ABSTRACT
Integrated information systems and wireless technology have been increasingly incorporated into health care organizations with the premise that information technology will promote safe, high-quality, cost-effective patient care. With the advancement of technology, the level of expertise necessary to assume health care information technology roles has escalated. The purpose of this article is to describe a clinical residency project whereby students in a graduate degree health care informatics program successfully fulfilled program competencies through a faculty-lead research project focused on the use of home telehealth with a group of heart failure patients. Through the use of Donabedian's framework of structure, process, and outcomes, the health care informatics students completed essential learning activities deemed essential for transition into the role of an informatics specialist. Health care informatics educational leaders are encouraged to adapt this template of applied learning into their practices.
Subject(s)
Cooperative Behavior , Curriculum , Education, Graduate/methods , Internship and Residency/methods , Medical Informatics/education , California , Humans , Interprofessional Relations , Universities/organization & administrationABSTRACT
Effective healthcare relies on the ability to communicate with patients. Ninety-eight million Americans are estimated to have limited health literacy that can impair their ability to read and interpret health-related education and information. Low health literacy is associated with higher mortality and 30-day hospital readmissions. Clinical nurse specialists and other advanced practice nurses must be able to evaluate and select a health literacy assessment instrument that is both reliable and produces valid data for the populations they serve. To assist with this important decision-making process, the psychometric properties of the Short Test of Functional Health Literacy in Adults are critiqued in the following article.
Subject(s)
Health Literacy , Adult , Humans , Nurse Clinicians , Psychometrics , Reproducibility of ResultsABSTRACT
Technology holds potential to improve the quality of healthcare delivery. The use of remote patient monitoring, or telehealth (TH), has been widely adopted by many home care agencies to facilitate early identification of disease exacerbation, particularly for patients with chronic diseases such as heart failure. TH has been successfully used to improve symptom detection and potentially reduce rehospitalization rates. Quantifying program effectiveness through data analysis is a critical step for program improvement, resource allocation, and future strategic planning. Using the Outcome and Assessment Information Set-C database, a retrospective analysis was conducted examining 22 months of heart failure patient data from one home care agency in southern California. Seventy patients receiving TH were compared to patients who received usual home care nursing services. No major differences in baseline socio-demographics were found between the 2 groups. While receiving home healthcare services, the non-TH patients had a 21% all-cause hospital readmission rate, compared to the home TH patients with a 10% all-cause readmission rate. Statistical differences were found between groups on the variables of fall risk, vision, smoking, shortness of breath, the ability to bathe and take oral meds, along with having been discharged from a skilled nursing facility in the last 2 weeks. These results indicate that aggregate data analysis is useful in providing insight into program effectiveness. This study suggests TH programs have the potential to reduce the burden associated with rehospitalizations in the heart failure population.
Subject(s)
Home Care Services/organization & administration , Outcome Assessment, Health Care , Patient Readmission/statistics & numerical data , Telemedicine/methods , Aged , Aged, 80 and over , California , Databases, Factual , Female , Humans , Male , Quality Improvement , Retrospective StudiesABSTRACT
A survey was conducted to obtain information regarding adult intensive care unit (ICU) orientation and postorientation practices throughout the nation. This article presents the results of a random sampling of ICUs throughout the nation regarding orientation practices of newly licensed registered nurses (RNs), experienced RNs new to the ICU setting, and experienced ICU RNs. Twenty-four hospitals from 7 geographic regions within the United States were surveyed. Classroom training remains the predominant method of instruction outside the ICU. Most hospitals offer a formalized training for new preceptors. When provided, preceptor incentives include both monetary recognition and professional growth/recognition. Postorientation support for new ICU nurses varied. Geographic regional differences in orientation practices were not found. The major limitation of this study was the small sample size. Results from this survey are the beginning steps in understanding a national perspective of comprehensive orientation practices for new ICU nurses.
