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PubMedDate not supplied

The meaning of mental health: a report of two ethnoscientific studies.

The use of the ethnoscientific method in nursing research is demonstrated in an initial study and a replication of that study, utilizing male and female informants. The domain of "mental health" was explored, analyzed, and contrasted within the subculture of the central city resident and the subculture of the psychiatric-mental health professional. To facilitate an understanding of ethnoscience, the method is briefly outlined; then, to illustrate the methodology, data from one informat are presented in depth. A summary of the major similarities and contrasts that emerged from the data of both studies is presented. Implications for nursing of the research and ethnoscience are discussed.

Adult↗
PubMed2001

The nursing terminology summit: collaboration for progress.

The Nursing Terminology Summit has used collaborative processes to bring about significant changes in the development of terminology standards for nursing. This paper draws on agendas, reports, notes, and other documents from the Summit, in addition to the authors' own experience as Organizer, Steering Committee, and participants, to provide a brief history of the Summit process. The analysis identifies factors that increased the risk of failure as well as factors that fostered success. The paper concludes with lessons learned that can be applied in other arenas to promote change in medical informatics.

Nursing↗
PubMed2004

Health informatics education for clinicians and managers--what's holding up progress?

This paper reports outcomes of a national survey of health informatics (HI) education and training carried out in the UK. A questionnaire to elicit details of HI and IT skills teaching was derived from a national consensus document (Learning to Manage Health Information, LtMHI). Forms were sent to all pre-qualification medical and nursing schools and to a stratified sample of postgraduate and post-registration programmes. Three case studies were carried out in acute hospital trusts to gain insight into opportunities for continuing professional development in health informatics and IT. Our evidence suggests that in the UK, health informatics is not yet integrated into the clinical curriculum. Nearly all the pre-qualification courses made some provision for teaching IT skills. Nonetheless, many respondents felt that students did not receive sufficient training. There was considerable variation in the amount of HI teaching provided in the different educational sectors. The case studies suggested very little HI training was provided for clinical staff and take-up of provision was not monitored. A number of factors are holding up progress, the most important being a lack of staff with the knowledge and skills to provide academic leadership. The paper outlines some steps that need to be taken to ensure health informatics is embedded in all clinical curricula.

Computer Literacy↗
PubMed2002

Save our skin.

Explore the source record for details and available documents.

Education, Nursing, Continuing↗
PubMed2005

HIPAA: a few years later.

This article addresses the impact of the Health Insurance Portability and Accountability Act (HIPAA) several years after implementation. The rationale for HIPAA and a clarification of key terms, including covered entities, personal health information, and designated record sets, is reviewed. The impact of HIPAA at work, including increased cost and the complexities of educating employees and patients is assessed. Implications for homeland security, disaster planning, unique patient identifiers, the compilation of personal health records, and research are discussed.

Attitude of Health Personnel↗
PubMed1994

Automation at the point of care.

Clinical Information Systems (CISs) are systems of microcomputers used at patient bedsides to collect, process, retrieve and display information related to patient care. At our facility, 65 terminals are used in selected units and the CIS has virtually replaced paper charts in daily practice and documentation. Though currently employed in only a small number of hospitals, the use of CISs is expected to grow rapidly during the coming decade.

Computer Systems↗
PubMed2004

Research in long-term care: issues, dilemmas, and challenges from the public purchaser's perspective.

Expenditures for long-term care for older Americans are sizable and likely to increase as the population ages. As the largest purchaser of health care for this group of citizens, the Centers for Medicare & Medicaid Services (CMS) is working to improve the quality of the long-term care services it purchases through quality monitoring and enforcement, providing information to beneficiaries about quality of care and enhancing resources to improve quality. Although CMS has used the best scientific information available to inform the planning of quality initiative projects, there are a number of issues, dilemmas, and challenges for which the research base is insufficient to fully answer programmatic needs. In many instances, research needs in the long-term care setting differ substantially from those in acute care. Using the Nursing Home Quality Initiative as an example, this article presents a descriptive, conceptual discussion of strategic issues and a summary of research that would be valuable in informing critical areas of decision-making in quality and outcomes research over the next decade. The issues, dilemmas, and challenges discussed are grouped into 5 categories: measurement methods and tools, uses of quality data, organizational and cultural factors, information and informatics, and impact evaluation and research.

