JMIR nursing最新文献

{"title":"Code-Switching Automatic Speech Recognition for Nursing Record Documentation: System Development and Evaluation.","authors":"Shih-Yen Hou,&nbsp;Ya-Lun Wu,&nbsp;Kai-Ching Chen,&nbsp;Ting-An Chang,&nbsp;Yi-Min Hsu,&nbsp;Su-Jung Chuang,&nbsp;Ying Chang,&nbsp;Kai-Cheng Hsu","doi":"10.2196/37562","DOIUrl":"https://doi.org/10.2196/37562","url":null,"abstract":"<p><strong>Background: </strong>Taiwan has insufficient nursing resources due to the high turnover rate of health care providers. Therefore, reducing the heavy workload of these employees is essential. Herein, speech transcription, which has various potential clinical applications, was employed for the documentation of nursing records. The requirement of including only one speaker per transcription facilitated data collection and system development. Moreover, authorization from patients was unnecessary.</p><p><strong>Objective: </strong>The aim of this study was to construct a speech recognition system for nursing records such that health care providers can complete nursing records without typing or with only a few edits.</p><p><strong>Methods: </strong>Nursing records in Taiwan are mainly written in Mandarin, with technical terms and abbreviations presented in both Mandarin and English. Therefore, the training set consisted of English code-switching information. Next, transfer learning (TL) and meta-TL (MTL) methods, which perform favorably in code-switching scenarios, were applied.</p><p><strong>Results: </strong>As of September 2021, the China Medical University Hospital Artificial Intelligence Speech (CMaiSpeech) data set was established by manually annotating approximately 100 hours of recordings from 525 speakers. The word error rate (WER) of the benchmark model of syllable-based TL was 29.54% in code-switching. The WER of the proposed model of syllable-based MTL was 22.20% in code-switching. The test set comprised 17,247 words. Moreover, in a clinical case, the proposed model of syllable-based MTL yielded a WER of 31.06% in code-switching. The clinical test set contained 1159 words.</p><p><strong>Conclusions: </strong>This paper has two main contributions. First, the CMaiSpeech data set-a Mandarin-English corpus-has been established. Health care providers in Taiwan are often compelled to use a mixture of Mandarin and English in nursing records. Second, an automatic speech recognition system for nursing record document conversion was proposed. The proposed system can shorten the work handover time and further reduce the workload of health care providers.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"5 1","pages":"e37562"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10420934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Health Literacy During the COVID-19 Pandemic Among Health Care Providers in Resource-Limited Settings: Cross-sectional Study.","authors":"Mohammedjud Hassen Ahmed,&nbsp;Habtamu Alganeh Guadie,&nbsp;Habtamu Setegn Ngusie,&nbsp;Gizaw Hailiye Teferi,&nbsp;Monika Knudsen Gullslett,&nbsp;Samuel Hailegebreal,&nbsp;Mekonnen Kenate Hunde,&nbsp;Dereje Oljira Donacho,&nbsp;Binyam Tilahun,&nbsp;Shuayib Shemsu Siraj,&nbsp;Gebiso Roba Debele,&nbsp;Mohammedamin Hajure,&nbsp;Shegaw Anagaw Mengiste","doi":"10.2196/39866","DOIUrl":"https://doi.org/10.2196/39866","url":null,"abstract":"<p><strong>Background: </strong>Digital health literacy is the use of information and communication technology to support health and health care. Digital health literacy is becoming increasingly important as individuals continue to seek medical advice from various web-based sources, especially social media, during the pandemics such as COVID-19.</p><p><strong>Objective: </strong>The study aimed to assess health professionals' digital health literacy level and associated factors in Southwest Ethiopia in 2021.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted from January to April 2021 in Ethiopia. Simple random sampling technique was used to select 423 study participants among health professionals. SPSS (version 20) software was used for data entry and analysis. A pretested self-administered questionnaire was used to collect the required data. Multivariable logistic regression was used to examine the association between the digital health literacy skill and associated factors. Significance value was obtained at 95% CI and P<.05.</p><p><strong>Results: </strong>In total, 401 study subjects participated in the study. Overall, 43.6% (n=176) of respondents had high digital health literacy skills. High computer literacy (adjusted odds ratio [AOR] 4.43, 95% CI 2.34-5.67; P=.01); master's degree and above (AOR 3.42, 95% CI 2.31-4.90; P=.02); internet use (AOR 4.00, 95% CI 1.78-4.02; P=.03); perceived ease of use (AOR 2.65, 95% CI 1.35-4.65; P=.04); monthly income of >15,000 Ethiopian birr (>US $283.68; AOR 7.55, 95% CI 6.43-9.44; P<.001); good knowledge of eHealth (AOR 2.22, 95% CI 1.32-4.03; P=.04); favorable attitudes (AOR 3.11, 95% CI 2.11-4.32; P=.04); and perceived usefulness (AOR 3.43, 95% CI 2.43-5.44; P=.02) were variables associated with eHealth literacy level.