nursing informatics

The concurrent validity of a new eDiagnostic system for mental disorders in primary care.

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The concurrent validity of a new eDiagnostic system for mental disorders in primary care.

Fam Pract. 2016 Dec;33(6):607-616

Authors: Dijksman I, Dinant GJ, Spigt M

Abstract
BACKGROUND: An eDiagnostic system was implemented to classify mental disorders, to support general practitioners.
OBJECTIVE: Assessing the validity of the system, compared to the psychologists' judgment.
METHODS: Concurrent validity, using routinely collected data of 675 primary care patients with a suspicion of a mental disorder in the Netherlands. Four psychologists classified the patients according to the DSM-IV. Hundred records were randomly selected to investigate the inter-rater reliability among psychologists. To investigate the concurrent validity of the system the sensitivity, specificity, positive predictive values (PPVs), negative predictive values (NPVs) and Cohen's ?-values (?-values) were calculated.
RESULTS: Inter-rater agreement between psychologists were fair to good or excellent. The system could correctly estimate the echelon (sensitivity range: 0.85-0.95, specificity range: 0.88-0.98) and correctly identify most Axis I classifications (sensitivity: 0.46-1.00, specificity: 0.75-0.99), except for Asperger's, sexual and adjustment disorders (sensitivity: 0.10-0.24, specificity: 0.97-0.99). It could determine the absence of a personality disorder (sensitivity: 0.81, specificity: 0.84, PPV: 0.77, NPV: 0.87 and ?-value: 0.65). The sensitivities and specificities for most specific personality disorders were good, but the PPVs for several specific Axis II classifications were low (PPV range: 0.06-0.77). The system was inaccurate in identifying the global assessment of functioning of patients (e.g. ?-values varied from 0.17-0.46).
CONCLUSIONS: Generally, the system can be seen as a valid instrument for most DSM-IV classifications in primary care patients. It could assist healthcare professionals in the assessment and classification of mental disorders. Future research should include comparison to an independently administered structured clinical interview.

PMID: 27515416 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

ALL THINGS DIGITAL.

NLM - Nursing Informatics - Fri, 2018-01-19 17:16
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ALL THINGS DIGITAL.

Aust Nurs Midwifery J. 2016 Sep;24(3):13

Authors: Reeves J

Abstract
Recently I attend the Nursing Informatics Australia annual conference in Melbourne. The theme of the conference was the role of the nurse in digital health innovation for consumers, clinicians, connectivity and community.

PMID: 29243463 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Nurses' Perception of Challenges in the Use of an Electronic Nursing Documentation System.

NLM - Nursing Informatics - Tue, 2018-01-09 17:02
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Nurses' Perception of Challenges in the Use of an Electronic Nursing Documentation System.

Comput Inform Nurs. 2017 Nov;35(11):599-605

Authors: Heidarizadeh K, Rassouli M, Manoochehri H, Zagheri Tafreshi M, Kashef Ghorbanpour R

Abstract
This qualitative study was based on the Technology Acceptance Model and conducted through directed content analysis to explore perceptions of nurses in Iran of the challenges of using an electronic documentation system. Participants were selected through purposive sampling via interview from a teaching hospital in western Iran. Data were analyzed using MAXQDA 10. Data consistency was ensured through validation methods and by the researcher's prolonged engagement in the subject. Twelve codes, four subcategories, and two main categories ("perceived usefulness" and "perceived difficulty") emerged from the analysis of the data based on the Technology Acceptance Model. "Perceived usefulness" consisted of the subcategories "subjective norms" and "experienced benefits"; and "perceived difficulty" contained the subcategories "rationalization" as well as "challenges in accepting change." According to the Technology Acceptance Model, to promote acceptance of this system, the benefits of usage should be highlighted. The biggest hurdle to acceptance is familiarity and comfort with previous methods.

PMID: 28471763 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Nurses' Use of Positive Deviance When Encountering Electronic Health Records-Related Unintended Consequences.

