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PubMed2000

[Technological change and work organization: usage producing competence. Case study of nursing records computerization in a cardiac surgical unit. Haut-Leveque Hospital, Bordeaux].

The computerisation of the nursing care file represents a technological change affecting the tools of the nursing processes. What is its incidence on the working procedures and the actors' knowledge? The computerised file appropriation comes within the scope of the instrumental genesis producing individual and collective skills. It requires the actors' ingenuity, mobilises their subjectivity, and implements co-operation dynamics which reconstruct the activity social dimension. The instrument considered here is a semiotic tool which mediatises the use of nursing methodological aids. It participates in the subject's action as a means of his action. How does the training then meet the demands of the people, the activity and its contexts? Between training logic and apprenticeship, the training proposed in a working situation becomes a training by work at the expense of people's contribution to the multiple collective regulations.

Attitude of Health Personnel↗
PubMedDate not supplied

Project planning, training, measurement and sustainment: the successful implementation of voice recognition.

Computerized voice recognition systems (VR) can reduce costs and enhance service. The capital outlay required for conversion to a VR system is significant; therefore, it is incumbent on radiology departments to provide cost and service justifications to administrators. Massachusetts General Hospital (MGH) in Boston implemented VR over a two-year period and achieved annual savings of $530,000 and a 50% decrease in report throughput. Those accomplishments required solid planning and implementation strategies, training and sustainment programs. This article walks through the process, step by step, in the hope of providing a tool set for future implementations. Because VR has dramatic implications for workflow, a solid operational plan is needed when assessing vendors and planning for implementation. The goals for implementation should be to minimize operational disruptions and capitalize on efficiencies of the technology. Senior leadership--the department chair or vice-chair--must select the goals to be accomplished and oversee, manage and direct the VR initiative. The importance of this point cannot be overstated, since implementation will require behavior changes from radiologists and others who may not perceive any personal benefits. Training is the pivotal factor affecting the success of voice recognition, and practice is the only way for radiologists to enhance their skills. Through practice, radiologists will discover shortcuts, and their speed and comfort will improve. Measurement and data analysis are critical to changing and improving the voice recognition application and are vital to decision-making. Some of the issues about which valuable date can be collected are technical and educational problems, VR penetration, report turnaround time and annual cost savings. Sustained effort is indispensable to the maintenance of voice recognition. Finally, all efforts made and gains achieved may prove to be futile without ongoing sustainment of the system through retraining, education and technical support.

Certification↗
PubMed2005

Workflow analysis in primary care: implications for EHR adoption.

Within busy practice settings, it is difficult to provide adequate provider training on evolving electronic health record (EHR) functionality. As a result, providers may not reap the full benefits of EHR. This poster presents a systematic workflow study conducted to enhance the adoption of advanced EHR features. This study led us to develop new adoption and training strategies, which resulted in statistically significant (p<0.03) improvement in the adoption of advanced results management features.

Computer User Training↗
PubMed1998

Audit of computer literacy and skills.

Information technology (IT) has radically changed the way that many people work and think. This audit was designed to evaluate the IT skills and training needs of different professional groups. Most clerical staff but only about 33% of medical and nursing staff were able to use the current patient information system. 72% of the staff were interested in further training in information technology skills. The local college agreed to come to the hospital to run the CLAIT (Computer Literacy and Information Technology) course on our premises.

Attitude to Computers↗
PubMedDate not supplied

Nursing informatics: the trend of the future.

Nursing informatics is a combination of computer, information, and nursing sciences. This new and expanding field addresses the efficient and effective use of information for nurses. Preparing nurses for computerization is essential to confront an explosion of sophisticated computerized technology in the workplace. It is critical in a competitive health care market for preparing nurses to use the most cost-effective methods. A model is presented that identifies six essential factors for preparing nurses for computerization. Strong leadership, effective communication, organized training sessions, established time frames, planned change, and tailored software are the essential factors to consider for development of a successful educational program.

Computer User Training↗
PubMed2003

User acceptance of an anaesthesia information management system.