</p><p><strong>Conclusions: </strong>In general, less than half of the study participants had a high digital health literacy level. High computer literacy, master's degree and above, frequent internet use, perceived ease to use, income of >15,000 Ethiopian birr (>US $283.68), good knowledge of digital health literacy, favorable attitude, and perceived usefulness were the most determinant factors in the study. Having high computer literacy, frequent use of internet, perceived ease of use, perceived usefulness, favorable attitude, and a high level of education will help to promote a high level of digital health literacy.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e39866"},"PeriodicalIF":0.0,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9665171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40428547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Technologies and the Role of Health Care Professionals: Scoping Review Exploring Nurses' Skills in the Digital Era and in the Light of the COVID-19 Pandemic.","authors":"Valentina Isidori, Francesco Diamanti, Lorenzo Gios, Giulia Malfatti, Francesca Perini, Andrea Nicolini, Jessica Longhini, Stefano Forti, Federica Fraschini, Giancarlo Bizzarri, Stefano Brancorsini, Alessandro Gaudino","doi":"10.2196/37631","DOIUrl":"10.2196/37631","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The nursing role significantly changed following reforms in the nurse training process. Nowadays, nurses are increasingly trained to promote and improve the quality of clinical practice and to provide support in the assistance of patients and communities. Opportunities and threats are emerging as a consequence of the introduction of new disruptive technologies in public health, which requires the health care staff to develop new digital skills.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this paper is to review and define the role of nurses and the skills they are asked to master in terms of new methodological approaches and digital knowledge in a continuously evolving health care scenario that relies increasingly more on technology and digital solutions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This scoping review was conducted using a thematic summary of previous studies. Authors collected publications through a cross-database search (PubMed, Web of Science, Google Scholar) related to new telemedicine approaches impacting the nurses' role, considering the time span of 2011-2021 and therefore including experiences and publications related to the first phase of the COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The assessment was completed between April and July 2021. After a cross-database search, authors reviewed a selection of 60 studies. The results obtained were organized into 5 emerging macro areas: (1) leadership (nurses are expected to show leadership capabilities when introducing new technologies in health care practices, considering their pivotal role in coordinating various professional figures and the patient), (2) soft skills (new communication skills, adaptiveness, and problem solving are needed to adapt the interaction to the level of digital skills and digital knowledge of the patient), (3) training (specific subjects need to be added to nursing training to boost the adoption of new communication and technological skills, enabling health care professionals to largely and effectively use new digital tools), (4) remote management of COVID-19 or chronic patients during the pandemic (a role that has proved to be fundamental is the community and family nurse and health care systems are adopting novel assistance models to support patients at home and to enable decentralization of services from hospitals to the territory), and (5) management of interpersonal relationships with patients through telemedicine (a person-centered approach with an open and sensitive attitude seems to be even more important in the framework of telemedicine where a face-to-face session is not possible and therefore nonverbal indicators are more problematic to be noticed).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Further advancing nurses' readiness in adopting telemedicine requires an integrated approach, including combination of technical knowledge, management abilities, soft skills, and communication skills. This scoping review provides a","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e37631"},"PeriodicalIF":0.0,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9579937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33486814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Decision-Making About Patient Mobility in the Intensive Care Unit Nurse Work Environment: Work Domain Analysis.","authors":"Anna Krupp,&nbsp;Linsey Steege,&nbsp;John Lee,&nbsp;Karen Dunn Lopez,&nbsp;Barbara King","doi":"10.2196/41051","DOIUrl":"https://doi.org/10.2196/41051","url":null,"abstract":"<p><strong>Background: </strong>Patient mobility is an evidenced-based physical activity intervention initiated during intensive care unit (ICU) admission and continued throughout hospitalization to maintain functional status, yet mobility is a complex intervention and not consistently implemented. Cognitive work analysis (CWA) is a useful human factors framework for understanding complex systems and can inform future technology design to optimize outcomes.