NLM - Nursing Informatics - Tue, 2017-12-19 16:31
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Nurses' Use of Positive Deviance When Encountering Electronic Health Records-Related Unintended Consequences.

Nurs Adm Q. 2018 Jan/Mar;42(1):E1-E11

Authors: Bristol AA, Nibbelink CW, Gephart SM, Carrington JM

Abstract
As organizations adopt electronic health records (EHRs), nurses frequently encounter system barriers and difficulty performing role expectations. This article describes nurses' experiences with unintended consequences emerging from the use of an EHR. In some situations, nurses were positively deviant when encountering unintended consequences relating to EHRs to accomplish patient care or protect patient safety. Nurses engaged in work-arounds to provide patient care when the EHR did not meet their needs, sometimes in positively deviant ways. Qualitative data were collected from 5 open-ended questions at the end of a quantitative survey. Analysis included coding of responses and organization of processes in line with the triangle model, a human factors framework, to identify overarching themes. Five themes emerged: (1) User support after implementation of EHR; (2) User satisfaction with EHR; (3) Communication for patient care, quality, and safety; (4) Effort to complete tasks; and (5) Areas for improvement. Nurses' ability to adopt positive deviance as they experience unintended consequences offers opportunities for organizations to engage nursing perspectives in improving the EHR and engineer it to be more resilient to nursing work.

PMID: 29194338 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Integrative review of clinical decision support for registered nurses in acute care settings.

NLM - Nursing Informatics - Sat, 2017-12-16 16:28
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Integrative review of clinical decision support for registered nurses in acute care settings.

J Am Med Inform Assoc. 2017 03 01;24(2):441-450

Authors: Dunn Lopez K, Gephart SM, Raszewski R, Sousa V, Shehorn LE, Abraham J

Abstract
Objective: To report on the state of the science of clinical decision support (CDS) for hospital bedside nurses.
Materials and Methods: We performed an integrative review of qualitative and quantitative peer-reviewed original research studies using a structured search of PubMed, Embase, Cumulative Index to Nursing and Applied Health Literature (CINAHL), Scopus, Web of Science, and IEEE Xplore (Institute of Electrical and Electronics Engineers Xplore Digital Library). We included articles that reported on CDS targeting bedside nurses and excluded in stages based on rules for titles, abstracts, and full articles. We extracted research design and methods, CDS purpose, electronic health record integration, usability, and process and patient outcomes.
Results: Our search yielded 3157 articles. After removing duplicates and applying exclusion rules, 28 articles met the inclusion criteria. The majority of studies were single-site, descriptive or qualitative (43%) or quasi-experimental (36%). There was only 1 randomized controlled trial. The purpose of most CDS was to support diagnostic decision-making (36%), guideline adherence (32%), medication management (29%), and situational awareness (25%). All the studies that included process outcomes (7) and usability outcomes (4) and also had analytic procedures to detect changes in outcomes demonstrated statistically significant improvements. Three of 4 studies that included patient outcomes and also had analytic procedures to detect change showed statistically significant improvements. No negative effects of CDS were found on process, usability, or patient outcomes.
Discussion and Conclusions: Clinical support systems targeting bedside nurses have positive effects on outcomes and hold promise for improving care quality; however, this research is lagging behind studies of CDS targeting medical decision-making in both volume and level of evidence.

PMID: 27330074 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Setting nursing science priorities to meet contemporary health care needs.

NLM - Nursing Informatics - Thu, 2017-12-07 13:17
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Setting nursing science priorities to meet contemporary health care needs.

Nurs Outlook. 2016 Jul-Aug;64(4):399-401

Authors: DeVon HA, Rice M, Pickler RH, Krause-Parello CA, Richmond TS

PMID: 27298193 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Time for TIGER to ROAR! Technology Informatics Guiding Education Reform.

