RESUMO
Nurses faced numerous challenges during the pandemic, particularly with the increased burden of electronic documentation. Surges in patient volume and visits led to rapid changes in nursing documentation, prompting diverse responses from regulatory and healthcare organizations. Nurses expressed safety concerns and struggled with changes, calling for national standards and regulatory support. Policy relaxations, such as the 1135 Waiver, sparked debate on the future of nursing care plan documentation. Using mixed-methods exploratory design, the study identified modifications of nursing documentation during crises, commonalities in documentation burden reduction for applicability beyond pandemics, and consensus on the definition of "surge." Documentation patterns were assessed from February to November 2022, involving 175 North American nurse leaders and informaticists. Data analysis included descriptive statistics, thematic analysis, and Pearson correlation coefficient. Significant differences were found between rural and urban settings (P = .02), with urban areas showing higher odds of changes to care plans (odds ratio, 4.889; 95% confidence interval, 1.27-18.78). Key findings highlighted the persistence of postcrisis documentation changes and varied definitions of surge criteria based on organizational leadership, policy, and mandates. The study yielded insights for modifying documentation, offering policy recommendations, and emphasizing ongoing collaboration and evidence-based approaches for future nursing practices.
RESUMO
BACKGROUND: ChatGPT, an artificial intelligence-driven, pretrained, deep learning language model, can generate natural language text in response to a given query. Its rapid growth has led to concerns about ethical use in academia. PROBLEM: The exponential rise in the popularity of ChatGPT, and concerns of academic integrity with its use, has raised concerns among faculty for how to best address this issue. APPROACH: Faculty should understand the potential benefits and limitations of ChatGPT and create assignments that emphasize self-reflection, critical thinking, problem solving, and independent learning. Students must be taught how to critically evaluate information and how to make informed decisions. CONCLUSIONS: ChatGPT has the potential to revolutionize nursing education. However, it is critical for faculty to be familiar with its capabilities and limitations in order to foster effective, yet ethical and responsible utilization, while preparing students for the dynamic, rapidly advancing technological landscape in nursing and health care.
Assuntos
Educação em Enfermagem , Estudantes de Enfermagem , Humanos , Inteligência Artificial , Pesquisa em Educação em Enfermagem , Docentes de EnfermagemRESUMO
Clinicians across the globe face overwhelming dissatisfaction and burden with electronic health records due to poor usability and the sheer volume of data collection requirements. In the United States, electronic health records are noted to be a principal source of distress, dissatisfaction, and endless workarounds, leading to poor clinician performance and, ultimately, poor patient outcomes. The purpose of this article is to present a detailed review of a 2020 Texas pilot study. The study's focus was the engagement of nursing informatics experts from around the state to gain consensus on nursing documentation's current status and if plans were being developed to modify or decrease documentation, specifically to alleviate burden during a time of crisis. The study consisted of subject matter expert focus groups, a high-level Delphi for instrument development, and the implementation of the statewide instrument to gain consensus. Ultimately, the research team learned that there were gaps in not only what documentation could be removed (either temporarily or permanently) but also what standards dictate the use of crisis documentation (ie, "surge" criteria). The study findings discussed in this article will inform improvement strategies and policy recommendations to increase the value and usability of crisis nursing documentation requirements.
Assuntos
Documentação , Registros Eletrônicos de Saúde , Estados Unidos , Humanos , Consenso , Projetos Piloto , Coleta de Dados , Registros de EnfermagemRESUMO
The purpose of this project was to implement an improved rapid-deployment clinical decision support strategy for the detection and treatment of emerging and reemerging infectious diseases within an electronic health record informed by end-user satisfaction. After a review of the evidence and comprehensive workflow assessments, interdisciplinary focus groups were assembled to determine current infectious disease needs within the electronic health record and what guidance should be provided to clinicians to assist in making the best decisions for both patient care and population health. Education and reeducation issues were handled throughout the implementation process. Using the Plan-Do-Study-Act quality improvement framework for rapid cycle deployment, the design was implemented and monitored. To evaluate efficacy and clinician satisfaction of the implementation, presurvey and postsurvey measurements were employed. The Clinical Information System Implementation Evaluation Scale was used, along with demographic and qualitative textual questions, to evaluate clinician satisfaction. Findings indicate the implementation was successful (P < .05).