JMIR nursingPub Date : 2023-06-06DOI: 10.2196/44630
Alice Auton, Sameer Zaman, Yorissa Padayachee, Jack W Samways, Nicholas M Quaife, Mark Sweeney, Indira Tenorio, Nick W F Linton, Graham D Cole, Nicholas S Peters, Jamil Mayet, Carys Barton, Carla Plymen
{"title":"Smartphone-Based Remote Monitoring for Chronic Heart Failure: Mixed Methods Analysis of User Experience From Patient and Nurse Perspectives.","authors":"Alice Auton, Sameer Zaman, Yorissa Padayachee, Jack W Samways, Nicholas M Quaife, Mark Sweeney, Indira Tenorio, Nick W F Linton, Graham D Cole, Nicholas S Peters, Jamil Mayet, Carys Barton, Carla Plymen","doi":"10.2196/44630","DOIUrl":"10.2196/44630","url":null,"abstract":"<p><strong>Background: </strong>Community-based management by heart failure specialist nurses (HFSNs) is key to improving self-care in heart failure with reduced ejection fraction. Remote monitoring (RM) can aid nurse-led management, but in the literature, user feedback evaluation is skewed in favor of the patient rather than nursing user experience. Furthermore, the ways in which different groups use the same RM platform at the same time are rarely directly compared in the literature. We present a balanced semantic analysis of user feedback from patient and nurse perspectives of Luscii, a smartphone-based RM strategy combining self-measurement of vital signs, instant messaging, and e-learning.</p><p><strong>Objective: </strong>This study aims to (1) evaluate how patients and nurses use this type of RM (usage type), (2) evaluate patients' and nurses' user feedback on this type of RM (user experience), and (3) directly compare the usage type and user experience of patients and nurses using the same type of RM platform at the same time.</p><p><strong>Methods: </strong>We performed a retrospective usage type and user experience evaluation of the RM platform from the perspective of both patients with heart failure with reduced ejection fraction and the HFSNs using the platform to manage them. We conducted semantic analysis of written patient feedback provided via the platform and a focus group of 6 HFSNs. Additionally, as an indirect measure of tablet adherence, self-measured vital signs (blood pressure, heart rate, and body mass) were extracted from the RM platform at onboarding and 3 months later. Paired 2-tailed t tests were used to evaluate differences between mean scores across the 2 timepoints.</p><p><strong>Results: </strong>A total of 79 patients (mean age 62 years; 35%, 28/79 female) were included. Semantic analysis of usage type revealed extensive, bidirectional information exchange between patients and HFSNs using the platform. Semantic analysis of user experience demonstrates a range of positive and negative perspectives. Positive impacts included increased patient engagement, convenience for both user groups, and continuity of care. Negative impacts included information overload for patients and increased workload for nurses. After the patients used the platform for 3 months, they showed significant reductions in heart rate (P=.004) and blood pressure (P=.008) but not body mass (P=.97) compared with onboarding.</p><p><strong>Conclusions: </strong>Smartphone-based RM with messaging and e-learning facilitates bilateral information sharing between patients and nurses on a range of topics. Patient and nurse user experience is largely positive and symmetrical, but there are possible negative impacts on patient attention and nurse workload. We recommend RM providers involve patient and nurse users in platform development, including recognition of RM usage in nursing job plans.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e44630"},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10282903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9707031","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":"Information and Communication Technologies to Support the Provision of Respite Care Services: Scoping Review.","authors":"Aimee R Castro, Lydia Ould Brahim, Qirong Chen, Antonia Arnaert, Amélie Quesnel-Vallée, Karyn Moffatt, John Kildea, Vasiliki Bitzas, Carolyn Pang, Audrey-Jane Hall, Ariana Pagnotta, Argerie Tsimicalis","doi":"10.2196/44750","DOIUrl":"10.2196/44750","url":null,"abstract":"<p><strong>Background: </strong>Respite care is one of the most frequently requested support services by family caregivers. Yet, too often, respite care services are inaccessible, due in part to families' lack of knowledge regarding available services and a lack of service flexibility. Information and communication technologies (ICTs) may help to improve the flexibility of services available and families' knowledge of such services. However, an understanding of the use of ICTs and research in this area is lacking.