A systematic review of artificial intelligence-powered (AI-powered) chatbot intervention for managing chronic illness.

BACKGROUND: Utilizing artificial intelligence (AI) in chatbots, especially for chronic diseases, has become increasingly prevalent. These AI-powered chatbots serve as crucial tools for enhancing patient communication, addressing the rising prevalence of chronic conditions, and meeting the growing demand for supportive healthcare applications. However, there is a notable gap in comprehensive reviews evaluating the impact of AI-powered chatbot interventions in healthcare within academic literature. This study aimed to assess user satisfaction, intervention efficacy, and the specific characteristics and AI architectures of chatbot systems designed for chronic diseases. METHOD: A thorough exploration of the existing literature was undertaken by employing diverse databases such as PubMed MEDLINE, CINAHL, EMBASE, PsycINFO, ACM Digital Library and Scopus. The studies incorporated in this analysis encompassed primary research that employed chatbots or other forms of AI architecture in the context of preventing, treating or rehabilitating chronic diseases. The assessment of bias risk was conducted using Risk of 2.0 Tools. RESULTS: Seven hundred and eighty-four results were obtained, and subsequently, eight studies were found to align with the inclusion criteria. The intervention methods encompassed health education (n = 3), behaviour change theory (n = 1), stress and coping (n = 1), cognitive behavioural therapy (n = 2) and self-care behaviour (n = 1). The research provided valuable insights into the effectiveness and user-friendliness of AI-powered chatbots in handling various chronic conditions. Overall, users showed favourable acceptance of these chatbots for self-managing chronic illnesses. CONCLUSIONS: The reviewed studies suggest promising acceptance of AI-powered chatbots for self-managing chronic conditions. However, limited evidence on their efficacy due to insufficient technical documentation calls for future studies to provide detailed descriptions and prioritize patient safety. These chatbots employ natural language processing and multimodal interaction. Subsequent research should focus on evidence-based evaluations, facilitating comparisons across diverse chronic health conditions.

Retaining employment in the hospital setting: A descriptive phenomenological study of Indonesian nurses' experiences.

Background: Losing competent nurses due to turnover can have adverse effects on healthcare administration, service delivery, and organizational dynamics. Frequent staff turnover can hinder optimal nursing practices, but some nurses remain committed. Therefore, understanding factors that foster sustained engagement and retention is crucial to create a retention strategy. Objective: This study aimed to explore the current experience of Indonesian nurses who retain their jobs in the hospital setting. Methods: A phenomenological design was employed in this study, with ten nurses selected using purposive sampling. Semi-structured interviews were used to gather data from a private hospital in Batam, Indonesia, between January and March 2022. A conventional content analysis was used to analyze the data. Results: The participants had an average total work experience of 10.4 years and an average age of 35.6 years, ranging from 28 to 44 years. The majority of the participants were females, held bachelor's degrees, and were married. Three main themes were developed in this study: solid teamwork, adequate compensation, and professional career development. Conclusion: Retaining experienced nurses in hospitals is influenced by antecedents such as teamwork, pay, and career growth. These findings offer nursing and hospital managers insights into developing policies and strategies to improve hospital nursing retention programs in Indonesia and beyond.

Researching nurses' adherence to patient safety guidelines in emergency departments.

BACKGROUND: One of the reasons why patient safety may be put at risk during healthcare interventions is a lack of staff adherence to patient safety guidelines. There could be a relationship between staff's adherence to patient safety guidelines and their perceived level of reward for their work and/or motivation. AIM: To examine the relationship between reward and adherence to patient safety guidelines, and between motivation and adherence to patient safety guidelines, among nurses working in emergency departments (EDs) in Indonesia. METHOD: This was a cross-sectional study of 101 nurses working in the EDs of four hospitals in Indonesia. Self-reported questionnaires were used to collect data on the level of reward participants felt they received for their work, the level of participants' motivation for their work, and participants' adherence to patient safety guidelines. Spearman's rank correlation testing was used to determine the relationships between variables. RESULTS: There was a statistically significant negative relationship between reward and adherence (P=0.019, r=-0.233), which meant that those who perceived their reward as low were more likely to adhere to patient safety guidelines than those who felt they were highly rewarded. There was a statistically significant positive relationship between motivation and adherence to patient safety guidelines (P=0.017, r=0.236), which meant that the higher the motivation, the higher participants' level of adherence to patient safety guidelines. CONCLUSION: Ensuring ED nurses are motivated for their work by offering rewards - such as a decent salary, a supportive workplace environment and career progression opportunities - is important to enhance their adherence to patient safety guidelines.

