Adopting an American framework to optimize nursing admission documentation in an Australian health organization.

Objective: Apply and modify the American Essential Clinical Dataset (ECD) approach to optimize the data elements of an electronic nursing admission assessment form in a metropolitan Australian local health district. Materials and Methods: We used the American ECD approach but made modifications. Our approach included (1) a review of data, (2) a review of current admission practice via consultations with nurses, (3) a review of evidence and policies, (4) workshops with nursing and informatics teams in partnership with the electronic medical record (eMR) vendor, and (5) team debrief sessions to consolidate findings and decide what data elements should be kept, moved, or removed from the admission form. Results: Of 165 data elements in the form, 32% (n = 53) had 0% usage, while 25% (n = 43) had 100% usage. Nurses' perceptions of the form's purpose varied. Eight policy documents specifically prescribed data to be noted at admission. Workshops revealed risks of moving or removing data elements, but also uncovered ways of streamlining the form. Consolidation of findings from all phases resulted in a recommendation to reduce 91% of data elements. Discussion: Application of a modified ECD approach allowed the team to identify opportunities for significantly reducing and reorganizing data elements in the eMR to enhance the utility, quality, visibility, and value of nursing admission data. Conclusion: We found the modified ECD approach effective for identifying data elements and work processes that were unnecessary and duplicated. Our findings and methodology can inform improvements in nursing clinical practice, information management, and governance in a digital health age.

Empirically grounded clinical interventions clients' and referrers' perceptions of computer-guided CBT (FearFighter).

BACKGROUND: Computer-guided CBT has been shown to be a potentially useful way of closing the gap between the demand and supply for CBT. Moreover, this approach has additional benefits in terms of less travel times for treatment, accessibility in remote and unusual locations, increased confidentiality, easier disclosure of sensitive information, and more egalitarian therapist-client interactions. Research on computerized CBT has concentrated on clinical outcomes, but the views of clients on this treatment approach have been relatively neglected. AIMS: The aims were to assess client satisfaction, professionals' views, and ease of programme use after completion of treatment via an internet-based CBT programme for panic and phobic anxiety (FearFighter). METHOD: A feasibility and effectiveness study of FearFighter was conducted in remote and rural areas of Scotland. Treatment data are available for 35 clients at post-treatment, of whom 29 completed an 18-item set of rating scales designed to assess satisfaction, including ease of use, accessibility, how far needs were met, whether changes to the programme were required, the benefits and drawbacks of not having a therapist, and quality of support. Open-ended questions were included. Referring agencies were also asked to rate their views on FearFighter. RESULTS: Clients reported moderate to high levels of improvement and of overall satisfaction; very few difficulties in logging on to and using the programme were encountered. Similar levels of satisfaction with the programme were reported by referrers. CONCLUSIONS: It is concluded that computer-guided CBT is acceptable to clients and to professionals, and that it could play a valuable part in a "stepped care" system of delivering CBT.

Computer equipment used in patient care within a multihospital system: recommendations for cleaning and disinfection.

Computer hardware has been implicated as a potential reservoir for infectious agents. Leaders of a 22-hospital system, which spans North America and serves pediatric patients with orthopedic or severe burns, sought to develop recommendations for the cleaning and disinfection of computer hardware within its myriad patient care venues. A task force comprising representatives from infection control, medical affairs, information services, and outcomes management departments was formed. Following a review of the literature and of procedures within the 22 hospitals, criteria for cleaning and disinfection were established and recommendations made. The recommendations are consistent with general environmental infection control cleaning and disinfection guidelines, yet flexible enough to be applicable to the different locales, different computer and cleaning products available, and different patient populations served within this large hospital system.