The widespread use of telehealth, providing healthcare remotely, is hampered by various barriers. Dutch nurses currently working in practice never received education in this new way of healthcare delivery. Education is frequently suggested as a strategy to overcome barriers in telehealth use. However, the nature and effectiveness of such education has not yet been specified and tested in practice. In a previous study, we identified 14 nursing telehealth activities and accompanying competencies. In the current study, we established the effectiveness of training in these competencies on nurses' subjective knowledge, self-efficacy and usage of telehealth. A two-day tailored training program in nursing telehealth activities was evaluated in a Dutch context among 37 participants across three settings: (a) twelve primary care (PC), (b) fourteen homecare (HC) and (c) eleven hospital (H) nurses. In each team, telehealth knowledge significantly increased during the training sessions. In each team, nurses' telehealth self-efficacy also significantly increased 6–10 weeks after the training. After the training, the number of remote consultations increased from 2 to 12 in primary care, 12 to 35 in homecare and decreased from 28 to 17 in the hospital setting. We conclude that training nurses in telehealth activities contributes to their knowledge and self-efficacy.
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Many quality aspects of software systems are addressed in the existing literature on software architecture patterns. But the aspect of system administration seems to be a bit overlooked, even though it is an important aspect too. In this work we present three software architecture patterns that, when applied by software architects, support the work of system administrators: PROVIDE AN ADMINISTRATION API, SINGLE FILE LOCATION, and CENTRALIZED SYSTEM LOGGING. PROVIDE AN ADMINISTRATION API should solve problems encountered when trying to automate administration tasks. The SINGLE FILE LOCATION pattern should help system administrators to find the files of an application in one (hierarchical) place. CENTRALIZED SYSTEM LOGGING is useful to prevent coming up with several logging formats and locations. Abstract provided by the authors. Published in PLoP '13: Proceedings of the 20th Conference on Pattern Languages of Programs ACM.
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