Nurse workforce scheduling: A qualitative study of Indonesian nurse managers' experiences during the COVID-19 pandemic.

Background: The increase in COVID-19 cases in Indonesia has resulted in changes in the hospital workflow, including the staffing process and scheduling, especially in the isolation units. Nurse managers are working hard in the scheduling system to ensure high-quality care is provided with the best human resources. Objective: This study aimed to explore the experiences of nurse managers in managing staff nurses' work schedules during the COVID-19 pandemic. Methods: A qualitative descriptive design was used in this study. Eleven nurse managers from three COVID-19 referral hospitals were selected using purposive sampling. Data were collected using online semi-structured interviews. Thematic analysis was used for data analysis, and data were presented using a thematic tree. Consolidated criteria for reporting qualitative research (COREQ) checklist was used as a reporting guideline of the study. Results: Four themes were developed: (i) Nurse shortage, (ii) Strategically looking for ways to fulfill the workforce, (iii) Change of shift schedule, and (iv) Expecting guidance from superiors and compliance from staff. Conclusion: The lack of nurse staff is a problem during a pandemic. Thus, managing personnel effectively, mobilizing and rotating, and recruiting volunteers are strategies to fulfill the workforce during the pandemic. Using a sedentary shift pattern and sufficient holidays could prevent nurses from falling ill and increase compliance with scheduling. In addition, a staffing calculation formula is needed, and top nursing managers are suggested to provide guidance or direction to the head nurses to reduce confusion in managing the work schedule during the pandemic.

Completeness Documentation of Fall Risk Management: A Cross-Sectional Study.

Background: Patient safety management includes the documentation of fall risks. This study aims to portray the nurses' performance toward the risk of falling management in hospitals. Materials and Methods: A cross-sectional approach was used as the study design to measure the documentation completeness of the nursing process toward the risk of falling at hospitals during 2020. There are 110 selected medical records of hospitalized patients based on inclusion criteria such as low-risk medical records, hospitalization within 3 days, and a maximum hospitalization length of one year after the beginning of the data collection procedure. Univariate analysis is chosen to analyze the data. Results: The results showed that nurses were inconsistent in implementing fall risk management. Furthermore, the assessment was 68.18%, where 45.45% of nurses made the nursing diagnosis, 4.55% described the problems and etiology, and also 32.72% evaluated patients' integrated records. Conclusions: The incomplete documentation of fall risk describes the nonoptimal risk management implementation. The head nurse should develop a dynamic interaction with the fall risk patients, as well as increase nursing coordination and integration.

Nurse career mapping: a qualitative case study of a new hospital.

BACKGROUND: Career mapping is an effective strategy for providing nurses with a clear direction and a realistic time scale for achieving their career goals. The purpose of this research is to investigate career mapping for nurses at a new hospital in Jakarta. METHOD: The study design is qualitative and implements a focussed case study approach. Data were collected from focus group discussions (FGDs) with two groups: one group consisted of eight staff nurses and the other consisted of six nurse managers. An inductive content analysis of all transcripts from the FGDs and of field notes was conducted independently. RESULT: This research produced seven themes that together portray the entire career mapping process. In Hospital X, the career map for a particular nurse is based on the level of formal education, the length and nature of their work experience and a competency assessment. A self-assessment process and considerations related to competence in all aspects of nursing have been included in the process for nurses at Hospital X. The idea that nurses should be positioned in a working environment that matches their level of competency is a fundamental principle for nursing managers. CONCLUSION: As a new hospital, Hospital X has implemented nurse career mapping and striven for accreditation. Career developments not only become the responsibility of an organisation but also the responsibility of individuals to develop themselves and their careers.

Nursing care activities based on documentation.

