Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Analysis of the Current Situation and Influencing Factors of Knowledge,Attitude,and Practice of Nursing Informatics Among Intern Nursing Students

Objective:To investigate the current situation of knowledge,attitude,and practice(KAP)of nursing informatics for intern nursing students.Methods:A total of 213 intern nursing students were selected as subjects.Results:The total score of the questionnaire of knowledge dimension was 10.32±3.23;the score of attitude dimension was 58.78±6.80;the score of practice dimension was 29.06±14.35.Logistic regression analysis showed that further learning plans,telemedicine hospital intern experience,self-learning ability,and telecare training were the related influencing factors of KAP(P<0.05).Conclusions:The current KAP level of nursing informatics among intern nursing students was low to moderate.Hence,the strengthening of school courses and skill training programs is urgently needed.

The effectiveness of mI SMART:A nurse practitioner led technology intervention for multiple chronic conditions in primary care

Aims:Used as integrated tools,technology may improve access and outcomes of care.A new intervention that integrates multiple technologies called mI SMART has been developed,implemented,and evaluated by Nurse Practitioners.The aim of this paper is to present the initial effectiveness of a webbased,structure of sensors and mobile devices designed to overcome the known health determinant of access to care for rural,chronically ill patients by using technology.Methods:The study was conducted at a community primary-care clinic that provides free healthcare to impoverished adults.Adults with at least one chronic condition,a minimum of 3rd grade reading level,and without dementia/psychosis were recruited.Participants were given a Nexus7 tablet and Bluetooth self-monitoring devices.The intervention lasted for 12 weeks.Blood glucose,blood pressure,and weight were collected using the provided Bluetooth devices and means were evaluated with paired-samples ttests before and after the intervention.Results:Thirty participants were majority female,white,married,high-school educated or less,earning less than$20,000 per annum,and had multiple chronic conditions.Pre-intervention glucose,systolic blood pressure,diastolic blood pressure,weight and Body Mass Index were all reduced after the 12-week intervention.Conclusions:The mI SMART intervention is efficacious for use in improvised adults living in rural areas with multiple chronic conditions.As previously reported,the intervention was also shown to be feasible and acceptable to patients.The next step is a larger randomized controlled trial.

Part A: The Development of mI SMART, a Nurse-Led Technology Intervention for Multiple Chronic Conditions

Background: The treatment of Multiple Chronic Conditions (MCC) is complex for both patients and providers. Used as integrated tools, technology may decrease complexity, remove the barrier of distance to obtain care, and improve outcomes of care. A new platform that integrates multiple technologies for primary health care called mI SMART (Mobile Improvement of Self-Management Ability through Rural Technology) has been developed. The purpose of this paper is to present to development of mI SMART, a nurse-led technology intervention for treating for MCC in primary care. Methods: The creation of mI SMART was guided by the model for developing complex nursing interventions. The model suggests a process for building and informing interventions with the intention of effectiveness, sustainability, and scalability. Each step in the model builds from and informs the previous step. Results: The process resulted in the integrated technologies of mI SMART. The system combines a HIPAA compliant, web-based, structure of mHealth sensors and mobile devices to treat and monitor multiple chronic conditions within an existing free primary care clinic. The mI SMART system allows patients to track diagnoses, medications, lab results, receive reminders for self-management, perform self-monitoring, obtain feedback in real time, engage in education, and attend visits through video conferencing. The system displays a record database to patients and providers that will be integrated into existing Electronic Health Records. Conclusion: By using the model for developing complex nursing interventions, a multifaceted solution to clinical problems was identified. Through modeling and seeking expert review, we have established a sustainable and scalable integrated nurse-led intervention that may increase access and improve outcomes for patients living in rural and underserved areas. The first trial of mI SMART has been completed and evaluated for feasibility, acceptability, and effectiveness in persons in rural areas living with multiple chronic conditions.

