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At least 559 records · Page 31Linked to original sources
PubMed1993

The role of the data manager in clinical cancer research. An opportunity for nurses.

A clinical trial is a research study conducted in humans and designed to answer specific questions using scientifically controlled methods. These trials require considerable effort to assure that the data obtained are reliable, reproducible, and readily available. Data managers play a key role in this research effort. A nurse with a clinical background, computer knowledge, and some experience in the research environment is well suited for the role of data manager. The data manager performs a variety of tasks in this position that will enhance the quality of the data gathered in a research study. These responsibilities include designing forms, monitoring protocol accrual, abstracting data, entering data onto protocol-specific forms and/or specifically designed computerized data-entry screens, assuring the quality and the integrity of the data, and providing investigators with interim and summary reports. In addition, the data manager can be responsible for the management of a computerized clinical data base system, including the training of users and the designing of basic reports for the investigators. A nurse, functioning as a data manager, who understands research methodology, is detail oriented, and is well organized, could be a valuable asset to the clinical trials team in the successful management of any clinical study.

Clinical Trials as Topic↗
PubMed2006

Evaluation of the KA24 (Knowledge Access 24) service for health and social care staff in London and the south-east of England. Part 2: qualitative.

AIM AND OBJECTIVES: The aim of this two-part paper is to identify the main transferable lessons learned from both the quantitative and qualitative evaluations of the KA24 (Knowledge Access 24) service of online databases and selected full-text journals for health and social care staff in London and the south-east of England. The objectives of the qualitative evaluation were to assess the enablers and barriers to usage, and to assess the impact of the service on patient care. METHODS: Telephone interviews (n = 65) and a questionnaire survey (n = 296) were conducted with various types of user, in various Trust settings. Some non-users were also contacted. Selection of interviewees and questionnaire recipients was not random, and aimed to cover all groups of users representatively. RESULTS: Results show that policy goals were being delivered, with indications of changes to clinical practice, and improved clinical governance. Promotion, training and support needs to be extensive, and tailored to needs, but users are not always aware they need training. The sharing of passwords cast doubts on the reliability of some usage data. CONCLUSIONS: Digital health library services, delivered at the point of care, are changing the way some clinicians practise. A combination of qualitative and quantitative evaluation methods are needed to assess digital library services.

Computer Literacy↗
PubMed1997

Nursing systems '97. Time for new thinking.

The nursing information systems challenge in 1997 is to identify and implement technology and information systems solutions that provide more breadth, depth, flexibility and standardization than ever before, and at a faster pace. To meet the challenge we need more than application checklists. We need to challenge the old approaches to defining needs, implementing systems and training users. Nurses must be educated, involved and accountable for the integration of systems into the patient care process. It's time for new thinking; it's time to ask why we are doing things the same way we did them 20 years ago when everything else about healthcare has changed.

Catalogs, Commercial as Topic↗
PubMed1999

Uniforming of outpatient health care statistics.

In the process of developing the health care information system, the Public Health Institute of the Republic of Slovenia harmonized the outpatient health care statistics at the national level. This paper presents the goals, contents, methodology and a brief analysis of the new data structure. The main functions of the ZUBSTAT computer program, user training methods, and planned further activities in this field are described.

Adolescent↗
PubMed1997

A strategy for empowerment: the role of midwives in computer systems implementation.

The procurement and implementation of patient administration systems has been done on numerous occasions in the past. The Rotunda project however encompassed major bespoke clinical developments which were going to impact upon large clusters of midwives, and medical staff to a lesser extent. A broad based four level structured methodology was used to implement the project which is significantly ahead of schedule. This methodology together with its strengths and weaknesses is comprehensively discussed. The empowerment of midwives, their roles in systems analysis and design, software testing and organisational re-engineering is described. The importance of undertaking comprehensive computer training is highlighted and a compact 10 h information technology course coupled with ongoing educational and related activities which could be adopted by any organisation is documented. The seven deadly sins of project management are mapped out. An update on benefits realisation is provided. Gender issues are also discussed.

Computer Systems↗
PubMedDate not supplied

Application of clinical workstations: functionality and usability.

