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PubMed1989

Teaching medical informatics: teaching on the seams of disciplines, cultures, traditions.

This paper reviews different concepts of medical informatics and identifies two families of approaches to education in it: a "specialist" approach, whereby medical informatics is taught as a specialization track for established disciplines like medicine, computer science, nursing, engineering, etc., and a "generalistic" approach, whereby it is taught as an integrated discipline incorporating essential traits of the aforementioned disciplines. The pros and cons of these approaches are outlined. The need to accommodate specific requirements of education is emphasized and these are identified, together with an outline of particular challenges that we are facing.

Attitude to Computers↗
PubMed1997

Nursing intervention intensity and focus: indicators of process for outcomes studies.

Outcomes research has become increasingly important in the current health care environment and for informatics research efforts. Recent efforts in automating clinical data for use in outcomes studies has focused attention on the need to represent the processes of care in the classic structure-process-outcome models of care. This paper reports on use of the Nursing Intervention Lexicon and Taxonomy for classifying interventions to characterize two process of care variables: intervention intensity and intervention focus. Study results demonstrate that these variables are descriptive and provide promise for describing processes of nursing care for describing clinical care.

Breast Neoplasms↗
PubMed2005

Reduction in neonatal intensive care unit admission rates in a Medicaid managed care program.

BACKGROUND: Neonatal intensive care unit admission rates are an important birth outcome indicator for Medicaid managed care organizations. OBJECTIVES: To reduce neonatal intensive care unit admission rates by at least 15% and to maintain that reduction through implementation of a quality improvement program. STUDY DESIGN: The organization performed a longitudinal population-based review of its birth outcomes from 1997 through 2003, focusing on neonatal intensive care unit admission rates. The return-on-investment evaluation reflected attributable incremental program costs and resultant savings. METHODS: Interventions included enhanced identification and stratification of high-risk women with the use of a health risk assessment form; outreach through nursing care coordination offering home visits, transportation, support services, social work services, and connection with other community-based organizations; and implementation of a strong informatics structure. RESULTS: Neonatal intensive care unit admission rates decreased from 107.6 per 1000 births in 1998 to 56.7 per 1000 births in 2003. The return on investment from the incremental program enhancements was just over dollars 2 per dollars 1 expended. CONCLUSION: A program that identifies its high-risk pregnant enrollees in a timely fashion, provides outreach using a strong nursing care coordination and social work emphasis, and has an enhanced informatics structure can significantly affect birth outcomes for a Medicaid managed care population.

Health Services Research↗
PubMedDate not supplied

Implementing information technology in a behavioral health setting.

The art and practice of nursing in today's health care arena is becoming increasingly complex. One of the newest challenges in the field of behavioral health is the integration of quality health care with information technology. The authors of this paper examine four emerging aspects of information technology: the electronic medical record, automated medication distribution systems, computerized charting, and hand-held computers. The benefits, costs, uses of these technologies, and the potential problems they can provide in the field of behavioral health are discussed. Implications for nursing practice also are explored.

Behavioral Medicine↗
PubMed1997

An information infrastructure for long-term care.

Emerging trends promise to alter the way long-term care is practiced. These include: changing regulation of the nursing home industry with emphasis on outcome and assessment, a trend in medical informatics away from expert systems and toward on-line decision support and reminder systems, and the application of industrial statistical quality management techniques to the realm of human services. Emerging standards such as the Arden Syntax and Unified Medical Language Systems and technologies such as Rapid Application Development Tools will facilitate the use of modern computing to mold and implement these converging trends.

Abstracting and Indexing↗
PubMed2005

A multimedia educational system to teach epidemiology.

