[How do nurses use their time?].
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Biomedical subjects
Publications and source records attributed to G Hendrickson.
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Nurses spend an average of only 31% of their time with patients. The authors determined how nurses spend their time and suggest three ways to reduce time spent on non-essential nursing functions: delegation of some tasks to support personnel, greater use of pharmacy personnel in a decentralized setting, and greater use of computers. Together these changes may both decrease demand for nurses' time and enable professional nurses to focus their energy on tasks that require professional expertise.
An interactive microcomputer-videodisc programme for providing instruction in interpreting the peripheral blood smear was evaluated by 23 medical students. The mean scores of the students on a test of interpretation of photomicrographs of blood smears increased significantly after use of the teaching programme. The students' responses to a questionnaire indicated that they viewed computer based instruction as a useful learning tool. The results of the study suggest that computer assisted instruction may be one method for addressing some of the current problems in medical education.
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A double-blind controlled study comparing the effects of bupropion to doxepin in outpatients with primary depression was conducted to evaluate efficacy and safety differences between the two drugs. Following a 7-day placebo washout period, patients could be treated for up to 13 weeks on either treatment. Antidepressant response was assessed by the Hamilton Depression and Anxiety Scales, Clinical Global Severity and Improvement Ratings, and the Zung Self-Rating Depression Scale. Comparable efficacy between the compounds was found across the 13-week study. Doxepin differed from bupropion mainly on the sleep factor of the Hamilton Depression Scale, with doxepin improving sleep to a greater extent than bupropion. Doxepin produced a greater incidence of anticholinergic side effects, including dry mouth, constipation, sleepiness, and tiredness, in comparison to bupropion. Also, increased appetite and weight gain were consistent side effects of doxepin relative to bupropion.
Over the past seven years, Columbia-Presbyterian Medical Center has been planning and implementing an integrated academic information management system. Accomplishments to date include establishing an institutional information architecture, installing a campus-wide network of workstations, recruiting the staff needed to develop and implement the system, and developing various applications. This paper presents the rationale and steps involved in these accomplishments, as well as data on use of the system so far.
Computers assist oncology nurses in their roles as "care integrators" and caregivers. Computers assist nurses in their care integrator role by supporting communication with ancillary departments and by aiding in the collection, organization, and storage of data. Computers helps nurses in their role as caregivers through automated care planning, discharge planning, and patient monitoring and by tracking patients' educational, therapeutic, comfort, or other needs. Using computers, nurses can document their assessments and interventions and patient outcomes while receiving cues and reminders about policies, procedures, and standards of care. In the future, oncology nurses can expect to see computer technology in more hospitals and a host of new developments, such as more intelligent systems, nursing and medical knowledge on-line, documentation at the bedside, and use of patient data bases in education and research.
The effects of information systems on nursing resource use are reviewed. The information systems in place in various hospitals differ in major ways; some have an impact on nursing resource use while others do not. Evidence is strong and consistent that computer systems that manage flow of information between nursing units and ancillary departments save time for nurses. The reported findings may even understate the case because workload may have increased during the period of the studies. There is also strong, but unreplicated, evidence that a work plan or electronic Kardex for each patient saves time at report. If nurses are paid for overtime, these savings can translate into cost savings for hospitals. On the other hand, systems that emphasize on-line charting and not communications do not save time. Bedside terminals are too new to have been subjected to careful research by independent investigators, but early reports, which primarily come from vendors, indicate that bedside terminals may further save time and reduce errors. More systematic research into effects of various components is needed to fully document the effect of computers on nurses' time.
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