</p><p><strong>Objective: </strong>The aim of this study is to understand the complexity and constraints of the ICU work environment as it relates to nurses carrying out patient mobility interventions, using CWA.</p><p><strong>Methods: </strong>We conducted a work domain analysis and completed an abstraction hierarchy using the CWA framework. Data from documents, observation (32 hours), and interviews with nurses (N=20) from 2 hospitals were used to construct the abstraction hierarchy.</p><p><strong>Results: </strong>Nurses seek information from a variety of sources and integrate patient and unit information to inform decision-making. The completed abstraction hierarchy depicts multiple high-level priorities that nurses balance, specifically, providing quality, safe care to patients while helping to manage unit-level throughput needs. Connections between levels on the abstraction hierarchy describe how and why nurses seek patient and hospital unit information to inform mobility decision-making. The analysis identifies several opportunities for technology design to support nurse decision-making about patient mobility.</p><p><strong>Conclusions: </strong>Future interventions need to consider the complexity of the ICU environment and types of information nurses need to make decisions about patient mobility. Considerations for future system redesign include developing and testing clinical decision support tools that integrate critical patient and unit-level information to support nurses in making patient mobility decisions.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e41051"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9555320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40375602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Impact of Virtual Reflection Groups on Advanced Practice Nurse Students During the COVID-19 Pandemic: Focus Group Study With Master's Students.","authors":"Jofrid Berit Høybakk,&nbsp;Andréa Aparecida Gonçalves Nes,&nbsp;Monica Evelyn Kvande,&nbsp;Marianne Trygg Solberg","doi":"10.2196/40418","DOIUrl":"https://doi.org/10.2196/40418","url":null,"abstract":"<p><strong>Background: </strong>In the master's program of advanced practice nursing at a Norwegian university college, the learning activity reflection groups were converted into virtual reflection group (VRG) meetings during the COVID-19 pandemic. Regardless of the students' clinical practices in different hospitals, they could participate in the same VRG meeting on the web together with the educator from the university college, and the clinical supervisors were invited to participate. The students were in the process of developing the core competence required in their role as advanced practice nurses (APNs), and they had increased responsibility in the implementation of the VRG meetings.</p><p><strong>Objective: </strong>In this study, we aimed to explore how master's students of advanced practice nursing experienced VRG meetings during the COVID-19 pandemic.</p><p><strong>Methods: </strong>A qualitative exploratory design was adopted using focus group interviews. A group of students in the master's program of advanced practice nursing participated in an interview that lasted for 60 minutes. They had experienced participating in the VRG meetings following a rigorous guide during their clinical practice. The data from the focus group were analyzed using qualitative content analysis.</p><p><strong>Results: </strong>The main findings of this study highlighted the importance of structure in VRG meetings, the role of increased responsibility in students' learning processes, the development of APN students' competencies, and increased professional collaboration with clinical supervisors. The APN students and clinical supervisors also continued their discussions in the clinical setting afterward, which strengthened the collaboration between students' education in the master's program and their clinical practice.</p><p><strong>Conclusions: </strong>VRG meetings gave the students the opportunity to lead professional discussions while reflecting thoroughly on the chosen patient cases from clinical practice. They experienced receiving feedback from fellow students, supervisors, and educators as stimulating their critical thinking development.