{"title":"The influence of integrated electronic medical records and computerized nursing notes on nurses' time spent in documentation.","authors":"Tracy Yee, Jack Needleman, Marjorie Pearson, Patricia Parkerton, Melissa Parkerton, Joelle Wolstein","doi":"10.1097/NXN.0b013e31824af835","DOIUrl":"https://doi.org/10.1097/NXN.0b013e31824af835","url":null,"abstract":"<p><p>We investigated nurses' time spent in documentation as it relates to the use of electronic charting. A cross-sectional analysis was completed using time and motion data collected during a nursing process improvement initiative for 105 units in 55 hospitals. Ordinary least squares regression with a cluster adjustment revealed very little difference in time spent in documentation with or without the use of electronic medical records or computerized nursing notes. Nurses spent 19% of their time completing documentation, regardless of electronic charting usage, compared with all other categories of care. These findings suggest that integrated electronic medical records and computerized nursing notes do not appear to increase the time nurses spend documenting.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"287-92"},"PeriodicalIF":1.3,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NXN.0b013e31824af835","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40159788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Virtual reality simulation: using three-dimensional technology to teach nursing students.","authors":"Carole E Jenson, Diane McNally Forsyth","doi":"10.1097/NXN.0b013e31824af6ae","DOIUrl":"https://doi.org/10.1097/NXN.0b013e31824af6ae","url":null,"abstract":"<p><p>The use of computerized technology is rapidly growing in the classroom and in healthcare. An emerging computer technology strategy for nursing education is the use of virtual reality simulation. This computer-based three-dimensional educational tool simulates real-life patient experiences in a risk-free environment, allows for repeated practice sessions, requires clinical decision making, exposes students to diverse patient conditions, provides immediate feedback, and is portable. The purpose of this article was to review the importance of virtual reality simulation as a computerized teaching strategy. In addition, a project to explore readiness of nursing faculty at one major Midwestern university for the use of virtual reality simulation as a computerized teaching strategy is described where faculty thought virtual reality simulation would increase students' knowledge of an intravenous line insertion procedure. Faculty who practiced intravenous catheter insertion via virtual reality simulation expressed a wide range of learning experiences from using virtual reality simulation that is congruent with the literature regarding the barriers to student learning. Innovative teaching strategies, such as virtual reality simulation, address barriers of increasing patient acuity, high student-to-faculty ratio, patient safety concerns from faculty, and student anxiety and can offer rapid feedback to students.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"312-8; quiz 319-20"},"PeriodicalIF":1.3,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NXN.0b013e31824af6ae","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40159782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Examining the functionality of the DeLone and McLean information system success model as a framework for synthesis in nursing information and communication technology research.","authors":"Richard G Booth","doi":"10.1097/NXN.0b013e31824af7f4","DOIUrl":"https://doi.org/10.1097/NXN.0b013e31824af7f4","url":null,"abstract":"<p><p>In this review, studies examining information and communication technology used by nurses in clinical practice were examined. Overall, a total of 39 studies were assessed spanning a time period from 1995 to 2008. The impacts of the various health information and communication technology evaluated by individual studies were synthesized using the DeLone and McLean's six-dimensional framework for evaluating information systems success (ie, System Quality, Information Quality, Service Quality, Use, User Satisfaction, and Net Benefits). Overall, the majority of researchers reported results related to the overall Net Benefits (positive, negative, and indifferent) of the health information and communication technology used by nurses. Attitudes and user satisfaction with technology were also commonly measured attributes. The current iteration of DeLone and McLean model is effective at synthesizing basic elements of health information and communication technology use by nurses. Regardless, the current model lacks the sociotechnical sensitivity to capture deeper nurse-technology relationalities. Limitations and recommendations are provided for researchers considering using the DeLone and McLean model for evaluating health information and communication technology used by nurses.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"330-45"},"PeriodicalIF":1.3,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NXN.0b013e31824af7f4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40159785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of a conceptual framework to guide a program of research exploring nurse-to-nurse communication.","authors":"Jane M Carrington","doi":"10.1097/NXN.0b013e31824af809","DOIUrl":"https://doi.org/10.1097/NXN.0b013e31824af809","url":null,"abstract":"<p><p>Research in nursing informatics has been described as problem based rather than theory guided. Furthermore, few examples exist in the literature where the process of theory development is described. This article describes a process used to develop a conceptual framework that supports a theory-driven program of research in nursing informatics. The conceptual framework combines Symbolic Interaction Theory and Information Theory. Constructs of Symbolic Interaction Theory (mind, self, and society) and Information Theory (entropy, negentropy, redundancy, probability, and noise) were then organized according to Gerbner's Communication Model. Theory derivation was the method used for organizing abstract constructs and reducing them to a measurable level. Theory derivation was supplemented with initial research findings. The measurable or middle-range constructs were then organized in a meaningful manner for conceptual framework development. The use of theory derivation to develop a conceptual framework to support theory-driven nursing informatics research will be discussed. The framework entitled \"Effective Nurse-to-Nurse Communication\" that guides a program of research will then be presented.