</p><p><strong>Objective: </strong>The objective of this study was to provide a comprehensive overview of the academic literature on ICTs for supporting the provision of respite care services.</p><p><strong>Methods: </strong>A scoping review study was conducted. Six library databases were systematically searched for relevant literature. Key data were extracted into a summary chart. Text and quantitative data were coded using descriptive qualitative content analysis techniques, and the results were collated and summarized into a comprehensive narrative.</p><p><strong>Results: </strong>A total of 23 papers describing 15 unique ICT programs exploring the potential of ICTs to support respite care services met the inclusion criteria. ICTs supported the provision of respite care by facilitating information-sharing with families and providers, recruiting and training respite care providers, and coordinating services. Key design considerations for developing respite care ICTs were trustworthiness and participatory design methods. Implementation considerations included designing for complementarity with existing services, assessing the appropriate timing for introducing the ICT-based services, and ensuring adequate promotion strategies to raise awareness about the services.</p><p><strong>Conclusions: </strong>There is limited but promising research on the potential of ICTs to support the provision of respite care services. Further research should be conducted to advance the results of this review, ultimately aiming to build ICTs that can improve the quality of, and access to, respite care services.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e44750"},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10265430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9641378","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}
JMIR nursingPub Date : 2023-05-18DOI: 10.2196/46673
Mette Linnet Olesen, Sine Rossen, Rikke Jørgensen, Line Langballe Udbjørg, Helena Hansson
{"title":"Usefulness of a Digitally Assisted Person-Centered Care Intervention: Qualitative Study of Patients' and Nurses' Experiences in a Long-term Perspective.","authors":"Mette Linnet Olesen, Sine Rossen, Rikke Jørgensen, Line Langballe Udbjørg, Helena Hansson","doi":"10.2196/46673","DOIUrl":"https://doi.org/10.2196/46673","url":null,"abstract":"<p><strong>Background: </strong>Person-centered care responsive to individual preferences, needs, and values is recognized as an important aspect of high-quality health care, and patient empowerment is increasingly viewed as a central core value of person-centered care. Web-based interventions aimed at empowerment report a beneficial effect on patient empowerment and physical activity; however, there is limited information available on barriers, facilitators, and user experiences. A recent review of the effect of digital self-management support tools suggests a beneficial effect on the quality of life in patients with cancer. On the basis of an overall philosophy of empowerment, guided self-determination is a person-centered intervention that uses preparatory reflection sheets to help achieve focused communication between patients and nurses. The intervention was adapted into a digital version called digitally assisted guided self-determination (DA-GSD) hosted by the Sundhed DK website that can be delivered face-to-face, via video, or by the combination of the 2 methods.</p><p><strong>Objective: </strong>We aimed to investigate the experiences of nurses, nurse managers, and patients of using DA-GSD in 2 oncology departments and 1 gynecology department over a 5-year implementation period from 2018 to 2022.</p><p><strong>Methods: </strong>This qualitative study was inspired by action research comprising the responses of 17 patients to an open-ended question on their experience of specific aspects of DA-GSD in a web questionnaire, 14 qualitative semistructured interviews with nurses and patients who initially completed the web questionnaire, and transcripts of meetings held between the researchers and nurses during the implementation of the intervention. The thematic analysis of all data was done using NVivo (QSR International).</p><p><strong>Results: </strong>The analysis generated 2 main themes and 7 subthemes that reflect conflicting perspectives and greater acceptability of the intervention among the nurses over time owing to better familiarity with the increasingly mature technology. The first theme was the different experiences and perspectives of nurses and patients concerning barriers to using DA-GSD and comprised 4 subthemes: conflicting perspectives on the ability of patients to engage with DA-GSD and how to provide it, conflicting perspectives on DA-GSD as a threat to the nurse-patient relationship, functionality of DA-GSD and available technical equipment, and data security. The other theme was what influenced the increased acceptability of DA-GSD among the nurses over time and comprised 3 subthemes: a re-evaluation of the nurse-patient relationship; improved functionality of DA-GSD; and supervision, experience, patient feedback, and a global pandemic.