BACKGROUND: The time that nurses spent on documentation can be substantial and burdensome. To date it was unknown if documentation activities are related to the workload that nurses perceive. A distinction between clinical documentation and organizational documentation seems relevant. This study aims to gain insight into community nurses' views on a potential relationship between their clinical and organizational documentation activities and their perceived nursing workload.METHODS: A convergent mixed-methods design was used. A quantitative survey was completed by 195 Dutch community nurses and a further 28 community nurses participated in qualitative focus groups. For the survey an online questionnaire was used. Descriptive statistics, Wilcoxon signed-ranked tests, Spearman's rank correlations and Wilcoxon rank-sum tests were used to analyse the survey data. Next, four qualitative focus groups were conducted in an iterative process of data collection - data analysis - more data collection, until data saturation was reached. In the qualitative analysis, the six steps of thematic analysis were followed.RESULTS: The majority of the community nurses perceived a high workload due to documentation activities. Although survey data showed that nurses estimated that they spent twice as much time on clinical documentation as on organizational documentation, the workload they perceived from these two types of documentation was comparable. Focus-group participants found organizational documentation particularly redundant. Furthermore, the survey indicated that a perceived high workload was not related to actual time spent on clinical documentation, while actual time spent on organizational documentation was related to the perceived workload. In addition, the survey showed no associations between community nurses' perceived workload and the user-friendliness of electronic health records. Yet focus-group participants did point towards the impact of limited user-friendliness on their perceived workload. Lastly, there was no association between the perceived workload and whether the nursing process was central in the electronic health records.CONCLUSIONS: Community nurses often perceive a high workload due to clinical and organizational documentation activities. Decreasing the time nurses have to spend specifically on organizational documentation and improving the user-friendliness and intercommunicability of electronic health records appear to be important ways of reducing the workload that community nurses perceive.
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Background: The strain on health care services is increasing due to an ageing population and the increasing prevalence of chronic health conditions. eHealth could contribute to optimise effective and efficient care to older adults with one or more chronic health conditions in the general practice. Aim: The aim of this study was to identify the needs, barriers and facilitators amongst community-dwelling older adults (60þ) suffering from one or more chronic health conditions, in using online eHealth applications to support general practice services. Methods: A qualitative study, using semi-structured followed by think-aloud interviews, was conducted in the Netherlands. The semi-structured interviews, supported by an interview guide were conducted and analysed thematically. The think-aloud method was used to collect data about the cognitive process while the participant was completing a task within online eHealth applications. Verbal analysis according to the Chi approach was conducted to analyse the think-aloud interviews. Findings: A total of n = 19 older adults with a mean age of 73 years participated. The ability to have immediate contact with the GP on important health issues was identified as an important need. Identified barriers were non-familiarity with the online eHealth applications and a mismatch of user health needs. The low computer experience resulted in non-familiarity with the online eHealth applications. Faltering applications resulted in participants refusing to participate in the use of online eHealth applications. Convenience, efficiency and the instant availability of eHealth via applications were identified as important facilitators. Conclusion: To improve the use and acceptability of eHealth applications amongst older adults in the general practice, the applications should be tailored to meet individual needs. More attention should be given to improving the user-friendliness of these applications and to the promotion of the benefits such as facilitating older adults independent living for longer.
