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Nursing Informatics: Where Technology and Caring Meet

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Abstract

Despite paying more for healthcare than any other country in the world, the US ranks below more than 40 other countries in life expectancy – down significantly from two decades earlier. As the Institute of Medicine concluded, “The current care systems cannot do the job. Trying harder will not work. Changing systems will.” Creating a new system that is “safe, effective, patient-centered, timely, efficient, and equitable” demands transformative change and the health information technology (IT) to support it. For the more than 2.6 million nurses who make up more than half of the national healthcare workforce, IT will be more than an enabler. This fourth edition of Nursing Informatics serves as a definitive guide to the transformation now underway, drawing insight and energy from the initiative known as Technology Informatics Guiding Education Reform (TIGER). Launched by a small group of nurse advocates, TIGER is a guiding force for integration of technology and informatics into education and practice nationally and provides leadership across health professions and delivery settings. Subsequently, it has developed nine collaborative sections that address critical areas for change: education and faculty development, staff development, informatics competencies, standards and interoperability, usability and clinical application design, leadership development, national health information technology agenda, virtual demonstration center, and consumer and personal health record. This new edition reflects the core tenets set forth in the recommendations made by the TIGER initiative, focusing on a range of issues: • Transformation, culture change, and diffusion • Competencies, education, staff development, and leadership • Infrastructure, adoption, and implementation • Comparative effectiveness research and personalized medicine • Global initiatives The editors for this new edition include key nurse advocates and informaticians active in the TIGER initiative: Marion J. Ball, Judith V. Douglas, Patricia Hinton Walker, Donna DuLong, Brian Gugerty, Kathryn J. Hannah, Joan Kiel, Susan Newbold, Joyce Sensmeier, Diane Skiba, and Michelle Troseth.

Chapters (3)

The Technology Informatics Guiding Education Reform (TIGER) Initiative started with a passionate dinner discussion among informatics colleagues after the announcement of the Office of the National Coordinator of Health Information Technology. These colleagues were determined to insure that nurses had the necessary knowledge and skills to practice in the “Decade of Health Information Technology” as it was being defined in July of 2004. From this conversation, a planning meeting was held in January of 2005 at Johns Hopkins University School of Nursing. The planning meeting brought together informatics colleagues from academia, health care institutions, the vendor community, and other federal entities. Many ideas were exchanged, but perhaps the most influential was from Dr. Angela McBride, who noted that the informatics community had many accomplishments but as a community we had not engaged our nursing colleagues. If we truly wanted to reach our goal of insuring that all nurses were prepared to practice, it was essential for us to engage the broader nursing community. Thus, the mission of TIGER was defined – to bring together leaders from various nursing specialty organizations to coalesce and create a vision plus an informatics agenda for the next 3 years and 10 years. This mission involved bringing together the intellectual and social capital of these specialty organizations with the informatics community to create an informatics agenda.
Why is there such an urgency to adopt health information technology (IT) interoperability standards? What does this urgency mean for nursing? It has been well documented that our health care system is in crisis. What worked in the past is no longer viable and must be improved. Despite spending over $1.6 trillion on health care as a nation, there are still serious concerns about high costs, avoidable medical errors, administrative inefficiencies, and poor coordination – all of which are closely connected to the failure to incorporate health IT into our health care system, according to the Agency for Healthcare Research and Quality.1 To address these concerns, numerous efforts have commenced which include setting a goal for the adoption of electronic health records (EHRs) recognition of interoperable health IT standards as part of the President’s National Health IT Agenda to lower cost and drive quality improvement, and the American Recovery and Reinvestment Act of 2009 (ARRA). Through these and other public/private efforts, the importance of advancing quality care and reducing costs through adopting interoperable health IT has been brought to the forefront of the nation’s efforts to improve the health care system.