</p><p><strong>Conclusions: </strong>The nurses experienced more barriers to DA-GSD than the patients did. Acceptance of the intervention increased over time among the nurses in keeping wit","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e46673"},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9927932","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}
JMIR nursingPub Date : 2023-05-04DOI: 10.2196/44061
Jobbe P L Leenen, Henriëtte J M Rasing, Cor J Kalkman, Lisette Schoonhoven, Gijsbert A Patijn
{"title":"Process Evaluation of a Wireless Wearable Continuous Vital Signs Monitoring Intervention in 2 General Hospital Wards: Mixed Methods Study.","authors":"Jobbe P L Leenen, Henriëtte J M Rasing, Cor J Kalkman, Lisette Schoonhoven, Gijsbert A Patijn","doi":"10.2196/44061","DOIUrl":"https://doi.org/10.2196/44061","url":null,"abstract":"<p><strong>Background: </strong>Continuous monitoring of vital signs (CMVS) using wearable wireless sensors is increasingly available to patients in general wards and can improve outcomes and reduce nurse workload. To assess the potential impact of such systems, successful implementation is important. We developed a CMVS intervention and implementation strategy and evaluated its success in 2 general wards.</p><p><strong>Objective: </strong>We aimed to assess and compare intervention fidelity in 2 wards (internal medicine and general surgery) of a large teaching hospital.</p><p><strong>Methods: </strong>A mixed methods sequential explanatory design was used. After thorough training and preparation, CMVS was implemented-in parallel with the standard intermittent manual measurements-and executed for 6 months in each ward. Heart rate and respiratory rate were measured using a chest-worn wearable sensor, and vital sign trends were visualized on a digital platform. Trends were routinely assessed and reported each nursing shift without automated alarms. The primary outcome was intervention fidelity, defined as the proportion of written reports and related nurse activities in case of deviating trends comparing early (months 1-2), mid- (months 3-4), and late (months 5-6) implementation periods. Explanatory interviews with nurses were conducted.</p><p><strong>Results: </strong>The implementation strategy was executed as planned. A total of 358 patients were included, resulting in 45,113 monitored hours during 6142 nurse shifts. In total, 10.3% (37/358) of the sensors were replaced prematurely because of technical failure. Mean intervention fidelity was 70.7% (SD 20.4%) and higher in the surgical ward (73.6%, SD 18.1% vs 64.1%, SD 23.7%; P<.001). Fidelity decreased over the implementation period in the internal medicine ward (76%, 57%, and 48% at early, mid-, and late implementation, respectively; P<.001) but not significantly in the surgical ward (76% at early implementation vs 74% at midimplementation [P=.56] vs 70.7% at late implementation [P=.07]). No nursing activities were needed based on vital sign trends for 68.7% (246/358) of the patients. In 174 reports of 31.3% (112/358) of the patients, observed deviating trends led to 101 additional bedside assessments of patients and 73 consultations by physicians. The main themes that emerged during interviews (n=21) included the relative priority of CMVS in nurse work, the importance of nursing assessment, the relatively limited perceived benefits for patient care, and experienced mediocre usability of the technology.</p><p><strong>Conclusions: </strong>We successfully implemented a system for CMVS at scale in 2 hospital wards, but our results show that intervention fidelity decreased over time, more in the internal medicine ward than in the surgical ward. This decrease appeared to depend on multiple ward-specific factors. Nurses' perceptions regarding the value and benefits of the intervention varied. Impli","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e44061"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866395","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}
JMIR nursingPub Date : 2023-04-21DOI: 10.2196/44355
Rosa Maria Baños, Laura-Maria Peltonen, Blaine Martin, Ekaterina Koledova
