Nursing Systems Could Be a Platform for Quality Improvement

“Complexity Compression” — a term coined by the Minnesota Nursing Association — aptly captures the essence of today’s nursing world. More demanding regulations on patient documentation, multifaceted IT initiatives, new training requirements and a sicker population are heightening both indirect and direct care workloads for nurses. Indeed, we are often expecting our nurses to do more with less.”
Article
Tonushree Jaggi, iHealthBeat, 28 October 2008

Nursing and Computers: the Inevitable Move Towards Electronic Health Records (ehr)

“Nursing and computers have not always been a perfect mix. Typically, nurses try to get away from new computer systems as much as possible. However, it is an inevitable workflow evolution in today’s hospitals.”
Article
Softcosys, 27 October 2008

Community nurses get mobile access to iPM

“Community nurses at Wolverhampton Primary Care Trust have gone live with 3G technology that allows them to access its iPM system and record patient activity.
A total of 60 nurses working for the community out-of-hours service in Wolverhampton have been given 3G enabled-laptops to enable remote access to the system provided by its local service provider.”
Article
e-Health Insider Primary Care, 2 October 2008

New world of medical treatment

“Student nurse Chris Chapman got ready to give her next patient his medications Wednesday morning at Parkview Hospital. She logged onto a laptop computer on a rolling cart and checked Jeff Enyeart’s chart for the drugs and dosages he needed.
From the pocket in her scrubs, she pulled out a Palm Pilot and brought up information on the medications in a drug reference guide, one of five nursing textbooks on her PDA.”
Article
Jennifer L. Boen, The News-Sentinel, 18 September 2008

Visiting nurses to use telehealth program

“The Visiting Nurse Association of Greater Philadelphia will be monitoring patients in Montgomery County through a telehealth program.
The association will provide a personalized telehealth service in Montgomery County, a suburban county northwest of Philadelphia, for patients with chronic heart failure and chronic obstructive pulmonary disease.”
Article
Molly Merrill, Healthcare IT News, 18 September 2008

Electronic Documentation calls for Standardized Nursing Language

“Electronic documentation has called attention to the need for standardization of nursing terminology and ways to capture nursing interventions.
“Nurses’ voice is a weak echo of the medical voice,” says Marilyn E. Parker, Ph.D., RN, FAAN, professor of nursing at the Florida Atlantic University (FAU) Christine E. Lynn College of Nursing in Boca Raton.
When Parker’s community nursing practice began shifting to an electronic record system, she realized there were places for nurses to record data, such as vital signs or medical symptoms, but no place for them to enter interactions and relationships with patients.”
Article
Cougarnurse, UltimateNurse.com, 11 September 2008

Getting more nurses on the Web (2.0)

“As a soon to graduate nursing student, I am starting to pay more attention to the profession I will (hopefully) be joining next year. Currently, I am on the front end of the curve when looking at nurses using technology. I can learn more new applications quickly, transfer knowledge between programs, problem solve/trouble shoot, and I am genuinely interested in finding new things to learn and use. I just recently was introduced to Twitter, by my friend Josh (a web developer). It introduced me to a new community of people.”
Article
Robert Fraser, Nurses 2.0, 21 July 2008

Journal of Telemedicine and Telecare, TOC, July 2008

Telerehabilitation for service delivery in speech-language pathology
“Communication disorders in adults and children can have a significant effect on their quality of life and on that of their families. Speech-language pathologists face several challenges in providing assessment and treatment services to such people. Challenges include facilitating equitable access to services and providing appropriate management within a changing social and economic context. Telerehabilitation has the potential to deliver services in the home or local community via videoconferencing and through interactive computer-based therapy activities. This form of service delivery has the capacity to optimize functional outcomes by facilitating generalization of treatment effects within the person’s everyday environment, and enable monitoring of communication and swallowing behaviours on a long-term basis. A number of image-based telerehabilitation applications have been used in the management of adult neurogenic speech and language disorders, stuttering, voice disorders, speech and language disorders in children, laryngectomy and swallowing dysfunction. Further development of such applications and other computer-based therapies, cost-benefit and cost-effectiveness analyses, and professional education are needed if telerehabilitation is to become an integral part of speech-language pathology practice.”
Abstract
Deborah G Theodoros, J Telemed Telecare 2008;14 221-224, doi:10.1258/jtt.2007.007044