NLM - Nursing Informatics - Wed, 2017-11-29 13:05
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Time for TIGER to ROAR! Technology Informatics Guiding Education Reform.

Nurse Educ Today. 2017 Nov;58:78-81

Authors: O'Connor S, Hubner U, Shaw T, Blake R, Ball M

Abstract
Information Technology (IT) continues to evolve and develop with electronic devices and systems becoming integral to healthcare in every country. This has led to an urgent need for all professions working in healthcare to be knowledgeable and skilled in informatics. The Technology Informatics Guiding Education Reform (TIGER) Initiative was established in 2006 in the United States to develop key areas of informatics in nursing. One of these was to integrate informatics competencies into nursing curricula and life-long learning. In 2009, TIGER developed an informatics competency framework which outlines numerous IT competencies required for professional practice and this work helped increase the emphasis of informatics in nursing education standards in the United States. In 2012, TIGER expanded to the international community to help synthesise informatics competencies for nurses and pool educational resources in health IT. This transition led to a new interprofessional, interdisciplinary approach, as health informatics education needs to expand to other clinical fields and beyond. In tandem, a European Union (EU) - United States (US) Collaboration on eHealth began a strand of work which focuses on developing the IT skills of the health workforce to ensure technology can be adopted and applied in healthcare. One initiative within this is the EU*US eHealth Work Project, which started in 2016 and is mapping the current structure and gaps in health IT skills and training needs globally. It aims to increase educational opportunities by developing a model for open and scalable access to eHealth training programmes. With this renewed initiative to incorporate informatics into the education and training of nurses and other health professionals globally, it is time for educators, researchers, practitioners and policy makers to join in and ROAR with TIGER.

PMID: 28918322 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Teaching Informatics to Prelicensure, RN-to-BSN, and Graduate Level Students.

NLM - Nursing Informatics - Wed, 2017-11-29 13:05
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Teaching Informatics to Prelicensure, RN-to-BSN, and Graduate Level Students.

Nurse Educ. 2017 Sep/Oct;42(5S Suppl 1):S22-S26

Authors: Vottero B

Abstract
Teaching nursing informatics to students in associate, baccalaureate, RN-BSN, and graduate nursing programs poses challenges for curriculum design, as well as developing appropriate instruction and assessment methods. The current state of nursing informatics education provides opportunities for unique instructional design and assessment techniques. Key course content is provided with suggestions for teaching informatics that focus on leveling for prelicensure, RN-BSN, and graduate nursing programs.

PMID: 28832458 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

[Smart Medicine and Healthcare].

NLM - Nursing Informatics - Wed, 2017-11-08 15:43
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[Smart Medicine and Healthcare].

Hu Li Za Zhi. 2017 Aug;64(4):26-33

Authors: Lu YA, Chen LC

Abstract
Innovation and rapid technological development in Smart Medicine or Smart Healthcare impact profoundly on many aspects of healthcare. It is believed that Health Information Technology (HIT) has the potential to improve integration between care providers, reduce administrative costs and burdens, reduce medical errors, and improve care quality and patient outcomes. However, issues such as interoperability, compatibility, and integration are critical to effectively integrating hardware and software in order to fully realize the benefits of HIT. High-end medical devices and equipment, including medical carts / mobile computer carts and wireless physiological and biomedical monitoring devices, should also be integrated into the hospital information system. Furthermore, the Data, Information, Knowledge, and Wisdom Hierarchy (DIKW) has been gaining popularity in the development of Nursing Information Systems (NIS) since 2013. To create a DIKW-based information system, data must first be defined and analyzed and then transformed into meaningful information. Eventually, this information is transformed into an intelligent system. For example, if evidence-based nursing research results / findings are integrated into the NIS to guide clinical practice, patient outcomes, patient safety, and healthcare quality will be greatly enhanced.

PMID: 28762222 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

[The Role and Function of Informatics Nurses in Information Technology Decision-Making].