{"title":"An Augmented Reality Mobile App (Easypod AR) as a Complementary Tool in the Nurse-Led Integrated Support of Patients Receiving Recombinant Human Growth Hormone: Usability and Validation Study.","authors":"Rosa Maria Baños, Laura-Maria Peltonen, Blaine Martin, Ekaterina Koledova","doi":"10.2196/44355","DOIUrl":"https://doi.org/10.2196/44355","url":null,"abstract":"<p><strong>Background: </strong>Children with growth hormone deficiency face the prospect of long-term recombinant human growth hormone (r-hGH) treatment requiring daily injections. Adherence to treatment is important, especially at treatment initiation, to achieve positive health outcomes. Historically, telenursing services embedded in patient support programs (PSPs) have been a valid approach to support r-hGH treatment initiation and patient education and facilitate adherence by identifying and optimizing appropriate injection techniques. The development of mobile phones with augmented reality (AR) capabilities offers nurses new tools to support patient education.</p><p><strong>Objective: </strong>To investigate experiences among nurses of a new mobile phone app developed to support patient training with a phone-based PSP for r-hGH treatment.</p><p><strong>Methods: </strong>In 2020, the Easypod AR mobile app was launched to support nurse-driven telehealth education for patients initiating r-hGH therapy with the Easypod electromechanical auto-injector device. Nurses who were part of PSPs in countries where the Easypod AR app had been launched or where training was provided as part of an anticipated future launch of the app were invited to participate in an online survey based on the Mobile App Rating Scale to capture their feedback after using the app.</p><p><strong>Results: </strong>In total, 23 nurses completed the online questionnaire. They positively rated the quality of the app across multiple dimensions. The highest mean scores were 4.0 for engagement (ie, adaptation to the target group; SD 0.74), 4.1 (SD 0.79) for functionality (navigation) and 4.1 (SD 0.67) for aesthetics (graphics). Responses indicated the potential positive impact of such a tool on enhancing patient education, patient support, and communication between patients and PSP nurses. Some participants also suggested enhancements to the app, including gamification techniques that they felt have the potential to support the formation of positive treatment behaviors and habits.</p><p><strong>Conclusions: </strong>This study highlights the potential for new digital health solutions to reinforce PSP nurse services, including patient education. Future studies could explore possible correlations between any behavioral and clinical benefits that patients may derive from the use of such apps and how they may contribute to support improved patient experiences and treatment outcomes.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e44355"},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9421513","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}
JMIR nursingPub Date : 2023-04-17DOI: 10.2196/42552
Maxim Topaz, Jiyoun Song, Anahita Davoudi, Margaret McDonald, Jacquelyn Taylor, Scott Sittig, Kathryn Bowles
{"title":"Home Health Care Clinicians' Use of Judgment Language for Black and Hispanic Patients: Natural Language Processing Study.","authors":"Maxim Topaz, Jiyoun Song, Anahita Davoudi, Margaret McDonald, Jacquelyn Taylor, Scott Sittig, Kathryn Bowles","doi":"10.2196/42552","DOIUrl":"10.2196/42552","url":null,"abstract":"<p><strong>Background: </strong>A clinician's biased behavior toward patients can affect the quality of care. Recent literature reviews report on widespread implicit biases among clinicians. Although emerging studies in hospital settings show racial biases in the language used in clinical documentation within electronic health records, no studies have yet investigated the extent of judgment language in home health care.</p><p><strong>Objective: </strong>We aimed to examine racial differences in judgment language use and the relationship between judgment language use and the amount of time clinicians spent on home visits as a reflection of care quality in home health care.</p><p><strong>Methods: </strong>This study is a retrospective observational cohort study. Study data were extracted from a large urban home health care organization in the Northeastern United States. Study data set included patients (N=45,384) who received home health care services between January 1 and December 31, 2019. The study applied a natural language processing algorithm to automatically detect the language of judgment in clinical notes.