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PubMed1996

Pain management knowledge of hospital-based nurses in a rural Appalachian area.

The American Pain Society cites the failure of health care providers to routinely assess pain and pain relief as the most common reason for unrelieved pain in US hospitals. Lack of knowledge on the part of nurses about pain and its treatment is one of the major barriers to achieving comfort for those in pain. Thus, the purpose of this descriptive study was to determine the pain management knowledge of hospital-based nurses in a rural Appalachian area. The nonpurposive sample consisted of 123 registered nurses. The questionnaire consisted of three sections: demographic items and two instruments designed to measure knowledge of opioid classification and pain management. The overall pain management knowledge score was 67.4%. The findings indicate a knowledge deficit specifically related to the behavioural indicators of pain, classification of opioid analgesics, properties of opioid analgesics and adjuvant medications, and incidence of addiction. This sample of rural nurses demonstrates similar pain management knowledge compared to the reported scores of urban nurses. These results may serve as the impetus to develop strategies to decrease the barriers to effective pain management. Further education about pain management is warranted.

Adult↗
PubMedDate not supplied

Dollar$ & $en$e. Part VI: Knowledge management: the state of the art.

In Part I of this series, I introduced the concept of memes (1). Memes are ideas or concepts--the information world equivalent of genes. The goal of this series of articles is to infect you with memes so you will assimilate, translate, and express them. No matter what our area of expertise or "-ology," we all are in the information business. Our goal is to be in the wisdom business. In the previous articles in this series, I showed that when we convert raw data into wisdom, we are moving along a value chain. Each step in the chain adds a different amount of value to the final product: timely, relevant, accurate, and precise knowledge that then can be applied to create the ultimate product in the value chain--wisdom. In part II of this series, I introduced a set of memes for measuring the cost of adding value (2). In part III of this series, I presented a new set of memes for measuring the added value of knowledge, i.e., intellectual capital (3). In part IV of this series, I discussed practical knowledge management tools for measuring the value of people, structural, and customer capital (4). In part V of this series, I applied intellectual capital and knowledge management concepts at the individual level, to help answer a fundamental question: what is my added value (5)? In the final part of this series, I will review the state of intellectual capital and knowledge management development to date and outline the direction of current knowledge management initiatives and research projects.

Administrative Personnel↗
PubMed2001

Instruments to measure cancer management knowledge of rural health care providers.

BACKGROUND: Instruments to measure cancer management knowledge of rural physicians, nurses, and pharmacists were needed to evaluate the effect of an educational intervention. Since such instruments did not exist, the authors designed and validated a new instrument for each discipline. METHODS: The design and validation process for these instruments are described. RESULTS: These three instruments were shown to be practical and to have high content and construct validity. Content validation demonstrated that all items were rated as essential or useful by 90% or more of the respondents. Construct validation show highly significant differences in mean scores among several levels of learners and practitioners as expected. CONCLUSIONS: These instruments may be useful to other investigators for measuring cancer management knowledge of rural physicians, nurses, and pharmacists.

Analysis of Variance↗
PubMed2004

Using knowledge management practices to develop a state-of-the-art digital library.

Diffusing knowledge management practices within an organization encourages and facilitates reuse of the institution's knowledge commodity. Following knowledge management practices, the Eskind Biomedical Library (EBL) has created a Digital Library that uses a holistic approach for integration of information and skills to best represent both explicit and tacit knowledge inherent in libraries. EBL's Digital Library exemplifies a clear attempt to organize institutional knowledge in the field of librarianship, in an effort to positively impact clinical, research, and educational processes in the medical center.

Academic Medical Centers↗
PubMed2005

Foundations of a healthcare knowledge management application system.

Much of the knowledge management (KM) literature suggests that organizations should adopt either a "personalization" or "codification" strategy and that to mix the two is unwise. Two European schools have come to the conclusion that a broad strategy is needed. Its key conceptual elements are in three dimensions: the type (explicit - tacit), focus (information - learning) and organization (digital - social) of knowledge. Without this broad approach it is impossible to reconcile the wish to provide (codified) evidence-based solutions to populations at the same time as personalized care for individuals.

Hospital Information Systems↗
PubMedDate not supplied

Nurses' retention of pain management knowledge.