Health Services Research↗
PubMed2004

'Rage against the machine?': nurses' and midwives' experiences of using Computerized Patient Information Systems for clinical information.

BACKGROUND: Computerized Patient Information Systems (CPIS) are used increasingly in health care, yet few studies have asked clinicians to describe their experiences of using these systems and what they mean to their practice and patient care. AIMS AND OBJECTIVES: The aim of this study was to explore clinical nurses' and midwives' perceptions and understandings of computerized information systems in everyday practice. The objective was to provide a detailed and faithful account of clinicians' experiences of using such systems. DESIGN: A qualitative design was used, based upon interpretive phenomenology. METHODS: A total of 13 focus groups involving 53 practitioners was conducted in hospitals across five Australian states with nurses and midwives from a wide range of practice settings. The participants ranged from Level 1 RNs to Clinical Nurse Consultants and nurses with an IT project management role. RESULTS: This study focuses specifically on clinicians' experiences of using CPIS to manage clinical information. Clinicians' experiences were characterized by digital disappointment rather than electronic efficiencies. Clinicians reported generally that computerization had neither enhanced their clinical practice nor patient care, nor had it improved patient outcomes. CONCLUSIONS: Participants' experiences were predominantly negative and mostly critical of CPIS and their: perceived inability to capture 'real nursing', difficulty in use, incompatibilities, non-responsiveness and irrelevance to patient care and meaningful clinical outcomes. RELEVANCE TO CLINICAL PRACTICE: Technological 'solutions' to health care problems are endlessly seductive and easily entrance policy and decision makers. Computerization will continue to impact upon clinical practice and cannot be wished away. Today's computerized systems may have been developed with scant regard for clinician end-users. A crucial issue facing everyone in health informatics is how point-of-care systems can be developed in ways that involve clinicians meaningfully and which recognize and respond to the complexity and subtlety of the world of nursing and midwifery practice.

Attitude of Health Personnel↗
PubMed2001

Informatics in managed care: HIM adds value to data.

The third installment of the Journal of AHIMA's special series on managed care focuses on informatics--methods that add value to data, turning it into useful information. How do informatics and managed care fit together and what is HIM's role in this picture? The HIM professional's knowledge is critical to the health team responsible for the interpretation and use of statically valid information. For example, HIM professionals are well positioned in their understanding of the construct and application of coding classification systems (ICD-9-CM, CPT, etc.), and groupers (DRGs, APCs, ETGs, etc.). Their unique training positions them to understand the associated rules, principles, guidelines, and nuances associated with correct coding and grouping. And when codes or groupers change, HIM professionals work closely with the health team to ensure parity, validity and reliability of the appropriate data or data sets. Managed care organizations use value-added data, as you will see in this article, to evaluate contract pricing, develop contracts, evaluate existing services or detail benefit plans, process and in some instances pay claims, and report results to a number of interested parties. The previous article in this series ("Can You Manage Managed Care?" July/August 2001) focused on effective management of data, including data acquisition. This article takes us to the next level, where informatics creates value-added information, and discusses some important uses of this information within managed care. These articles build on two of the functional areas that form the HIM process within managed care organizations. Author Scott Stratton studied under the creators of DRGs and was involved in the development of their nursing home counterpart, RUGs. He also has worked with the creators of ETGs. As a result, he can present the perspective and context within which these systems were created and intended. and how they form the foundation for informatics as a functional area within managed care.

Diagnosis-Related Groups↗
PubMed2002

Integrating health services research into nursing doctoral programs: the evolution of nursing research.

Traditionally, nursing research has focused on the effect of an intervention on selected patients without considering the influence of the system of care and its myriad characteristics. Health services research (HSR) focuses on organization and financing of health services; access to health care; quality of care; clinical evaluation and outcomes research; informatics and clinical decision making; practitioner, patient, and consumer behavior; health professions workforce; health policy formulation and analyses; and health care model and service use. Doctoral students can benefit from HSR's broad perspective if it is included in existing nursing curricula. Ultimately, HSR could help the nursing profession achieve the capacity to develop health policy and new systems of health care for the 21st century.

Education, Nursing, Graduate↗
PubMed2006

Knowledge content of advance practice nurse and physician experts: A cognitive evaluation of clinical practice guideline comprehension.