Telehealth: a child and family-friendly approach to mental health-care reform
“Limited access to paediatric mental health services and high drop-out rates from treatment result in poor health outcomes for families with children with mental health problems. New ways of delivering care are required. Telehealth is a promising approach. The Family Help programme employs manualized, distance treatment by telephone. Participants in the Family Help programme (both adults and children) have reported a strong therapeutic alliance with their telephone coach. Participants also described how during treatment sessions they felt comfortable and safe in their own home; they did not feel stigmatized or judged; they had little apprehension about self-disclosure and they felt that treatment was delivered at their convenience. Treatment calls were often scheduled after typical working hours. Attrition rates were found to be very low and children actively engaged in the structured, distance treatment. Evidence-based, distance delivery using non-professionals is a promising approach to the delivery of paediatric mental health care.”
Abstract
Patricia Lingley-Pottie and Patrick J McGrath, J Telemed Telecare 2008;14 225-226, doi:10.1258/jtt.2008.008001

Effect of a behavioural health and specialty care telemedicine programme on goal attainment for youths in juvenile detention
“We conducted a pre-post study of the effect of a telepsychiatry counselling service on youths housed in three juvenile detention facilities. In the first year of the telemedicine programme, 321 psychiatry consultations were conducted via telemedicine; in the second year of the programme, 573 psychiatry consultations were conducted. Records for 190 students were then examined by two raters. The total number of behavioural goals for each adolescent increased from 8.2 in the pre-telemedicine year to 8.7 in the first year of telemedicine and then to 10.0 in the second year (P < 0.05). In Year 2 of the study, subjects also had a significantly higher number of goals in four of the five categories: education, family, health and social skills (P < 0.05). Although other changes at the youth detention facilities or in the juvenile justice system may have been partly responsible for the effects observed, the study suggests that telemedicine may be useful for improving the rate of attainment of goals associated with family relations and personality/behaviour."
Abstract
Karen C Fox, Pamela Connor, Elizabeth McCullers, and Teresa Waters, J Telemed Telecare 2008;14 227-230, doi:10.1258/jtt.2008.071102

Non-invasive monitoring of the activities of daily living of elderly people at home – a pilot study of the usage of domestic appliances
“We conducted a feasibility study of a system for non-invasive monitoring of subjects at home. Electrical activity was recorded from room lights and from electrical domestic appliances; this was translated into the probability of physical activity or a particular Activity of Daily Living (ADL). Thirteen volunteer subjects were monitored for a period of 6.4 months (range 3–8). The mean age of the subjects was 80 years and they all lived alone at home; one had moderate Alzheimer’s disease. A one-week validation was carried out to ascertain whether the recorded activity actually occurred. The results showed that daily and nocturnal activity could be well differentiated. The probability of having eaten, taken a bath and going to the toilet could be calculated each day. Eating was the most accurately measured ADL; toileting and bathing results were less accurate. The system appears to be a promising component of home telecare.”
Abstract
Georgina Corte Franco, Floriane Gallay, Marc Berenguer, Christine Mourrain, and Pascal Couturier, J Telemed Telecare 2008;14 231-235, doi:10.1258/jtt.2008.071207

A paediatric therapeutic alliance occurs with distance intervention
“We investigated whether a distance therapeutic alliance occurs when children receive manualized, cognitive-behavioural treatment via telephone, in the absence of face-to-face contact. The therapeutic alliance scores were measured in 55 child–parent pairs. The mean total Working Alliance Inventory child scores were 236 (95% confidence interval [CI]: 232, 240) and the mean parent scores were 245 (95% CI: 242, 247). Parent scores were significantly higher than child scores, although the difference may not be clinically meaningful. This study provides evidence that a strong therapeutic alliance does occur between child–coach and parent–coach pairs when treatment is delivered from a distance by non-professionals. The term ‘child’ encompasses both children and adolescents.”
Abstract
Patricia Lingley-Pottie and Patrick J McGrath, J Telemed Telecare 2008;14 236-240, doi:10.1258/jtt.2008.080101

International telepsychiatry: a study of patient acceptability
“An international telepsychiatry service was established between Denmark and Sweden for cross-cultural patient groups, such as asylum seekers, refugees and migrants. Over an 18-month period starting in mid 2006, 30 patients were treated by telepsychiatry (21 men and 9 women). The patients received mental health care by videoconferencing from providers who spoke the patients’ own language, i.e. without the assistance of interpreters. The total number of telepsychiatry sessions was 203 (range 1–22; average 6.8 sessions per patient). Patients completed a satisfaction questionnaire at the end of treatment. Seven patients (23%) were not able to complete a questionnaire, due to illiteracy and/or a psychotic condition. The rest of the patients (n=23) reported a high level of acceptance and satisfaction with telepsychiatry, as well as a willingness to use it again or recommend it to others. Any disadvantages of telemedicine were compensated by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references. Mentally ill asylum seekers, refugees and migrants are under-served in their mother tongue and telepsychiatry can improve access to scarce health-care resources.”
Abstract
Davor Mucic , J Telemed Telecare 2008;14 241-243, doi:10.1258/jtt.2008.080301