This chapter presents the work of the TIGER Collaborative on Consumer Empowerment and the Personal Health Record (PHR). The entire body of work for the TIGER Collaborative Team #9 is available at http://tigerphr.pbworks.com/ The first part of this chapter will review the state of the science on the potential of health consumerism as seen through the lens of health literacy and nursing’s role as an advocate, educator, and facilitator for using health-enabling technologies. The second half of the chapter focuses on the domain of the PHR – state of the art, adoption, public policy, and nursing’s role in care delivery and enabling individuals to self-manage and to be active participants in their care decisions.
... Head nurses should be able to evaluate the proficiency of their workforce and identify requirements for safe patient care, including the obstacles that restrict their employees' use of Health Information Technology (HIT) (Ball et al., 2011). Hunter et al. (2013) identified one of the gaps in NI competency development as the measurement of competencies. ...
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Background Due to the increasing use of informatics as an infrastructure in developing the quality of care and patient safety, informatics competency has become a crucial requirement for nurses. Aim This study was conducted to assess nursing informatics competency, and identify related factors in registered nurses. Method This research is an analytical descriptive study in which the research community included 205 nurses working at Tabriz University of Medical Sciences’ hospitals. The researcher-made questionnaire was developed as a data collection tool (α = 98%). The data was entered into SPSS 16 software and correlation analysis and regression were carried out. Results The mean score percentage of total nursing informatics competency was 59.92%. The highest mean score was related to informatics skills (62.98), followed by the informatics knowledge subscale (59%). In addition, informatics competency was positively correlated with self-efficacy ( r = 0.27, p = 0.001), evidence-based practice ( r = 0.55, p = 0.001) and time spent on hospital information systems ( r = 0.16, p = 0.01). Conclusion Computer skills, self-efficacy, evidence-based practice and time spent on hospital information systems are determinant factors of nurses’ informatics competency. Developing nurses’ basic computer skills and incorporating informatics education programmes into the curriculum can enhance nurses’ informatics competency.
... The work of the CEN/TC251 European standardisation committee can be seen as of major importance to this issue, one example with respect to concepts and semantics is referenced below. Skiba (1995) adds to the list of Branger and Duisterhout the use of Bulletin Board Systems (BBS), Freenets, and videoconferencing. Brennan (1995) describes an concrete example of the use of electronic communication systems in health care delivery to support care givers for dementia patients. ...
... Also, In EBP, healthcare professionals make clinical decisions based on the best available research results while considering the preferences and clinical circumstances of their patients. EBP implementation has been related to improved health outcomes [3,4]. ...
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Background The development of nursing informatics started late in China. There is an urgent need to develop a clinical practice model that can guide nursing managers in constructing an organizational nursing informatics competency. Objective The objective of this study was to develop a nursing organizational informatics competency model based on the Professional Practice Model (PPM) and to provide a reference for training in clinical nursing informatics in hospitals. Methods A multidisciplinary team in the hospital was first formed as the working group, consisting of nurses trained with the TIGER (Technology Informatics Guiding Education Reform) Taiwan model and had practical experience in system development. We used an exploration map to help build the prototype of the hospital nursing informatics competency model. Then, a final model was constructed by experienced out-of-hospital experts using the Delphi method. The final model was determined according to the validity analysis. Results Ten hospital stakeholders were invited to form the multidisciplinary working team to develop the prototype organizational PPM model. Two rounds of Delphi were conducted to twelve experienced nurses' informatics experts outside the hospital by e-mail. The results showed that the questionnaire return rate was 100%, the expert authority coefficient was 0.84, the general validity of the two rounds of content was 92.46% and 100%, respectively, and the coefficient of variation of all items was < 0.3. The final model included five categories, including management strategy and leadership, organizational structure and operation, improvement of the environment for nursing information practice, cultivation of core competence in nursing information, and project management of the nursing information system, with 61 elements in total. Conclusions We propose this model to help hospital nursing managers to establish a plan of action to build up organizational clinical informatics competency.
