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Adopting best practices: "Agility" moves from software development to healthcare project management.

It is time for a change in mindset in how nurses operationalize system implementations and manage projects. Computers and systems have evolved over time from unwieldy mysterious machines of the past to ubiquitous computer use in every aspect of daily lives and work sites. Yet, disconcertingly, the process used to implement these systems has not evolved. Technology implementation does not need to be a struggle. It is time to adapt traditional plan-driven implementation methods to incorporate agile techniques. Agility is a concept borrowed from software development and is presented here because it encourages flexibility, adaptation, and continuous learning as part of the implementation process. Agility values communication and harnesses change to an advantage, which facilitates the natural evolution of an adaptable implementation process. Specific examples of agility in an implementation are described, and plan-driven implementation stages are adapted to incorporate relevant agile techniques. This comparison demonstrates how an agile approach enhances traditional implementation techniques to meet the demands of today's complex healthcare environments.

Adaptation, Psychological↗

Information literacy: developing lifelong skills through nursing education.

The amount and complexity of information nurses are expected to manage continues to increase exponentially. Support has grown for integrated curriculum approaches that include appropriate content on the use of a variety of information formats and instruction using resource-based and process methods. Such teaching-learning approaches demand a major shift in educational paradigms and encompass resource-based learning, undergraduate research, service learning, inquiry learning, and problem-based learning. The implementation of an integrated curriculum promises advanced information skills, access, and use of available evidence to support clinical decision making and a foundation for lifetime learning. In this article, we argue that for information literacy to be enhanced, collaboration between teaching faculty and librarians must be fostered in meaningful ways. We report on the rationale of an integrated curriculum, changes to nursing education, and obstacles to the development and application of advanced information skills that exist within higher education and clinical settings.

Computer Literacy↗

Participation in the International Classification for Nursing Practice (ICNP) programme.

The International Council of Nurses (ICN) is a federation of 129 national nurses associations. The International Classification for Nursing Practice (ICNP) is a programme of the ICN. The purpose of this paper is to describe the development and maintenance processes of the ICNP Programme that are used to increase participation. These include processes by which the ICNP was and continues to be developed, tested, distributed and implemented worldwide, with emphasis on the current version, ICNP Version 1.0. The ICNP is a unified nursing language that facilitates cross-mapping among local terms and existing terminologies. ICNP conforms to current terminology standards and criteria, for example, ISO standards and HL7. The ICNP Alpha and Beta Versions documented the progress of concept validation and classification of nursing phenomena and interventions. The ICNP Beta 2 Version was a combinatorial terminology organized in two multi-axial structures representing nursing phenomena and nursing actions. The ICNP Version 1.0, launched in 2005, changed the relatively straight-forward multi-axial structure into a compositional terminology through the application of description logics using Web Ontology Language (OWL) within Protégé, an ontology development environment. ICNP Version 1.0 is also represented in a multiaxial model (7-Axis) for nurses to compose nursing diagnosis, intervention and outcome statements. Language translations and clinical information systems applications are required to make the ICNP Version 1.0 available to nurses at the point of healthcare delivery. ICNP data collected in healthcare environments provide standardized terminology for nursing that allows comparison of nursing practice across health care settings, specialties and countries; facilitate data-based clinical and management decision making; and contribute to the development of guidelines and standards for best practices and optimal outcomes for patients, families and communities.

Nursing Informatics↗

A technology and nursing collaboration to help older adults age in place.

This is an account of an active collaboration between Computer Engineering, Health Informatics, and Nursing within an academic health science center to improve the quality of life of older adults as they "age in place." The Sinclair School of Nursing at the University of Missouri-Columbia has developed a licensed home health agency, Senior Care, to provide the care needed by residents of TigerPlace, a specially designed independent living center near the University. Technology has the potential to help address common problems encountered by older adults related to functional decline. Collaboration between Nursing, Computer Engineering, and Health Informatics is likely on a path to improve the quality of life of seniors.

Aged↗

Electronic Self-report Assessment--Cancer (ESRA-C): Working towards an integrated survey system.

The Clinical Informatics Research Group and Biobehavioral Nursing and Health Systems at the University of Washington are working with interdisciplinary teams to improve patient care and tracking of patient-reported symptoms and outcomes by creating an extensible web-based survey and intervention platform. The findings and cumulative experience from these processes have led to incremental improvements and variations in each new implementation of the platform. This paper presents progress in the first year of a three-year NIH study entitled Electronic Self Report Assessment--Cancer (ESRA-C). The project's goals are to enhance and evaluate the web-based computerized patient self-reporting and assessment system at the Seattle Cancer Care Alliance. Preliminary work and lessons learned in the modification of the platform and enhancements to the system will be described.

Automation↗

Research to support holistic nursing taxonomies.

A philosophy of holism and the development of nursing taxonomies may appear to have goals that are inconsistent. Taxonomies are typically hierarchic in structure, and their content often consists of atomic level elements rather than holistic concepts. The article explores the development of taxonomies and how they can be enriched by a holistic perspective.

Holistic Nursing↗

[Analysis of the nursing interventions performed by public health nurses in health centers using the NIC].

PURPOSE: The purpose of this study was to identify nursing interventions performed by public health nurses in health centers. METHOD: Data was collected by the taxonomy of Nursing Intervention Classification (NIC 3rd: 486 nursing interventions) from 131 public health nurses in health centers and analyzed using descriptive statistics. RESULT: As its result, more than 50% of public health nurses performed 137 nursing interventions at least monthly. The most frequently used intervention class was "activity and exercise management", followed by "physical comfort promotion", "community health promotion", "life span care", "coping assistance", "self care facilitation", "information management", "nutrition support", "community risk management" and "patient education". One hundred twenty nursing interventions were rarely performed by 90% or more of the nurses. Most of them were in the physical complex domain. CONCLUSION: In conclusion, 137 interventions were performed by public health nurses at least monthly. NIC is helpful to build a standardized language for public health nursing.

Hospitals, Community↗