BACKGROUND: Nurses engage in various activities from the time of a patient's admission to his or her discharge from the hospital, helping patients to meet their needs. Each of the activities should be documented properly as authentic and crucial evidence. This study aimed to identify nursing activities in the delivery of nursing care based on the documentation completed. METHODS: A quantitative design with a retrospective approach was used, in which 240 medical records from Dr. Kariadi Hospital in Semarang, dating from July through September 2016, were obtained and assessed. The records were randomly selected based on the 10 most common medical and surgical diseases and a hospital stay of more than 3 days. The instrument for collecting the data from the patient progress notes used an observations form. The data were analyzed using univariate statistics and needed to be at least 80% of the values for a certain criteria for it to be considered. The results were analyzed to compare the standard of care. RESULTS: It was revealed that nursing activities in the delivery of nursing care were insufficient. These activities, according the standard of nursing activities, included the assessment of the functional status of decubitus risk (20.8%), biological status (0.4%), formulation of a nursing diagnosis (20.8%), identification of patients' home needs (41.3%), quality of life (66.3%), collaboration intervention in drug administration (60.8%), monitoring of vital signs (23.3%), monitoring of daily living activities (37.5%), mobilization/rehabilitation (37.5%), outcome (46.7%), and resume activities nursing (0.8%). CONCLUSIONS: Nursing activities are very important within the hospital and must solve the problems that the patient needs. Every nursing activity should produce documentation with critical thinking. If nursing documents are not clear and accurate, inter-professional communication and an evaluation of nursing care cannot be optimal. Nursing activity and documentation should be continuously directed, controlled, and evaluated by a nurse manager. The quality of nursing activities should always be good to increase patient satisfaction, patient safety, and cost-effectiveness.

Improving nurses' performance through remuneration: a literature review

Background: A remuneration system greatly influences the quality of nursing care and services. Objective: The goal of this study was to identify the effects of a remuneration system on nurses' performance. Design: This research used a literature review design and involved the analysis of 25 articles published in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, EMBASE, PsycINFO, and Global Health databases. The literature was limited to articles published in English between August 2006 and August 2015. Results: The results of this study indicate that the improvement of remuneration systems has positive consequences in terms of nurses' performance and subsequent quality of healthcare services. A well-managed remuneration system has the potential to increase nurses' motivation, productivity, satisfaction, and even improve retention. In contrast, poorly managed and low remuneration contributes to a shortage of nurses due to high turnover rates. Conclusions: Adequate remuneration has been shown to improve nurses' performance and, consequently, improve the quality of healthcare. This literature review provides scientific evidence for decision-makers to consider the implementation of remuneration systems that include credentialing, re-credentialing, and career ladders. Future studies are suggested to investigate the development of well-managed remuneration systems for nurses

No disponible

The association between stereotyping and interprofessional collaborative practice

Objective: This study aimed to identify the association between stereotyping and professional intercollaborative practice. Method: This study used a cross-sectional analytical study involving physicians, nurses, pharmacists, and dietitians in a hospital in Jakarta, Indonesia, who were selected using the stratified random sampling method. Data was collected using the Student Stereotypes Rating Questionnaire (SSRQ) and the Assessment of Interprofessional Team Collaboration Scale (AITCS). The stereotyping level was analyzed based on a nine-point SSRQ, while interprofessional collaborative practice was scored based on partnership/shared decision-making, cooperation, and coordination. Results: Stereotyping was shown to significantly correlate with interprofessional collaborative practice as measured by the SSRQ and AITCS. Conclusions: Poor interprofessional collaborative practice in subscale partnership/decision-making was dominant. Also, low-rating stereotyping was shown to be dominant with poor interprofessional collaborative practice. Recommendation: The research recommends that health care providers improve partnership/ decision-making skills for better interprofessional collaboration. For further research, it's recommended to explore another barrier of interprofessional collaborative practice

No disponible

The relationship between nurses' job satisfaction and continuing professional development

Objective: To identify the correlation between nurse's perception of the continuing professional development (CPD) and the satisfaction of nursing career ladder system (NCLS) implementation. Method: A non-experimental survey design was used for this study. The respondents were selected using proportional random sampling technique with the total sample size of 149 nurses. Data were measured using proportion, central tendency and Pearson product-moment correlation. Results: There was a moderate, positive correlation between the CPD and the NCLS satisfaction (R: 0.42, p= 0.0001). Conclusions: The results of this research should be used as recommendation for improving CPD at the hospitals in Indonesia