Clinical workstations are software systems that support physicians and nurses in all their specific activities concerned with the medical care of inpatients. In the university hospital of Saarland, we are testing several commercial systems so as to whether they can give such comprehensive support. For their evaluation, we developed a list of criteria grouped in functions to support the physicians, functions to support the nurses, and general functions, together with a grading schema. Besides scope and quality of functions, the acceptance of clinical workstations strongly depends on organizational environment and human factors. To evaluate these conditions, we interviewed all people concerned with the system, using a checklist. The following are examples of problems that we detected: "Facts" (new design of work flow, eg, for examination or nursing procedures); some tasks have to be performed twice; reaction to emergencies; frequent changes of staff. Technical deficiencies (response times too long; mobile data collection was insufficient due to width of display and lack of data consistency, eg, during the doctor's visit). Psychological factors (fear of using computers; statements such as "Medical work cannot be planned" or "Too few benefits from the system"; in view of increasing "transparency," no use for electronic scheduling; insufficient understanding of work flow of automated tasks). The consequences of this study are the introduction of clinical workstations in hospital needs, as well as reengineering the business processes of the ward as a careful and intensive training of staff. This article will present and discuss methods and results of this evaluation study.

Attitude of Health Personnel↗
PubMed1994

Major issues in user interface design for health professional workstations: summary and recommendations.

Lack of good user interfaces has been a major impediment to the acceptance and routine use of health-care professional workstations. Health-care providers, and the environment in which they practice, place strenuous demands on the interface. User interfaces must be designed with greater consideration of the requirements, cognitive capabilities, and limitations of the end-user. The challenge of gaining better acceptance and achieving widespread use of clinical information systems will be accentuated as the variety and complexity of multi-media presentation increases. Better understanding of issues related to cognitive processes involved in human-computer interactions is needed in order to design interfaces that are more intuitive and more acceptable to health-care professionals. Critical areas which deserve immediate attention include: improvement of pen-based technology, development of knowledge-based techniques that support contextual presentation, and development of new strategies and metrics to evaluate user interfaces. Only with deliberate attention to the user interface, can we improve the ways in which information technology contributes to the efficiency and effectiveness of health-care providers.

Cognition↗
PubMedDate not supplied

Diabetes intervention in the information age.

Sustained improvement in blood glucose control is the only treatment outcome which will reduce or eliminate the long term complications of diabetes mellitus. We have designed and evaluated an electronic information system which facilitates this task. The system is voice-interactive, physician directed and affords, to remote patients, 24 h access via touch-tone telephone. Accordingly, patients access the system each day to report self-measured blood glucose levels or hypoglycaemic symptoms together with dietary changes, planned exercise, stress, illness or other lifestyle events. In turn they receive immediate advice with respect to medication dosing changes, and other pertinent feedback. Preliminary system beta-testing for safety and efficacy was performed for one year in an open study of 204 patients derived from two independent, health-care environments. Among the two testing centres, over 60,000 telephone cells were received by the computer systems during the start-up year. Safety and efficacy expectations were met. In addition, prevalence of diabetes related crises (hyperglycaemia or hypoglycaemia) fell approximately 3-fold. Glycated haemoglobin fell significantly (1.0-1.3%) in patients actively using the system. In control groups of patients not actively using the system, there were no improvements in metabolic control while body weights were stable in all groups. The new system was safe and effective in our hands and empowered our health professionals to provide improved diabetes care.

Algorithms↗
PubMed1998

Implementing enterprisewide databases: a challenge that can be overcome.

The evolving health care industry is placing new demands on its participants. Traditional institutional boundaries are being replaced by the need to cooperate, collaborate, and share increasingly scarce resources to provide high-quality care to patients. Information, which historically was coveted and protected, must now be shared by the multiple providers and organizations that together provide services. This need to share information has brought on the need for organizations to build common databases from which reports can be run, trends can be noted, and patient information can be drawn. Data warehouses and clinical data repositories are being recognized as solutions to issues of segregation of information. Both solutions are relatively new to health care, and there is acknowledgment that neither is simple to implement and that both represent new challenges to health care organizations. The article provides working definitions of the two solutions, describes at a high level some of the challenges associated with their implementation, and provides some of the key steps required to develop, implement, and realize the benefits of the clinical data repository or data warehouse.

Computer User Training↗
PubMed1999

The transition to automated practitioner order entry in a teaching hospital: the VA Puget Sound experience.