An educational system has been developed which consists of a module to help both teachers to design courses with different levels of knowledge regarding epidemiology and students to get acquainted with the field of epidemiology.The software development product Director was used to develop the software application. The capacity required to install the software is 130MB although each individual component is not greater than 1.2 megabytes in order to facility its handling. The user interface of the system employs colour, text, complementary voices and animation. Moreover, exercises have been designed to facilitate the learning process and to allow students and teachers to interchange information with it.The system has been evaluated by a number of 65 students both graduate and undergraduate. Half of them were attending the undergraduate course in Nursing. The rest were graduate students attending a Master's Course in Health Informatics and Health Management. The first group of students had some prior knowledge of Epidemiology. The latter group had different levels of knowledge (none, little prior knowledge or an intermediate level of knowledge), of Epidemiology. The scope of this research is to prove the efficiency of Multimedia in teaching the rather difficult subject of Epidemiology.

Computer-Assisted Instruction↗
PubMed2006

An international online curriculum for nurses in emergency planning and response.

The Vanderbilt University School of Nursing has taken a leadership role with the establishment of the International Nursing Coalition for Mass Casualty Education (INCMCE). This coalition consists of organizational representatives of schools, accrediting bodies, specialty organizations and governmental agencies interested in promoting mass casualty education for nurses. Several grants have been obtained to develop an online curriculum that addresses the competencies as developed by the INCMCE members for all nurses. Four of the six proposed modules have been developed and are currently in use. This demonstration will showcase the educational informatics strategies used to enhance the mastery of the INCMCE competencies.

Curriculum↗
PubMed1997

The information age: the status of technology in nursing education programs in the United States.

The purpose of this research was to determine the status of technology in nursing education in the United States. The research design was a comparative descriptive survey of a stratified random sample of National League for Nursing accredited diploma, associate, baccalaureate and master programs. The instrument for data collection was developed by a panel of six experts in the area of educational technology. The survey, mailed to 347 randomly selected schools, identified four primary areas of investigation: 1) technology inventory, 2) technology applications and content, including education and clinical areas, 3) implementation plan, and 4) decision making including funding and staffing resources. Findings indicated there was a significant difference in available electronic resources among baccalaureate, associate and diploma programs. A majority of schools utilize computer applications to enhance teaching, but a very small percentage of schools addressed informatics in the curriculum. The project was funded by a grant from the Helene Fuld Health Trust Fund.

Attitude to Computers↗
PubMed1996

Assessing users' satisfaction through perception of usefulness and ease of use in the daily interaction with a hospital information system.

The present study deals with the assessment of the subjective perception of the clinical core of the hospital information system (HIS) we are building. This HIS is not in use on a voluntary basis, but physicians and nurses use it for all the aspects of their inpatient care that have been informatized. Two questionnaires, aimed at the assessment of users perceived usefulness and ease of use of information technology, were utilized to: obtain feedback of the actual users' satisfaction as a predictive factor for the future life of the system, assess the real influence of the often-mentioned problems of age and unfamiliarity with computers of potential users, learn about the aspects which would enhance users' acceptance. The analysis of answers to the questionnaires has indicated a substantially positive perception of the system in terms of both usefulness and ease of use. This constitutes a good reason to keep on investing in the project. Even though this study has the intrinsic limit of the small dimension of the inquired population (53 users, equivalent to 98% of the personnel of the assessed clinical units), our data confirm the inconsistency of the relationship between perception of usefulness and age, and show "unfamiliarity with computers" as commonplace. On the other hand, it seems that the keystone for usefulness perception is the knowledge the users have of the system. An effort by the technical personnel in establishing a broader collaboration with the users, and in providing more exhaustive training and support may well be worthwhile.

Age Factors↗
PubMed1997

Technology: nursing the system. Technology and the potential for entrepreneurship.

Many nurses are stepping beyond the boundaries of traditional practice and creating their own business or service centers. New entrepreneurial opportunities include working on computer-based patient records, providing consulting services, developing policies and more. Getting involved--joining informatics groups, taking classes--is the first step.

Clinical Competence↗
PubMedDate not supplied

The Nursing Terminology Summit Conferences: a case study of successful collaboration for change.

