Digital Skills Among Elderly Care Workers.

The aim of our study was to determine the current status of digital skills of elderly care workers (n=169) at well-being services. A survey was sent to elderly services providers in the municipalities (n=15) of North Savo, Finland. Respondents' experience as client information systems users was higher than that as assistive technologies users. Devices supporting independent living were seldom used, but safety devices and alarm monitoring were used daily.

Nurse Managers' Opinions of Information System Support for Performance Management: A Correlational Study.

BACKGROUND: Current information systems do not effectively support nurse managers' duties, such as reporting, resource management, and assessing clinical performance. Few performance management information systems are available and features in many are scattered. OBJECTIVES: The purpose of the study was to determine nurse managers' opinions of information system support for performance management. METHODS: An online questionnaire was used to collect data from nurse managers (n = 419). Pearson's correlation coefficients and linear regression were used to examine the relationships between variables, which were nurse managers' ability to manage resources, to report and evaluate productivity, and to assess nursing performance and clinical procedures. RESULTS: More than half of the managers used performance management systems daily. Managers (60%) felt that they can use information systems to follow the use of physical resources, and in general (63%), they felt that it is easy to perform searches with the systems used for following up activity. Nurse managers' ability to manage resources, to report productivity, and to assess nursing care performance were correlated significantly with each other. CONCLUSION: Currently, managers have to collect data from various systems for management purposes, as system integration does not support performance data collection. The availability of continuous in-service training had a positive effect on information system use.

Technology Supporting Nursing at Homecare - Seems to Be Lacking.

The use of welfare technologies in the home setting has drawn increased attention in healthcare. From a historical perspective, medical technologies were designed for hospital settings. Digitalization and internet of things have changed the structure of our society. The aim of this paper is to describe the factors that determine a user's intent to adopt new welfare technologies in the context of homecare. The phenomenon was being examined by the unified theory of acceptance and use of technology. This study was to show that performance expectancy, effort expectancy, and facilitating conditions are significant factors in determining a user's intention to use new welfare technologies. While, the use of welfare technologies was rare in homecare.

Patient Awareness of the Severity of Their Information and Medication Management-Related Adverse Events.

Adverse events (AEs) in healthcare are commonly reported internationally. However, the structure of event reporting varies based on the healthcare service system, legislation, and the safety culture among service providers. Based on several studies, medication management-related errors have a long history of being reported. However, there is evidence that information management-related errors increase workload, costs, and patient suffering. This study focuses on AEs reported in the categories of medication and information management in a national reporting system. Our aim was to determine whether patients were informed about these errors and whether there were any relationships between the severity of these errors and the disclosure to patients. Based on the results, almost all errors in both categories without any harm to patients were disclosed to patients. Patients were not informed about 40% of information management-related AEs that caused severe harm.

Register-Based Research of Adverse Events Revealing Incomplete Records Threatening Patient Safety.

Inadequate, missing or incorrect patient information is usually related to poor documentation. It has several negative effects on patient care processes, and, thus to quality of care, care continuity, and patient safety. It is one of the causes of patient claims. The aim of this study was to analyze patient safety reports and to find out which documentation hazards are damaging to patient safety. Data consisted of the patient incident reports (n=82 353) from seven health and social care areas from 2007-2016 in Finland. A descriptive analysis was conducted to explore the type of service provider and incidents reporting risks in patient data management and documentation. Adverse events due to patient data management and documentation were unusual; however, 18 cases were documented where patients suffered serious harm. Nearly half of the reports resulted from inadequate, missing or incorrect information. Uniform structures, documentation, and service processes need to be developed.

How to Assess Success of HIT Project Management: An Example of the Use of the Common Assessment Framework (CAF).

The purpose of this study was to assess the project management of a national health information technology project focused on developing digital health care services. An e-questionnaire was sent at the end of the development project, and 93 experts (18%) from five university hospitals responded. The questionnaire was based on the Common Assessment Framework (CAF) to identify management success and also to get an overview of the project's performance. The questionnaire contained 11 background variables and 17 Likert scale items in five themes on leadership, strategy and planning, people, partnerships and resources, and processes, and one open-ended question. After analysis using descriptive statistical methods, the results showed that, overall, participants felt confident about management of the project. Criticism focused on the distribution of resources and lack of knowledge about the status of development activities in other hospitals. The CAF enablers criteria revealed subjects for further development.

Patients' Use of Health Village Portal: The Central Role of Healthcare Professional Support.

Healthcare professionals play a key role in supporting self-care among patients and clients. Their attitudes and behaviors may influence a patient's capacity to use electronic services (e-services) and may increase patients' trust toward a technical solution. The technology acceptance model explains information systems use and the important variables that play a role in an individual's acceptance of e-services. This survey was designed to capture the expectations of healthcare personnel. Participants (n = 91) suggested that patients would benefit from this e-service. The e-services enabled participants to find patient health records more easily than before, and they perceived that the care relationship improved as a result.

