Computers, clinical applications, and the CCU nurse.
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A computer is nothing more than an organized bureaucratic structure that allows one to perform a large number of very simple acts by the issuance of a few simple commands. It has the disadvantage of being a machine and, at the present time, being incapable of interpretive behavior. Such machines can only follow orders blindly. On the other hand, the computer is capable of performing simple tasks at lightning speed. Learning how to take advantage of this ability is no more difficult than learning to reduce a Colle's fracture. Buy a book, obtain some "clinical material" (a computer), and start experimenting. Learn from your mistakes; it only takes time and interest--not genius.
The organization of data and the services available from a computerized data base management system are discussed in this article. A primitive medical office management system is built to illustrate how one such system (dBASE III) could be used. The case study shows not only the immediate applications, but also how the system allows new features and functions to be added.
On a regular basis we are upgrading and modifying our software package to meet our ever-changing needs. The day of the user-friendly computer is upon us. We have found the computer to be an ever-important extension of our own minds, truly our own electronic servant. It has relieved us of the mental tedium that in the past has eaten up so much of our time, leaving us free to accomplish the tasks that our electronic servant could never accomplish, including the creation of new ideas and the appreciation and nurturing of old ones.
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Nutrition education has become an integral part of work-site health promotion programs. As more corporations, large and small, become involved in establishing their own programs, the need for qualified nutrition educators will increase. Registered dietitians should have a proactive role in this awareness process and should strive to develop specific skills in the areas of communications, management, and computer literacy. To succeed as nutrition educators at the work site, registered dietitians need to be able to wear many hats and to be organizers, planners, and innovative deliverers of nutrition information, as more and more U.S. corporations "reach out for health."
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One hundred sixty-one MEDLINE searches conducted by third-year medical students were analyzed and evaluated to determine which search moves were used, whether those individual moves were effective, and whether there was a relationship between specific search behaviors and the effectiveness of the search strategy as a whole. The typical search included fourteen search statements, used seven terms or "limit" commands, and resulted in the display of eleven citations. The most common moves were selection of a database, entering single-word terms and free-text term phrases, and combining sets of terms. Syntactic errors were also common. Overall, librarians judged the searches to be adequate, and students were quite satisfied with their own searches. However, librarians also identified many missed opportunities in the search strategies, including underutilization of the controlled vocabulary, subheadings, and synonyms for search concepts. No strong relationships were found between specific search behaviors and search effectiveness (as measured by the librarians' or students' evaluations). Implications of these findings for system design and user education are discussed.
The goal of this study was to assess the usage frequency, user satisfaction, and quality of literature searchers for a multi-application computer workstation in a university-based general medicine clinic. A computer with medical literature searching, textbook searching, and a decision-support program was deployed in the workroom of the clinic and made available for routine use. Data were collected for ten months. More than three quarters of the study participants used the computer, with use increasing by level of medical training. Despite physicians' known preferences for nonjournal sources of information, literature searching was the application used most frequently, followed by textbooks and decision support. The literature searches were replicated by experienced clinician and librarian searchers using first full MEDLINE and then text-word-only searching, to compare the quantities of relevant references retrieved. Novice searchers retrieved a larger number of relevant references than did the experienced searchers, but they also retrieved more nonrelevant references. For both groups of experienced searchers, the full MEDLINE feature set conferred little benefit over searching with only text words. These searching results call into question the value of traditional searching methods for both novice and experienced physicians.
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A field-based evaluation is conducted of a Clinical Computerized Information System (CCIS). Following training, the use of the CCIS database, word processing and other programs by thirteen full-time practicing emergency physicians in two urban emergency departments of a University-associated teaching hospital was studied over a one-year period. A tracking program automatically logged frequency and duration of use by the physicians, and user satisfaction was assessed by a reliable and validated questionnaire instrument. Based on utilization data and verbal reports of these physicians, CCIS database searching was not only found to be easy-to-learn but was readily accessible during emergency shifts. Individual physicians were found to perform an average of 3.5 searches per month lasting a mean search time of 8 min. Positive notes about the CCIS system included ease-of-use, accuracy of data, accessibility of system, and value of output while negative perceptions included a lack of integration with other systems, a lack of system completeness, and a high subscription cost. It was suggested that a less costly telephone link to a high-volume Centre would be desirable in actual implementation of the system.
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DataBook is a computer application developed to assist the nurse manager in collecting, assessing and monitoring unit data on a day-to-day and summary basis. Once captured, this information can then be presented to create "information snapshots" of unit characteristics. Utilizing a PC-based spreadsheet program, the application is designed to be used by individuals with a modest degree of computer literacy.
The patient has been one of the focal points of the process followed to design, implement, and evaluate an integrated informatics curriculum in a baccalaureate nursing program. This paper describes the third stage of a process to design the informatics nursing courses. A challenge is to structure the nursing informatics curriculum so as to enhance the patient care process. A number of strategies were used to focus the curriculum, students, and faculty around the patient. The basic components of the framework are information, technology, and clinical care process. The clinical care process which emphasizes the patient is an inherent part of the conceptual framework in all aspects of the curriculum. Therefore the faculty has ensured a blend of information, technology, and the clinical care process throughout the curriculum.
The authors describe the assessment, planning, implementation, and benefits of a local area network (LAN) for the nursing service of a 504-bed urban teaching hospital. The major goals of the network were to increase the efficiency and effectiveness of the nursing administrative areas and improve communication systems. A network of more than 90 workstations, spanning 12 buildings, was installed. The network provides access to multiple programs that support clinical, managerial, and research activities. Gateways provide access to the hospital's two mainframe computers. Network benefits identified by nursing management include: improved communication and access to information; increased accuracy, efficiency and timeliness of data; and improved computer literacy.