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"293-9"},"PeriodicalIF":1.3,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NXN.0b013e31824af809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40159786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tami H Wyatt, Xueping Li, Chayawat Indranoi, Matthew Bell
{"title":"Developing iCare v.1.0: an academic electronic health record.","authors":"Tami H Wyatt, Xueping Li, Chayawat Indranoi, Matthew Bell","doi":"10.1097/NXN.0b013e31824af81f","DOIUrl":"https://doi.org/10.1097/NXN.0b013e31824af81f","url":null,"abstract":"<p><p>An electronic health record application, iCare v.1.0, was developed and tested that allows data input and retrieval while tracking student performance over time. The development and usability testing of iCare v.1.0 followed a rapid prototyping software development and testing model. Once the functionality was tested by engineers, the usability and feasibility testing began with a convenience sample of focus group members including undergraduate and graduate students and faculty. Three focus groups were created, and four subjects participated in each focus group (n = 12). Nielsen's usability heuristics and methods of evaluation were used to evaluate data captured from each focus group. Overall, users wanted a full-featured electronic health record with features that coached or guided users. The earliest versions of iCare v.1.0 did not provide help features and prompts to guide students but were later added. Future versions will incorporate a full-featured help section. The interface and design of iCare v.1.0 are similar to professional electronic health record applications. As a result of this usability study, future versions of iCare will include more robust help features along with advanced reporting and elements specific to specialty populations such as pediatrics and mental health services.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"321-9"},"PeriodicalIF":1.3,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NXN.0b013e31824af81f","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40159787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paulina S Sockolow, Kathryn H Bowles, Harold P Lehmann, Patricia A Abbott, Jonathan P Weiner
{"title":"Community-based, interdisciplinary geriatric care team satisfaction with an electronic health record: a multimethod study.","authors":"Paulina S Sockolow, Kathryn H Bowles, Harold P Lehmann, Patricia A Abbott, Jonathan P Weiner","doi":"10.1097/NCN.0b013e31823eb561","DOIUrl":"https://doi.org/10.1097/NCN.0b013e31823eb561","url":null,"abstract":"<p><p>This multimethod study measured the impact of an electronic health record (EHR) on clinician satisfaction with clinical process. Subjects were 39 clinicians at a Program of All-inclusive Care for Elders (PACE) site in Philadelphia utilizing an EHR. Methods included the evidence-based evaluation framework, Health Information Technology Research-Based Evaluation Framework, which guided assessment of clinician satisfaction with surveys, observations, follow-up interviews, and actual EHR use at two points in time. Mixed-methods analysis of findings provided context for interpretation and improved validity. The study found that clinicians were satisfied with the EHR; however, satisfaction declined between time periods. Use of EHR was universal and wide and was differentiated by clinical role. Between time periods, EHR use increased in volume, with increased timeliness and decreased efficiency. As the first EHR evaluation at a PACE site from the perspective of clinicians who use the system, this study provides insights into EHR use in the care of older people in community-based healthcare settings.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"300-11"},"PeriodicalIF":1.3,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NCN.0b013e31823eb561","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40158597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Criteria for quantitative and qualitative data integration: mixed-methods research methodology.","authors":"Seonah Lee, Carrol A M Smith","doi":"10.1097/NXN.0b013e31824b1f96","DOIUrl":"https://doi.org/10.1097/NXN.0b013e31824b1f96","url":null,"abstract":"<p><p>Many studies have emphasized the need and importance of a mixed-methods approach for evaluation of clinical information systems. However, those studies had no criteria to guide integration of multiple data sets. Integrating different data sets serves to actualize the paradigm that a mixed-methods approach argues; thus, we require criteria that provide the right direction to integrate quantitative and qualitative data. The first author used a set of criteria organized from a literature search for integration of multiple data sets from mixed-methods research. The purpose of this article was to reorganize the identified criteria. Through critical appraisal of the reasons for designing mixed-methods research, three criteria resulted: validation, complementarity, and discrepancy. In applying the criteria to empirical data of a previous mixed methods study, integration of quantitative and qualitative data was achieved in a systematic manner. It helped us obtain a better organized understanding of the results. The criteria of this article offer the potential to produce insightful analyses of mixed-methods evaluations of health information systems.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"251-6"},"PeriodicalIF":1.3,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NXN.0b013e31824b1f96","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40159789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maureen E Wassef, Lyn Riza, Tony Maciag, Christine Worden, Andrea Delaney