Chapter
This chapter introduces the reader to the scope and practice of nursing informatics. Contextualized across the health care system from an international perspective, the authors lead readers through an exploration of information and communication technologies (ICT), concepts related to eHealth and mHealth, and emerging topics such as clinical intelligence as they inform and support professional nursing practice. An overview of nursing informatics as a specialty practice distinct from health informatics and the evolution of definitions and competencies are also presented.
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Abstract Eight home health nurses from the Visiting Nurse Service of New York participated in a focus group discussion after their initial experiences using wireless, pen-based computing in the inner-city, home care environment. Transcripts of the nurses' responses to open-ended questions were analyzed and central themes were found, following the method of concept analysis described by Strauss and Corbin (1990). The central concepts were “Readiness,”“A thousand pounds on my back,”“Call for support,”“Problems with transmission.”“Using the computer as an assistant,”“Nurses discovered glitches,” and “Everybody has to have a computer.” These themes reflected the nurses' initial experiences with the wireless computers and also revealed their concerns. This article will describe these themes and will discuss the implications of current improvements in wireless computing for health care. The focus group themes aided in understanding how this group of experienced home health nurses began to transition from handwriting on several different forms to checking-off items on a small, hand-held computer screen, from innovating methods to communicate when telephones were not available, to using a wireless computer to send and receive data involved in the patient admission process
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Social network is a social structure made up of individuals and organizations that represent "nodes", and they are associated with one or more types of interdependency; such as: friendship, common interests, work, knowledge, prestige and many other interests. Beginning with the late twentieth and early twenty-first century, the Internet was a significant additional tool in the education of teenagers. Later, it takes more and more significant role in educating students and professionals. The aim of this paper is to investigate, to what extent and how effectively the Internet is used today. In addition, more specifically, this paper will research the implications of the well-known social networks in education of students and health professionals in Bosnia and Herzegovina (B&H). We compared the ratio of using Medline, as the largest biomedical data base system for spreading medical information, as basics for health education at biomedical faculties at five universities in B&H. According to data from the CRA (i.e. Communications Regulatory Agency) in B&H, in 2010, there were 522,364 internet access accounts, with about 2 million Internet users, representing about 52% of the total population. The Internet users' preference is dominated by the users of fast broadband access (e.g. xDSL) with 42.8%, and elsewhere, still with dialup access, with 25.2%. The results showed that only 11.6% of professors use Facebook type of social network, 49.3% of them have a profile on BiomedExperts scientific social network and 79% have available articles in the largest biomedical literature database MEDLINE. Students are also frequent users of general social networks and educational clips from You Tube, which they prefer to utilize considerably more than the other types of professionals. Students rarely use the facilities of professional social networks, because they contain mainly data and information needed for further, postgraduate professional education. In our research, we analized cited published papers in the journal Medical Archives, the oldest medical journal in B&H (established in 1947) of randomly included 151 full and part time professors, authors from five medical faculties in B&H and B&H authors who currently work in the EU and USA.. ANOVA showed that there was no significant difference in the number of articles published between the Universities in Bosnia, but there was significant difference in the number of articles published on MEDLINE, between all faculties in B&H and a group of scientists who work around the world. Students' tests showed that there was a statistically significant difference in the average number of papers published on Medline, between groups of part-time and full time professors. However, there were no statistically significant differences, between the professors for preclinical and clinical subjects. In B&H there are decent conditions for the use of online social networks in the education of health professionals. While students enthusiastically embraced these opportunities, this is not so much a case with health care professionals in practice; while scientific health care workers have not shown greater interest in the use of social networks, both for purposes of scientific research and in terms of self-education and training of students. There is much more use of the advantages offered by online social networks, both in education and in support of the scientific research.
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Keeping individuals aware of their own health is a global challenge in health care. Observations of Daily Living (ODLs), cues to health that are derived from and personally meaningful to an individual, provide a detailed picture of one's experience of health. Project HealthDesign, an 8-year initiative of the Robert Wood Johnson Foundation, is investigating ODLs and devising innovative ways of tracking them through personal health record deployment in diverse communities and health care settings. Nursing informatics knowledge base and skills, applied to the ODL challenge can accelerate their identification, capture, and interpretation, thus empowering individuals toward meaningful action and facilitating more robust information exchange between individuals and their health care providers.