BACKGROUND AND OBJECTIVE: This paper describes the user acceptance of an anaesthesia information management system at the University Hospital in Giessen, Germany, after 5 yr of routine use. METHODS: A questionnaire with 75 items was distributed to all anaesthesiologists and anaesthetic nurses of the Department of Anaesthesiology. The questions were answered anonymously on a five-point Likert scale. RESULTS: The return rate was 60% (44 physicians and 24 nurses). The results indicated that the system generally met user expectations. The respondents thought that electronic record keeping improved the quality of their work, and they did not want to switch back to paper records. Problems arose with hardware placement and software features, e.g. coding tools for diagnoses and type of surgery. The perceived quality of training strongly influenced user acceptance. CONCLUSIONS: Despite the deficits revealed by the survey, the respondents did not want to switch back to manual record keeping. A structured user survey is a useful tool for the development, adaptation and implementation of an anaesthesia information management system. A training strategy that takes the needs of the users into account is recommended.

Adult↗
PubMedDate not supplied

Designing an EMR planning process based on staff attitudes toward and opinions about computers in healthcare.

Electronic medical record (EMR) systems have been in use for more than 2 decades. Studies documenting nursing satisfaction with an EMR system, the benefits of an EMR, implementation barriers, user acceptance, the importance of staff buy-in, and the importance of attitudes toward and expectations from user buy-in are in the literature. Central to many studies is the importance of nursing staff buy-in to the successful implementation and ongoing use of an EMR, as well as the dependency of buy-in on staff attitudes and expectations. Buy-in is a precursor to effective use. Consequently, staff buy-in is a prerequisite to collecting and making optimum use of the data contained in an EMR. Data collected from an EMR containing rich, accurate documentation of nursing interventions and patient responses support evidence-based practice changes and documentation of the import of the care provided by nurses.

Attitude of Health Personnel↗
PubMedDate not supplied

Information technology in complex health services: organizational impediments to successful technology transfer and diffusion.

OBJECTIVE: To identify impediments to the successful transfer and implementation of packaged information systems through large, divisionalized health services. DESIGN: A case analysis of the failure of an implementation of a critical application in the Public Health System of the State of New South Wales, Australia, was carried out. This application had been proven in the United States environment. MEASUREMENTS: Interviews involving over 60 staff at all levels of the service were undertaken by a team of three. The interviews were recorded and analyzed for key themes, and the results were shared and compared to enable a continuing critical assessment. RESULTS: Two components of the transfer of the system were considered: the transfer from a different environment, and the diffusion throughout a large, divisionalized organization. The analyses were based on the Scott-Morton organizational fit framework. In relation to the first, it was found that there was a lack of fit in the business environments and strategies, organizational structures and strategy-structure pairing as well as the management process-roles pairing. The diffusion process experienced problems because of the lack of fit in the strategy-structure, strategy-structure-management processes, and strategy-structure-role relationships. CONCLUSION: The large-scale developments of integrated health services present great challenges to the efficient and reliable implementation of information technology, especially in large, divisionalized organizations. There is a need to take a more sophisticated approach to understanding the complexities of organizational factors than has traditionally been the case.

Computer User Training↗
PubMed2005

Web services and workflow management for biological resources.

BACKGROUND: The completion of the Human Genome Project has resulted in large quantities of biological data which are proving difficult to manage and integrate effectively. There is a need for a system that is able to automate accesses to remote sites and to "understand" the information that it is managing in order to link data properly. Workflow management systems combined with Web Services are promising Information and Communication Technologies (ICT) tools. Some have already been proposed and are being increasingly applied to the biomedical domain, especially as many biology-related Web Services are now becoming available. Information on biological resources and on genomic sequences mutations are two examples of very specialized datasets that are useful for specific research domains. RESULTS: The architecture of a system that is able to access and execute predefined workflows is presented in this paper. Web Services allowing access to the IARC TP53 Mutation Database and CABRI catalogues of biological resources have been implemented and are available on-line. Example workflows which retrieve data from these Web Services have also been created and are available on-line. CONCLUSION: We present a general architecture and some building blocks for the implementation of a system that is able to remotely execute workflows of biomedical interest and show how this approach can effectively produce useful outputs. The further development and implementation of Web Services allowing access to an exhaustive set of biomedical databases and the creation of effective and useful workflows will improve the automation of in-silico analysis.

Animals↗
PubMed1990

The effects of analogical training models and age on problem-solving in a new domain.

