Intuitive Data Visualization for Enhanced Patient Comprehension.

The pilot study explores how data visualization influences patient comprehension and engagement in understanding hyperlipidemia test results across diverse patient groups. Employing Gestalt theory and the Relational Information Display (RID) framework, intuitive visual tools were developed using Google Sheets, QlikView®, and Microsoft® Excel®. The survey conducted with patients used a Likert scale to evaluate six different line and bar graphs, each presenting the same LDL cholesterol data. The study emphasized the creation of graphs that were easily interpretable. The survey aimed to assess preferences for various data visualization formats. The survey results indicated that patients preferred stacked area charts, while healthcare providers favored line charts. The results highlight the importance of user-centric design and the effective application of theoretical frameworks in creating visualizations that enhance patient engagement and comprehension. The study highlights the role of tailored data visualizations in healthcare, emphasizing the need for such tools in user-centered health technology.

Systematic review of interruptions in the emergency department work environment.

OBJECTIVE: The purpose of this systematic review is to describe the operationalization of interruptions measurement and to synthesize the evidence on the causes and consequences of interruptions in the emergency department (ED) work environment. METHODS: This systematic review of studies explores the causes and consequences of interruptions in the ED. Of 2836 abstract/titles screened, 137 full-text articles were reviewed, and 44 articles met inclusion criteria of measuring ED interruptions. RESULTS: All articles reported primary data collection, and most were cohort studies (n = 30, 68%). Conceptual or operational definitions of interruptions were included in 27 articles. Direct observation was the most common approach. In half of the studies, quantitative measures of interruptions in the ED were descriptive only, without measurements of interruptions' consequences. Twenty-two studies evaluated consequences, including workload, delays, satisfaction, and errors. Overall, relationships between ED interruptions and their causes and consequences are primarily derived from direct observation within large academic hospitals using heterogeneous definitions. Collective strengths of interruptions research in the ED include structured methods of naturalistic observation and definitions of interruptions derived from concept analysis. Limitations are conflicting and complex evaluations of consequences attributed to interruptions, including the predominance of descriptive reports characterizing interruptions without direct measurements of consequences. CONCLUSIONS: The use of standardized definitions and measurements in interruptions research could contribute to measuring the impact and influence of interruptions on clinicians' productivity and efficiency as well as patients' outcomes, and thus provide a basis for intervention research.

A systematic review of prehospital telehealth utilization.

Objective There has been moderate evidence of telehealth utilization in the field of emergency medicine, but less is known about telehealth in prehospital emergency medical services (EMS). The objective of this study is to explore the extent, focus, and utilization of telehealth for prehospital emergency care through the analysis of published research. Methods The authors conducted a systematic literature review by extracting data from multiple research databases (including MEDLINE/PubMed, CINAHL Complete, and Google Scholar) published since 2000. We used consistent key search terms to identify clinical interventions and feasibility studies involving telehealth and EMS, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results We identified 68 articles focused specifically on telehealth interventions in prehospital care. The majority (54%) of the studies involved stroke and acute cardiovascular care, while only 7% of these (4) focused on telehealth for primary care. The two most common delivery methods were real-time video-conferencing capabilities (38%) and store and forward (25%); and this variation was based upon the clinical focus. There has been a significant and positive trend towards greater telehealth utilization. European telehealth programs were most common (51% of the studies), while 38% were from the United States. Discussion and Conclusions Despite positive trends, telehealth utilization in prehospital emergency care is fairly limited given the sheer number of EMS agencies worldwide. The results of this study suggest there are significant opportunities for wider diffusion in prehospital care. Future work should examine barriers and incentives for telehealth adoption in EMS.

An Exploratory Analysis of Questions Submitted to a Brazilian Telemedicine System.

The Rede NUTES telemedicine question submission system provides second opinions to remote healthcare professionals in the northeastern state of Pernaumbuco, Brazil. Submitted questions to the telemedicine system by general practitioners and nurses were analyzed using big data exploration techniques to summarize topic, trends and lexical features.

Nursing Informatics Pioneers Embrace Social Media.