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Real-time location systems (RTLS) can be implemented in aged care for monitoring persons with wandering behaviour and asset management. RTLS can help retrieve personal items and assistive technologies that when lost or misplaced may have serious financial, economic and practical implications. Various ethical questions arise during the design and implementation phases of RTLS. This study investigates the perspectives of various stakeholders on ethical questions regarding the use of RTLS for asset management in nursing homes. Three focus group sessions were conducted concerning the needs and wishes of (1) care professionals; (2) residents and their relatives; and (3) researchers and representatives of small and medium-sized enterprises (SMEs). The sessions were transcribed and analysed through a process of open, axial and selective coding. Ethical perspectives concerned the design of the system, the possibilities and functionalities of tracking, monitoring in general and the user-friendliness of the system. In addition, ethical concerns were expressed about security and responsibilities. The ethical perspectives differed per focus group. Aspects of privacy, the benefit of reduced search times, trust, responsibility, security and well-being were raised. The main focus of the carers and residents was on a reduced burden and privacy, whereas the SMEs stressed the potential for improving products and services. Original article at MDPI: https://doi.org/10.3390/info9040080
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Background: Despite the compelling case for engaging parents in speech and language therapy, research indicates that speech and language therapists (SLTs) currently have a leading role in the goal-setting process of therapy for children with developmental language disorder (DLD). Therefore, we set out to develop a tool that aims to support the dialogue between SLTs and parents and enhance shared decision-making about children's communicative participation goals. We used co-design techniques with SLT–practitioners to include their perspectives throughout the design process. Although co-design has been used for some years in healthcare research, it is still a relatively new research methodology in the field of speech and language therapy. Aims: To provide a detailed description of the co-design process that led to the development of a physical artefact that can support SLTs to engage parents of children with DLD in collaborative goal-setting. Methods & Procedures: The Design Council's Double Diamond model was used to develop a tool in co-design, together with eight SLTs, who participated in all stages of the development process. Usability was tested in actual goal-setting conversations between four SLTs and 11 parents of a child with DLD resulting in stepwise improvements. In addition, usability of the first and final prototypes was tested with five usability criteria that were rated on a 10-point scale by 64 SLTs. Outcomes & Results: The co-design process resulted in the development of a physical prototype of the tool called ‘ENGAGE’, consisting of a metal ‘tree trunk’ on which parents can stick magnetic ‘leaves’ containing potential participation goals for their child. The ‘tree’ shape represents a child's development and opportunities for growth. This first prototype received marks between 7.0 and 8.0 out of 10 on attractiveness, user-friendliness, safety, functionality and affordability. After several iterations, there were significantly higher marks for attractiveness, user-friendliness and safety in favour for the final prototype. Marks for functionality and affordability did not change significantly. Conclusions & Implications: As researchers we usually develop pen-and-paper tools, interview protocols, apps or questionnaires to support clinical practice. Including the SLTs’ perspectives in the design process resulted in a tree-shaped physical artefact that, according to the SLTs, helps to order information and encourages and guides their dialogue with parents. We strongly advocate the inclusion of end-users in developing innovative user-centred tools for speech and language therapy and we hope that this will become widespread practice.
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Background Despite the compelling case for engaging parents in speech and language therapy, research indicates that speech and language therapists (SLTs) currently have a leading role in the goal-setting process of therapy for children with developmental language disorder (DLD). Therefore, we set out to develop a tool that aims to support the dialogue between SLTs and parents and enhance shared decision-making about children's communicative participation goals. We used co-design techniques with SLT–practitioners to include their perspectives throughout the design process. Although co-design has been used for some years in healthcare research, it is still a relatively new research methodology in the field of speech and language therapy. Aims To provide a detailed description of the co-design process that led to the development of a physical artefact that can support SLTs to engage parents of children with DLD in collaborative goal-setting. Methods & Procedures The Design Council's Double Diamond model was used to develop a tool in co-design, together with eight SLTs, who participated in all stages of the development process. Usability was tested in actual goal-setting conversations between four SLTs and 11 parents of a child with DLD resulting in stepwise improvements. In addition, usability of the first and final prototypes was tested with five usability criteria that were rated on a 10-point scale by 64 SLTs. Outcomes & Results The co-design process resulted in the development of a physical prototype of the tool called ‘ENGAGE’, consisting of a metal ‘tree trunk’ on which parents can stick magnetic ‘leaves’ containing potential participation goals for their child. The ‘tree’ shape represents a child's development and opportunities for growth. This first prototype received marks between 7.0 and 8.0 out of 10 on attractiveness, user-friendliness, safety, functionality and affordability. After several iterations, there were significantly higher marks for attractiveness, user-friendliness and safety in favour for the final prototype. Marks for functionality and affordability did not change significantly. Conclusions & Implications As researchers we usually develop pen-and-paper tools, interview protocols, apps or questionnaires to support clinical practice. Including the SLTs’ perspectives in the design process resulted in a tree-shaped physical artefact that, according to the SLTs, helps to order information and encourages and guides their dialogue with parents. We strongly advocate the inclusion of end-users in developing innovative user-centred tools for speech and language therapy and we hope that this will become widespread practice.
