Various kinds of works of 6-11th-form schoolchildren on Macintosh computers were physiologically and hygienically assessed at the lesson of information science and computer engineering (ISCE), as well as typing. The fatigue of a visual analyzer was due to the time of looking through the data available on the display; the adverse changes of the higher nervous activity depends on the complexity of educational materials and the intensity of work on a computer. Three-hour studies in ISCE should be excluded from the time able of lessons as they do not meet hygienic requirements.
To study the implementation of electronic guidelines designed for general practitioners (GPs).
A descriptive 3-year follow-up study.
All new subscribers to Physician's Desk Reference and Database (PDRD) in 1992.
Locations of computers, where PDRD software was installed for the first time in 1992.
Expectations of the program and changes in attitudes towards it, getting started with the system, frequency and continuity of use and estimated usefulness of the program.
The guidelines were expected to enhance diagnostic accuracy (60% of subscribers), save time (45%), and reduce costs (11%). After 1 year's use, the opinions of the users on these topics had become slightly more positive. Technical problems delayed starting to use the program in 27%. After 1 year 72% were using the program at least weekly. Using frequency was associated with having the computer in the office. The subscribers who renewed their subscription after one year often became regular users.
The study provides insight into the implementation phase of computer-based guidelines in a population of early adopters. Technical support was essential to overcome the barriers associated with computer technology. The perceived need for information was independent of the age and experience of the physicians.
In order to support decisions and analyze outcomes, the Spanish Health System has shown a great interest in developing data bases and high quality information systems. Nevertheless the use of these data bases are limited, not very systematized and, some times, their accessibility may be difficult.
We describe in this review the experience in using the Institute for Clinical Evaluative Science (ICES, Ontario, Canada) as an efficient model to improve the usefulness of these data bases.
Under restrictive conditions of confidentiality and privacy, the ICES has the legal capacity to use several population based data bases, for research projects and reports. ICES's functional structure (with an administrative and scientific level) is an interesting framework since it guarantees its independent and economic assessment.
To date, its scientific production has been high in many areas of knowledge and open to those interested, with points of view of many health care professionals (including management), for whom the quality of research is of the ultimate importance, to be able to access these resources.
The purpose of this study was to identify barriers and facilitators influencing the implementation of an interactive Internet-portal application for patient education in psychiatric hospitals.
The data were collected from nurses by means of a questionnaire with thematic open-ended questions. The data was analysed using qualitative content analysis.
Four main categories were formed to describe barriers and facilitators of portal implementation in psychiatric wards. These categories were organisational resources, nurses' individual characteristics, patient-related factors and portal-related factors. Some major barriers were identified restricting the use of the portal in patient education: lack of computers, lack of time for patients, nurses' negative attitudes towards computer use and lack of education. The main facilitators for portal use were appropriate technological resources, easy Internet access, enough time for portal use, and level of motivation among staff to use computers.
The specific challenge in achieving patient education with the computer in psychiatric care is to ensure technological resources and that the staff are motivated to use computers. At the same time, attention should be paid the relationship between patient and nurse.
It is important to examine the patient-nurse relationship in the education process and also to define the usability of the application from the patients' point of view.
Only limited pedagogical use has been made of information and communications technology (ICT) in nursing education in Norway. In this study the use of ICT was linked to assignments in the first year undergraduate nursing program and included four on-line discussions. There is evidence to suggest that on-line discussions can enhance the learning environment. The students' experiences of the on-line discussions are compared to those of the students participating in traditional group discussions. The results show little difference between the two groups' opinions of the discussions' fruitfulness and the ease in which they expressed their feelings, thoughts and ideas. However, there is a marked difference between the two groups regarding their experience of how the discussions affected the amount of contact between group members outside the discussions. Possible reasons for these findings are discussed.
The purpose of this study was to identify nurses' computer training needs. A 20-statement questionnaire was circulated to 30 nurses. From the 26 responses received, a profile was created of the target group (nurses working in a teaching hospital), with a view to determining their current and desired level of knowledge. A number of diverse training needs were revealed through the study. The most interesting aspects, from the nurses' point of view, were those related to clinical practice and education. Figure one illustrates the low level of current knowledge of computer science. Figure two, however, demonstrates the high level of interest on the part of respondents (desired level) in becoming more computer literate and their wish to use computers in a wide range of applications, including teaching, health care delivery, clinical decision making and in-service training. Figure three highlights the training needs identified under each statement. The establishment of an information system in a teaching hospital setting is not dealt with in this article. This will be the subject of a second article, to appear next month. A number of teaching variables are described here, including the instructor, the learner, the training process itself, content, media and budgetary constraints. The outline of a training program will be proposed in a third and final article.
We conducted this study to evaluate the feasibility of implementing an internet-linked handheld computer procedure logging system in a critical care training program.
Subspecialty trainees in the Interdepartmental Division of Critical Care at the University of Toronto received and were trained in the use of Palm handheld computers loaded with a customized program for logging critical care procedures. The procedures were entered into the handheld device using checkboxes and drop-down lists, and data were uploaded to a central database via the internet. To evaluate the feasibility of this system, we tracked the utilization of this data collection system. Benefits and disadvantages were assessed through surveys.
All 11 trainees successfully uploaded data to the central database, but only six (55%) continued to upload data on a regular basis. The most common reason cited for not using the system pertained to initial technical problems with data uploading. From 1 July 2002 to 30 June 2003, a total of 914 procedures were logged. Significant variability was noted in the number of procedures logged by individual trainees (range 13-242). The database generated by regular users provided potentially useful information to the training program director regarding the scope and location of procedural training among the different rotations and hospitals.
A handheld computer procedure logging system can be effectively used in a critical care training program. However, user acceptance was not uniform, and continued training and support are required to increase user acceptance. Such a procedure database may provide valuable information that may be used to optimize trainees' educational experience and to document clinical training experience for licensing and accreditation.
This article describes a data warehouse approach when designing an information system to meet nursing management needs in acute hospital setting.
The rapidly changing health care environment has created new challenges for nursing leaders and requires appropriate, accurate and timely data for decision-making.
Key aspects of current information needs were identified by a nursing expert group. A data warehouse-based Nursing Management Information System was produced and piloted in nine wards. A survey and interviews were conducted to evaluate the piloting.
Data from the patient administrative system together with nursing rostering data and measures for nursing care intensity brought new opportunities for nursing management.
A Nursing Management Information System is suggested to be built using data warehouse model. Successful implementation of a Nursing Management Information System requires systematic data quality checks. An information analyst is essential for interpreting and communicating nursing data to multi-professional management groups.
Telenurses at call centers use decision aid software programs to offer triage recommendations and self-care advice to the general public. Decision aid programs are intended to support medical safety but were suggested by telenurses to be a hindrance to the dialogue. The aim of this study was to explore the use of decision aid software programs for telenursing, from the perspective of the users. A qualitative, descriptive approach was used. Twelve telenurses in Sweden were interviewed twice. The interviews were transcribed and analyzed thematically. Four themes were found: support for assessment but not for the decision; inconsistency between actual practice and the decision aid software; limited support for learning and information; and communication challenges and software programs. The software programs were a support for assessment, rather than decision-making, assuring the nurses that the relevant questions were asked. They were not fully adapted to current clinical practice, focusing mainly on acute conditions. Nurses worked to a large extent with self-care advice, often over-riding the recommendations made.