The American Medical Informatics Association (AMIA) established the Nursing Informatics History Project to recognize the pioneers of nursing informatics. Fundamental to the pioneers was dissemination of knowledge. The purpose of this review was to identify pioneers who have embraced social media as of 2016. It is suggested that the pioneers participate in the advancement of nursing informatics via social media.

Health Informatics Competencies, Workforce and the DNP: Why Connect These 'Dots'?

This panel will provide the perspectives of nurse informatics experts on the development of informatics education integrating health information technology (HIT) and immersive simulation. The panel will also address student and provider access to the electronic health record (EHR) for educational purposes. This panel examines the education and preparation of students and practicing nurses to meaningfully use EHRs. The target audience is clinicians, educators, trainers, students and those interested in the meaningful use of EHRs and achievement of the Informatics competencies defined by AACN and TIGER.

Nursing Informatics Pioneers Continue to Influence the Profession: A Sustainable Impact.

The American Medical Informatics Association (AMIA) established the Nursing Informatics History Project to recognize the pioneers of nursing informatics. Fundamental to the pioneers was dissemination of knowledge. The purpose of this review was to identify contributions to the field of nursing informatics as peer-reviewed manuscripts for the years 2010-2015 and indexed in PubMed. Results indicate that many of the pioneers continue to have manuscripts indexed in PubMed. It is anticipated this project will be extended to identify other types of contributions made by the pioneers in the advancement of nursing informatics.

Social Media and Population Health Virtual Exchange for Senior Nursing Students: An International Collaboration.

The authors have all engaged in using social media with students as a means for collaboration across national and international boundaries for various educational purposes. Following the explosion of big data in health the authors are now moving this concept forward within undergraduate and postgraduate nursing curricula for the development of population health virtual exchanges. Nursing has a global presence and yet it appears as though students have little knowledge of the health and social care needs and provision outside their local environment. This development will allow for explorative exchange amongst students in three countries, enhancing their understanding of their own and the selected international population health needs and solutions through asking and responding to questions amongst the learning community involved. The connection of the students will be recorded for their use in reflection; of particular interest will be the use of information included by the students to answer questions about their locality.

Factors influencing clinicians' perceptions of interruptions as disturbing or non-disturbing: A qualitative study.

OBJECTIVE: Emergency departments consist of multiple systems requiring interaction with one another while still being able to operate independently, creating frequent interruptions in the clinical workflow. Most research on interruptions in health care settings has focused on the relationship between interruptions and negative outcomes. However, there are indications that not all interruptions are negatively perceived by those being interrupted. Therefore, this study aimed to explore factors that influence when a clinician perceives interruptions as non-disturbing or disturbing in an emergency department context. METHOD: Explorative design based on interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. Data were analyzed using qualitative content analysis. RESULT: Factors influencing whether emergency department clinicians perceived interruptions as non-disturbing or disturbing were identified: clinician's constitution, external factors of influence and the nature of the interrupted task. The clinicians' perceptions were related to a complex of attributes inherent in these three factors at the time of the interruption. Thus, the same type of interruption could be perceived as either non-disturbing or disturbing contingent on the surrounding circumstances in which the event occurred. CONCLUSION: Emergency department clinicians' perceptions of interruptions as non-disturbing or disturbing were related to the character of identified influencing factors.

Contributing factors to errors in Swedish emergency departments.

OBJECTIVE: The Emergency Department (ED) is a complex and dynamic environment, often resulting in a somewhat uncontrolled and unpredictable workload. Contributing factors to errors in health care and in the ED are largely related to communication breakdowns. Moreover, the ED work environment is predisposed to multitasking, overcrowding and interruptions. These factors are assumed to have a negative impact on patient safety. Reported errors from care providers are mainly related to diagnostic procedures in Swedish EDs. However, there is a lack of knowledge and national oversight regarding contributing factors. The aim of this study was therefore to describe contributing factors in regards to errors occurring in Swedish EDs. METHOD: Descriptive design based on registry data from the Lex Maria database of the Swedish National Board of Health and Welfare. RESULTS: The results indicate that factors contributing to errors in Swedish EDs are multifactorial in nature. The most common contributing factor was human error followed by factors in the local ED environment and teamwork failure. CONCLUSION: Factors contributing to ED errors were multifactorial and included both organizational and teamwork failure in which human error was implicated. To reduce errors, further research is needed to develop methods that disclose latent working conditions such as high workload and interruptions. Patient safety research needs to include understanding of human behaviour in complex organizational systems and the impact of working conditions on patient safety and quality of care.