Despite efforts to improve nurses' pain management knowledge, a lack of understanding about basic pain management concepts remains. This article presents results of a pilot study about the effectiveness of a pain management education program. Nurses' mean scores on pain management concepts tests increased from 56% to 76%. The scores are still low, and nurses need further education and reinforcement about basic pain management concepts.

Analysis of Variance↗
PubMed2005

Introduction to the special issue on advances in clinical and health-care knowledge management.

Clinical and health-care knowledge management (KM) as a discipline has attracted increasing worldwide attention in recent years. The approach encompasses a plethora of interrelated themes including aspects of clinical informatics, clinical governance, artificial intelligence, privacy and security, data mining, genomic mining, information management, and organizational behavior. This paper introduces key manuscripts which detail health-care and clinical KM cases and applications.

Confidentiality↗
PubMed2026

A flipped classroom approach compared with low-interactive online learning for pediatric pain management knowledge and instructional motivation in nursing students: A randomized controlled study.

AIM: This study aimed to compare a flipped classroom approach with low-interactive online learning in terms of nursing students' questionnaire-assessed pediatric pain management knowledge and instructional motivation. BACKGROUND: Pain management in children is a critical and multidimensional nursing responsibility. However, limited curricular time and opportunities for applied learning may restrict nursing students' preparedness in this area. Structured and interactive instructional formats, such as the flipped classroom, may support knowledge acquisition and motivation in pediatric nursing education. METHODS: This study employed a parallel-group randomized controlled trial design with a 1:1 allocation ratio. Eighty-eight third-year prelicensure nursing students were randomized to either the flipped classroom group (n = 44) or the low-interactive online learning group (n = 44). Due to attrition (2 intervention, 2 control), analyses included 42 participants per group (n = 84 in total). Data were collected between February and July 2022 using the Pediatric Pain Management Knowledge Scale for Nursing Students and the Instructional Materials Motivation Survey. This study was prospectively registered at ClinicalTrials.gov (Identifier: NCT07129044). RESULTS: At baseline, the groups were comparable in terms of knowledge and learning motivation. Following the intervention, the flipped classroom group demonstrated greater improvements in questionnaire-assessed pediatric pain management knowledge and instructional motivation than the low-interactive online learning group. Although scores declined from post-test to the three-month follow-up, they remained above baseline in the flipped classroom group. CONCLUSIONS: Within the context of this course, the flipped classroom approach was associated with greater improvement in questionnaire-assessed pediatric pain management knowledge and instructional motivation than low-interactive online learning. The findings should be interpreted as proximal educational outcomes rather than evidence of improved clinical competence or durable long-term effectiveness. Further studies using objective performance-based outcomes and longer follow-up periods are needed.

Humans↗
PubMed2001

[Knowledge management (I)].

Beyond to be in fashion, the knowledge management (KM) is by itself a powerful strategic weapon for managing organizations. In a first part, the authors analyze strategic concepts related to management, emphasizing the attachment between KM and competitive advantage. Finally, the authors tie the KM to learning process ("tacit knowledge", "socialization", "externalization", "combination", and "internationalization").

Knowledge↗
PubMed2001

The application of knowledge management principles to compliant coding activities.

This article applies the concepts of knowledge management to diagnostic and procedural coding performed by health care providers. The process of diagnostic and procedural coding is both an art and a science. In particular, the information stored away in the minds of individuals performing the coding function is ripe for the basis of an effective knowledge Health Information Management (HIM) coding management system. In this article, we explore the issues and processes that HIM professionals can take advantage of in standardizing the coding function.

Database Management Systems↗
PubMed2002

Just-in-time delivery comes to knowledge management.

Like all primary care physicians, Dr. Bob Goldszer must stay on top of approximately 10,000 different diseases and syndromes, 3,000 medications, 1,100 laboratory tests, and many of the 400,000 articles added each year to the biomedical literature. That's no easy task. And it is, quite literally, a matter of life and death. The Institute of Medicine's 1999 report, To Err Is Human, suggests that more than a million injuries, and 90,000 deaths are attributable to medical errors annually. Something like 5% of hospital patients have adverse reactions to drugs, another study reports, and of those, 43% are serious, life threatening, or fatal. Many knowledge workers have problems similar to Dr. Goldszer's (though they're usually less life threatening). No matter what the field, many people simply can't keep up with all they need to know. In the early years of knowledge management, companies established knowledge networks and communities of practice, built knowledge repositories, and attempted to motivate people to share knowledge. But each of these activities involved a great deal of additional labor for knowledge workers. A better approach, say the authors, is to bake specialized knowledge into the jobs of highly skilled workers. Partners HealthCare has started to embed knowledge into the technology that doctors use in their jobs so that consulting it is no longer a separate activity. Now when Dr. Goldszer orders medicine or a lab test, the order-entry system automatically checks his decision against a massive clinical database as well as the patient's own medical record. Knowledge workers in other fields could likewise benefit from a just-in-time knowledge-management system tailored to deliver the right supporting information for the job at hand.

