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AnteayerCIN: Computers, Informatics, Nursing

A Pilot Randomized Controlled Trial of a Text Message Intervention to Promote Help Seeking for Psychiatric Outpatients

imageMental illness often affects and is affected by other diseases, such as cardiovascular disease, cancer, and AIDS/HIV infection, and people living with mental illness require additional common services and resource mobilization efforts. Therefore, we developed a mobile phone intervention and conducted a randomized controlled trial with 45 psychiatric outpatients with mental illnesses. Data from 39 individuals (intervention group: 20, control group: 19; mean [SD] age, 44.64 [14.12] years) were included in the analyses. The intervention involved the promotion of help-seeking behaviors by sending text messages, including information about social welfare services, for 3 months. After the intervention period, no significant differences were found in the proportion of help-seeking behaviors between the intervention and control groups. However, concerning the reason for not using social services, the proportion of participants who answered “I do not know how to use it” in the intervention group was significantly lower compared to the control group. More than 80% of participants in the intervention group reported that the text messaging service was helpful and useful, and they wanted more messages and information. This was the first randomized controlled trial to promote psychiatric patients' help-seeking behavior using text messaging. Moreover, the text messaging intervention was found to be cost-effective.

Digital Storytelling: A Qualitative Study Exploring the Benefits, Challenges, and Solutions

imageMany years ago, the National League for Nursing voiced the need to improve nursing education through innovative pedagogies supported by research. Digital stories are one of the newest pedagogical tools using storytelling in the digital world. This descriptive qualitative study reports the benefits, challenges, and solutions of digital story use in nursing education. Twelve nurse educators from Europe and the United States who had published or demonstrated use of digital stories in the classroom were recruited and interviewed. Data analysis revealed themes about the benefits and challenges associated with digital story use. The benefits identified were a greater depth of discussion, making points, engaging students, and promoting reflection and empathy. Development of critical thinking and the use of information technology skills were also identified. Challenges associated with digital stories included finding an appropriate digital story, legal issues involved, and the ability to assess student learning. Time in class to show digital stories and recognition of intended points by students were also uncovered. Solutions to some of these issues are also presented. This study revealed that the new pedagogy of digital stories engages students in the learning process.

Taxonomic Triangulation of Care in Healthcare Protocols: Mapping of Diagnostic Knowledge From Standardized Language

imageTaxonomic triangulation is a data mining technique for the management of care knowledge. This technique uses standardized languages, such as North American Nursing Diagnosis Association International, Nursing Outcomes Classification, and Nursing Interventions Classification, as well as logic. Its purpose is to find patterns in the data and identify care diagnoses. Triangulation can be applied to databases (clinical records) or to bibliographic sources (eg, protocols). The objective of this study is to identify the care diagnoses implicit in the nursing care protocols of the Community of Madrid. The method followed has three phases: knowledge extraction for mapping of variables, linking to diagnoses, and triangulation with analysis. The study analyzes six protocols, and 344 variables (167 assessment, 29 planning, and 148 intervention) and 6118 links have been extracted. Triangulation identified 165 NANDA diagnoses (68.48%), and only 25 labels were not revealed through this process. As a limitation, the results depend on the knowledge presented in protocols and change with language editions. Some labels included in the sample are recent and are not included in the links with nursing outcomes classification and nursing interventions classification. In conclusion, taxonomic triangulation makes it possible to manage knowledge, discover data patterns, and represent care situations.

Online Cognitive Training: An Adaptation of the Memory, Attention, and Problem Solving Skills for Persons With Diabetes Intervention

imageResearch shows the risk for cognitive impairment and the rate of cognitive decline double after type 2 diabetes mellitus is diagnosed and can make self-management more difficult. Cognitive training has been found to be one way to improve self-management and cognitive function, and this article reports the adaptation of one such intervention to an online format. Ten adults with diabetes participated in an 8-week intervention that combined webinar classes with online computer game training. Perceived memory ability, executive function, self-management, and self-efficacy were measured. Evaluation of recruitment, data collection, and implementation demonstrated good feasibility and reduced barriers to engagement. Although the intervention did not result in significant changes in cognitive function, scores on all surveys improved. Adherence to diet, exercise, and foot care recommendations also improved. Most participants stated they preferred the intervention's online format to “traditional” in-person formats. Online technology in this 8-week intervention helped improve recruitment, retention, participant engagement, and use of cognitive strategies in people with type 2 diabetes mellitus. Overall, participants found the intervention helpful and said it reduced the time and travel burden associated with educational interventions. A larger randomized controlled trial is needed to further explore the intervention's potential impact over a longer period.