Health Professionals' Perceptions of Information Quality in the Health Village Portal.

Information quality has an important role in health care as digital services provide patients and healthcare professionals more opportunities for searching and utilising information. Information quality is one of the key factors affecting user satisfaction, perception of digital service usability and intention to use the service. The conceptual framework for this study was the updated Information Systems Success Model of DeLone and McLean. The study was conducted in the context of Health Village, a digital interactive and secured portal providing health services to patients and citizens. The purpose of the study was to survey health professionals' perception (n = 91) of information quality and its effect on user satisfaction. Concerns were raised about the interoperability of the portal with other health information systems and the ease of finding information. Generally, in the Health Village portal, information quality was considered relatively high.

Lack of Patient Data Privacy Challenges Patient Safety.

Patient data privacy is emphasized due to increase in electronic health data processing. This paper highlights the importance of data privacy in healthcare and its connection to the European Union's (EU) General Data Protection Regulation, which aims to protect all EU citizens from privacy and data violations. The clinical environment is prone to hazards in information management, especially in care coordination, the management of patient data, and verbal communication. The Swiss cheese model was used to discuss the importance of patient data privacy based on statistics from a national patient safety incident registry. Patient identification proved an important factor leading to hazards that can cause severe harm to patients.

Electronic Health Services in the Patients' Daily Activities - Willingness to Use Health Village Services.

Patients and citizens are experienced in Internet use. Earlier studies have suggest that citizens' interest in electronic healthcare services has increased, and there is a need of healthcare professionals to inform patients and their families about this new format and provide them with guidance. The purpose of this study was to find out how patients accept electronic healthcare services and determine their intention to use them based on their opinions of perceived usefulness and perceived ease of use. A survey (N=150) was carried out at a university hospital before electronic services (e-service) were implemented. Participants were motivated to monitor their wellness based on their previous experiences of using electronic services. Patients were confident about the effectiveness of e-service provision.

The Guiding Role of a Paradigm in Informatics Education and Research.

This study presents the current status of a paradigm used in informatics education and research in the health and human services fields. The aim is to synthesize the research focuses of students' theses and evaluate the current situation. The paradigm models informatics research. The research focus, questions and applied research methods were coded for 144 Master's degree theses. Based on the results, the theses could easily be coded for the paradigm concepts and research focuses. The most often used concept was data, which was connected to steering and organizing information management in work processes.

Functionality of Triggers for Epilepsy Patients Assessed by Text and Data Mining of Medical and Nursing Records.

A trigger is a powerful tool for identifying adverse events to measure the level of any kind of harm caused in patient care. Studies with epilepsy patients have illustrated that using triggers as a methodology with data mining may increase patient well-being. The purpose of this study is to test the functionality and validity of the previously defined triggers to describe the status of epilepsy patient's well-being. In both medical and nursing data, the triggers described patients' well-being comprehensively. The narratives showed that there was overlapping in triggers. The preliminary results of triggers encourage us to develop some reminders to the documentation of epilepsy patient well-being. These provide healthcare professionals with further and more detailed information when necessary.

Testing of Triggers by Data Mining of Epilepsy Patients' Structured Nursing Records.

Epilepsies are neurological disorders with many different etiologies, symptoms and prognoses. Care for epilepsy patients should be uniform, homogeneous and optimized to avoid unnecessary hospitalizations or even worse outcomes. FinCC-based structured nursing documentation facilitates analyzing patient profiles and populations, developing care processes, nursing documentation, decision-making, and data reuse. This research aimed to determine the potential for finding possible risks for epilepsy patients' health and well-being from the structured nursing data with defined triggers for epilepsy patients. The research data included structured documentation of nursing diagnoses of and interventions for adult epilepsy patients (n = 100) at one neurological ward in a university hospital in 2009-2013. The results showed that nurses documented abundantly, and all triggers were mostly found. The study results will be reviewed by the neurological ward nurses to assess the FinCC and highlight the importance of documentation.

General practitioners' attitudes towards electronic prescribing and the use of the national prescription centre.