NLM - Nursing Informatics - Wed, 2017-11-08 15:43
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[The Role and Function of Informatics Nurses in Information Technology Decision-Making].

Hu Li Za Zhi. 2017 Aug;64(4):5-9

Authors: Lee TY

Abstract
The medical environment has changed greatly with the coming of the information age, and, increasingly, the operating procedures for medical services have been altered in keeping with the trend toward mobile, paperless services. Informatization has the potential to improve the working efficiency of medical personnel, enhance patient care safety, and give medical organizations a positive image. Informatics nurses play an important role in the decision-making processes that accompany informatization. As one of the decision-making links in the information technology lifecycle, this role affects the success of the development and operation of information systems. The present paper examines the functions and professional knowledge that informatics nurses must possess during the technology lifecycle, the four stages of which include: planning, analysis, design/development/revision, and implementation/assessment/support/maintenance. The present paper further examines the decision-making shortcomings and errors that an informatics nurses may make during the decision-making process. We hope that this paper will serve as an effective and useful reference for informatics nurses during the informatization decision-making process.

PMID: 28762219 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Again, What Is Nursing Science?

NLM - Nursing Informatics - Wed, 2017-11-01 15:38
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Again, What Is Nursing Science?

Nurs Sci Q. 2017 Apr;30(2):129-133

Authors: Barrett EAM

Abstract
This article again asks, What is nursing science? Who knows? Who cares? The author describes the threat to the survival of nursing science grounded in nursing frameworks and theories. This threat is magnified by the proposal of the Council for the Advancement of Nursing Science (CANS) to change the curricula of PhD education. The aim of CANS is to prepare nurse scientists for lifelong competitive careers in interdisciplinary research, often focused on funding priorities of the National Institute of Nursing Research (NINR). Curricula would include preparation for conducting research in topics such as omics, e-science, translation science, biobehavioral science, symptom science, and team science. How can this be nursing science? It is argued that this focus might obliterate nursing's discipline-specific phenomenon of concern, the human-universe-health process.

PMID: 28899250 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Modeling Flowsheet Data to Support Secondary Use.

NLM - Nursing Informatics - Wed, 2017-11-01 15:38
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Modeling Flowsheet Data to Support Secondary Use.

Comput Inform Nurs. 2017 Sep;35(9):452-458

Authors: Westra BL, Christie B, Johnson SG, Pruinelli L, LaFlamme A, Sherman SG, Park JI, Delaney CW, Gao G, Speedie S

Abstract
The purpose of this study was to create information models from flowsheet data using a data-driven consensus-based method. Electronic health records contain a large volume of data about patient assessments and interventions captured in flowsheets that measure the same "thing," but the names of these observations often differ, according to who performs documentation or the location of the service (eg, pulse rate in an intensive care, the emergency department, or a surgical unit documented by a nurse or therapist or captured by automated monitoring). Flowsheet data are challenging for secondary use because of the existence of multiple semantically equivalent measures representing the same concepts. Ten information models were created in this study: five related to quality measures (falls, pressure ulcers, venous thromboembolism, genitourinary system including catheter-associated urinary tract infection, and pain management) and five high-volume physiological systems: cardiac, gastrointestinal, musculoskeletal, respiratory, and expanded vital signs/anthropometrics. The value of the information models is that flowsheet data can be extracted and mapped for semantically comparable flowsheet measures from a clinical data repository regardless of the time frame, discipline, or setting in which documentation occurred. The 10 information models simplify the representation of the content in flowsheet data, reducing 1552 source measures to 557 concepts. The amount of representational reduction ranges from 3% for falls to 78% for the respiratory system. The information models provide a foundation for including nursing and interprofessional assessments and interventions in common data models, to support research within and across health systems.

PMID: 28346243 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Assessment of a prototype for the Systemization of Nursing Care on a mobile device.

NLM - Nursing Informatics - Wed, 2017-11-01 15:38
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Assessment of a prototype for the Systemization of Nursing Care on a mobile device.

