Software documentation: variations and uses.
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The utility of the online computer services BRS Colleague and Dialog Medical Connection, when used primarily as drug information sources by physicians, nurses, and pharmacists and attitudes toward their use, are described. Study sites included office-based medical practices, a university clinic family medicine group, and a university clinical pharmacy department. Participants had access to either of the computer services during two 9 1/2-month periods. All searches were automatically recorded and analyzed. A total of 1,112 search sessions were conducted (78% by pharmacists, 16% by nurses, 6% by physicians) by 38 of 65 participants. Information which completely answered questions was found for slightly less than one-third of searches. Errors occurred in about 81% of searches which retrieved incomplete information. Lack of time was a major factor which limited use of the services, and infrequent users felt that the services did not fit in well with their daily work routine.
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The authors describe a theory-based approach to computer skill development in nursing administration that is a strategy for preparing nurse administrators to meet the challenge for effective decision making in the rapidly changing health care environment. A framework is presented using theories of decision making and information processing to integrate the development of knowledge and skills for decision making with knowledge and skills associated with computer decision support. Computerized support is available to help managers be effective at each stage of the decision-making process. Focusing on five stages of the decision-making process, the authors discuss how computers can facilitate decision-making. Computer applications introduced throughout a three-semester program in nursing administration include bibliographic databases, thought and word processing, database programs, decision analysis programs, spreadsheets, and project management programs. The curriculum and course activities are described.
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Computerization is no more improvised just like that and the management of computer plans is from now on a matter for methods and approaches which leave nothing to chance. The main purpose of the present work's empirical part is to a priori determine the attitude which will be the one of the nurses toward the implementation of computer aid in the care units that is expected on the short term. So we will have at our disposal pertinent information which will enable the concerned people to efficiently negotiate this change. For the realization of the present study, we built a LIKERT scale of attitude and integrated it within a question paper with nearly 40 questions. This later was submitted to a stratified random sample of 100 nurses in office at the Clinique St-Pierre in Ottignies (Belgium). After a presentation of that hospital's computer position and of observations made in other hospitals, a detailed study protocol specifies all the features of the research. The achieved results show us that the concerned nurses are highly favorable to the implementation of computer aid. The present work sets out and develops very numerous findings expressed in figures as well as relations and correlations between the attitude and certain features of the sample. The realization of the objectives of any care institution--i.e. a better nursing of the patients and a better managing of the care distribution--colldies with the abundance and the complexity of "Information" which is itself conveyed by numerous systems: nursing, medical, operational, managing information system,... Facing such a reality which is sometimes complex and relatively less analysed, this work is an outline reflection on a bibliographical basis, a conceptual approach that puts certain of the Nursing Information System's generalities in a prominent position--but also some of its specifies--themselves mainly brought to light by means of the introduction of computer aid. The reader will also find here a conceptual pattern integrating the various hospital information sub-systems in interaction, as well as a graphical representation of their information and overlap areas. As the reader will see, the information system--which has become an essential notion in today's data processing--is in the heart of the running of any hospital. Hardly unperceptible, the information system, as long as it is not materialized by the computerization project nonetheless represents a major stake which is covetted by the whole hospital contributors.
At Intermountain Health Care, we evaluated whether physicians in an ambulatory setting will voluntarily choose to enter data directly into an electronic health record (EHR). In this paper we describe the benefits of an EHR, as they exist in the current IHC application and the ways in which we have sought to minimize obstacles to physician data entry. Currently, of 472 IHC employed physicians, 321 (68%) routinely enter some data directly into the EHR without coercion. Twenty-five percent (80/321) of the physicians use voice recognition for some data entry. Twelve of our 95 ambulatory clinics have voluntarily adopted measures to eliminate paper charts. Of the 212 physicians who entered data in 2004, sixty-nine physicians (22%) increased their level of data entry, while 12 (6%) decreased. We conclude that physicians will voluntarily adopt an EHR system, and will continue and even increase use after implementation barriers are addressed.
Medical students use many forms of medical electronic resources (MER) during clinical clerkships. Such resources may be inaccurate, irrelevant or inappropriate, yet most medical students do not receive guidance on the use of MER. During the earliest clinical clerkship we gave a series of seminars and assignments on the use of MER. These were well accepted and were followed by increased knowledge in the use of MER.
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