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e40418"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40359101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Digital Health Transformation Driven by COVID-19 on Nursing Practice: Systematic Literature Review.","authors":"Robab Abdolkhani,&nbsp;Sacha Petersen,&nbsp;Ruby Walter,&nbsp;Lin Zhao,&nbsp;Kerryn Butler-Henderson,&nbsp;Karen Livesay","doi":"10.2196/40348","DOIUrl":"https://doi.org/10.2196/40348","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has accelerated the uptake of digital health innovations due to the availability of various technologies and the urgent health care need for treatment and prevention. Although numerous studies have investigated digital health adoption and the associated challenges and strategies during the pandemic, there is a lack of evidence on the impact on the nursing workforce.</p><p><strong>Objective: </strong>This study aims to identify the impact of digital health transformation driven by COVID-19 on nurses.</p><p><strong>Methods: </strong>The online software Covidence was used to follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Relevant scientific health and computing databases were searched for papers published from January 2020 to November 2021. Using the 8D sociotechnical approach for digital health in health care systems, the papers were analyzed to identify gaps in applying digital health in nursing practice.</p><p><strong>Results: </strong>In total, 21 papers were selected for content analysis. The analysis identified a paucity of research that quantifies the impact of the digital health transformation on nurses during the pandemic. Most of the initiatives were teleconsultation, followed by tele-intensive care unit (tele-ICU), and only 1 (5%) study explored electronic medical record (EMR) systems. Among the sociotechnical elements, the human-related factor was the most explored and the system measurement was the least studied item.</p><p><strong>Conclusions: </strong>The review identified a significant gap in research on how implementing digital health solutions has impacted nurses during the COVID-19 pandemic. This gap needs to be addressed by further research to provide strategies for empowering the nursing workforce to be actively involved in digital health design, development, implementation, use, and evaluation.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e40348"},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9431991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40530989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personality, Attitudes, and Behaviors Predicting Perceived Benefit in Online Support Groups for Caregivers: Mixed Methods Study.","authors":"Athena Milios,&nbsp;Ting Xiong,&nbsp;Karen McEwan,&nbsp;Patrick McGrath","doi":"10.2196/36167","DOIUrl":"https://doi.org/10.2196/36167","url":null,"abstract":"<p><strong>Background: </strong>Online support groups (OSGs) are distance-delivered, easily accessible health interventions offering emotional, informational, and experience-based support and companionship or network support for caregivers managing chronic mental and physical health conditions.</p><p><strong>Objective: </strong>This study aimed to examine the relative contribution of extraversion, agreeableness, neuroticism, positive attitudes toward OSGs on social networking sites, and typical past OSG use patterns in predicting perceived OSG benefit in an OSG for parents and caregivers of children with neurodevelopmental disorders.</p><p><strong>Methods: </strong>A mixed methods, longitudinal design was used to collect data from 81 parents across Canada. Attitudes toward OSGs and typical OSG use patterns were assessed using the author-developed Attitudes Toward OSGs subscale (eg, \"Online support groups are a place to get and give emotional support\") and Past Behaviors in OSGs subscale (eg, \"How often would you typically comment on posts?\") administered at baseline-before OSG membership. The personality traits of extraversion, agreeableness, and neuroticism were assessed at baseline using the Ten-Item Personality Inventory. Perceived OSG benefit was assessed using the author-developed Perceived OSG Benefit scale (eg, \"Overall, did you feel supported by other members in this group?\"), administered 2 months after the initiation of OSG membership.</p><p><strong>Results: </strong>A hierarchical regression analysis found that extraversion was the only variable that significantly predicted perceived OSG benefit (R²=0.125; P<.001).</p><p><strong>Conclusions: </strong>The key suggestions for improving future OSGs were facilitating more in-depth, customized, and interactive content in OSGs.