</p><p><strong>Results: </strong>The use of judgment language was observed in 38% (n=17,141) of the patients. The highest use of judgment language was found in Hispanic (7,167/66,282, 10.8% of all clinical notes), followed by Black (7,010/65,628, 10.7%), White (10,206/107,626, 9.5%), and Asian (1,756/22,548, 7.8%) patients. Black and Hispanic patients were 14% more likely to have notes with judgment language than White patients. The length of a home health care visit was reduced by 21 minutes when judgment language was used.</p><p><strong>Conclusions: </strong>Racial differences were identified in judgment language use. When judgment language is used, clinicians spend less time at patients' homes. Because the language clinicians use in documentation is associated with the time spent providing care, further research is needed to study the impact of using judgment language on quality of home health care. Policy, education, and clinical practice improvements are needed to address the biases behind judgment language.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e42552"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10152333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9404691","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}
JMIR nursingPub Date : 2023-02-06DOI: 10.2196/40676
Haoqiang Jiang, Arturo Castellanos, Alfred Castillo, Paulo J Gomes, Juanjuan Li, Debra VanderMeer
{"title":"Nurses' Work Concerns and Disenchantment During the COVID-19 Pandemic: Machine Learning Analysis of Web-Based Discussions.","authors":"Haoqiang Jiang, Arturo Castellanos, Alfred Castillo, Paulo J Gomes, Juanjuan Li, Debra VanderMeer","doi":"10.2196/40676","DOIUrl":"https://doi.org/10.2196/40676","url":null,"abstract":"<p><strong>Background: </strong>Web-based forums provide a space for communities of interest to exchange ideas and experiences. Nurse professionals used these forums during the COVID-19 pandemic to share their experiences and concerns.</p><p><strong>Objective: </strong>The objective of this study was to examine the nurse-generated content to capture the evolution of nurses' work concerns during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We analyzed 14,060 posts related to the COVID-19 pandemic from March 2020 to April 2021. The data analysis stage included unsupervised machine learning and thematic qualitative analysis. We used an unsupervised machine learning approach, latent Dirichlet allocation, to identify salient topics in the collected posts. A human-in-the-loop analysis complemented the machine learning approach, categorizing topics into themes and subthemes. We developed insights into nurses' evolving perspectives based on temporal changes.</p><p><strong>Results: </strong>We identified themes for biweekly periods and grouped them into 20 major themes based on the work concern inventory framework. Dominant work concerns varied throughout the study period. A detailed analysis of the patterns in how themes evolved over time enabled us to create narratives of work concerns.</p><p><strong>Conclusions: </strong>The analysis demonstrates that professional web-based forums capture nuanced details about nurses' work concerns and workplace stressors during the COVID-19 pandemic. Monitoring and assessment of web-based discussions could provide useful data for health care organizations to understand how their primary caregivers are affected by external pressures and internal managerial decisions and design more effective responses and planning during crises.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e40676"},"PeriodicalIF":0.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9907981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236327","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}
JMIR nursingPub Date : 2023-01-13DOI: 10.2196/41331
Christopher Picard, Manal Kleib, Colleen Norris, Hannah M O'Rourke, Carmel Montgomery, Matthew Douma
{"title":"The Use and Structure of Emergency Nurses' Triage Narrative Data: Scoping Review.","authors":"Christopher Picard, Manal Kleib, Colleen Norris, Hannah M O'Rourke, Carmel Montgomery, Matthew Douma","doi":"10.2196/41331","DOIUrl":"10.2196/41331","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments use triage to ensure that patients with the highest level of acuity receive care quickly and safely. Triage is typically a nursing process that is documented as structured and unstructured (free text) data. Free-text triage narratives have been studied for specific conditions but never reviewed in a comprehensive manner.</p><p><strong>Objective: </strong>The objective of this paper was to identify and map the academic literature that examines triage narratives. The paper described the types of research conducted, identified gaps in the research, and determined where additional review may be warranted.