We recently installed an automated practitioner order entry system on our busiest inpatient wards and critical care units. The installation followed 20 months preparation in which we created the workstation, network, and host infrastructure, developed requisite policies, recruited personnel to support the system, and installed the software in areas where the pace of order entry was less intense. Since implementing automated order entry, we have experienced problems such as an increase in time required for practitioners to enter orders, workflow changes on inpatient units, difficulties with patient transfers, and others. Our user support system has been heavily used during the transition period. Software tailoring and enhancements designed to address these problems are planned, as is installation of the order entry system in remaining clinical units in our medical centers.

Attitude to Computers↗
PubMed1997

Information-seeking behavior of health sciences faculty: the impact of new information technologies.

This paper reports on an ongoing investigation into health sciences faculty's information-seeking behavior, including their use of new information technologies. A survey was administered to all faculty in medicine, nursing, and pharmacy at the University of Illinois at Chicago. It was similar to one administered to the same population in 1991. The survey asked about faculty's use of electronic resources, documented any shift from the use of print to electronic formats, and measured the utilization of library training. The response rate was 48.5% for medicine faculty, 45.0% for nursing, and 62.5% for pharmacy. The study found that use of the print Index Medicus among faculty was in transition: While 30.5% continued to use the print resources, 68.0% of faculty accessed MEDLINE through electronic means. Faculty preferred accessing electronic databases from their offices to doing so from the library. Health sciences faculty used a wide variety of databases, in addition to MEDLINE, to fill their information needs. Most faculty did not take advantage of either in-house or electronic training sessions offered by librarians. The study concluded that the training preferences of faculty need to be further explored.

CD-ROM↗
PubMedDate not supplied

From hard copy to computer integration: developing clinical indicators for quality improvement.

The Clinical Indicator Workbook is a computerized tool that allows users to develop measures of healthcare quality. The electronic workbook, which includes selected clinical indicators to measure various aspects of patient care and teaching examples, was developed by using a major word processing package and uses a point-and-click feature. Its distribution and installation are managed by a program that enables users to select one of three options: (a) installation of the required files and indicator documents, (b) duplication of material on two diskettes for future distribution within the user's facility, and (c) on-line help. Once the workbook is installed, users are able to copy and customize the indicators for use with interdisciplinary teams in clinical settings. A survey of initial users, who are, for the most part, quality managers in the Veterans Affairs system, indicated that they are satisfied with this tool overall.

Computer User Training↗
PubMed1998

An educational program in the medical uses of computers for rural physicians.

The Medical College of Ohio and three rural hospitals co-sponsored three educational programs in the medical applications of computers for rural physicians in Northwest Ohio. The College's Outreach Librarian played a major role in the programs. These programs were significant and possibly unique because of the comprehensiveness of the material presented and their focus on training rural physicians. Topics covered in the programs included: basic computer skills; online catalogs; online databases; CD-ROMs; the World Wide Web; and e-mail.

Area Health Education Centers↗
PubMed1998

A survey of computer technology utilization in school nursing.

Computer technology offers a solution to problems associated with paper-based health records. The purposes of this descriptive study were to identify the utilization of and support for computer technology in managing student health data and documenting school nurse practice. Findings from a sample of school nurse respondents to the Computer Technology and School Nursing Survey (CTSNS) indicated that of the 65% that used computers, nearly two-third used computers for three years or less. Although there was an increase in computer use when compared with an earlier study, more training, financial support, and research are needed for optimal utilization of computer technology.

Attitude of Health Personnel↗
PubMed2006

The Berlin Brain-Computer Interface: EEG-based communication without subject training.

The Berlin Brain-Computer Interface (BBCI) project develops a noninvasive BCI system whose key features are 1) the use of well-established motor competences as control paradigms, 2) high-dimensional features from 128-channel electroencephalogram (EEG), and 3) advanced machine learning techniques. As reported earlier, our experiments demonstrate that very high information transfer rates can be achieved using the readiness potential (RP) when predicting the laterality of upcoming left- versus right-hand movements in healthy subjects. A more recent study showed that the RP similarily accompanies phantom movements in arm amputees, but the signal strength decreases with longer loss of the limb. In a complementary approach, oscillatory features are used to discriminate imagined movements (left hand versus right hand versus foot). In a recent feedback study with six healthy subjects with no or very little experience with BCI control, three subjects achieved an information transfer rate above 35 bits per minute (bpm), and further two subjects above 24 and 15 bpm, while one subject could not achieve any BCI control. These results are encouraging for an EEG-based BCI system in untrained subjects that is independent of peripheral nervous system activity and does not rely on evoked potentials even when compared to results with very well-trained subjects operating other BCI systems.

Algorithms↗