Rev Lat Am Enfermagem. 2016;24:e2714

Authors: Rezende LC, Santos SR, Medeiros AL

Abstract
OBJECTIVES: assess a prototype for use on mobile devices that permits registering data for the Systemization of Nursing Care at a Neonatal Intensive Care Unit.
METHOD: an exploratory and descriptive study was undertaken, characterized as an applied methodological research, developed at a teaching hospital.
RESULTS: the mobile technology the nurses at the Neonatal Intensive Care Unit use was positive, although some reported they faced difficulties to manage it, while others with experience in using mobile devices did not face problems to use it. The application has the functions needed for the Systematization of Nursing Care at the unit, but changes were suggested in the interface of the screens, some data collection terms and parameters the application offers. The main contributions of the software were: agility in the development and documentation of the systemization, freedom to move, standardization of infant assessment, optimization of time to develop bureaucratic activities, possibilities to recover information and reduction of physical space the registers occupy.
CONCLUSION: prototype software for the Systemization of Nursing Care with mobile technology permits flexibility for the nurses to register their activities, as the data can be collected at the bedside.

PMID: 27384467 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Thinking outside the box.

NLM - Nursing Informatics - Tue, 2017-10-31 15:37
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Thinking outside the box.

Nursing. 2017 09;47(9):6

Authors:

PMID: 28795989 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Big data science: A literature review of nursing research exemplars.

NLM - Nursing Informatics - Tue, 2017-10-31 15:37
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Big data science: A literature review of nursing research exemplars.

Nurs Outlook. 2017 Sep - Oct;65(5):549-561

Authors: Westra BL, Sylvia M, Weinfurter EF, Pruinelli L, Park JI, Dodd D, Keenan GM, Senk P, Richesson RL, Baukner V, Cruz C, Gao G, Whittenburg L, Delaney CW

Abstract
BACKGROUND: Big data and cutting-edge analytic methods in nursing research challenge nurse scientists to extend the data sources and analytic methods used for discovering and translating knowledge.
PURPOSE: The purpose of this study was to identify, analyze, and synthesize exemplars of big data nursing research applied to practice and disseminated in key nursing informatics, general biomedical informatics, and nursing research journals.
METHODS: A literature review of studies published between 2009 and 2015. There were 650 journal articles identified in 17 key nursing informatics, general biomedical informatics, and nursing research journals in the Web of Science database. After screening for inclusion and exclusion criteria, 17 studies published in 18 articles were identified as big data nursing research applied to practice.
DISCUSSION: Nurses clearly are beginning to conduct big data research applied to practice. These studies represent multiple data sources and settings. Although numerous analytic methods were used, the fundamental issue remains to define the types of analyses consistent with big data analytic methods.
CONCLUSION: There are needs to increase the visibility of big data and data science research conducted by nurse scientists, further examine the use of state of the science in data analytics, and continue to expand the availability and use of a variety of scientific, governmental, and industry data resources. A major implication of this literature review is whether nursing faculty and preparation of future scientists (PhD programs) are prepared for big data and data science.

PMID: 28057335 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Cross the nursing and HIT divide.

NLM - Nursing Informatics - Sat, 2017-10-21 13:31
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Cross the nursing and HIT divide.

Nurs Manage. 2017 06;48(6):21-23

Authors: Staggers N, Elias BL

PMID: 28548983 [PubMed - indexed for MEDLINE]

Categories: nursing informatics

Nursing diagnoses in intensive care: cross-mapping and NANDA-I taxonomy.

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Nursing diagnoses in intensive care: cross-mapping and NANDA-I taxonomy.

Rev Bras Enferm. 2016 Mar-Apr;69(2):307-15

Authors: Ferreira AM, Rocha Edo N, Lopes CT, Bachion MM, Lopes Jde L, Barros AL

PMID: 27280567 [PubMed - indexed for MEDLINE]

Categories: nursing informatics
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