RESUMEN
The current exploratory, qualitative study discovered and clarified implementation factors that led to technology adoption in long-term care (LTC). The Integrated Technology Implementation model guided the study of an electronic health record used in three LTC settings. Thirty key stakeholders (i.e., directors of nursing, nurses, and certified nurse aides) participated in focus groups or interviews. Findings indicated experiences were more similar than different among groups and facilities. Five major implementation themes supported by a variety of minor themes were identified. Implications for nursing include that leaders must be knowledgeable and committed to the change and engage staff throughout the implementation process. In addition, various communication and education strategies are required. [Journal of Gerontological Nursing, 43(10), 21-26.].
Asunto(s)
Actitud del Personal de Salud , Actitud hacia los Computadores , Registros Electrónicos de Salud , Enfermería Geriátrica/métodos , Personal de Salud/psicología , Cuidados a Largo Plazo/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Invenciones , Masculino , Persona de Mediana Edad , Estados UnidosRESUMEN
Healthcare technology is used to improve delivery of safe patient care by providing tools for early diagnosis, ongoing monitoring, and treatment of patients. This technology includes bedside physiologic monitors, pulse oximetry devices, electrocardiogram machines, bedside telemetry, infusion pumps, ventilators, and electronic health records. Healthcare costs are a challenge for society, and hospitals are pushed to lower costs by discharging patients sooner. Healthcare technology is being used to facilitate these early discharges. There is little understanding of how healthcare facilities purchase, implement, and adopt technology. There are two areas of theories and models currently used when investigating technology: technology adoption and implementation science. Technology adoption focuses mainly on how the end users adopt technology, whereas implementation science describes methods, interventions, and variables that promote the use of evidence-based practice. These two approaches are not well informed by each other. In addition, amplifying the knowledge gap is the limited conceptualization of healthcare technology implementation frameworks. To bridge this gap, an all-encompassing model is needed. To understand the key technology implementation factors utilized by leading healthcare facilities, the prevailing technology adoption and implementation science theories and models were reviewed. From this review, an integrated technology implementation model will be set forth.
Asunto(s)
Tecnología Biomédica , Informática Médica , Actitud hacia los Computadores , Práctica Clínica Basada en la Evidencia , Humanos , Modelos TeóricosRESUMEN
There are many benefits of having an electronic reference at the patient bedside. Because of the significant costs involved, it is important to first understand if staff will utilize the system. A cost-benefit analysis of such an electronic clinical procedural resource at one large, academic health system showed a significant savings of $360,899. Having an electronic reference system at the patient bedside increased standardization throughout the organization. Additionally, clinical and instructional experts are not needed to write standard policies and procedures. Ongoing education was needed to increase utilization of the system within the organization.
Asunto(s)
Bases de Datos Factuales/economía , Bases de Datos Factuales/estadística & datos numéricos , Práctica Clínica Basada en la Evidencia/organización & administración , Internet/economía , Sistemas de Atención de Punto/economía , Sistemas de Atención de Punto/estadística & datos numéricos , Análisis Costo-Beneficio , Economía de la Enfermería , Humanos , Internet/estadística & datos numéricosRESUMEN
This study examined work-arounds and artifacts in the work performed by nurses and other healthcare providers when physicians transitioned to a computer physician order entry system. There were 5 types of work-arounds and artifacts identified: (1) workflow timing of events, (2) communication changes, (3) system problems, (4) learning curve, and (5) patient safety. Benefits of this study include the ability to understand how nursing work changes in the transition to a computer physician order entry system.
Asunto(s)
Sistemas de Entrada de Órdenes Médicas/organización & administración , Personal de Enfermería en Hospital/organización & administración , Relaciones Médico-Enfermero , Artefactos , Departamentos de Hospitales/organización & administración , Humanos , Investigación en Administración de Enfermería , Análisis y Desempeño de Tareas , Carga de TrabajoRESUMEN
A critical path defines the optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure. Critical paths are developed through collaborative efforts of physicians, nurses, pharmacists, and others to improve the quality and value of patient care. They are designed to minimize delays and resource utilization and to maximize quality of care. Critical paths have been shown to reduce variation in the care provided, facilitate expected outcomes, reduce delays, reduce length of stay, and improve cost-effectiveness. The approach and goals of critical paths are consistent with those of total quality management (TQM) and can be an important part of an organization's TQM process.