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Implementing an informatics system in a perioperative environment.

This article identifies and describes strategies for successful implementation of an informatics system in a perioperative environment. With the trend toward managed care, perioperative nurses must address the challenge of instituting advanced technology in organizations with limited staffing and other resources. Planning methods of the past no longer are relevant in today's health care systems; therefore, innovative planning approaches are important. Five key elements in implementation of an informatics system are: a collaborative planning process, education and involvement of staff members regarding the systems design, development of a timetable, selection of a focus group, and assessment of staff members' training requirements. Methods are described for using a focus group process, including recommendations for structuring the focus group and establishing responsibilities of core group members.

Computer User Training↗

Data quality of general practice electronic health records: the impact of a program of assessments, feedback, and training.

OBJECTIVE: The aim of this study was to investigate the impact of a program of repeated assessments, feedback, and training on the quality of coded clinical data in general practice. DESIGN: A prospective uncontrolled intervention study was conducted in a general practice research network. MEASUREMENTS: Percentage of recorded consultations with a coded problem title and percentage of patients receiving a specific drug (e.g., tamoxifen) who had the relevant morbidity code (e.g., breast cancer) were calculated. Annual period prevalence of 12 selected morbidities was compared with parallel data derived from the fourth National Study of Morbidity Statistics from General Practice (MSGP4). RESULTS: The first two measures showed variation between practices at baseline, but on repeat assessments all practices improved or maintained their levels of coding. The period prevalence figures also were variable, but over time rates increased to levels comparable with, or above, MSGP4 rates. Practices were able to provide time and resources for feedback and training sessions. CONCLUSION: A program of repeated assessments, feedback, and training appears to improve data quality in a range of practices. The program is likely to be generalizable to other practices but needs a trained support team to implement it that has implications for cost and resources.

Computer User Training↗

Problems facing the radiologist tendering for a hospital wide PACS system.

As PACS becomes a reality the practical difficulties of installing the new technology become evident. The practical issues of developing a strategy, understanding the market, writing a business case, and an outline based specification are considered. The complexities of European procurement, the evaluation of responses, the contracting process and the problems of implementation, training, assessing the benefits and foreseeing the problems are covered. Provided there is careful attention to detail a hospital can expect to implement a successful PACS system.

Competitive Bidding↗

Study of basic computer competence among public health nurses in Taiwan.

Rapid advances in information technology and media have made distance learning on the Internet possible. This new model of learning allows greater efficiency and flexibility in knowledge acquisition. Since basic computer competence is a prerequisite for this new learning model, this study was conducted to examine the basic computer competence of public health nurses in Taiwan and explore factors influencing computer competence. A national cross-sectional randomized study was conducted with 329 public health nurses. A questionnaire was used to collect data and was delivered by mail. Results indicate that basic computer competence of public health nurses in Taiwan is still needs to be improved (mean = 57.57 +- 2.83, total score range from 26-130). Among the five most frequently used software programs, nurses were most knowledgeable about Word and least knowledgeable about PowerPoint. Stepwise multiple regression analysis revealed eight variables (weekly number of hours spent online at home, weekly amount of time spent online at work, weekly frequency of computer use at work, previous computer training, computer at workplace and Internet access, job position, education level, and age) that significantly influenced computer competence, which accounted for 39.0 % of the variance. In conclusion, greater computer competence, broader educational programs regarding computer technology, and a greater emphasis on computers at work are necessary to increase the usefulness of distance learning via the Internet in Taiwan. Building a user-friendly environment is important in developing this new media model of learning for the future.

Adult↗

An exploratory study to assess the computer knowledge, attitude and skill among nurses in health care setting of a selected hospital in Ludhiana, Punjab, India.

Explorative study conducted to assess and identify deficit areas of computer knowledge, attitudes and skills among nurses working in the hospital and to examine the relationship among these factors. 120 staff nurses were surveyed by systematic random sampling. Computer knowledge, attitudes and skills were measured by a self-structured computer knowledge questionnaire, computer attitude and skill scale respectively. Data analysis showed that the majority 75% staff nurses had good computer knowledge. 100% of nurses had positive attitudes towards computer utilization. 50.8% and 30.8% had average and fair computer skills respectively. No significant correlation was found between nurses' computer knowledge, attitude and skills. The relationships of computer knowledge, attitude and skill were analyzed among nurses with the selected variables like age, sex, designation, years of nursing service, professional qualification, area of nursing service, type of computer training received, frequency of computer usage and monthly family income. Strategies to enhance nurses' computer knowledge, attitudes and skills were proposed.

Attitude of Health Personnel↗

Republican Scientific-Medical Library, The Republic of Armenia: progress and programs.