Young and middle-aged adults learned a microcomputer drawing package either with or without an analogical model of the package. Following training, problem-solving flexibility was assessed. Although no age differences were obtained following no-model training, middle-aged subjects performed worse than young subjects following model-based training. These results support the hypothesis that model-based training encourages elaboration and abstraction processes, and that older adults are less likely or less able to engage in such processing.

Adult↗
PubMed2000

Information dissemination and training: two key issues for consolidating and strengthening the results of health telematic projects.

The concepts expressed in this paper concerns the activities to be developed within HEALTHLINE, a European project under the Telematics Application programme. HEALTHLINE is an umbrella project which takes initiatives and provides links to other international projects on health telematics. The projects involved are NIVEMES and RISE; they represent the starting point from which a common approach will be developed. The experience gained from these projects has highlighted two emerging requirements: information dissemination and training. To fulfil the needs of information, an Internet corner will be set up; it will allow citizens and health professionals to find and exchange information as well as to discuss themes concerning health care. Due to the most advanced technologies recently introduced, the Health care sector has had to modify its traditional ways of working to aid professionals in exploiting new training techniques and Health Care provision methods. HEALTHLINE will focus on training and on the development of the use of new tools and services. Furthermore, the project will exploit the training methodologies based on multimedia technology for developing training-on-the-job modules. The entire system, in its final stage, will consist of a network for co-operating training and information dissemination; European sites in the project will share information, training material and provide education and information on tele-health, medical and health-care issues to health care providers, beneficiaries and the general public.

Computer User Training↗
PubMed1999

Improving computer skills to support hospital restructuring.

A vital part of restructuring in hospitals is a continuing effort to find ways to meet the growing demands of caregivers for efficient ways to enter and retrieve patient information. The process of effectively meeting these demands was coordinated through the leadership and efforts of the chief nurse executive and the information manager for nursing at New York Veterans Affairs Medical Center. These efforts resulted in timely support for restructuring, improvement in the development of competency skills among nursing staff, and increase in the use of electronic methods for documentation of patient care. Discussion of the changes implemented include approaches and content of training for computer skills development, a position description for an expanded role of a nurse in the field of informatics, and the facility's structure that fits a patient-centered care model.

Computer User Training↗
PubMedDate not supplied

The importance of informatics competencies in nursing: an Australian perspective.

Over the past two decades, dramatic changes have occurred in the nature and extent of communication and information technology use in nursing worldwide. The need for student nurses to be well prepared for the use and application of information technology in nursing is arguably now paramount. This article details areas where information and communication technology is used in nursing in Australia and discusses why nurses must be diligent in maintaining skills in this area to facilitate the delivery of safe, quality care in any healthcare setting. It will then discuss the importance of information and communication technology (ICT) skills, knowledge and understanding as an integral aspect of nursing programs in tertiary institutions. The challenge for training providers to prepare nurses for ever-changing ICT technology and technological applications in their workplace is highlighted.

Attitude of Health Personnel↗
PubMedDate not supplied

Implementation of physician order entry: user satisfaction and self-reported usage patterns.

OBJECTIVES: To evaluate user satisfaction, correlates of satisfaction, and self-reported usage patterns regarding physician order entry (POE) in one hospital. DESIGN: Surveys were sent to physician and nurse POE users from medical and surgical services. RESULTS: The users were generally satisfied with POE (mean = 5.07 on a 1 to 7 scale). The physicians were more satisfied than the nurses, and the medical staff were more satisfied than the surgical staff; satisfaction levels were acceptable (more than 3.50) even in the less satisfied groups. Satisfaction was highly correlated with perceptions about POE's effects on productivity, ease of use, and speed. POE features directed at improving the quality of care were less strongly correlated with satisfaction. The physicians valued POE's off-floor accessibility most, and the nurses valued legibility and accuracy of POE orders most. Some features, such as off-floor ordering, were perceived to be highly useful and reported to be frequently used by the physicians; while other features, such as "quick mode'' ordering and personal order sets, received little self-reported use. CONCLUSIONS: Survey of POE users showed that satisfaction with POE was good. Satisfaction was more correlated with perceptions about POE's effect on productivity than with POE's effect on quality of care. Physicians and nurses constitute two very different types of users, underscoring the importance of involving both physicians and nonphysicians in POE development. The results suggest that development efforts should focus on improving system speed, adding on-line help, and emphasizing quality benefits of POE.

Attitude of Health Personnel↗