The availability of telecardiology consultations and transfer patterns from a remote neonatal intensive care unit
“We examined records of all admissions to an isolated community neonatal intensive care unit (NICU) in California between 2001 and 2006. We also reviewed the echocardiograms for diagnosis, disposition of patient and necessity for transport. In 2004, a telemedicine link (mainly store-and-forward) was established to a university children’s hospital (UCH) 290 km away. The number of NICU patients having an echocardiogram increased from 280 (27% of 1029 admissions) to 385 (40% of 963, P = <0.001) after telemedicine became available. There was an increase in the proportion of normal studies, from 31% to 37% (P = 0.03), and an increase in the number of patients diagnosed with cardiac pathology from 192 (19% of all admissions) to 241 (25%, P < 0.001). Twenty-four patients were transferred for cardiac reasons during each three-year period; however seven pre-telemedicine transfers were avoidable, compared with two post-telemedicine transfers (P = 0.06). There was a change in referral pattern (65% to the UCH pre-telemedicine, compared with 78% post-telemedicine) although it was not significant (P = 0.10). Thus the availability of the telecardiology link was associated with increases in the utilization of echocardiography, in the proportion of normal studies, and in the percentage of neonates diagnosed with cardiac pathology without an increase in the number transferred for cardiac reasons. There was a reduction in unnecessary transfers and a strengthened relationship with the centre providing the telecardiology service."
Abstract
Tannie Huang, Anita J Moon-Grady, Craig Traugott, and James Marcin, J Telemed Telecare 2008;14 244-248, doi:10.1258/jtt.2008.080102

Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis
“We conducted a randomized controlled multicentre trial to investigate the feasibility of a telerehabilitation intervention for arm/hand function (the Home Care Activity Desk [HCAD] training) in a home setting. Usual care was compared to HCAD training. The hypothesis was that the clinical outcomes of the HCAD intervention would be at least the same as those measured after a period of usual care for patients with stroke, traumatic brain injury (TBI) and multiple sclerosis (MS) with respect to their arm/hand function. Eighty-one patients with affected arm/hand function resulting from either stroke, MS or TBI were recruited in Italy, Spain and Belgium; 11 were lost during follow-up (14%). The outcome measures were the Action Research Arm Test (ARAT) and the Nine Hole Peg Test (NHPT). There were no significant differences between the two groups on the outcome measures (ARAT and NHPT); in both groups, patients maintained or even improved their arm/hand function. The HCAD training was found to be as feasible as usual care in terms of clinical outcomes, and both therapists and patients were satisfied with the HCAD intervention. A telerehabilitation intervention using HCAD may increase the efficiency of care.”
Abstract
Barbara CH Huijgen, Miriam MR Vollenbroek-Hutten, Mauro Zampolini, Eloy Opisso, Montse Bernabeu, Johan Van Nieuwenhoven, Stephan Ilsbroukx, Riccardo Magni, Claudia Giacomozzi, Velio Marcellari, Sandro Scattareggia Marchese, and Hermie J Hermens, J Telemed Telecare 2008;14 249-256, doi:10.1258/jtt.2008.080104

Satisfaction with care in post-stroke patients undergoing a telerehabilitation programme at home
“We conducted a pilot telerehabilitation study with post-stroke patients with arm motor impairment. We compared the degree of satisfaction of patients undergoing a virtual reality (VR) therapy programme at home (Tele-VR group) to satisfaction experienced by those undergoing the same VR therapy in a hospital setting (VR-group). The rehabilitation equipment used a 3D motion tracking system to create a virtual environment in which the patient’s movement was represented. In tele-therapy, the patient equipment was installed in their homes, connected to the hospital by four ISDN lines at a total bandwidth of 512 kbit/s. Rehabilitation data were transmitted via one line and videoconferencing via the other three. Ten patients with mild to intermediate arm motor impairment due to an ischaemic stroke, were randomized into VR or Tele-VR groups. A questionnaire was used at the end of treatment to measure each patient’s degree of satisfaction. Tele-VR treated patients showed median values equal to or higher than the VR group patients in all 12 items investigated, except one. In motor performance, the Tele-VR group improved significantly (P ? 0.05), while the VR group showed no significant change. Patients assigned to the Tele-VR group were able to engage in therapy at home and the videoconferencing system ensured a good relationship between the patient and the physical therapist whose physical proximity was not required.”
Abstract
Lamberto Piron, Andrea Turolla, Paolo Tonin, Francesco Piccione, Lisa Lain, and Mauro Dam, J Telemed Telecare 2008;14 257-260, doi:10.1258/jtt.2008.080304