In 1990, the Republican Scientific-Medical Library (RSML) of the Ministry of Health of Armenia in collaboration with the Fund for Armenian Relief created a vision of a national library network supported by information technology. This vision incorporated four goals: (1) to develop a national resource collection of biomedical literature accessible to all health professionals, (2) to develop a national network for access to bibliographic information, (3) to develop a systematic mechanism for sharing resources, and (4) to develop a national network of health sciences libraries. During the last decade, the RSML has achieved significant progress toward all four goals and has realized its vision of becoming a fully functional national library. The RSML now provides access to the literature of the health sciences including access to the Armenian medical literature, provides education and training to health professionals and health sciences librarians, and manages a national network of libraries of the major health care institutions in Armenia. The RSML is now able to provide rapid access to the biomedical literature and train health professionals and health sciences librarians in Armenia in information system use. This paper describes the evolution of the RSML and how it was accomplished.

Armenia↗

TNEEL workshop. Interactive methods for teaching end-of-life care.

Nurse educators have identified lack of end-of-life content as a serious deficit in undergraduate nursing education. TNEEL, a new software program with tools for teaching end-of-life topics, was created to help educators overcome this problem. The authors implemented an experiential workshop to help educators learn how to use TNEEL's wide variety of educational tools. Trainers provided information about TNEEL and coached participants (N = 94) as they practiced using laptop computers to increase their familiarity and comfort in using the toolkit. Workshop participants completed pre- and posttest evaluations addressing their opinions and beliefs about using this computer tool. Findings support the workshop as an effective way to facilitate adoption of this innovative educational resource and support the development of a nation-wide training plan for TNEEL with experiential workshops.

CD-ROM↗

A new Internet resource for chronic kidney disease patients.

This paper focuses on the development of a portal in the World Wide Web (WWW), which captures and locates quality information for patients with chronic kidney disease (CKD). It examines the problems patients face when accessing and understanding information gleaned from Web sites and describes an idea from a Research Board Member to facilitate patient access to quality information. The idea germinated into the development of a patient specific Web site, providing one stop access and links to appropriate CKD information, assessed by patients and health professionals. Collaboration between the EDTNA/ERCA Research Board and CEAPIR the European Federation of Kidney Patients has enhanced the project.

Computer Literacy↗

Information technology education for health professionals: opportunities and challenges.

Computer applications are on the increase in virtually every aspect of health care, from the routine management of information to clinical diagnoses or clinical decision making. Indeed, the use of computers extends from patient monitoring and point-of-care testing to basic and applied research. Given the ubiquity of computers in health care, it is crucial that health professions education programs provide students with the computer proficiencies they need to apply to their roles as health professionals. This article highlights the importance of such training. It also provides results of two separate needs assessment surveys, and presents curriculum design strategies and competencies to meet health care's present and emerging information technology needs.

Computer User Training↗

Using training needs analysis to implement change.

This article describes the application of a systematic approach to training needs analysis prior to a major change in practice. The authors suggest that such a systematic approach is a central component in the successful management of change.

Attitude to Computers↗

A comparison of teaching strategies for integrating information technology into clinical nursing education.

As health care becomes more information-intensive and diverse, there is a need to integrate information technology (IT) into clinical education. Little is known, however, about how to design instructional strategies for integrating information technology into clinical nursing education. This article outlines the instructional strategies used by faculty in five nursing programs who taught students to use a point-of-care information technology system. The article also reports students' computer acceptance and summarizes IT clinical teaching recommendations.

Adult↗

Information Management and Technology (IM&T): training provision in postgraduate medical education.

Information Management and Technology (IM&T) is assuming a greater role within the modern NHS and there is an increasing need for members of the medical, and other health care, professions to receive appropriate training and education in these areas. Over half the Postgraduate Deans, Regional Advisers in General Practice and the Medical Royal Colleges have made a conscious decision to supply training in IM&T-related areas. These courses are open to a wide range of health care professionals. However, the number of reported places is not adequate for the large number of people who require the training. Less than half the organizations employed staff with a remit to provide training but over half provided courses in collaboration with educational establishments. As the medical undergraduate curriculum changes and incorporates training in computer skills, the links between the postgraduate institutions and medical schools must be fostered and developed. This will lead to increasing opportunities for health professionals both in the range of subjects and the number of places available.

Computer User Training↗

Laboratory cross training needs assessment.