Clinical practice guidelines (CPGs) are intended to provide evidence based knowledge for decision making for patient care. However, these guidelines have been poorly adopted by healthcare providers. One reason for this may be the static paper-based formats, isolated from the point of care. Biomedical informatics has provided a solution to this limitation through Computer Interpretable Guidelines (CIGs). An essential component of this process is CPG translation to a computer interpretable model. From the guideline modeling literature, the translators of CPGs typically are physicians. It is not known if other healthcare providers (i.e., Advance Practice Nurses [APNs]) comprehend CPGs similarly. This descriptive study utilized novice and expert APN and physician participants (varied by level of expertise) in a CPG comprehension task. Demographic data, verbal protocols, and recall model drawings were obtained and analyzed by description, protocol analysis, discourse analysis, and content analysis. The findings of this study indicate similar comprehension by the expert APNs and physicians suggesting that either type of expert may be utilized for modeling CPGs.

Comprehension↗
PubMed1999

Understanding the Internet and World Wide Web.

If home care providers have computers and Internet connections at work or home, they can access the latest information regarding their clients' diseases, communicate with colleagues by electronic mail (E-mail), access government health care policies affecting home care, and much more. The Internet's increased popularity and utilization are a result of high-speed, high-capacity personal computers and related equipment and the development of easy-to-use graphics-intensive software.

Community Health Nursing↗
PubMed1998

Computers in the Faculty of Health Science--5 years on.

In 1989, the Faculty of Health Science at Central Queensland University (CQU) committed itself to a major instructional development project for its nursing education program. Partially supported by a National Priority (Reserve) Fund (NPRF) grant, the Faculty undertook a multi-year project to develop computer-based learning materials. The success of that project was mixed. However, by 1993 staff and students within the Faculty were using computers regularly, many of the staff were involved in developing computer-based instructional materials, and some staff were using available computer-based tools to extend the scope of the standard Health Science materials developed under the project. As well, the Faculty was committed to using Faculty funds for technical support staff to maintain its computer infrastructure and to assist both staff and students in using that infrastructure. The authors review the original NPRF project, then explore the Faculty's continued development and use of computer-based learning materials through an examination of student and staff evaluations, personal recollections, and subsequent projects. This paper demonstrates that the NPRF project spawned a number of other computer-based developments, including the offering of health informatics degree programs at the undergraduate and postgraduate levels, the development of the Faculty's current Internet site and a CD-ROM based interactive multimedia project for diabetes education. It also demonstrates that moderate levels of funding can maintain a computer-literate Faculty which views computers as essential tools for learning.

Australia↗
PubMed1996

A multidimensional evaluation of a nursing information-literacy program.

The goal of an information-literacy program is to develop student skills in locating, evaluating, and applying information for use in critical thinking and problem solving. This paper describes a multidimensional evaluation process for determining nursing students' growth in cognitive and affective domains. Results indicate improvement in student skills as a result of a nursing information-literacy program. Multidimensional evaluation produces a well-rounded picture of student progress based on formal measurement as well as informal feedback. Developing new educational programs can be a time-consuming challenge. It is important, when expending so much effort, to ensure that the goals of the new program are achieved and benefits to students demonstrated. A multidimensional approach to evaluation can help to accomplish those ends. In 1988, The University of Northern Colorado School of Nursing began working with a librarian to integrate an information-literacy component, entitled Pathways to Information Literacy, into the curriculum. This article describes the program and discusses how a multidimensional evaluation process was used to assess program effectiveness. The evaluation process not only helped to measure the effectiveness of the program but also allowed the instructors to use several different approaches to evaluation.

Adolescent↗
PubMed2001

Informatics application provides instant research to practice benefits.

A web-based research information system was designed to enable our research team to efficiently measure health related quality of life among frail older adults in a variety of health care settings (home care, nursing homes, assisted living, PACE). The structure, process, and outcome data is collected using laptop computers and downloaded to a SQL database. Unique features of this project are the ability to transfer research to practice by instantly sharing individual and aggregate results with the clinicians caring for these elders and directly impacting the quality of their care. Clinicians can also dial in to the database to access standard queries or receive customized reports about the patients in their facilities. This paper will describe the development and implementation of the information system. The conference presentation will include a demonstration and examples of research to practice benefits.

Abstracting and Indexing↗