Part B: The Feasibility and Acceptability of mI SMART, a Nurse-Led Technology Intervention for Multiple Chronic Conditions

Background: An opportunity to improve care of multiple chronic conditions for those living in rural areas of the country may exist through the use of technology. Integrating technology interventions into existing rural health systems allows for increased access to healthcare services and augments self-management ability for patients. However, questions remain about acceptability and feasibility of technology use in rural populations. The purpose of this paper is to present the feasibility of mI-SMART, a HIPAA compliant, web-based, structure of mHealth sensors and mobile devices designed to overcome the known health determinant of access to care for rural, chronically ill patients by using technology. Methods: The study was conducted at a primary-care clinic that provided healthcare at no or low cost to low income adults. Inclusion criteria encompassed adults, with at least one chronic condition, having at least 3rd grade reading level, without having dementia/psychosis. Each participant was given a Nexus7 tablet and Bluetooth self-monitoring devices. Feasibility was evaluated in four ways and acceptability was evaluated with post-intervention questionnaires. Results: Thirty participants [mean age: 52 years (SD: 10.0, range: 29 - 74)] were majority female (70%), white (70%), married (60%), high-school educated or less (56.7%), impoverished (less than $20,000 per annum (56.7%), with multiple chronic conditions (96.7%)). During the trial, all participants were able to transmit data. No error messages were due to the mI-SMART system. Errors were user related and solved with technical support. Mean number of self-monitor transmissions was 219.7 [(SD: 197.4), range: 1 - 733]. Participants logged into the system an average of 163. 1 [(SD: 169.7), range: 2 - 568] times and viewed an average of 1092.1 [(SD: 1205.6), range: 8 - 3851] intervention components. Over eighty-six percent of participants sent data for 12 weeks and 43.1% used the intervention for longer. Conclusions: The mI-SMART system is a feasible option for impoverished persons living in rural areas.

Use of content management systems to address nursing workflow

Nurses are at the forefront of providing healthcare services to individuals of all age groups and with varying medical conditions.Aside from the critical knowledge and technical skills from nursing science,advancement in technology has assisted nurses in delivering quality nursing care by streamlining workflow processes and ensuring that data can easily be retrieved or modified.Electronic health records dramatically changed the landscape of the healthcare practice by providing an electronic means to store data and for healthcare professionals to retrieve and manipulate health information in a secured and collaborative environment.But with the nature of data being stored in the electronic health records,nurses still need to organize and process these data into relevant information,knowledge or wisdom so they can provide better holistic care to patients.This discussion paper details the role of content management systems in addressing nursing workflow by providing a mechanism for nurses to be developers themselves,and not just users or consumers of health innovative technologies.By using content management systems as platform for application development,nurses or other healthcare professionals,may be able to address problems with internal workflow without having to incur huge amounts in software development,or having to extensively learn programming languages.

Challenges using electronic nursing routine data for outcome analyses:A mixed methods study

Objectives To explore the challenges of secondary use of routinely collected data for analyzing nursing-sensitive outcomes in Austrian acute care hospitals.Method A convergent parallel mixed methods design was performed.We conducted a quantitative representative survey with nursing managers from 32 Austrian general acute care hospitals and 11 qualitative semi-structured interviews with nursing quality management experts.Both results were first analyzed independently and afterward merged in the discussion.Results On average,76%of nursing documentation is already electronically supported in the surveyed Austrian hospitals.However,existing nursing data is seldom used for secondary purposes such as nursing-sensitive outcome analyses.This is due to four major reasons:First,hospitals often do not have a data strategy for the secondary use of routine data.Second,hospitals partly lack the use of standardized and uniform nursing terminologies,especially for nursing evaluation.Third,routine nursing data is often not documented correctly and completely.Fourth,data on nursing-sensitive outcomes is usually collected in specific documentation forms not integrated into routine documentation.Conclusion The awareness of the possibilities for secondary use of nursing data for nursing-sensitive outcome analyses in Austrian hospitals is still in its infancy.Therefore,nursing staff and nursing management must be trained to understand how to collect and process nursing data for nursing-sensitive outcome analyses.Further studies would be interesting in order to determine the factors that influence the decision-making processes for the secondary use of nursing data for outcome analyses.