</p><p><strong>Methods: </strong>We conducted a scoping review of unstructured triage narratives. We mapped the literature, described the use of triage narrative data, examined the information available on the form and structure of narratives, highlighted similarities among publications, and identified opportunities for future research.</p><p><strong>Results: </strong>We screened 18,074 studies published between 1990 and 2022 in CINAHL, MEDLINE, Embase, Cochrane, and ProQuest Central. We identified 0.53% (96/18,074) of studies that directly examined the use of triage nurses' narratives. More than 12 million visits were made to 2438 emergency departments included in the review. In total, 82% (79/96) of these studies were conducted in the United States (43/96, 45%), Australia (31/96, 32%), or Canada (5/96, 5%). Triage narratives were used for research and case identification, as input variables for predictive modeling, and for quality improvement. Overall, 31% (30/96) of the studies offered a description of the triage narrative, including a list of the keywords used (27/96, 28%) or more fulsome descriptions (such as word counts, character counts, abbreviation, etc; 7/96, 7%). We found limited use of reporting guidelines (8/96, 8%).</p><p><strong>Conclusions: </strong>The breadth of the identified studies suggests that there is widespread routine collection and research use of triage narrative data. Despite the use of triage narratives as a source of data in studies, the narratives and nurses who generate them are poorly described in the literature, and data reporting is inconsistent. Additional research is needed to describe the structure of triage narratives, determine the best use of triage narratives, and improve the consistent use of triage-specific data reporting guidelines.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1136/bmjopen-2021-055132.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e41331"},"PeriodicalIF":0.0,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9883744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10639549","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}
JMIR nursingPub Date : 2023-01-06DOI: 10.2196/39815
Amy Vercell, Sally Taylor, Janelle Yorke, Dawn Dowding
{"title":"Assessing the Acceptability of Home Blood Monitoring for Patients With Cancer Who Are Receiving Systemic Anticancer Therapy From a Patient, Caregiver, and Clinician Perspective: Focus Group and Interview Study.","authors":"Amy Vercell, Sally Taylor, Janelle Yorke, Dawn Dowding","doi":"10.2196/39815","DOIUrl":"https://doi.org/10.2196/39815","url":null,"abstract":"<p><strong>Background: </strong>Regular blood testing is an integral part of systemic anticancer therapy delivery. Blood tests are required before every administration of treatment to ensure that a patient is sufficiently well to receive it. Blood testing is burdensome for patients as they require either an extra visit within 48 hours of planned administration of treatment or a significantly long visit if performed on the day of treatment. The additional time for appointments can have a significant impact on the quality of life of someone who is living with cancer. In the United Kingdom, the COVID-19 pandemic created unprecedented disruption to the delivery of cancer care. Face-to-face hospital visits were reduced, resulting in the need to develop more innovative ways of working to minimize treatment interruptions. This led to significant uptake of digital technologies, with new models of care rapidly deployed across the UK health service to meet these challenges.</p><p><strong>Objective: </strong>This study aimed to explore the acceptability of a point-of-care home blood monitoring device for people with cancer who are receiving systemic anticancer therapy, which is being developed in response to the increased need for remote care for patients with cancer.</p><p><strong>Methods: </strong>Qualitative focus groups and semistructured interviews were conducted with patients (23/47, 49%), caregivers (6/47, 13%), and health care professionals (18/47, 38%) over a 19-month time frame from May 2019 to December 2020. Data were analyzed using framework analysis guided by the Unified Theory of Acceptance and Use of Technology model.</p><p><strong>Results: </strong>Analysis identified 4 overarching themes: performance expectancy, effort expectancy, social influence, and facilitating conditions.