Caregivers’ acceptance of electronic documentation in nursing homes
“A comparative study was conducted in two Australian nursing homes operated by the same organization. One home had implemented an electronic documentation system and the other remained paper-based. Survey questionnaires were answered by 14 of the 17 caregivers at the electronic documentation site (82%) and 10 of the 23 caregivers at the paper documentation site (43%). They provided opinions about satisfaction with their home’s documentation system, and the training and support provided. Information was also obtained on the caregivers’ attitudes towards using electronic documentation. The caregivers at the electronic documentation site quickly adapted to the use of the new technology after receiving effective training and support. Caregivers at both homes were satisfied with their homes’ documentation system, and had positive attitudes towards using electronic documentation systems. As an important communication tool, electronic nursing documentation may lead to improved efficacy of telemedicine in nursing home settings.”
Abstract
Ping Yu, David Hailey, and Haocheng Li, J Telemed Telecare 2008;14 261-265, doi:10.1258/jtt.2008.080310

The use of videoconferencing for mental health services in Finland
“The utilization of telemental health (TMH) services in Finland was surveyed in 2006. In total, 135 health-care units provided responses. Eighty-four responses were received from primary care units (health-care centres and clinics) and eight from other clinics, in all hospital districts. The overall rate of TMH consultations was 4 per 100,000 population. The highest TMH consultation per population ratio, 22 per 100,000, was in northern Finland. Most of the sites used telepsychiatry services for less than 10% of clinical outpatient services. The sites with over 20% utilization of clinical TMH services from all psychiatric consultations were all rural health centres. Compared with Finland, the utilization rates of TMH were higher in Canada; that might be due to differences between the countries in the organization of mental health services in primary and specialized care. In Finland TMH consultations made up only a very small proportion of all mental health services. The use of TMH was particularly common in remote areas; however, there were many rural centres that did not utilize clinical TMH. TMH was widely utilized for continuing and medical education.”
Abstract
Arto Ohinmaa, Risto Roine, David Hailey, Marja-Leena Kuusimäki, and Ilkka Winblad, J Telemed Telecare 2008;14 266-270, doi:10.1258/jtt.2008.071212

Use of mobile phone cameras for after-hours triage in primary care
“Mobile phone images might be useful in after-hours triage of primary care. We conducted a study to identify population access to mobile phone cameras and to assess the clinical usefulness of mobile phone cameras. The survey was conducted among 480 patients attending two rural New Zealand practices. There were significantly more Maori owners compared to non-Maori (P = 0.002). Age was a significant factor influencing the ownership of mobile phones. We also conducted a clinical quiz among health professionals to assess how the provision of images on a mobile phone and on CD-ROM (to simulate the image that would be seen if email was used to transmit the images) influenced diagnostic confidence. Ten photographable clinical conditions were used to quiz 30 health professionals who were randomized into three groups of 10 each on diagnostic confidence. Images were found to significantly increase diagnostic confidence in all cases except one. It appears that mobile phone cameras are generally acceptable to patients and likely to be of practical use to rural practitioners in a range of clinical scenarios.”
Abstract
Chandra Jayaraman, Paul Kennedy, Gaelle Dutu, and Ross Lawrenson, J Telemed Telecare 2008;14 271-274, doi:10.1258/jtt.2008.080303

DH group to look at wider NHS CRS access

“The Department of Health has convened a group to look at widening access to the NHS Care Records Service including representatives from patients, nurses and pharmacists, according to Prof Michael Thick, Connecting for Health’s chief clinical officer.”
Article
e-Health Insider Primary Care, 15 July 2008

Barcoded Technology Used To Reduce Medication Administration Has Flaws

“In the first study of its kind, researchers led by The University of Pennsylvania School of Medicine’s Ross Koppel, Ph.D. studied how hospital nurses actually use bar-coded technology that matches the right patient with the right dose of the right medication. The surprising result is that the design and implementation of the technology, which is often relied upon as a “cure-all” for medication administration errors, is flawed, and can increase the probabilities of certain errors.”
Article
Medical News Today, 2 July 2008