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Purpose: The Patient-Generated Subjective Global Assessment (PG-SGA), including the PG-SGA Short Form (SF, aka ‘abridged’), was originally developed in the mid 1990’s as a scored, patient self-report, paperbased instrument and has been widely validated. The PG-SGA (SF) has been used for screening, assessment and monitoring, triageing for multimodal intervention and for evaluation of clinical and health economic outcomes. There have been ad hoc translations, often with permission of the originator (FDO) but broad international use requires consistent, medically accurate, and certified translations. Although the PG-SGA (or SF) is known to be quick and easy, current advances in technology could further improve and facilitate quick and easy use of global patient screening and assessment, standardized scoring algorithms, limiting inter-observer variability, and global collaboration and communication. We aimed to develop a user friendly, cross-culturally validated, multilingual digital app and resources to support the clinical and research applications of the PG-SGA (SF) and Pt-Global app in the context of a global centralized database and research consortium. Methods: After completion of a Dutch PG-SGA cross-cultural adaptation project, a digital app based on the English and Dutch PG-SGA was developed. Steps included: 1) development and testing of standardized scoring and decision-making algorithms based on the validated PG-SGA scoring system; 2) compatibility with iOS, Android and WindowsPhone platforms; 3) development and pilot testing of prototype by an international test panel (n=35; professionals testing the app on patients as part of routine care process, researchers, and lay persons) from Australia, Belgium, Canada, Norway, Sweden, The Netherlands and USA, evaluating the app on lay-out, user friendliness, relevance and time of completion; 4) improvement based on input; 5) launch of app and supportive website at www.pt-global.org on 12 Jun 2014, including complimentary introductory use; 5) international education activities; 6) digital presence through Twitter, Facebook, LinkedIn and YouTube; 7) launch of web-based version on 15 September 2014. Results: 15 professionals (Pros; 11 dietitians, 1 doctor, 1 physiotherapist) and 2 lay persons participated in the pilot testing. Included settings were: 9 hospitals, 4 cancer centers, 2 nursing homes, 3 research. 8/15 had experience with the PG-SGA, 7/15 PG-SGA were naïve. 5 Pros tested on 1-5 patients, and 9 on 6-10 patients. 88% rated layout (very) good with feedback: calm, professional, clear, intuitive, easy; 88% rated good for user friendliness. 75% rated flow/user interface (very) good. In 88% Patient screens were completed by Pros. Reported time to complete Patient screens was: 65% in 0-5 minutes, 29% in 5-10 min; 6% (n=1) >10 minutes. Interestingly, patients started completing the app spontaneously. Some issues with concerns about touch screen were expressed. 87% completed the professional section in.
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AIM: To obtain an overview of existing evidence on quality criteria, instruments, and requirements for nursing documentation.DESIGN: Systematic review of systematic reviews.DATA SOURCES: We systematically searched the databases PubMed and CINAHL for the period 2007-April 2017. We also performed additional searches.REVIEW METHODS: Two reviewers independently selected the reviews using a stepwise procedure, assessed the methodological quality of the selected reviews, and extracted the data using a predefined extraction format. We performed descriptive synthesis.RESULTS: Eleven systematic reviews were included. Several quality criteria were described referring to the importance of following the nursing process and using standardized nursing terminologies. In addition, some evidence-based instruments were described for assessing the quality of nursing documentation, such as the D-Catch. Furthermore, several requirements for formats and systems of electronic nursing documentation were found that refer to the importance of user-friendliness and development in consultation with nursing staff.CONCLUSION: Aligning documentation with the nursing process, using standard terminologies, and using user-friendly formats and systems appear to be important for high-quality nursing documentation. The lack of evidence-based quality indicators presents a challenge in the pursuit of high-quality nursing documentation.IMPACT: There is uncertainty in nursing practice about which criteria have to be met to achieve high-quality documentation. Aligning documentation with the nursing process, using standard terminologies, and using user-friendly formats and systems appear to be important. These findings can help nursing staff and care organizations enhance the quality of nursing documentation.
