Caregiver Perceptions of a Telehealth Wellness Program.

OBJECTIVE: We sought to understand caregivers' experience of an education-based wellness program delivered using telehealth. METHOD: In this qualitative pilot study, 4 caregivers participated in a focus group after completing a 6-wk telehealth program. Data analysis involved open coding, thematic analysis, and coding triangulation. RESULTS: Two major themes emerged. The first, "I feel like I am now prepared," included the subthemes of strategies for caregiver self-maintenance, the understanding that caregiving is a normal process, and the value of a group experience. The second theme, "It was just a good interaction," included the subthemes of benefits of telehealth, challenges of telehealth, and process of learning the technology. CONCLUSION: Participant discussion of the content learned and the value of group support indicated that telehealth was effective in both promoting learning and facilitating relationships. Even with challenges, participants reported an overall positive experience. Telehealth holds promise for increasing access to health promotion programs.

Fostering completion of the doctor of philosophy degree through scholarly collegial support.

The doctor of philosophy (PhD) degree in nursing science prepares nurses to be scientists through a rigorous program of scholarship and research. Nurses who complete this degree are recognized globally as researchers who are expected to pursue a career of intellectual inquiry. Today, the internationally small cohort of PhD-prepared nurses contributes empirically to the generation and development of nursing science. There is currently a shortage of doctorally prepared nurses to meet the increased demands for researchers and educators in schools of nursing and experts in patient care. The Institute of Medicine has recommended doubling the number of doctorally prepared nurses by 2020 and has emphasized that nurses achieve higher levels of education and training through an improved educational system that promotes seamless academic progression. However, in the United States, the overall PhD completion rate is only 57%. This article reports on the process undertaken by a collegial support group of students in a PhD in nursing science program who encouraged each other's progress through the dissertation process within a calendar year.

Reasons for after-hours calls by hospital floor nurses to on-call physicians.

BACKGROUND: Communication failure is a common root cause of preventable medical errors affecting hospitalized patients. A study was conducted to determine the reasons for calls made by nurses working on the general medical wards to on-call physicians from 6:00 P.M. to 7:00 A.M. METHODS: A retrospective review was performed of a random sample of 500 inpatients admitted to general medical wards at an urban public teaching hospital in Houston between January 1, 2000, and February 28, 2003. RESULTS: In 139 (47%) of 293 medical records there were 304 documented calls. The majority of calls (81%) took place between 6:00 P.M. and 2:00 A.M., with peak call volume between midnight and 2:00 P.M. Patients with one or more calls had an average of 2.2 calls during their stay. Ten categories accounted for 65% of all the nurse calls. In 44% of calls, physicians responded by ordering a medication. DISCUSSION: Communication between floor nurses and on-call physicians might be improved by several interventions. Because 10 reasons accounted for 65% of after-hours calls, protocols could allow nurses to resolve some acute problems without physician involvement. For example, appropriate standing orders (e.g., PR.N. medications) may prevent some calls. In addition, sign-out procedures can be tailored to address common problems that are likely to require future telephone communication. With efforts to change error-prone systems, it seems prudent to focus on after-hours coverage.

Feasibility of Using Telehealth to Deliver the "Powerful Tools for Caregivers" Program.

Caregivers report poorer health and wellness than the general population and identify numerous barriers to their attending programs to improve health and wellness. The purpose of this study was to explore the feasibility of employing a telehealth delivery method to enhance access to caregiver wellness programs. This article presents the quantitative results of a mixed methods feasibility study of translating the Powerful Tools for Caregivers (PTC) program to a telehealth delivery format. Four unpaid family caregivers of older adults participated in a telehealth delivered PTC program, a wellness program with established outcomes in the in-person environment. The program was delivered using synchronous videoconferencing methods. High class attendance and a high median total average Telehealth Usability Questionnaire score of 5.7 indicated the telehealth delivery method was feasible. This research suggests that telehealth is a feasible delivery format for a caregiver program traditionally delivered in an in-person format.

Improving the human computer interface design for a physician order entry system.

The computerized physician order entry (CPOE) system has become a primary focus of time and monetary investment in the healthcare arena. This focus is partly due to the need to reduce medical errors that occur due to illegibility, drug interactions, and misplaced decimals. A CPOE system can potentially prevent many of these errors, resulting in a significantly safer healthcare system. However, only one-third of the hospitals in the United States have installed CPOE systems, and only 1 percent of these require the physicians to use them.1 The success and failure of such a system is dependent on the acceptance by the users, in this case, the physicians. Unfortunately, many of the CPOE systems are not designed to address usability issues. They are hard to use, hard to learn, and they often generate user frustrations and abandonment. In this project, the user interface of one such software program was analyzed. As a result of this analysis, a prototype was developed as a component of the system to offer alternative solutions to the identified usability problems.

Comparing communication technology on Chinese, English, and Spanish diabetes web sites.

Technological and cultural factors influence access to health information on the web in multifarious ways. We evaluated structural differences and availability of communication services on the web in three diverse language and cultural groups: Chinese, English, and Spanish. A total of 382 web sites were analyzed: 144 were English language sites (38%), 129 were Chinese language sites (34%), and 108 were Spanish language sites (28%). We did not find technical differences in the number of outgoing links per domain or the total availability of communication services between the three groups. There were differences in the distribution of available services between Chinese and English sites. In the Chinese sites, there were more communication services between consumers and health experts. Our results suggest that the health-related web presence of these three cultural groups is technologically comparable, but reflects differences that may be attributable to cultural factors.