The Nursing Terminology Summit, a series of invitational conferences and ongoing collaboration, has played both initiating and contributing roles to bring about a second-order change in the development and integration of standards for nursing terminology. What factors enabled this success? What factors made change difficult? This paper examines the structure and process of the Nursing Terminology Summit using concepts, principles, theories, and strategies identified in Lorenzi and Riley [Organizational Aspects of Health Informatics: Managing Technological Change, Springer, 1995]. As a case study, this critical analysis offers practical lessons for informaticians in managing change across disciplinary, organizational, and national boundaries.

Computational Biology↗
PubMed1990

A research-knowledge system (ARKS) for storing, managing, and modeling knowledge from the scientific literature.

Nursing knowledge and nursing data are the foundation for nursing practice. Domain knowledge that is stored in the literature of nursing and related disciplines, if not in memory, needs to be available to nurses during the process of clinical decision making. Although the electromechanical technology for delivering knowledge is available, conceptual technology lags far behind. An informatics solution to the conceptual problem is provided by knowledge engineering, the branch of informatics that addresses such problems by developing methods for restructuring knowledge from one form into a form that is more useful. The purpose of this article is to describe a research program for engineering nursing knowledge that has resulted in the development of such a tool, a prototype computer system for storing, managing, and modeling research-knowledge. The system is called ARKS, acronym for A Research-Knowledge System.

Computer Simulation↗
PubMedDate not supplied

Connecting to Internet--search tools.

The amount of information on the Internet is growing by the nanosecond. It is no longer expeditious to "surf" site to site now that automated convenient-to-use search tools can find the information you are looking for swiftly. Unfortunately, no one tool covers the entire worldwide web (www), much less the entire Internet. The following describes the components and characteristics of popular Internet search tools.

Education, Nursing, Continuing↗
PubMed2002

Challenges in medical informatics: perspectives of an international medical informatics organization.

OBJECTIVE: As an international organization with the missions to promote informatics in health care and biomedical research, advance international cooperation, stimulate research, development and education, and disseminate and exchange information, the International Medical Informatics Association (IMIA) must be constantly cognizant of new developments in medical informatics and address the challenges to the discipline. From an international organization standpoint, it perceives three major challenges viz. the Identity, Organizational and Leadership challenges. METHOD: This paper attempts to identify and discuss these challenges and to offer ways to overcome them through the activities of an international organization for medical informatics. RESULTS AND CONCLUSION: From an international organization standpoint, IMIA can help overcome these organizational challenges by ensuring strong leadership throughout its echelon, actively promoting its goals and objectives worldwide through its national and institutional members as well as its regional groups and encouraging strategic partnerships between its many Working Groups and Special Interest Group on Nursing with other international organizations and industry to further promote the awareness and the perception of the relevance of medical informatics to health and medicine by the international community.

International Cooperation↗
PubMed2004

Nursing curriculum and continuing education: future directions.

Redefinition of roles and functions in the healthcare systems of the future requires embracing to the value of continuing education. Within this framework healthcare professional education and continuing education, there are several core competencies described by Institute of Medicine (IOM) [A.C. Greiner, E. Knebel (Eds.), Health Professionals Education: Bridge to Quality, IOM, available at, May 2003] that form the foundation for practice for nurses and other healthcare professionals. An overarching sentence in the document says "All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics" (p. 45). These IOM core competencies are: (1) Common value for respecting patients' differences, values, preferences and expressed needs. (2) Ability to cooperate, collaborate, communicate and integrate care using interdisciplinary teams. (3) Knowledge of and willingness to employ evidence-based practice principles. (4) Capability to apply quality and safety improvement approaches in care. (5) Understand, value and use informatics to all areas of health care, to reduce errors, manage knowledge and information, and make decisions and communicate. In enveloping these core competencies in basic and continuing education, it is necessary to build an evidence base for education itself, demand that faculty are prepared for the future. A crucial need is for healthcare professional students (including nursing students) learn interdisciplinary collaboration in the education of patients. A global strategy, using these competencies for preparing faculty is necessary; and some models already exist that can be further developed to meet future needs that are informatics driven in our increasingly technological future care systems.

Curriculum↗