Article
Objectives: eHealth and innovation are often regarded as synonyms - not least because eHealth technologies and applications are new to their users. This position paper challenges this view and aims at exploring the nature of eHealth innovation against the background of common definitions of innovation and facts from the biomedical and health informatics literature. A good understanding of what constitutes innovative eHealth developments allows the degree of innovation to be measured and interpreted. Methods: To this end, relevant biomedical and health informatics literature was searched mainly in Medline and ACM digital library. This paper presents seven facts about implementing and applying new eHealth developments hereby drawing on the experience published in the literature. Results: The facts are: 1. eHealth innovation is relative. 2. Advanced clinical practice is the yardstick. 3. Only used and usable eHealth technology can give birth to eHealth innovatio. 4. One new single eHealth function does not make a complex eHealth innovation. 5. eHealth innovation is more evolution than revolution. 6. eHealth innovation is often triggered behind the scenes; and 7. There is no eHealth innovation without sociocultural change. Conclusions: The main conclusion of the seven facts is that eHealth innovations have many ingredients: newness, availability, advanced clinical practice with proven outcomes, use and usability, the supporting environment, other context factors and the stakeholder perspectives. Measuring eHealth innovation is thus a complex matter. To this end we propose the development of a composite score that expresses comprehensively the nature of eHealth innovation and that breaks down its complexity into the three dimensions: i) eHealth adoption, ii) partnership with advanced clinical practice, and iii) use and usability of eHealth. In order to better understand the momentum and mechanisms behind eHealth innovation the fourth dimension, iv) eHealth supporting services and means, needs to be studied. Conceptualising appropriate measurement instruments also requires eHealth innovation to be distinguished from eHealth sophistication, performance and quality, although innovation is intertwined with these concepts. The demanding effort for defining eHealth innovation and measuring it properly seem worthwhile and promise advances in creating better systems. This paper thus intends to stimulate the necessary discussion.
Article
This paper contributes to research into the interconnections between the new digital technologies, the work of nurses and their professionalisation, particularly in relation to theoretical debates about technology and the shaping of skill sets and work processes associated with patient care. The research was conducted in five acute care hospitals, across two Australian states, with qualitative interviews of 125 nurses to explore nurses’ experience of digital clinical technology and information technology (IT). Differentiating between clinical and information technologies and the specific contexts within which they were employed (high/low dependency wards; teaching/non-teaching hospitals) revealed the complexities and variability of the relationship between nurses and new technologies. In high dependency (HD) wards (for example, intensive care units – ICUs), the use of highly sophisticated clinical technologies has made nurses’ work easier and quicker, yet has not led to deskilling because it requires considerable interpretative capacity based on nurses knowledge and experience of patient pathology and treatment. As a result, nurses’ sense of autonomy is enhanced. In lower dependency wards, however, the use of less sophisticated clinical technology did not enhance their sense of autonomy, although it did make their work quicker and easier. The use of this freed-up time, in the context of increasing patient flow rates, in these wards was diverted to processing more patients and to using computers, rather than on direct patient care. The introduction of new IT systems, without any consultation with nurses as end-users, has resulted in both increased nursing workloads and a shift to less direct patient interaction.