</p><p><strong>Conclusions: </strong>This study found that patients with cancer, their caregivers, and health care professionals had positive perceptions about home blood monitoring. Although they are often considered synonymously, self-testing and self-management are not mutually exclusive, and this study illustrated some disparity in opinions regarding patient self-management. Home blood monitoring has the potential to provide patients with cancer with a convenient option for blood monitoring. It would minimize hospital attendances, decrease late treatment deferrals, and provide prompt recognition of cancer treatment toxicities, thus enhancing the existing nurse-led protocols and clinical pathways. Home blood monitoring would create a long-term sustainable transformation for the delivery of cancer care, using digital health to act as a facilitator to address a pertinent issue regarding improving the efficiency of hospital resources and increasing the delivery of personalized patient care. Further studies are needed to determine how and where home blood monitoring would fit within clinical pathways, in a way that is robust and equitable.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e39815"},"PeriodicalIF":0.0,"publicationDate":"2023-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10557148","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":"Nurse-Led Virtual Delivery of PIECES in Canadian Long-Term Care Homes to Support the Care of Older Adults Experiencing Responsive Behaviors During COVID-19: Qualitative Descriptive Study.","authors":"Anna Garnett, Denise Connelly, Marie-Lee Yous, Lillian Hung, Nancy Snobelen, Melissa Hay, Cherie Furlan-Craievich, Shannon Snelgrove, Melissa Babcock, Jacqueline Ripley, Pam Hamilton, Cathy Sturdy-Smith, Maureen O'Connell","doi":"10.2196/42731","DOIUrl":"https://doi.org/10.2196/42731","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the COVID-19 pandemic has resulted in profound loss of life among older adults living in long-term care (LTC) homes. As a pandemic response, LTC homes enforced infection control processes, including isolating older adults in their rooms, canceling therapeutic programs, and restricting family member visits. Social isolation negatively impacts older adults in LTC, which may result in increased rates of anxiety, depression, physical and cognitive decline, disorientation, fear, apathy, and premature death. Isolation of older adults can also cause an increase in responsive behaviors (eg, yelling, hitting, calling out) to express frustration, fear, restricted movement, and boredom. To respond to the challenges in LTC and support frontline staff, older adults, and family members, a novel registered practical nurse (RPN)-led delivery of the PIECES approach for addressing responsive behaviors among older adults with dementia using virtual training/mentoring was implemented in Canadian LTC homes. PIECES employs a person- and family/care partner-centered collaborative team-based approach to provide education and capacity-building for nurses; engages families as active participants in care; and embeds evidence-informed practices to provide person- and family-centered care to older adults with complex needs, including dementia.</p><p><strong>Objective: </strong>The aim of this study was to describe the experiences of LTC staff, family/care partners, and older adult research partners with implementation of a novel RPN-led virtual adaptation of the PIECES care-planning approach for responsive behaviors in two Canadian LTC homes during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Using a qualitative descriptive design, two focus groups were held with three to four staff members (eg, RPNs, managers) per LTC home in Ontario. A third focus group was held with three PIECES mentors. Individual semistructured interviews were conducted with RPN champions, family/care partners, and older adult research partners. Research team meeting notes provided an additional source of data. Content analysis was performed.</p><p><strong>Results: </strong>A total of 22 participants took part in a focus group (n=11) or an in-depth individual interview (n=11). Participant experiences suggest that implementation of RPN-led virtual PIECES fostered individualized care, included family as partners in care, increased interdisciplinary collaboration, and improved staff practices. However, virtual PIECES, as delivered, lacked opportunities for family member feedback on older adult outcomes. Implementation facilitators included the provision of mentorship and leadership at all levels of implementation and suitable technological infrastructure. Barriers were related to availability and use of virtual communication technology (family members) and older adults became upset due to lack of comprehension during virtual care conferences.</p><p><stro","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"5 1","pages":"e42731"},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10389982","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}