Biomedical subjects

Patricia Flatley Brennan

Publications and source records attributed to Patricia Flatley Brennan.

At least 19 recordsLinked to original sources

PubMed2006

Guideposts to the future--an agenda for nursing informatics.

As new directions and priorities emerge in health care, nursing informatics leaders must prepare to guide the profession appropriately. To use an analogy, where a road bends or changes directions, guideposts indicate how drivers can stay on course. The AMIA Nursing Informatics Working Group (NIWG) produced this white paper as the product of a meeting convened: 1) to describe anticipated nationwide changes in demographics, health care quality, and health care informatics; 2) to assess the potential impact of genomic medicine and of new threats to society; 3) to align AMIA NIWG resources with emerging priorities; and 4) to identify guideposts in the form of an agenda to keep the NIWG on course in light of new opportunities. The anticipated societal changes provide opportunities for nursing informatics. Resources described below within the Department of Health and Human Services (HHS) and the National Committee for Health and Vital Statistics (NCVHS) can help to align AMIA NIWG with emerging priorities. The guideposts consist of priority areas for action in informatics, nursing education, and research. Nursing informatics professionals will collaborate as full participants in local, national, and international efforts related to the guideposts in order to make significant contributions that empower patients and providers for safer health care.

Forecasting↗

PubMed2006

Cross-cultural factors necessary to enable design of flexible consumer health informatics systems (CHIS).

Examples from on-going work are analyzed to point out cross-cultural factors that need consideration as they are likely to influence the design of consumer health information systems (CHIS). Tailored and flexible presentation of information, appropriate communication services and access to health information can contribute to CHIS use in diverse local and international contexts. It is argued that being mindful of socio-cultural environments, age groups, and health conditions will enhance design and use of CHIS. This will augment current approaches by developing more suitable and culturally sensitive CHIS.

Consumer Health Information↗

PubMed2006

Photographic data--An untapped resource to explore complex phenomena such as health information management in the household (HIMH).

Exploring the context of use for informatics tools and applications can provide insight into requirements for their design. Historically, photographs have been used by social scientists as a way to study context in complex environments. Using data collected in the study "Advanced technologies for Health@Home" we share how photographs can be used to understand one such complex environment where informatics tools appear, the household. By capture, categorization, analysis and interpretation of photographs, we developed a richer understanding of information artifacts and the context of these artifacts used to support health information management in the household (HIMH). Photographs are an underused data source. Appropriately used, photographs can aid in the development of informatics resources that align with and extend current practices of health information management in the household (HIMH). Their use should be investigated further concerning other complex environments within nursing informatics.

Delivery of Health Care↗

PubMed2006

Making the procedure manual come alive: A prototype relational database and dynamic website model for the management of nursing information.

The nursing procedural manual is an essential resource for clinical practice, yet insuring its currency and availability at the point of care remains an unresolved information management challenge for nurses. While standard HTML-based web pages offer significant advantage over paper compilations, employing emerging computer science tools offers even greater promise. This paper reports on the creation of a prototypical dynamic web-based nursing procedure manual driven by a relational database. We created a relational database in MySQL to manage, store, and link the procedure information, and developed PHP files to guide content retrieval, content management, and display on demand in browser-viewable format. This database driven dynamic website model is an important innovation to meet the challenge of content management and dissemination of nursing information.

Information Management↗

PubMed2006

Creating technology-enhanced practice: A university-home care-corporate alliance.

Insuring full benefit of consumer health informatics innovations requires integrating the technology into nursing practice, yet many valuable innovations are developed in research projects and never reach full integration. To avoid this outcome, a team of researchers partnered with a home care agency's staff and patients and their corporate parent's Information Systems and Research group to create a Technology-Enhanced Practice (TEP) designed to enhance care of home bound patients and their family care givers. The technology core of TEP, the HeartCare2 web site, was built in a collaborative process and deployed within the existing patient portal of the clinical partner. This paper describes the innovation and the experience of bringing it into full operation.

Cooperative Behavior↗

PubMed2005

Health@Home: the work of health information management in the household (HIMH): implications for consumer health informatics (CHI) innovations.

OBJECTIVE: Contemporary health care places enormous health information management demands on laypeople. Insights into their skills and habits complements current developments in consumer health innovations, including personal health records. Using a five-element human factors model of work, health information management in the household (HIMH) is characterized by the tasks completed by individuals within household organizations, using certain tools and technologies in a given physical environment. DESIGN: We conducted a descriptive-exploratory study of the work of HIMH, involving 49 community-dwelling volunteers from a rural Midwestern community. MEASUREMENTS: During in-person interviews, we collected data using semistructured questionnaires and photographs of artifacts used for HIMH. RESULTS: The work of HIMH is largely the responsibility of a single individual, primarily engaged in the tasks of acquiring, managing, and organizing a diverse set of health information. Paper-based tools are most common, and residents develop strategies for storing information in the household environment aligned with anticipated use. Affiliative relationships, e.g., parent-child or spousal, within the household serve as the organization that gives rise to health information management practices. Synthesis of these findings led to identification of several storage strategies employed in HIMH. These strategies are labeled "just-in-time," "just-because," "just-in-case," and "just-at-hand," reflecting location of the artifacts of health information and anticipated urgency in the need to retrieve it. CONCLUSION: Laypeople develop and employ robust, complex strategies for managing health information in the home. Capitalizing on these strategies will complement and extend current consumer health innovations to provide functional support to people who face increasing demands to manage personal health information.