{"title":"Implementing a competency-based electronic portfolio in a graduate nursing program.","authors":"Maureen E Wassef, Lyn Riza, Tony Maciag, Christine Worden, Andrea Delaney","doi":"10.1097/NXN.0b013e31824af6d4","DOIUrl":"https://doi.org/10.1097/NXN.0b013e31824af6d4","url":null,"abstract":"<p><p>Use of electronic portfolios (e-portfolios) has been advocated to demonstrate nursing student accomplishments as well as to document program and course outcomes. This use of e-portfolios incorporates information technology, thus aligning the educational process in professional degree programs to 21st-century teaching and learning scholarship. Here we describe a project to explore the feasibility of transitioning from documenting student competencies in hard-copy binders to e-portfolios. To make this transition in an efficient manner in our graduate nursing program, we used the Plan, Do, Study, Act quality-improvement model. An interdisciplinary team of nursing faculty and educational computing consultants developed a professional e-portfolio template and implemented a pilot program for 10 students enrolled in our nurse educator specialty. This program was executed by assessing university resources, evaluating the technological competence of both students and faculty, and through the interdisciplinary team members' commitment to provide ongoing support for the program.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"242-8; quiz 249-50"},"PeriodicalIF":1.3,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NXN.0b013e31824af6d4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40159784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ibrahim Abbass, Jeffrey Helton, Shivani Mhatre, Sujit S Sansgiry
{"title":"Impact of electronic health records on nurses' productivity.","authors":"Ibrahim Abbass, Jeffrey Helton, Shivani Mhatre, Sujit S Sansgiry","doi":"10.1097/NXN.0b013e31824b29a8","DOIUrl":"https://doi.org/10.1097/NXN.0b013e31824b29a8","url":null,"abstract":"<p><p>As the use of electronic health records increases, it becomes necessary to address their global impact on nurses' productivity in hospitals. A retrospective cross-sectional study was conducted to explore the impact of electronic health records on nurses' productivity and to examine whether the impacts are moderated through case-mix index or adjusted patient-days. Two sources of data were linked and analyzed for years 2007 and 2008: the American Hospital Association survey and the Centers for Medicare & Medicaid Services data. Almost two-thirds of the respondent hospitals in both years (63.9% in 2007 and 68.4% in 2008) had a high electronic health record index (≥5). Hospitals with higher penetration of electronic health records had more RNs employed (coefficient=0.234, P=.002) compared with hospitals with low penetration of electronic health records, even when controlling for adjusted patient-day volumes. This difference decreased for hospitals with higher case-mix index values. The study findings fail to suggest any financial savings or superior productivity in nurses due to usage of electronic health records.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"237-41"},"PeriodicalIF":1.3,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NXN.0b013e31824b29a8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40158596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abbey C Sidebottom, Beverly Collins, Tamara J Winden, Asha Knutson, Heather R Britt
{"title":"Reactions of nurses to the use of electronic health record alert features in an inpatient setting.","authors":"Abbey C Sidebottom, Beverly Collins, Tamara J Winden, Asha Knutson, Heather R Britt","doi":"10.1097/NCN.0b013e3182343e8f","DOIUrl":"https://doi.org/10.1097/NCN.0b013e3182343e8f","url":null,"abstract":"<p><p>While studies have been conducted to assess nurse perception of electronic health records, once electronic health record systems are up and running, there is little to guide the use of features within the electronic health record for nursing practice. Alerts are a promising tool for implementing best practice for patient care in inpatient settings. Yet the use of alerts for inpatient nursing is understudied. This study examined nurse attitudes and reactions to alerts in the inpatient setting. Focus groups were conducted at three hospitals with 50 nurses. Nurses were asked about five different alert features. For each alert, participants were asked about their feelings and reactions to the alert, how alerts help or hinder work, and suggestions for improvements. Findings include clear preferences for alert types and content. Nurses preferred a dashboard style alert with functions included to accomplish tasks directly in the alert. While nurses reported positive reactions to certain alert pages, they also reported low use of those features and occasional distrust of the data included in alerts. Findings provide guidance for future use of alerts and design of new alerts. Findings also identify the important challenge of designing and implementing alerts for integration with nursing workflow.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":"218-26; quiz 227-8"},"PeriodicalIF":1.3,"publicationDate":"2012-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/NCN.0b013e3182343e8f","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40121594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}