Benchmarking↗
PubMed1999

Healthcare knowledge management through building and operationalising healthcare enterprise memory.

In this paper we suggest that the healthcare enterprise needs to be more conscious of its vast knowledge resources vis-à-vis the exploitation of knowledge management techniques to efficiently manage its knowledge. The development of healthcare enterprise memory is suggested as a solution, together with a novel approach advocating the operationalisation of healthcare enterprise memories leading to the modelling of healthcare processes for strategic planning. As an example, we present a simulation of Service Delivery Time in a hospital's OPD.

Artificial Intelligence↗
PubMed2002

Knowledge management: evaluating the organizational requirements and culture for an emerging technology.

The purpose of this paper is to explore the application of knowledge management concepts to an information systems (IS) knowledge base, as opposed to a clinical one. The field of Medical Informatics is committed to helping others manage medical information and knowledge through the application of information technology. At Partners HealthCare, a wide variety of clinical information management systems have been built and implemented in complex environments, creating an extensive applied informatics knowledge base. How should healthcare IS departments manage this intellectual capital? That's the question that Partners HealthCare is asking its senior and middle IS managers. This paper reports on an internal survey addressing Knowledge Management (KM) requirements, the potential application of this technology in our organization, and discusses where we are today and where to go from here.

Data Collection↗
PubMedDate not supplied

Managing knowledge workers in clinical systems.

In Future Work, Coates and colleagues cite seven forces that are reshaping work and the workforce. One is the advent of "knowledge workers," who gather, distribute, and add value to information. In health care, the transition to integrated delivery systems, replete with care plans, critical paths, and assessment of clinical outcomes supported by information technology, is driving the need to reeducate for a knowledge-based workforce. Managers of clinical systems need to be familiar with the characteristics of knowledge workers affecting the delivery environment, organizational structure, and culture of an organization. These same managers will be expected to develop strategies to manage the transition to a knowledge-based workforce.

Clinical Laboratory Information Systems↗
PubMed2005

A knowledge management framework to morph clinical cases with clinical practice guidelines.

In this paper we present a knowledge management framework that allows the automatic linking/mapping of contextually and functionally similar medical knowledge that may originate from different sources and be represented in diverse modalities. Our tacit-explicit knowledge morphing framework supports the extraction of tacit knowledge from past cases stored in a case-base and maps it to corresponding explicit knowledge stored in clinical practice guidelines. The novelty of our approach is inherent in the fact that it allows practitioners to simultaneously refer to explicit knowledge-i.e. clinical practice guidelines-and experiential knowledge-i.e. past clinical cases. Here we present the system design and intended functionality of our knowledge morphing framework.

Health Knowledge, Attitudes, Practice↗
PubMed1988

The knowledge workstation: an electronic environment for knowledge management.

This paper focuses on the creation of the IAIMS workstation in the context of the outcomes of a year-long IAIMS strategic planning process at the Johns Hopkins Medical Institutions (JHMI). These outcomes include a long-term institutional vision for a functional knowledge management environment, a JHMI IAIMS model, a strategic plan, and two model prototypes. The functional requirements and specific implementation strategies for the IAIMS workstation, the prototype for managing the knowledge base of the published biomedical literature, are discussed in detail.

Academic Medical Centers↗
PubMed2003

Prioritizing the human genome: knowledge management for drug discovery.

This review covers recent methods to create a manageable subset of drug targets for development by prioritizing novel genes from the Human Genome Project. The ability to organize genomic data into a distinct set of drug discovery assets can be viewed as a form of knowledge management. While bioinformatics systems have been built to manage genomics-based data, the central theme in creating any bioinformatics infrastructure should be organization-specific knowledge management.

Animals↗