the social sciences on place from a social and cultural perspective, and a wider turn to 'place' across disciplines are probably equally important factors. This trend is raising some interesting questions for nurses, but at the same time contributes some confusion with regard to imputed meanings of 'place'. While it is clear that most nurse clinicians and researchers certainly understand that place of care matters to their practices and patients, many diverse uses of 'place' are found within nursing literature, and contemporary understandings of the term 'place' within nursing are not immediately clear. It is in this context that this article plans to advance the discussion of place. More specifically, the aims of this paper are threefold: to critique 'place' as it appears in nursing literature, to explore the use of 'place' within health geography, whence notions of place and 'geographies of' have originated and, finally, to compare and contrast the use of 'place' in both disciplines. This critique intends to address a deficit in the literature, in this era of growing spatialization in nursing research. The specific questions of interest here are: 'what is "place" in nursing?' and 'how do concepts of place in nursing compare to concepts of place in health geography?'

Body Image↗

PubMed2005

Applicability of the Nursing Interventions Classification to describe nursing.

The aim of this survey was to test the applicability of the Nursing Interventions Classification (NIC) system for use in a future nursing information system for documenting nursing in an electronic patient record in Iceland. Also, the aim was to test the translation of NIC into Icelandic. In order to be applicable to nursing NIC needs to be sensitive enough to describe the work nurses do, differentiate between specialities in nursing, and be understandable to nurses. A sample of 198 nurses was asked to identify how often they used each of 433 NIC nursing interventions. Of the 36 most frequently used interventions half are within the physiological domain. Core nursing interventions were different between specialities, e.g. Analgesic Administration had a high mean score in surgical nursing, and Health Education in primary health care. anova for the 27 classes in NIC showed significant differences (p < 0.01) by all nursing specialities except one, Crisis Management. A Tukey post hoc test showed how nursing specialities were reflected differently in the NIC domains, e.g. medical/surgical nursing in the Physiological: Basic Domain, but psychiatric nursing in the Behavioural Domain. Factor analysis of classes in NIC show good resemblance with the domains in NIC and the structure of the classification is strongly supported, except the Safety Domain. The results from this study indicate that nurses in the sample consider NIC to be applicable to describe nursing. The language is a powerful tool and is central in reflecting nursing practice as well as supporting the construct of knowledge. The translation of NIC to Icelandic is one step in many in preparing nurses to use a standardized language which can also be used in an electronic patient record.

Adult↗

PubMed2006

Operational failures and interruptions in hospital nursing.

OBJECTIVE: To describe the work environment of hospital nurses with particular focus on the performance of work systems supplying information, materials, and equipment for patient care. DATA SOURCES: Primary observation, semistructured interviews, and surveys of hospital nurses. STUDY DESIGN: We sampled a cross-sectional group of six U.S. hospitals to examine the frequency of work system failures and their impact on nurse productivity. DATA COLLECTION: We collected minute-by-minute data on the activities of 11 nurses. In addition, we conducted interviews with six of these nurses using questions related to obstacles to care. Finally, we created and administered two surveys in 48 nursing units, one for nurses and one for managers, asking about the frequency of specific work system failures. PRINCIPAL FINDINGS: Nurses we observed experienced an average of 8.4 work system failures per 8-hour shift. The five most frequent types of failures, accounting for 6.4 of these obstacles, involved medications, orders, supplies, staffing, and equipment. Survey questions asking nurses how frequently they experienced these five categories of obstacles yielded similar frequencies. For an average 8-hour shift, the average task time was only 3.1 minutes, and in spite of this, nurses were interrupted mid-task an average of eight times per shift. CONCLUSIONS: Our findings suggest that nurse effectiveness can be increased by creating improvement processes triggered by the occurrence of work system failures, with the goal of reducing future occurrences. Second, given that nursing work is fragmented and unpredictable, designing processes that are robust to interruption can help prevent errors.

Cross-Sectional Studies↗

PubMed2006

Advanced practice psychiatric mental health nursing, finding our core: the therapeutic relationship in 21st century.