Implementation of an Electronic Nursing Record for Nursing Documentation and Communication of Patient Care Information in a Tertiary Teaching Hospital

imageDespite the fact that implementing an electronic nursing record has become an everyday event for nurses, little is known about which type of documentation used in an electronic nursing record is better for nursing practice. The aim of this exploratory study was to identify the most suitable type of electronic nursing documentation that nurses used to record care and communicate with clinicians. Participants consisted of 118 nurses and 12 physicians. Researchers developed a self-report questionnaire of 17 items about electronic nursing record use for documentation and communication of patient care information. Data were analyzed using descriptive statistics to calculate frequencies and percentages. The χ2 test was used to identify differences in responses by demographic and clinical characteristics of participants. Bar charts were used to identify response patterns. Results showed that semistructured nursing documentation was the most preferred for care documentation and communication of patient information. Nurses did not always use the electronic nursing record to communicate patient care-related information. This study adds empirical knowledge about which type of documentation used in the electronic nursing record works well, what improvement is needed for better nursing practice, and whether the electronic nursing record has been used for communication.

Clinical Research Integration Within the Electronic Health Record: A Literature Review

imageClinical trials have become commonplace as a treatment option. As clinical trial participants are integrated into all healthcare delivery settings, organizations are tasked with sustaining specific care regimens with appropriate documentation and maintenance of participant protections within electronic health records. Our aim was to identify the common elements necessary for electronic health record integration of clinical research for optimal trial conduct and participant management. Review of literature was conducted utilizing PubMed and CINAHL to identify relevant publications that described use of the electronic health record to directly support trial conduct, with a total of 15 publications ultimately meeting inclusion criteria. Three thematic groupings emerged that categorized common aspects of clinical research integration: functional, structural, and procedural components. These components include technological requirements (platform/system), regulatory and legal compliance, and stakeholder involvement with clinical trial procedures (recruitment of participants). Without a centralized means of providing clinicians with current treatment and adverse event management information, participant injury or likelihood of withdrawal will increase. Further research is required to develop an optimal model of research-related integration within commercial electronic health records.

Mobile Health in Adherence to Oral Anticancer Drugs: A Scoping Review

imageIn oncology, adherence to oral antineoplastic medication is a key element of treatment, on which the success of any therapeutic intervention depends. Given their widespread use in clinical practice, it is important to identify tools that can facilitate the monitoring and self-management of the patient at home, to avoid the consequences of employing ineffective treatment. One of the tools available today to take action on this phenomenon is mobile health technology. The aim of this review is to describe published studies relating to the use of mobile health to promote adherence to oral antineoplastic medication. This scoping review was conducted using the framework proposed by Arksey and O'Malley, adapted according to Levac et al. Of 1320 articles identified, only seven met the eligibility criteria and therefore were included in the review. All seven articles involved the use of digital means to measure adherence to treatment, patient satisfaction, acceptability and feasibility of the digital means used, and presence of symptoms, but not the effectiveness of the digital instrument used. In conclusion, the use of digital means to assist adherence of cancer patients to oral antineoplastic medication is widely recognized, but its effectiveness in clinical practice is poorly supported by the nature of the published studies.

Using Research Electronic Data Capture for Longitudinal Assessment Among Older Adults With Diabetes Enhances Real-Time Data Collection

imageThe aim of this study was to provide evidence on the application of Research Electronic Data Capture for collecting repeated data during a 7-day period among older adults. Fifty-seven adults (≥50 years) with type 2 diabetes were recruited. Participants completed one sleep diary upon awaking and one self-care diary before going to bed each day for 7 days. The diaries were administered via the Research Electronic Data Capture Web-based system and were completed via participants' own electronic devices. Objective compliance rate, time used to complete each diary, and participant experience were described. Approximately 80% (n = 45) of the participants used Research Electronic Data Capture. Among these participants, the noncompliance rate ranged between 0% and 8.9% for the sleep diary and 0% and 13.1% for the self-care diary. Participants spent 4.2 to 8.7 minutes on the sleep diary and 3.5 to 7.1 minutes on the self-care diary. It took the participants a longer time to complete the diaries during the first day than during the following 6 days. Few participants reported technical issues or felt inconvenient or stressful with completing the Research Electronic Data Capture diaries. Overall, the compliance rates were high. Completing the diaries was not time-consuming and participants were largely satisfied with the Research Electronic Data Capture data collection. Research Electronic Data Capture has aided the longitudinal data collection. With adequate training, Research Electronic Data Capture is an efficient tool to collect repeated data among older adults and thus is recommended for future research.