Adolescent↗

PubMed2005

Perceived health status and health-promoting behaviors of African-American and White informal caregivers of impaired elders.

Caregiving and its consequences are major concerns for nurses. Many studies have examined health-promoting behaviors in general (Duffy, 1993; Walker, Volkan, Sechrist, & Pender, 1988), but few studies have explored health-promoting behaviors of caregivers. The purpose of this study was to examine the effects of age, gender, race, and length of caregiving on perceived health status and health-promoting behaviors of African-American and White informal caregivers of impaired elders. Data from a larger study was used to examine a conceptual model linking perceived health status and health-promoting behavior. A sample of 136 (n = 136) African-American and 257 (n = 257) White caregivers was recruited from northeastern Ohio through random digit dialing and interviewed face to face. English-speaking caregivers were selected for study who provided unpaid assistance or care for a minimum of five hours a week to an impaired person 60 years of age or older living in the community. The Health-Promoting Behavior Questionnaire, perceived health status, and a demographic profile were used to measure the study variables. Data were analyzed using hierarchical multiple regression. Findings from this study suggest that the overall fit of the conceptual model was significant, and that moreover, the relationship found between perceived health status and health-promoting behaviors supported Pender's model of health promotion (Pender, 1987). The relationship between perceived health status and health-promoting behaviors has not been documented in prior studies of caregivers, or in studies comparing the two racial groups of African-Americans and Whites.

Adult↗

PubMed2005

Modeling participation in the NHII: operations research approach.

Regional health information organizations (RHIOs) form the core building blocks of any approach to creating the National Health Information Infrastructure. RHIOs are computer-supported information sharing alliances composed of health care institutions that need to exchange clinical, financial or administrative data. Many uncertainties, including institution conversion costs, price-to-participate, and RHIO governance decisions make estimating the cost consequences difficult to establish. Current approaches to health information technology investment rely on a net-present-value analysis, which is inadequate to capture the dynamic, uncertain course likely to occur in the RHIO environment. Methods from operations research provide decision makers robust tools for exploring the cost and consequences of RHIO structures. We present here an initial modeling approach that allows explicit examination of RHIO structure and pricing options. Once refined, these models will provide the core of a suite of decision support tools for evaluation of RHIO pricing options, discount rates, and optimal organizational structures.

Community Networks↗

PubMed2005

What are pregnant women's information needs and information seeking behaviors prior to their prenatal genetic counseling?

As a result of the Human Genome Project, more genetic diagnostic tests have become available to the public and genetic-related information has also grown exponentially. Pregnant women are now routinely offered tests for chromosomal disorders and screenings for genetic conditions that are relevant to their situations. In order to facilitate the information system (IS) development to support their informed decision-making, it is imperative for the IS designer to recognize their unique information needs and patterns of information seeking behavior (ISB) first. This paper presents results of a pilot study that examined pregnant women's information needs, ISBs, and information resources used prior to their prenatal genetic counseling. Findings suggest three distinctive areas, content, format, and timing, for IS design considerations.

Adolescent↗

PubMed2005

Health information exchange networks: understanding stakeholder views.

As the National Health Information Infrastructure (NHII) gains momentum, regional health information exchange networks are developing as a means to support this structure. While successful networks exist, their sustainability is complicated by the existence of multiple stakeholders with differing incentives for participation. Interviews conducted regarding the development of the NMESH network produced several key areas of stakeholder focus, an important step in creating network sustainability.

Delivery of Health Care↗

PubMed2004

A consensus action agenda for achieving the national health information infrastructure.

BACKGROUND: Improving the safety, quality, and efficiency of health care will require immediate and ubiquitous access to complete patient information and decision support provided through a National Health Information Infrastructure (NHII). METHODS: To help define the action steps needed to achieve an NHII, the U.S. Department of Health and Human Services sponsored a national consensus conference in July 2003. RESULTS: Attendees favored a public-private coordination group to guide NHII activities, provide education, share resources, and monitor relevant metrics to mark progress. They identified financial incentives, health information standards, and overcoming a few important legal obstacles as key NHII enablers. Community and regional implementation projects, including consumer access to a personal health record, were seen as necessary to demonstrate comprehensive functional systems that can serve as models for the entire nation. Finally, the participants identified the need for increased funding for research on the impact of health information technology on patient safety and quality of care. Individuals, organizations, and federal agencies are using these consensus recommendations to guide NHII efforts.

Health Policy↗

PubMed2004

Information technology as an infrastructure for patient safety: nursing research needs.