TOPIC: Increasingly, students from various professional backgrounds are enrolling in Psychiatric Mental Health (PMH) Nursing graduate programs, especially at the post-master's level. Faculty must educate these students to provide increasingly complex care while socializing them as PMH advanced practitioners. PURPOSE: To present how one online program is addressing these issues by reasserting the centrality of the relationship and by assuring it has at least equal footing with the application of a burgeoning knowledge base of neurobiology of mental illness. SOURCES: Published literature from nursing and psychology. CONCLUSIONS: The PMH graduate faculty believes that they have developed strategies to meet this challenge and to help build a PMH workforce that will maintain the centrality of the relationship in PMH practice.

Clinical Competence↗

PubMedDate not supplied

Returning nurses to the workforce: developing a fast track back program.

TOPIC: Fast Track Back: Re-entry into Nursing Practice program. PURPOSE AND SOURCES OF INFORMATION: Describes the development, implementation, and evaluation of a state-of-the-art re-entry program facilitating the return of licensed nonpracticing RNs to the workforce through a quality education program that retools them for the workforce in the areas of pharmacology, skill development using the latest technology, practice standards, and nursing issues. The program consists of didactic content taught via classroom, Internet, skills laboratory, and high fidelity human simulated technology and a clinical component. CONCLUSIONS: The program is a mechanism that enables re-entry nurses to improve skills and competencies necessary to practice in today's healthcare environment.

Academic Medical Centers↗

PubMed2007

Information and human freedom: nursing implications and ethical decision-making in the 21st century.

With globalization and the increasing volume of healthcare information available to people, questions surface as nurses contemplate and envision what role and how our nursing theory-guided discipline ought to be lived with colleagues of other disciplines, each other, and those we serve in the 21(st) century. This column begins a path of ethical exploration and possible implications for the opportunities and challenges associated with the information age in nursing research, practice, and education. Discussion focuses on the disciplinary responsibilities for information giving and receiving; coming to know, human freedom, and decision-making in the human-universe-health process.

Access to Information↗

PubMed2006

Health Outcomes for Better Information and Care (HOBIC): integrating patient outcome information into nursing undergraduate curricula.

Nursing-sensitive outcomes provide common information across sectors, thus eliminating duplication that frequently occurs as individuals move across settings. These outcomes also facilitate increased trust among colleagues and support common understandings of patient care needs, thus enhancing continuity of care. Outcomes-oriented information is also likely to increase patient safety and improve overall quality of care. Shared standards and data support consistent decision-making, as nursing decisions can be tracked back over time to assess patient care outcomes. Consequently, nurses will have the means to determine the impact of their interventions on patient outcomes. At the same time, adoption of common approaches to patient assessment leads to greater professional accountability and moves nursing care from a task orientation to an outcomes focus. For administrators, such improvements in monitoring and evaluating patient outcomes translate into improvements in efficiencies and effectiveness, thus providing a return on investment in implementing these outcomes within their agency. For nurses, integration and utilization of outcomes information increases the visibility and significance of their decision-making and patient care. Together with patients, nurses can utilize the outcomes information to make evidence-based decisions and advocate for appropriate care. At an aggregate level, the use of outcomes information creates a continuous feedback loop that is essential to ensuring evidence-based care and the best possible patient outcomes, not only for individuals, but also for families, communities and populations. Outcomes-oriented care provides a gateway for transforming the way we care for patients; puts safe, ethical, high-quality care for patients first; embodies the principles of evidence-based practice; ensures that the value of nursing is clearly understood within the larger system; and ensures that the requirements for measurability and accountability can be achieved. This journey is continuous and is being expanded to engage all other health disciplines in understanding and documenting their contributions to patient care, both as individual practitioners and as members of a healthcare team. Preparing nursing students in an outcomes approach will facilitate systemwide adoption of HOBIC patient outcomes over time and provide a means to determine the impact of nursing care on our patients.

Computer User Training↗

PubMed2005

Teaching with the Nightingale Tracker technology in community-based nursing education: a pilot study.

Changes in health care delivery are becoming increasingly focused on technology. Nursing students are often expected to travel long distances to suitable community sites for clinical experiences, which challenges nurse educators to design and implement instructional strategies to provide students with optimal clinical practice opportunities, while maintaining preceptor-student supervision and vital communication links. This article reports a pilot evaluation of the Nightingale Tracker system, which included both a server and an innovative, hand-held device designed to accommodate multiple forms of data input and allow timely communication between clinical faculty and students in community-based clinical settings. A sample of 5 nursing students reported that the Nightingale Tracker enhanced learning, particularly in performing and documenting physical assessments, data input and transmissions, and autonomous clinical practice.

Adult↗