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Airports have undergone a significant digital evolution over the past decades, enhancing efficiency, effectiveness, and user-friendliness through various technological advancements. Initially, airports deployed basic IT solutions as support tools, but with the increasing integration of digital systems, understanding the detailed digital ecosystem behind airports has become crucial. This research aims to classify technological maturity in airports, using the access control process as an example to demonstrate the benefits of the proposed taxonomy. The study highlights the current digital ecosystem and its future trends and challenges, emphasizing the importance of distinguishing between different levels of technological maturity. The role of biometric technology in security access control is examined, highlighting the importance of proper identification and classification. Future research could explore data collection, privacy, and cybersecurity impacts, particularly regarding biometric technologies in Smart Access Level 4.0. The transition from Smart Access Level 3.0 to 4.0 involves process automation and the introduction of AI, offering opportunities to increase efficiency and improve detection capabilities through advanced data analytics. The study underscores the need for global legislative frameworks to regulate and support these technological advancements.
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We need look no further than the use of email communication, mobile phones and cars to understand that technology has wide-ranging social consequences. What is more, designers are plainly not always aware of the social consequences of technology, despite practicing user-centred design. Email, for instance, was developed as an efficient mode of communication between two actors. As we all know, the introduction of email has fundamentally changed traditional business and office practices. These side effects were not identified until long after email was introduced. During recent years, designers have grown increasingly interested in these social aspects. Modern information technology, in particular, creates extensive possibilities to influence social behaviour. Persuasive technology has been developed to increase, e.g., environmental friendliness. Once a designer aims at defined social changes, the consequences of technology for practices become a responsibility, too. The present research is aimed at providing tools and methods to anticipate social consequences at an earlier stage of the design process. These consequences of technologies in social environments will be called social impacts. In order to be a meaningful concept for designers the characteristics of a particular technology that are responsible for social impacts must be identified. Social consequences of technologies have not been observed very thoroughly from a user-centred design point of view. Therefore, this thesis is aimed, not only at gaining knowledge about social impact, but also translating these insights into workable instruments for designers. This leads to the following research questions:1. What relations can be identified between social impacts and characteristics oftechnologies?2. How can a designer anticipate social impact?3. How can social impact be managed in design environments?
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Background: Nursing documentation could improve the quality of nursing care by being an important source of information about patients' needs and nursing interventions. Standardized terminologies (e.g. NANDA International and the Omaha System) are expected to enhance the accuracy of nursing documentation. However, it remains unclear whether nursing staff actually feel supported in providing nursing care by the use of electronic health records that include standardized terminologies.Objectives: a. To explore which standardized terminologies are being used by nursing staff in electronic health records. b. To explore to what extent they feel supported by the use of electronic health records. c. To examine whether the extent to which nursing staff feel supported is associated with the standardized terminologies that they use in electronic health records.Design: Cross-sectional survey design.Setting and participants: A representative sample of 667 Dutch registered nurses and certified nursing assistants working with electronic health records. The respondents were working in hospitals, mental health care, home care or nursing homes.Methods: A web-based questionnaire was used. Descriptive statistics were performed to explore which standardized terminologies were used by nursing staff, and to explore the extent to which nursing staff felt supported by the use of electronic health records. Multiple linear regression analyses examined the association between the extent of the perceived support provided by electronic health records and the use of specific standardized terminologies.Results: Only half of the respondents used standardized terminologies in their electronic health records. In general, nursing staff felt most supported by the use of electronic health records in their nursing activities during the provision of care. Nursing staff were often not positive about whether the nursing information in the electronic health records was complete, relevant and accurate, and whether the electronic health records were user-friendly. No association was found between the extent to which nursing staff felt supported by the electronic health records and the use of specific standardized terminologies.Conclusions: More user-friendly designs for electronic health records should be developed. The poor user-friendliness of electronic health records and the variety of ways in which software developers have integrated standardized terminologies might explain why these terminologies had less of an impact on the extent to which nursing staff felt supported by the use of electronic health records.
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