Electronic Documentation Calls for Standardized Nursing Language

“Electronic documentation has called attention to the need for standardization of nursing terminology and ways to capture nursing interventions.”
Article
Debra Wood, Nurse Zone, 30 May 2008

Positive effects of electronic patient records on three clinical activities

“Purpose
To investigate the effects of a fully functional electronic patient record (EPR) system on clinicians’ work during team conferences, ward rounds, and nursing handovers.
Method
In collaboration with clinicians an EPR system was configured for a stroke unit and in trial use for 5 days, 24 h a day. During the trial period the EPR system was used by all clinicians at the stroke unit and it replaced all paper records. The EPR system simulated a fully integrated clinical-process EPR where the clinicians experienced the system as if all transactions were IT supported. Such systems are not to be expected to be in operational use in Denmark until at least 2 years from now. The EPR system was evaluated with respect to its effects on clinicians’ mental workload, overview, and need for exchanging information. Effects were measured by comparing the use of electronic records with the use of paper records prior to the trial period. The data comprise measurements from 11 team conferences, 7 ward rounds, and 10 nursing handovers.
Results
During team conferences the clinicians experienced a reduction on five of six subscales of mental workload, and the physicians experienced an overall reduction in mental workload. The physician in charge also experienced increased clarity about the importance of and responsibilities for work tasks, and reduced mental workload during ward rounds. During nursing handovers the nurses experienced fewer missing pieces of information and fewer messages to pass on after the handover. Further, the status of the nursing plans for each patient was clearer for all nurses at the nursing handovers except the nurse team leader, who experienced less clarity about the status of the plans.
Conclusion
The clinicians experienced positive effects of electronic records over paper records for the three clinical activities involved in the evaluation. This is important in its own right and likely to affect clinicians’ acceptance of EPR systems, their command of their work, and consequently the attainment of ‘downstream’ effects on patient outcomes.”
Abstract
Morten Hertzum, Jesper Simonsen, International Journal of Medical Informatics, In Press, Corrected Proof, Available online 23 May 2008, doi:10.1016/j.ijmedinf.2008.03.006

Virtual medical care approach could save patient time, nursing resources

“A team of Japanese experts says that the time has come when researchers should start working on a virtual medical care system that might support nursing staff, care managers and other healthcare workers.”
Article
New Kerala.com, 25 May 2008

Nurses on Twitter, Twitter on Nurses

“Why would a nurse want to use twitter?
First things first, what is twitter? Quite simply, it’s a microblogging tool. Think you have something witty/amusing/relevant to say and can get it in under 140 characters? Then twitter is for you. Want to connect with a community of people without having to write long, drawn out blog posts? I would suggest trying twitter. It’s like a slimmed down version of social networking. You write something, you read something. And you can have conversations with people. Short ones.”
Article
Beth, Pixel RN, 20 May 2008

ICMCC Event Preview 1

This is the first of a series of blogs in which I will give a preview of the various aspects of the upcoming ICMCC Event.

The Monday morning has 2 parallel sessions.

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Two-stage evaluation of the impact of a nursing information system in Taiwan

Purpose
This study evaluated the post-implementation impact of a nursing information system and identified issues related to the technology adoption process. Given the high level of investment necessary to implement information systems, evaluation has become vital to ensure successful adoption and use. Improved understanding of implementation difficulties/barriers and factors leading to them can serve as a platform for the development of strategies and education programs for users.
Method
The study design was a two-stage data comparison analysis of a nursing information system focusing on computerized nursing care plan use. Data were collected from nurses by questionnaire during the first month (December 2004) and 1 year after system installation (December 2005).
Results
While nurses gave the information technology a higher evaluation score at the second stage than at the early stage, the overall ratings were slightly negative at both stages. Age and pressure to use the system were critical factors at both stages, whereas computer skills and perceived time using the system were vital at the beginning stage of implementation. Issues of concern at both stages were system functionality, efficiency, usability, and user support.
Conclusion
Implementation of an information system requires consideration of issues involving hardware and software, staff training, organizational policy, and workflow changes.
Abstract
Ting-Ting Lee, Mary Etta Mills, Barker Bausell and Ming-Hui Lu, International Journal of Medical Informatics, In Press, Corrected Proof, Available online 5 May 2008