This article describes the process utilized to create research questions which promote technology as an infrastructure to enable safe nursing practice. Beginning with scenarios of safety problems related to nursing practice, the team identified information technology including hardware, software, and organizational and operational components to help improve the safety aspects addressed in the scenarios. Further discussed are characteristics of technology necessary at each step in the nursing process and finally recommendations are presented for various research questions that would be needed to enable research on the use of the proposed technologies.

Computers↗

PubMed2004

Patient safety. Remember who it's really for.

Patients appear in the patient safety agenda in three important places: first and foremost as the individual most likely to experience the positive benefits of good care or negative consequences of unsafe care; second, as surveyors of quality of care indicators; and finally, through their presence as patient representatives on institutional safety committees. However, patient safety programs largely address provider-interests, and many times overlook patient preferences and needs. Active engagement of the patient in all aspects of the patient safety agenda is necessary for its success. Patient safety, then, requires: a comprehensive agenda informed by patient preferences and experiences; an informed and motivated populace; mechanisms integrate safe practices and patient preferences, and investment in safety-enhancing devices and care strategies.

Health Behavior↗

PubMed2004

Community-wide information systems design: concepts and an illustration.

Models for community-wide information systems design help insure the development of a health information infrastructure that supports life-long, community-centric, patient focused care. Collaborating with community health planning groups provides a reasonable starting point for such endeavors. We review existing approaches to community-based information systems design, draw design principles from the experiences of past innovations, and describe our team's experience in partnering with a community health planning group to establish a community-wide design approach to information systems design. Key themes include (1) partnerships; (2) brokering and integrating existing initiatives; and (3) creating business models for sustainability

Community Health Planning↗

PubMed2004

Linguistic analysis: terms and phrases used by patients in e-mail messages to nurses.

While some researchers are focusing on mapping free-text within health care fields into controlled vocabularies and classifications, many researchers are focusing on consumers' vocabularies. Using natural language processing (NLP) tools, such as MetaMap, to extract and map into terms in a controlled vocabulary is one way of understanding the pattern of terms used by lay people. Before an NLP tool can be effectively and efficiently used to extract concepts and create machine-understandable interpretations of the data, the appropriateness of the tool needs to be determined. This study aims were to determine the appropriateness of linguistic meaning captured for terms and phrases used by patients in electronic mail messages to nurses, using nursing-specific MetaMap output. Twenty messages were randomly selected from the 241 messages data set. Results indicated that four out of six nursing classification systems captured more than 50 % of the parsed word's linguistic meaning. This study demonstrates that it is possible to automatically extract and capture the linguistic meaning of the terms patients use in their electronic mail messages.

Electronic Mail↗

PubMed2003

Design and evaluation of SchoolhealthLink, a Web-based health information resource.

SchoolhealthLink, a Web-based information service for Missouri school nurses, is a promising resource to reach school nurses isolated from traditional professional networks. It also may serve as an important adjunct to stay abreast of the latest health information. Using a strategy to identify the health information needs of school nurses and to test the site early in its development, this pilot study found school nurses reported SchoolhealthLink was an easy-to-use method to find high-quality, up-to-date information relevant to school nursing practice, was better than existing methods to access information, and could change the way they practiced. In order to continue to build SchoolhealthLink, a partnership with Barnes College of Nursing and the Missouri Association of School Nurses has been established to work together to continue to add health information resources useful to school nursing practice.

Attitude of Health Personnel↗

PubMed2002

Patient-centered interventions.

Patient-centered care is valued in nursing. However, until recently, nurse-researchers have focused on testing the effects of standardized rather than patient-centered interventions (PCIs). The latter are those interventions that are altered to address selected patient characteristics (e.g., beliefs, habits, or goals). PCIs have been well received, and in some studies they have been associated with improved health outcomes. In this article we describe briefly the concept patient centered, summarize the development of research on PCIs, discuss kinds of PCIs, provide examples of PCIs and how they have been derived and implemented, and raise issues for theory and future research.

Forecasting↗

PubMed2002

Telehealth interventions to improve clinical nursing of elders.

This chapter reviews reports of research conducted worldwide from 1966 to January 2001 on telehealth interventions in clinical nursing for elders. Reports were identified through a systematic search of MEDLINE, CINAHL, PsychInfo, ERIC, and ACM using the search terms Telemedicine or Health Information Networks, Nursing, and Research, and were restricted to those published in English. Reports of research using interactive computer technology to assess or intervene with nursing problems commonly observed in persons age 65 and older were sought. Only published reports presenting the findings of an exploratory or experimental study and exploring the association between one intervention variable and technology were included. The search resulted in 18 research reports describing eight research projects. Due to the preponderance of demonstrations and feasibility reports, the dearth of experimental investigations, and the heterogeneous nature of the few studies identified, statistical summarization was not attempted. Telehealth interventions have the potential to improve the clinical nursing care of elders because they provide alternative, equivalent approaches to assess key indicators of the physical and psychological state of elders; are acceptable to nurses, elders, and family caregivers; and may prove less costly than face-to-face interventions. Telehealth approaches provide not only acceptable substitutes for discrete nursing actions but also can serve as a context within which a large range of professional gerontological nursing services can be delivered in a manner that is timely and convenient for elders.

Aged↗