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e36167"},"PeriodicalIF":0.0,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40620760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' Experiences of Care With or Without the Support of an Interactive App During Neoadjuvant Chemotherapy for Breast Cancer: Interview Study.","authors":"Maria Fjell,&nbsp;Ann Langius-Eklöf,&nbsp;Marie Nilsson,&nbsp;Kay Sundberg","doi":"10.2196/39983","DOIUrl":"https://doi.org/10.2196/39983","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy (NACT) is often recommended for patients with breast cancer with more aggressive tumor characteristics. As with all chemotherapies, they can cause substantially disturbing symptoms. Most patients receive their treatment as outpatients, which means that they must take responsibility for self-care and management of symptoms at home for a long period. Patients with breast cancer undergoing chemotherapy may not receive sufficient support for management of treatment-related symptoms. For patients undergoing NACT, it has been concluded that information and supportive needs are not always met. In our previous study, the use of mobile health to support patients with breast cancer undergoing NACT reduced symptoms during treatment with the support of an interactive app. Therefore, it is important to investigate how patients experience their care and explore any specific contribution that the app may have brought in care.</p><p><strong>Objective: </strong>This study aims to explore patients' experiences of care with or without the support of an interactive app during NACT for breast cancer.</p><p><strong>Methods: </strong>This qualitative study was part of a larger randomized controlled trial and included 40 individual face-to-face interviews conducted with patients in both intervention and control groups after the end of NACT. The interviews were audio recorded, and the data were analyzed inductively using thematic analysis.</p><p><strong>Results: </strong>No major differences in experience of care were observed between the groups. A total of 4 overarching themes emerged. In the first theme, The health care context, patients described care as assessible, although sometimes there was a lack of time and continuity with nurses. In the second theme, Being a recipient of care, it emerged that the patients experienced a warm and positive atmosphere at the clinics. In the third theme, Taking an active role as a patient, patients described being active in searching for information and various ways of participation in their own care. In the fourth theme, The value of the app, patients who had used the app experienced it as a complementary source of information, creating a sense of security. Using the app provided patients with the support of being contacted by a nurse if needed, enabled self-care, and facilitated the planning of daily activities.</p><p><strong>Conclusions: </strong>Overall, patients' experiences of care were similar and mostly positive. However, for patients using the app, it provided additional support for information and self-care and enhanced participation in their own care. The easy access to a nurse gave patients a sense of security. The findings suggest integrating an interactive app as a complement to standard care to support patients with breast cancer during treatment.</p><p><strong>International registered report identifier (irrid): </strong>RR2-DOI: 10.1186/s12885-017-3450-y.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e39983"},"PeriodicalIF":0.0,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9412756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40699003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' Experiences After Implementation of an Organization-Wide Electronic Medical Record: Qualitative Descriptive Study.","authors":"Rebecca M Jedwab,&nbsp;Elizabeth Manias,&nbsp;Alison M Hutchinson,&nbsp;Naomi Dobroff,&nbsp;Bernice Redley","doi":"10.2196/39596","DOIUrl":"https://doi.org/10.2196/39596","url":null,"abstract":"<p><strong>Background: </strong>Reports on the impact of electronic medical record (EMR) systems on clinicians are mixed. Currently, nurses' experiences of adopting a large-scale, multisite EMR system have not been investigated. Nurses are the largest health care workforce; therefore, the impact of EMR implementation must be investigated and understood to ensure that patient care quality, changes to nurses' work, and nurses themselves are not negatively impacted.</p><p><strong>Objective: </strong>This study aims to explore Australian nurses' postimplementation experiences of an organization-wide EMR system.</p><p><strong>Methods: </strong>This qualitative descriptive study used focus group and individual interviews and an open-ended survey question to collect data between 12 and 18 months after the implementation of an EMR across 6 hospital sites of a large health care organization in Victoria, Australia. Data were collected between November 2020 and June 2021, coinciding with the COVID-19 pandemic. Analysis comprised complementary inductive and deductive approaches. Specifically, reflexive thematic analysis was followed by framework analysis by the coding of data as barriers or facilitators to nurses' use of the EMR using the Theoretical Domains Framework.