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Article
The HITECH Act of 2009 encourages health care providers to become meaningful users of EHRs.2,5 Beginning in 2015, reimbursement for health care services will be based on the adoption and use of the EHR. 2,5 Meaningful use includes the use of certified EHRs to improve quality, safety, and efficiency and reduce health disparities. 8Unfortunately, a 2012 survey reported that only 44% of hospitals used at least a basic EHR system. EHRs can leverage other technologies and incorporate other digital processes. In addition, EHRs can transform the way health care is delivered and compensated. 12 Health care quality and convenience is improved for both the provider and patients with quick and remote access to patient records. 12Experts agree that EHRs can benefit patients and society when widely adopted and used meaningfully. 15 Examples of technology that complement EHRs are CDS and CPOE; when used with bar-code scanning technology, they can greatly reduce medication errors, with a 55% reduction in serious medication errors.15,22 Patient health records, also known as patient portals, are vehicles for meeting the meaningful use criteria by enabling secure messaging with health care providers and giving patients access to their personal health records.28 The need for mobile tools can reduce errors and redundancy allowing the nurse to be at the patients' side more instead of having to run to the nurses' station to gather information or communicate.32 Examples of mobile technology include VOIP phone systems that allow nurses to be at the bedside more and RFID tags that can track nurses, patients, equipment, medication, and supplies. Mobile charting makes it easier to perform electronic charting and can save time and increase efficiency. Electronic patient tracking boards can offer a quick status update of patients' current activity and streamline communication and coordination of patient care.32Smart pumps can prevent medication errors, such as wrong rate, wrong dose and pump setting, as well as reducing adverse drug event rates, while being cost-effective.43 High-fidelity simulations provide an ideal environment to address and improve teamwork in highacuity, stressful patient care scenarios and thereby mitigate the potential for human error. Advancements in technology have allowed for services, such as telehealth, which bring new ways to educate and access patients.50 The use of sensors, motion detectors, and wireless technology can monitor changes in behavior and activity. This information is recorded and transmitted to the health care provider.52 Nurses are caring and, therefore, must use technology to complement patient care.6 In this ever-changing health care environment, caring and technology must go hand in hand to create a culture in nursing that embraces transformative technologies that are emerging every day.6
Chapter
The TIGER Initiative, an acronym for Technology Informatics Guiding Education Reform, was launched in 2004 to bring together nursing stakeholders to develop a shared vision, strategies, and specific actions for improving nursing practice, education, and the delivery of patient care with health IT. In 2011, TIGER became The TIGER Initiative Foundation, incorporated as a 501(c) (Institute of Medicine. The future of nursing: leading change, advancing health. Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, The National Academies of Press; 2011.p. 172. HIMSH) organization operating for charitable, educational, and scientific purposes. To educate the workforce to use health IT, TIGER has developed a Virtual Learning Environment, which provides multi-faceted, virtual learning experiences and virtual communities to develop knowledge, skills, and awareness of technology and informatics to contribute to a safer, more effective, efficient, patient-centered, timely and equitable healthcare system.
Chapter
Early hospital information systems (HISs) placed computers at nursing stations, and the passage of Medicare in 1965 set reimbursement rules that required documentation, first met by nurses using precoded cards and forms. In the 1970s, interactive terminals with visual displays became available; in the 1980s, microcomputers custom-tailored for nursing functions began to be installed at the patient’s bedside. Handheld portable devices began to appear for use at the point of care, and hospitals began to use bar codes for identification purposes. Nurses became increasingly involved in specifying information requirements for nursing services. In the 1980s, nursing information systems (NISs) were probably the most widely used HIS subsystem. They were used for bed assignment and control, nurse staffing recommendations based on patient classification systems, quality assurance programs, nursing care planning, and decision support. The 1980s also saw advances toward implementation of the Nursing Minimum Data Set and development of nursing education programs. In the 1990s, the American Nurses Association published documents defining the scope and standards of nursing informatics practice, and the American Nurses Credentialing Center had established a certification in nursing informatics as a practice specialty. In the 2000s, an international nursing terminology summit brought nurses and standards experts together to integrate nursing concepts and map nursing interface terminologies to SNOMED-CT, ultimately creating what in 2007 became an international reference terminology standard. The 2000s also saw the establishment of the Alliance of Nursing Informatics (ANI) and TIGER (Technology Informatics Guiding Education Reform); both continue to be active today.