The Prevalence of Smartphones and WeChat Use Among Older Adults With Chronic Disease in a Western China

imageTelemedicine is a promising way to deliver patient education and health services, but access to information technology among potential patients is a prerequisite. This study surveyed the prevalence of smartphone use and the use of the Chinese social networking platform WeChat and Wi-Fi access in the homes of older adults in a western area of China. A convenience sample of 225 older adults with chronic diseases in two tertiary hospitals was interviewed regarding smartphone ownership, WeChat use, and access to Wi-Fi at home. Participant ability in performing the activities of daily living was also assessed. Logistic regressions were used to analyze the independently associated factors of smartphone ownership, WeChat use, and Wi-Fi access at home. The results show that the prevalence of smartphone use was 19.6%, only 8.9% of those surveyed used WeChat, but 39.6% had access to Wi-Fi at home. Education level was the only factor significantly associated with the three dependent variables. Ability in performing activities of daily living was positively correlated with access to Wi-Fi at home (odds ratio, 2.549; P = .011). It will be difficult to implement telemedicine through smartphones in such relatively poor areas of China. Better-educated older adults who are less dependent in performing activities of daily living are potential users of telemedicine.

Intradisciplinary Nursing Communication Post Hospital Merger: A Quality Improvement Project Using Online Communities of Practice in the Intensive Care Unit

imageAfter hospital mergers, unit work environments are at risk of being unhealthy due to poor intradisciplinary two-way communication in times of change. This quality improvement project explored the impact a 4-week, social-media–based, intradisciplinary communication strategy had on a postmerger intensive care unit work environment. The sample (N = 14) included 11 bedside nurses and three administrative nurses working in a 22-bed southwestern US ICU. The participants took part in a Facebook closed-group community of practice called Nurse to Nurse, with a total of 25.9% participation rate. Eleven participants completed the pre–Nurse to Nurse survey, a 20.4% completion rate, while eight participants completed the post–Nurse to Nurse survey, a 14.8% completion rate. After the conclusion of Nurse to Nurse, the overall mean skilled communication survey score increased to 3.79, a 1.6% improvement. Question 14, which measured zero-tolerance behavior perception, exhibited a mean of 2.3% improvement, boosting this metric to excellent status. Utilization data revealed 68 comments posted within Nurse to Nurse implementation, with 56 showing horizontal communication (73.5%) and 24 displaying vertical communication (26.5%). A total of 217 bedside nurse views (81.3%) and 50 administrative nurse views (18.7%) were noted. Nurse to Nurse, an online communication-focused community of practice, enhanced communication among bedside and administrative nurses working in a postmerger intensive care unit setting.

Health Professionals' Engagement With Email—Enabler or Disrupter?

imageThe use of email is an internationally recognized and accepted method to communicate information in an asynchronous manner. Yet, despite its ubiquitous use, there is evidence that there are differences in the degree of engagement with and perceived value of email as legitimate work within the healthcare setting. A lack of engagement with email could have consequences on the care of patients if email communication is not read or responded to by the intended recipient. The purpose of this study was to understand the email practices of health professionals within a hospital setting, including their interactions, experiences, and thoughts and ideas for sharing information in the future. Four focus groups (total number of participants, 30) were conducted in 2015 and 2016 using an Appreciative Inquiry model to focus on the use of email. Data were thematically analyzed, with three overarching themes identified: professional practice, workforce self-care, and shaping the future using technology. Overall, email was perceived as a less important function within a health professional's everyday clinical practice; however, this differed depending on their role. The health professionals' use of email ranged from very little engagement to what could be judged as over-engagement, all of which have implications for healthcare organizations who view email as a legitimate work task and a key way to communicate.

Use of an Electronic Reporting Tool and Clinical Surveillance Process in the Neonatal Intensive Care Unit to Decrease Risk for Central Venous Catheter Complications Associated With Tip Migration

imageThis quality improvement project formalized central venous catheter tip surveillance augmented by the use of electronic patient reporting tool. The project setting was a large level IV academic neonatal intensive care unit with a representative convenience sample of patients with central venous catheters and quality improvement reports of complications from tip migration. Providers received education before implementation of a central venous catheter tip surveillance program using a revised electronic reporting tool was initiated. Provider evaluations of the electronic reporting tool included compliance with the guidelines and use of the tool in multidisciplinary patient rounds, and were entered into a database for analysis. Nine evaluations of the electronic reporting tool were completed, with an average of 97% compliance with guidelines. Seven evaluations during multidisciplinary patient rounds using the reporting tool data demonstrated use by both resident physicians and advanced practice nurses. Central venous catheter patient data were reviewed after process implementation. Overall, infant central venous catheter complications related to tip migration decreased following implementation. Therefore, the use of an electronic reporting tool improved compliance with evidence-based clinical practice guidelines and resulted in a decrease in the risk for central venous line complications related to tip migration in this setting.