Characteristics of pioneers of nursing informatics: a thematic analysis.

Little has been published on the individuals and circumstances that shaped the development of Nursing Informatics. This qualitative research, through a process of concept analysis, was undertaken to shape an understanding, of the Pioneer aspect of the leaders and innovators whose work contributed significantly to the early accomplishments that framed the development of the specialty. A content analysis of the transcripts of the identified 33 Pioneers of Nursing Informatics, defined as "innovators, trailblazers and ground breakers in some area of nursing informatics" was conducted to begin to define relevant concepts. The large data set was coded and themed in an iterative, inductive fashion. Four overall themes emerged from the research, including: Envisioning, Forging, Tinkering, and Swarming. The presentation will describe the themes and offer narrative textual examples of each theme. Future research will use this analysis to create a theory of nursing leadership.

The roles of MDs and RNs as initiators and recipients of interruptions in workflow.

BACKGROUND: Previous research studies have focused on the recipients of interruptions because of the negative impact interruptions have on task performance. It is equally important to understand the initiators of interruptions to help design strategies to lessen the number of interruptions and the possible negatives consequences. The purpose of this study was to examine MDs and RNs as initiators and recipients of interruptions. METHODS: This was an instrumental case study using the shadowing method. A convenience sample of five attending trauma MDs and eight RNs were observed during the 07:00-15:00 and 15:00-21:00 shifts in the trauma section of a level one trauma center. RESULT: Seventy hours of observations were recorded. Initiator and recipient of an interruption emerged as major roles during categorization of the notes. Medical doctors and RNs were found to be the recipient of an interruption more frequently than the initiator. Findings from this study indicate that MDs and RNs initiate interruptions most often through face-to-face interactions and use of the telephone. CONCLUSIONS: A role-based taxonomy of interruptions was derived from the recorded notes. Strategies to successfully manage interruptions must consider both the role of initiator as well as the recipient when an interruption occurs. It is suggested that the role-based taxonomy presented in this paper be used to classify interruptions in future studies.

Creating experiential learning activities using Web 2.0 tools and technologies: a case study.

Learning is no longer an internal individual activity but occurs through networks and connections. The aim of this project was to teach online health informatics students to use Web 2.0 tools and technologies to form networks and connections through experiential learning assignments. Web 2.0 tools and technologies were evaluated using a criteria checklist prior to implementation for students enrolled in health informatics classes at the University of Kansas School of Nursing. Health informatics students have developed competencies using an instant message service, blogging, concept mapping, social bookmarking, and interacting a virtual environment. In the future, health care professionals will have to work in rapidly changing environments and keep abreast of new innovations and tools, learn to use those tools, and to teach others about the tools.

Second Life and health information.

Second Life (SL) is emerging as a repository of health information. The purpose of this study was to determine the number of places and groups that offer specific health information in SL. A retrospective analysis of SL places and groups was conducted for cancer. Findings indicate that more cancer information is available from groups than specific places in SL. All current and future cancer information will need to be evaluated for reliability and efficacy.

Second life: not your conventional simulation.

Second Life is a massive, multiuser, virtual environment. The University of Kansas School of Nursing has introduced SL into the health informatics curriculum as a virtual environment for students and faculty to interact and communicate. Students have successfully completed course activities in SL. Informatics faculty continue to develop simulations in SL.

Legibility of a volumetric infusion pump in a shock trauma ICU.