</p><p><strong>Results: </strong>A total of 158 nurses participated in this study. The EMR implementation dramatically changed nurses' work and how they viewed their profession, and nurses were still adapting to the EMR implementation 18 months after implementation. Reflexive thematic analysis led to the development of 2 themes: An unintentional divide captured nurses' feelings of division related to how using the EMR affected nurses, patient care, and the broader nursing profession. This time, it's personal detailed nurses' beliefs about the EMR implementation leading to bigger changes to nurses as individuals and nursing as a profession than other changes that nurses have experienced within the health care organization. The most frequent barriers to EMR use by nurses were related to the Theoretical Domains Framework domain of environmental context and resources. Facilitators of EMR use were most often related to memory, attention, and decision processes. Most barriers and facilitators were related to motivation.</p><p><strong>Conclusions: </strong>Nurses perceived EMR implementation to have a mixed impact on the provision of quality patient care and on their colleagues. Implementing technology in a health care setting was perceived as a complex endeavor that impacted nurses' perceptions of their autonomy, ways of working, and professional roles. Potential negative consequences were related to nursing workforce retention and patient care delivery. Motivation was the main behavioral driver for nurses' adoption of EMR systems and hence a key consideration for implementing interventions or organizational changes directed at nurses.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e39596"},"PeriodicalIF":0.0,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9328123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40555491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of an mHealth Family Self-management Intervention (myFAMI) for Pediatric Transplantation Families: Qualitative Focus.","authors":"Stacee Marie Lerret,&nbsp;Erin Flynn,&nbsp;Rosemary White-Traut,&nbsp;Estella Alonso,&nbsp;Alisha M Mavis,&nbsp;M Kyle Jensen,&nbsp;Caitlin G Peterson,&nbsp;Rachel Schiffman","doi":"10.2196/39263","DOIUrl":"https://doi.org/10.2196/39263","url":null,"abstract":"<p><strong>Background: </strong>Around 1800 pediatric transplantations were performed in 2021, which is approximately 5% of the annual rate of solid organ transplantations carried out in the United States. Effective family self-management in the transition from hospital to home-based recovery promotes successful outcomes of transplantation. The use of mHealth to deliver self-management interventions is a strategy that can be used to support family self-management for transplantation recipients and their families.</p><p><strong>Objective: </strong>The study aims to evaluate the acceptability of an mHealth intervention (myFAMI) that combined use of a smartphone app with triggered nurse communication with family members of pediatric transplantation recipients.</p><p><strong>Methods: </strong>This is a secondary analysis of qualitative data from family members who received the myFAMI intervention within a larger randomized controlled trial. Eligible participants used the app in the 30-day time frame after discharge and participated in a 30-day postdischarge telephone interview. Content analysis was used to generate themes.</p><p><strong>Results: </strong>A total of 4 key themes were identified: (1) general acceptance, (2) positive interactions, (3) home management after hospital discharge, and (4) opportunities for improvement.</p><p><strong>Conclusions: </strong>Acceptability of the intervention was high. Family members rated the smartphone application as easy to use. myFAMI allowed the opportunity for families to feel connected to and engage with the medical team while in their home environment. Family members valued and appreciated ongoing support and education specifically in this first 30 days after their child's hospital discharge and many felt it contributed positively to the management of their child's medical needs at home. Family members provided recommendations for future refinement of the app and some suggested that a longer follow-up period would be beneficial. The development and refinement of mHealth care delivery strategies hold potential for improving outcomes for solid organ transplantation patients and their families and as a model to consider in other chronic illness populations.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03533049; https://clinicaltrials.gov/ct2/show/NCT03533049.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e39263"},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9338419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40606017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}