RATIONALE, AIMS AND OBJECTIVES: The purpose of this study was to assess general practitioners' (GP) experience of an electronic prescription (e-prescription) system and the use of a national prescription centre. METHODS: A web-based survey with 29 structured questions and 8 open-ended questions was used. The technology acceptance model was used to explain first users' use of e-prescribing technology. GPs (n = 269) in two different primary health care organizations, which implemented the e-prescribing module as the first of its kind in Finland. RESULTS: Of the 269 GPs, 69 (26%) completed the survey. E-prescribing had influenced GP work and their management of patients' medication positively. Electronic health records and e-prescribing increased GPs' flexibility at work. There was a notable improvement in the management of prescription of narcotics with the introduction of e-prescribing. Issues with the e-prescribing system software delayed data processing and produced negative experience as users were forced to browse through too many pages to write a prescription. CONCLUSIONS: E-prescribing has improved GP's patient medication management, meeting Finland's national objectives. E-prescriptions not only reinforce the process of writing, transmitting and checking the authenticity of prescriptions but also make it mandatory for all key prescription information to be present for transmission. The perceived usefulness of e-prescribing by GPs could lead to more widespread adoption of the technology. Making e-prescribing more user friendly requires reforming work processes, which in turn would enhance the effectiveness of GP work.

Trigger Development for the Improvement of Neurological Patient Care.

By analyzing medical records, we developed triggers for epilepsy patients' care coordination. Thirteen triggers with potential to affect patient care outcomes and safety were found.

Structuring medication related activities for information management.

Medication treatment and the related information management are central parts of a patient's health care. As a cross-organizational and cooperative process, medication information management is a complex domain for development activities. We studied medication activities and related information management in a regional project in order to produce a shared broad picture of its processes and to understand the main issues and the needs for improvement. In this paper we provide a summary of the findings in a structured form, based on a six-dimensioned framework for design and analysis of activities and processes.

Medication information management: capturing multiprofessional perspective.

Medication information management (MIM) is a crucial activity for good quality of medication, but unfortunately not without problems. In order to improve medication information management the core activity of medication as a cooperative activity is to be studied as a whole, and the multiprofessional viewpoint for the improvement needs must be captured. In this paper we present our approach to gain such shared understanding, based on our regional development project experiences in Northern Savonia, Finland. The central features of the approach include thematic interviews supported by activity-driven models and a workshop with professionally mixed groups. Participants agreed strongly on the usefulness of the approach.

Improving the coordination of patients' medication management: a regional Finnish development project.

In this paper, we present an overview of activities and results from a regional development project in Finland. The aim in this project was to analyze how healthcare providers produce and receive information on a patient's medication, and to identify opportunities to improve the quality, effectiveness, availability and collaboration of social and healthcare services in relation to medication information. The project focused on the most important points in patients' medication management such as home care and care transitions. In a regional development project, data was gathered by interviews and a multi professional workshop. The study revealed that medication information reached only some professionals and lay caregivers despite electronic patient record (EPR) systems and tools. Differences in work processes related to medication reconciliation and information management were discussed in the group meeting and were regarded as a considerable risk for patient safety.

Impacts of structuring nursing records: a systematic review.

AIM: The study aims to describe the impacts of different data structuring methods used in nursing records or care plans. This systematic review examines what kinds of structuring methods have been evaluated and the effects of data structures on healthcare input, processes and outcomes in previous studies. MATERIALS AND METHODS: Retrieval from 15 databases yielded 143 papers. Based on Population (Participants), Intervention, Comparators, Outcomes elements and exclusion and inclusion criteria, the search produced 61 studies. A data extraction tool and analysis for empirical articles were used to classify the data referring to the study aim. Thirty-eight studies were included in the final analysis. FINDINGS: The study design most often used was a single measurement without any control. The studies were conducted mostly in secondary or tertiary care in institutional care contexts. The standards used in documentation were nursing classifications or the nursing process model in clinical use. The use of standardised nursing language (SNL) increased descriptions of nursing interventions and outcomes supporting daily care, and improving patient safety and information reuse. DISCUSSION: The nursing process model and classifications are used internationally as nursing data structures in nursing records and care plans. The use of SNL revealed various positive impacts. Unexpected outcomes were most often related to lack of resources. LIMITATIONS: Indexing of SNL studies has not been consistent. That might cause bias in database retrieval, and important articles may be lacking. The study design of the studies analysed varied widely. Further, the time frame of papers was quite long, causing confusion in descriptions of nursing data structures. CONCLUSION: The value of SNL is proven by its support of daily workflow, delivery of nursing care and data reuse. This facilitates continuity of care, thus contributing to patient safety. Nurses need more education and managerial support in order to be able to benefit from SNL.

The development and the trial of the Nationally Standardized Electronic Nursing Documentation (NSEND) in Southern Savos Hospital district.

Starting 2003 the target in Mikkeli Central Hospital was to develop a common platform for electronic nursing documentation. Evaluation of the Nursing Management Minimum Data Set (NMDS) was carried out twice: 2003 and 2004, this provided a picture as to whether the nursing process assisted in the planning of nursing care. NSEND education started 2003 and has been carried out systematically since.