BACKGROUND: Reports submitted to the Federal Food and Drug Administration (FDA) indicate that legibility of infusion pump interfaces contributes to medication errors (for example, patients have been seriously injured when nurses overinfused them after reading the number 7 as a 1). Health care has experienced an influx of medical devices with small-screen interfaces, generically described as small-screen devices. Legibility is widely acknowledged as a necessary aspect of safe operation of medical devices. Contextual analysis was used to observe conditions affecting the legibility of the screen interface of a dual-channel infusion volumetric infusion pump in a shock trauma intensive care unit (STICU). METHODS: Observations were made of registered nurses and physicians using the infusion pumps during a four-hour period. RESULTS: Results from the observations indicated that there was reduced legibility of the infusion pump screen interface because of an inherently subdued light situation, reduced screen contrast, and the small font size of the lettering. DISCUSSION: It was clear from the beginning of the observations that the screen of the infusion pump had limited legibility. In some instances, nurses attached handmade tape labels to the infusion pump to enhance and supplement the small screen. The pump was often positioned facing away from the nurses, who then had to reposition it to view the screen, contributing to interruptions in work flow and creating a potential safety hazard. A variety of strategies are recommended to ensure legibility of infusion pump interfaces and of medical-device labels. CONCLUSIONS: A more complete environmental approach is needed to determine the legibility and usefulness of microdisplay and small-screen devices in health care.

Interruptions in a level one trauma center: a case study.

BACKGROUND: The emergency department has been characterized as interrupt-driven. Government agencies and patient safety organizations recognize that interruptions contribute to medical errors. The purpose of this study was to observe, record, and contextualize activities and interruptions experienced by physicians and Registered Nurses (RNs) working in a Level One Trauma Center. DESIGN: A case study that relied on an ethnographic study design using the shadowing method. SUBJECTS: A convenience sample of physicians and RNs, each with at least 6 months of experience in the Emergency Department (ED), were asked to participate. In these kinds of detailed qualitative investigations, it is quite common to have a small sample size. Ethical approval: Approval was obtained from institutional ethic committees prior to initiating the study. Community consent was obtained from the ED staff through in-service education. SETTING: All observations were made in the trauma section of the ED of a tertiary teaching hospital. The hospital is situated in a major medical center in the Gulf Coast region of the United States of America (USA). FINDINGS: Five attending ED physicians were observed for a total of 29h, 31min. Eight RNs were shadowed for a total of 40 h, 9min. Interruptions and activities were categorized using the Hybrid Method to Categorize Interruptions and Activities (HyMCIA). Registered Nurses received slightly more interruptions per hour than physicians. People, pagers, and telephones were identified as mediums through which interruptions were delivered. The physical environment was found to contribute to interruptions in workflow because of physical design and when supplies were not available. Physicians and RNs usually returned to the original, interrupted activity more often than leaving the activity unfinished. CONCLUSION: This research provides an enhanced understanding of interruptions in workflow in the ED, the identification of work constraints, and the need to develop interventions to manage interruptions. It is crucial that interruptions be delivered in such a way that there is minimal negative impact on performance. The significance and importance of the interruption must always be weighed against the negative impact that it has on smooth, efficient workflow.

Initiators of interruption in workflow: the role of MDs and RNs.

The healthcare environment has been characterized as interrupt-driven with medical doctors (MDs) and registered nurses (RNs) receiving many interruptions during a shift. Previous research studies have focused on the recipient because of the negative impact on task performance. It is equally important to understand the initiator of an interruption to help design strategies to lessen the number of interruptions and the possible negatives consequences. The purpose of this instrumental study was to examine MDs and RNs as initiators of interruptions. Results of this study indicate that MDs and RNs initiate interruptions most often through face-to-face situations and use of the telephone. Strategies to successfully manage interruptions must consider both the role of initiator as well as the recipient in an interruption event.

A concept analysis of the phenomenon interruption.

An interruption was found to have no consistent definition in either healthcare or nonhealthcare literature. Walker and Avant's 8-step method of concept analysis was used to clarify, define, and develop a conceptual model of interruption. The analysis led to the identification of 5 defining attributes that include (1) a human experience; (2) an intrusion of a secondary, unplanned, and unexpected task; (3) discontinuity; (4) externally or internally initiated; and (5) situated within a context. Use of the defining attributes will be extended to form a category of interruption within a taxonomy of activity.