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Public health informatics (PHI) is one branch of the larger field of biomedical and health informatics (BMHI) (Hersh, BMC Med Inform Decis Mak 9:24, 2009). In this chapter, we will define the terminology of BMHI and identify where other branches of the field can inform the science and practice of PHI. We will also discuss the value of BMHI in all health-related disciplines.
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The increasingly complex informatics technology that evolved since 1950 created a new domain of knowledge and a new professional discipline. In this chapter we discuss the foundations and evolution of the field of medical informatics, focusing on the role of publications, professional organizations, government, and industry in promoting the field’s growth, success, and impact. The earliest reports on biomedical applications of computers began to appear at conferences sponsored by professional engineering societies as early as 1947. The English term, medical informatics, was successfully introduced at an international meeting held in 1974. Subsequently the range of topics and the field’s scientific base have broadened, while academic informatics programs have been established at a growing number of institutions. The number of informatics articles published annually has grown rapidly, as have peer-reviewed informatics journals, the first two of which were launched in the 1960s. The first comprehensive medical informatics textbook (published in 1990) is now in its fourth edition. Starting in the 1960s, multiple organizations have been formed to focus on medical informatics; as their activities and influence increased, mergers followed, ultimately resulting in the creation of the American Medical Informatics Association (AMIA) in 1988. Other key players have included nursing, industry, academia, and the federal government, especially through the National Institutes of Health (NIH). More recently the field has been further nurtured at the federal level by the Office of the National Coordinator (ONC), which has championed the diffusion of electronic medical records, and the National Center for Advancing Translational Science (NCATS), which has funded clinical translational science awards and their supporting information systems.
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In deutschen Krankenhäusern ergeben sich Anpassungserfordernisse hinsichtlich der Pflege zur Bewältigung der zahlreichen Herausforderungen, zu denen die Zunahme der absoluten Zahl an älteren Menschen, die Veränderungen der Beschäftigtenstruktur, die Arbeitsbedingungen in der Pflege wie auch der Prozess der Digitalisierung gehören. Vor diesem Hintergrund wird digitalen Techniken das Potenzial zugesprochen, die Situation in der Krankenhauspflege verbessern zu können. Es zeigt sich, dass digitale Technologien bereits zur Dokumentation, Informationsverarbeitung und Organisation sowie Kommunikation zwischen den professionellen Pflegekräften eingesetzt werden. Es wird davon ausgegangen, dass weitere Informations- und Kommunikationstechnologien, Roboter und assistierende Technologien in den nächsten Jahren vermehrt in Krankenhäusern eingesetzt werden. Die zunehmende Nutzung derartiger Technologien hat Auswirkungen auf die Arbeitsorganisation, das Berufsbild und das Selbstverständnis der Pflege.
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p> People with diabetes mellitus must take responsibility for their own care to improve their quality of life. People with diabetes mellitus often need a set of services and support ranging from glucose monitoring, insulin and other treatment management, psychotherapy and social support, physical activity, nutritional counseling and others. Diabetes mellitus patients can play a more active role in treating their diabetes with health information technology. This literature review uses the PRISMA statement as a guide to search for research articles from two databases, Ebsco and Scopus. The results of the analysis of nine selected research articles indicate that information technology provides patient education and support for patients with diabetes mellitus. Information technology has been used to improve the quality of care for patients with diabetes mellitus, enable health workers to more effectively manage patients and to help patients manage their own illnesses so that research and related publications are needed to improve the care of patients with diabetes mellitus at home. BAHASA INDONESIA ABSTRAK: Penderita diabetes mellitus harus bertanggung jawab atas perawatan mereka sendiri untuk meningkatkan kualitas hidupnya. Penderita diabetes mellitus seringkali membutuhkan seperangkat layanan dan dukungan mulai dari pemantauan glukosa, insulin dan manajemen pengobatan lainnya, psikoterapi dan dukungan sosial, aktivitas fisik, konseling gizi dan lain-lain. Pasien diabetes mellitus bisa memainkan peran lebih aktif dalam perawatan diabetesnya dengan teknologi informasi kesehatan. Kajian pustaka ini menggunakan PRISMA statement sebagai panduan pencarian artikel penelitian dari dua database yaitu Ebsco dan Scopus. Hasil analisis sembilan artikel penelitian terpilih menunjukkan bahwa teknologi informasi memberikan pasien pendidikan dan dukungan pada pasien diabetes mellitus. Teknologi informasi telah digunakan untuk meningkatkan kualitas asuhan pasien diabetes mellitus, memungkinkan tenaga kesehatan lebih efektif mengelola pasien dan untuk membantu pasien mengelola sendiri penyakitnya sehingga penelitian dan publikasi terkait diperlukan untuk meningkatkan perawatan pasien diabetes mellitus di rumah.</p