Equipping a Mobile Nurse

“The advent of wireless technology has made it possible for mobile health care professionals to access patient records, test results and other critical information from the field. While much of this focus is centered on computing from within the traditional hospital campus, a growing number of clinicians are traveling to patients’ homes, which requires remote connectivity to improve communication and to keep patient records up to date.”
Article
Andy Willett, HHNMostWired, 23 April 2008

What nurses want

“The health care industry’s continued reliance on paper astounds Lillee Gelinas, vice president and chief nursing officer at VHA Inc., an alliance of hospitals and non-acute-care facilities.
Gelinas was making rounds at a major hospital recently when she came upon a familiar sight: a nurse struggling with a huge pile of paper files. A work shift had just ended, and Gelinas assumed the nurse was catching up on the day’s charts. Instead, the nurse told her she had come in on her day off to manually gather data for review by the hospital’s quality committee, which was meeting the following day.”
Article
John Pulley, Government Health IT, 31 March 2008

Thoughts on EHR

Slowly the concept of Electronic Health Records (EHR) is gaining ground. However, not without many difficulties and an amazing silence from the side of the customer/patient.

Josh Seidman from PCHIT asked a very important question: “How much of a prerequisite is an EHR for implementing a PHR?” Absolutely, I would say, there is none without the other.
A couple of years ago it was deemed necessary, at least in the USA, to split the pure medical from the personal part, the so-called personal health record (PHR) (see Tang et al.). In my view this has been a very wrong decision. In stead of implementing a total record, including all aspects, the discussion has now begun how to link one with the other. It seems the world upside-down.

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Data farming used to improve nursing capacity

“Methodist Le Bonheur Healthcare of Memphis, Tenn. has joined the University of Memphis Center for Healthcare Technology on an innovative research program aiming to help nurses do their jobs.
The research method, known as “data farming,” uses computer simulation to analyze thousands of nurse workflow scenarios and find ways to apply healthcare IT and physical layouts, increasing the capacity of a nurse to be at bedside.”
Article
Diana Manos, Healthcare IT News, 4 January 2008

RFID Moves Beyond Assets

“Columbus (Ind.) Regional Hospital executives wanted to get the most bang for the buck from their new nurse call system.
So when they discovered that the technology, from Rauland-Borg Corp., Skokie, Ill., can use radio frequency identification technology to track clinicians to enable them to better communicate with each other, they came up with some other ideas for how RFID could help improve workflow and patient care.”
Article
Health Data Management, 1 January 2008

Nurse Survey: Mobile Tech Unreliable

“Sixty-four percent of nurses believe their organization’s wireless infrastructure isn’t reliable enough to support point-of-care computing, according to a recent survey. Further, the nurses sometimes have to log in and out of their wireless clinical systems up to 80 times a day because of frequent dropped connections as a result of dead zones or poor access point transitions, according to the survey.”
Article
Health Data Management, 17 December 2007

Technology Implementation and Workarounds in the Nursing Home

“Objective: This study sought to explore the relationship of workarounds related to the implementation of an electronic medication administration record and medication safety practices in five Midwestern nursing homes.
Conclusion: This study provides important practical examples of how nursing home staff work around work flow blocks encountered during the implementation of technology. Understanding these workarounds as a means of first-order problem solving is an important consideration to understanding risk to medication safety.”
Abstract
Amy A. Vogelsmeier, Jonathon R.B. Halbesleben and Jill R. Scott-Cawiezell, Journal of the American Medical Informatics Association, Volume 15, Issue 1, January-February 2008, Pages 114-119, doi:10.1197/jamia.M2378

An Earful from Nurse Executives

“Nurse executives and managers across the country released a floodgate of opinions and ideas when they were asked how well their patient care software solution was meeting their needs. KLAS’ study of nursing adoption of information technology uncovered pent-up demand among CNOs wanting to give constructive criticism to health care IT vendors and consulting firms alike.”
Article
Kent Gale, HHNMostWired, 11 December 2007

Towards automated classification of intensive care nursing narratives

“Background: Nursing narratives are an important part of patient documentation, but the possibilities to utilize them in the direct care process are limited due to the lack of proper tools. One solution to facilitate the utilization of narrative data could be to classify them according to their content.
Conclusions: Our results indicate that the free text in nursing documentation can be automatically classified and this can offer a way to develop electronic patient records.”
Abstract
Marketta Hiissa, Tapio Pahikkala, Hanna Suominen, Tuija Lehtikunnas, Barbro Back, Helena Karsten, Sanna Salanterä and Tapio Salakoski, International Journal of Medical Informatics, Volume 76, Supplement 3, December 2007, Pages S362-S368