OBJECTIVE: To define the continuing education topics and methods in the area of chemistry and hematology, that if developed, would best support the cross-training needs of hospital based laboratories in the State of Georgia. DESIGN: A cross sectional study of hospital based laboratories in Georgia was completed using surveys sent to 181 hospital laboratory managers and administrators. Descriptive statistics were used to evaluate the survey results. SETTING: Department of Medical Technology, Medical College of Georgia, Augusta GA. PARTICIPANTS: Laboratory managers and administrators. INTERVENTION: Not applicable. MAIN OUTCOME MEASUREMENTS: Four descriptive outcome measurements were requested from each participant: 1) demographic questions, 2) cross-training topics desired, 3) training material desired, and 4) computer literacy and equipment assessment. RESULTS: Sixty-six surveys were completed and returned in a usable form (36% return rate). Demographically, the respondent group is a representative sample of hospital based laboratories in the State of Georgia with 46% of the respondents from facilities of 100 hospital beds or less. Respondents desired that case study training topics be developed using paper and computer assisted instruction mediums. Additionally, respondents desired that Professional Acknowledgement for Continuing Education (P.A.C.E.) be associated with the training material. They were willing to pay for this administrative service. CONCLUSION: This cross sectional study assessed the cross-training needs of hospital based laboratories in Georgia. Findings will allow educators to focus and develop continuing education packages that best meet the needs of the laboratorian workforce.

Chemistry, Clinical↗

A survey of the computer literacy of undergraduate dental students at a University Dental School in Ireland during the academic year 1997-98.

As dental practice management becomes more computer-based, the efficient functioning of the dentist will become dependent on adequate computer literacy. A survey has been carried out into the computer literacy of a cohort of 140 undergraduate dental students at a University Dental School in Ireland (years 1-5), in the academic year 1997-98. Aspects investigated by anonymous questionnaire were: (1) keyboard skills; (2) computer skills; (3) access to computer facilities; (4) software competencies and (5) use of medical library computer facilities. The students are relatively unfamiliar with basic computer hardware and software: 51.1% considered their expertise with computers as "poor"; 34.3% had taken a formal typewriting or computer keyboarding course; 7.9% had taken a formal computer course at university level and 67.2% were without access to computer facilities at their term-time residences. A majority of students had never used either word-processing, spreadsheet, or graphics programs. Programs relating to "informatics" were more popular, such as literature searching, accessing the Internet and the use of e-mail which represent the major use of the computers in the medical library. The lack of experience with computers may be addressed by including suitable computing courses at the secondary level (age 13-18 years) and/or tertiary level (FE/HE) education programmes. Such training may promote greater use of generic softwares, particularly in the library, with a more electronic-based approach to data handling.

Chi-Square Distribution↗

Application of the Concerns-Based Adoption Model to the installation of telemedicine in a rural Missouri nursing home.

The Concerns-Based Adoption Model (C-BAM) was developed in education for the purpose of implementing innovations and change within the school/college system. This study used the principles of the C-BAM and, for the first time, applied them to the process (implementation/training) and product (computer) of the telemedicine technologies in a rural nursing home setting in Missouri. Three rural counties of the 23 Missouri Telemedicine Network sites were chosen to pilot implementation of the computer as one mode of telemedicine technology. One rural nursing home was enlisted for an in-depth study to examine how telemedicine would affect communication between and among community health professionals. Methodological triangulation was used to study individuals' concerns about and utilization of telemedicine through interviews, participant observations, chart reviews, and the Stages of Concern (SOC) survey. Responses to the SOC over time are reported here. The participants consisted of nursing home employees: administration, nursing, housekeeping, and dietary. Forty-three of 52 employees participated in the SOC survey at Time 1 (preimplementation). Twelve months later, 40 participated in the SOC survey at Time 2. While the majority of respondents expressed awareness of the technology, they also expressed a high concern for informational and personal implications. Concern scores in all subscales decreased at Time 2. Findings from this study provided feedback for the implementation and training phases of the project. Most importantly, findings support the appropriateness of this educational model to the healthcare setting.

Adaptation, Psychological↗

Evolution of an end-user training program.

The University of Illinois at Chicago Library of the Health Sciences has taught end-user classes on the MEDLARS system since early 1985. Registration, class composition, and, most importantly, class organization evolved continuously during the first year of operation. Several feedback mechanisms were used. An examination of the past training and specialization of participants helped to determine teaching examples and pace; a more varied group of participants necessitated a broader range of examples and increased explanations. Participant evaluation forms and oral comments helped define scheduling, agenda, and the need for additional equipment and practice time. Further evaluation will center on the searching done by the program's alumni.

Computer User Training↗

Information technology and information literacy for first year health sciences students in South Africa: matching early and professional needs.

The need to develop skills in Information Technology and Information Literacy for a career in the Health Sciences is not in dispute. More debated are the most appropriate ways of assessing existing skills, addressing training needs and incorporating IT/IL learning, and at what stage skills development should begin to be most effective. This article reports on three years of experience with a training model in the Faculty of Health Sciences, University of Cape Town, in providing IT/IL skills to a diverse group of students in South Africa. It provides an evaluation of the activities and discusses the possible advantages of the methodology. This training model is based on measuring rather than assuming existing computer skills in incoming students; it is informed by curriculum demands and focuses on early intervention and close integration into mainstream undergraduate courses.

Computer Literacy↗