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Caring expression in nursing is rapidly changing to include the use of sophisticated healthcare technologies. Unfortunately, few nurses participate in developing healthcare technologies. The current study aimed to generate a theory of nursing grounded in the phenomenon of nursing technologies creativity in nursing practice. The study design used a constructivist grounded theory. Sixteen Indonesian nurses selected by purposive sampling were interviewed in-depth. Data analysis used constant comparative analysis through Charmaz’s coding process. This study generated two core conceptual categories that included technological creativity and drivers for technological development. Five theoretical statements were developed leading to the Technological Creativity as Caring in Nursing Theory. This theory is a middle-range theory that focuses on technological creativity to express caring for patients, nurses, and management in nursing practice.
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Biomedical informatics is a discipline dating back to the 1950s that continues to evolve with the growth of data and advances in technology in biomedicine and health care. This field brings together foundational approaches from many scientific and technological disciplines that can be applied across the spectrum from molecules to individuals to populations. In the context of the learning healthcare system, this chapter highlights frameworks and methods for transforming data to knowledge, putting knowledge into practice through evidence-based technology innovations, and evaluating the impact of those innovations.
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■ Weiterentwicklungen der Studienrichtungen Medizinische Informatik und Medizinisches Informationsmanagement ■ Bachelor-Studienprogramme in Deutschland ■ Perspektiven grundständiger Ausbildung in Medizinischer Informatik in Deutschland
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Digitalisierung und Evidenzbasierung müssen curriculare Bestandteile in Aus-, Fort-, Weiterbildung und Studium der Pflege sein. Innovative Lehr- und Lernkonzepte müssen methodisch-didaktisch von geschulten Pflegedidaktiker*innen umgesetzt werden. Entscheidend ist neben den Anforderungen der Gesundheits- und Pflegepolitik und Pflegeforschung vor allem die Rolle der Pflegepraxis.
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The challenges facing healthcare in the 21st century frequently seem intractable and insurmountable. Systemic problems impair the quality and continuity of care and caregivers' quality of life. For over 25 years, the Clinical Practice Model Resource Center (CPMRC) in Grand Rapids, MI, has focused on transforming healthcare at the point of care to achieve its mission to co-create and sustain the best places to work and to receive care. The extent of the vision to transform practice at the point of care calls for a shift from the common quick fix change mindset to a Professional Practice Framework mindset that guides the actions steps to achieve greater clinical integration and standardize, sustainable transformation in a complex healthcare system. An overview of the Clinical Practice Model (CPM) Framework's conceptual underpinnings and the importance of the use of a Framework to guide transformation work across an International Consortium of hospitals are summarized. The lessons learned come from shared learning within a growing volunteer interdisciplinary, international consortium of over 276 rural, community, and university clinical settings. The Consortium's collective work has resulted in clinical, financial, and operational outcomes related to healthy work cultures, evidence-based practice, interdisciplinary, integrated documentation, and partnership councils. The cycle of organizational transformation ensures support for the professional processes, scope of practice, service across lifeline and continuum, integration and interoperability, evidence-based tools, interdisciplinary practice, and research-based and updated information. The power of organizational change flowing from a Framework is evident in replicable interventions and sustainable outcomes.
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