No disponible

Improving the interpersonal competences of head nurses through Peplau's theoretical active learning approach

Background: Effective interpersonal skills are essential for head nurses in governing and managing their work units. Therefore, an active learning strategy could be the key to enhance the interpersonal competences of head nurses. Purpose: This study aimed to investigate the effects of Peplau's theoretical approach of active learning on the improvement of head nurses' interpersonal skills. Method: This study used a pre-experimental design with one group having pretests and posttests, without control group. A total sample of 25 head nurses from inpatient units of a wellknown private hospital in Jakarta was involved in the study. Data were analyzed using the paired t-test. Results: The results showed a significant increase in head nurses' knowledge following the training to strengthen their interpersonal roles (P=.003). The results also revealed significant increases in the head nurses' skills in playing the roles of leader (P=.006), guardian (P=.014), and teacher/speaker (P=.015). Nonetheless, the results showed no significant increases in the head nurses' skills in playing the roles of counselor (P=.092) and stranger (P=.182). Conclusions and recommendations: Training in strengthening the interpersonal roles of head nurses significantly increased the head nurses' knowledge and skills. The results of the study suggested the continuation of active learning strategies to improve the interpersonal abilities of head nurses. Furthermore, these strategies could be used to build the abilities of head nurses in other managerial fields

No disponible

Factors that affect the development of nurses' competencies: a systematic review

Objective: To investigate factors affecting the development of nursing competency based on a review of the literature. Method: A systematic review was utilized. The articles were taken from the databases of Pro-Quest, ScienceDirect, SpringerLink, and Scopus. They were retrieved using the following keywords: nursing competence, nurse competencies and clinical competence. Twenty-one papers were selected. Results: Competence development is a continuous process of improving knowledge, attitudes and skills, and is influenced by a myriad of factors. Six factors were identified that affected the development of nursing competence in our systematic review: (1) work experience, (2) type of nursing environment, (3) educational level achieved, (4) adherence to professionalism, (5) critical thinking, and (6) personal factors. Work experience and education were shown to significantly influence the development of competency of nurses. Conclusions: Nurse managers need to support staffing competence through ongoing education, mentoring-preceptorship training, and case-reflection-discussion teaching programs

No disponible

The Effectiveness and Efficiency of Nursing Care Documentation Using the SIMPRO Model.

PURPOSE: The study aims to develop and test the effectiveness and efficiency of the SIMPRO. SIMPRO was developed with NANDA-I, Nursing Intervention Classification, and Nursing Outcome Classification nursing language. METHOD: The research was divided into two parts, in which we used two different designs-incremental and quasi-experimental design. Two hundred fifty-five samples of nursing documentations were randomly assessed with computer-assisted clustering out of 1,040 nursing records of discharged patients. Data were analyzed using Wilcoxon test to compare each elements of evaluation before and after the implementation of the system. RESULT: SIMPRO improved the quality of documentation (p = .0001) and time efficiency (p = .0001). CONCLUSION: SIMPRO increased the quality and functions of the decision support system in delivering nursing care as well as in nursing management. TUJUAN: Penelitian ini bertujuan untuk mengembangkan dan menguji keefektifan dan efisiensi SIMPRO. SIMPRO adalah sistem informasi manajemen keperawatan yang dikembangkan dengan menggunakan NANDA-I, Nursing Intervention Classification dan Nursing Outcome Classification. METODE: Penelitian ini dibagi menjadi dua tahap yang menggunakan desain incremental dan kuasi-eksperimental. 255 sampel dokumentasi keperawatan diambil secara acak dengan menggunakan klustering yang dibantu dengan komputer dari 1040 catatan keperawatan pasien yang sudah pulang. Data dianalisis dengan Uji Wilcoxon untuk membandingkan masing-masing elemen sebelum dan sesudah implementasi sistem. HASIL: SIMPRO memperbaiki kualitas dokumentasi (p = .0001) dan efisiensi (p = .0001). KESIMPULAN: SIMPRO meningkatkan kualitas dan fungsi sistem dukungan dalam memberikan asuhan keperawatan dan manajemen keperawatan.