Nurse prescriber's understanding of their antimicrobial stewardship role: a qualitative study.

Introduction Antimicrobial resistance is an infectious disease threat to public health globally, and antimicrobial stewardship among healthcare professionals is one key way to address this potential problem. Registered nurse designated prescribers are the newest group of health professionals to gain prescribing authority in Aotearoa New Zealand, yet little is known about their understanding of their antimicrobial stewardship role. Aim The aim of this study was to explore registered nurse designated prescribers' understanding of their antimicrobial stewardship role through their prescribing practices and approaches to clinical reasoning. Methods This exploratory descriptive qualitative study used individual semi-structured interviews with six registered nurse designated prescribers. Thematic analysis was used to analyse the interviews. Results Four themes were identified: antibiotic prescribing practices and antimicrobial resistance; clinical indicators for prescribing antibiotics, with the sub-themes of history taking, presence of infection and bacterial versus viral infection; patient education; and safety and monitoring. These themes provide insight into registered nurse designated prescribers' understanding of their antimicrobial stewardship role and prescribing of antibiotics. Discussion This research found that the registered nurse designated prescribers had an awareness of the importance of their antimicrobial stewardship role in relation to antibiotic prescribing and reducing antimicrobial resistance. Education about antimicrobial resistance and antimicrobial stewardship for this professional group can be effective, but further research is needed to understand their ongoing educational needs.

User perceptions of mobile digital apps for mental health: Acceptability and usability - An integrative review.

WHAT IS KNOWN ON THE SUBJECT?: Mobile mental health apps are increasingly being used by both mental health nurses to promote individual self-managemental of mental health conditions and by consumers. Perceptions about specific apps are known, but the overarching acceptability and usability of mental health apps in general less understood. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper identified consumer perceptions of mobile mental health apps. Six key areas were identified that future mobile app developers should consider to maximize consumer engagement with mental health apps. Consumers also highlighted that apps do not replace traditional mental health nursing-rather these supplement existing care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This review found that mental health apps are generally viewed positively by consumers; however, factors such as ease of use, usefulness of content and privacy need to be considered to maximise and sustain app engagement. ABSTRACT: Introduction There is increasing interest in the use of mobile mental health applications (apps) to manage mental health conditions. Understanding user perceptions is key to maximise app engagement and inform how apps can be used to support mental health nursing care. Aim This integrative review explores consumers' perceptions of mobile mental health apps to gain insight into user preferences and acceptability. Methods This integrative review was based on searching four databases: CINAHL, EMBASE, Medline, PsycInfo. Inclusion criteria were: (i) articles published after 2000; (ii) focused on apps for mental health disorders; (iii) explored consumers' perception of using a mental health app. Abstracts were screened and eligible papers reviewed. Data on user perceptions were extracted and analysed thematically. Results Seventeen articles were identified. Overall, consumers did not feel that app use replaced traditional health care. Six themes were identified: "Helpfulness," "Improvements/enhancements," "Technical issues," "Easy to use," "Satisfaction with the app" and "Perceived issues." Consumers indicated a preference for personalization for the app to meet individual needs. Discussion and Implications for Practice Mental health apps are generally viewed positively by consumers; however, factors such as ease of use, usefulness of content and privacy need to be considered to maximise and sustain app engagement.

Exploring medicines information needs of mental health service users at a New Zealand hospital.

Providing effective medicines information to individuals can improve outcomes, yet little is known about what information mental health service users need and want about their medicines, and how best to deliver this. The aim of this study was to explore the medicines information needs of mental health service users. Adults (n=30) under the care of acute mental health services in a New Zealand hospital were invited to take part in semi-structured interviews or a focus group to explore preferences for medicines information. Interview data were analysed using an inductive thematic approach. Six key themes were identified: 1) personalisation of information, 2) adverse and beneficial effects, 3) relationships and trust, 4) informed choice, 5) use of reliable internet resources and 6) involvement of family and support people. Preferences on content, timing, provider and format of information delivery were highly individualised indicating the need for information to be personalised to the needs of the service user. A trusted relationship with their healthcare provider was essential . Making informed decisions reduced confusion or fear about medicines. Understanding medicines information needs of patients can help improve the education health professionals provide on medicines, thus potentially improving patient engagement and outcomes.

In-Service Education: Evolving Internationally to Meet Nurses' Lifelong Learning Needs.

In-service education (ISE) in nursing is teaching that occurs in the workplace. Internationally, ISE activities have been evident in nursing for many years because it has been seen as a convenient and cost-effective way to deliver education to nurses with minimal disruption to staffing levels and the delivery of patient care. ISE-related literature was sought to address the aim of tracing development and focus of nursing ISE in New Zealand. A key finding of this literature review is that ISE has been adapted in New Zealand and internationally to meet the demands of evolving nursing practice, and for this reason it remains relevant and essential to nurses. The embeddedness of ISE within clinical environments also supports its relevance. Future research is called for to establish which aspects of ISE are critical to ensuring its ongoing success. [J Contin Educ Nurs. 2019;50(7):313-318.].

Feasibility of describing community strengths relative to Omaha system concepts.

OBJECTIVES: The purpose was to determine the feasibility of using a standardized language, the Omaha System, to describe community-level strengths. The objectives were: (a) to evaluate the feasibility of using the Omaha System at the community level to reflect community strengths and (b) to describe preliminary results of community strengths observations across international settings. DESIGN AND SAMPLE: A descriptive qualitative design was used. The sample was a data set of 284 windshield surveys by nursing students in 5 countries: Mexico, New Zealand, Norway, Turkey, and the United States. MEASURES: An online survey included a checklist and open-ended questions on community strengths for 11 concepts of the Omaha System Problem Classification Scheme: Income, Sanitation, Residence, Neighborhood/workplace safety, Communication with community resources, Social contact, Interpersonal relationship, Spirituality, Nutrition, Substance use, and Health care supervision. Themes were derived through content analysis of responses to the open-ended questions. RESULTS: Feasibility was demonstrated: Students were able to use the Omaha System terms and collect data on strengths. Common themes were described among the five countries. CONCLUSIONS: The Omaha System appears to be useful in documenting community-level strengths. Themes and exemplar quotes provide a first step in developing operational definitions of strengths at a more granular level.

Nursing Informatics Competencies for Entry to Practice: The Perspective of Six Countries.

Internationally, countries are challenged to prepare nurses for a future that has ever increasing use of technology and where information management is a central part of professional nursing practice. There has been a growing trend to move nursing to competency-based education, especially for those students undertaking their first nursing qualification. This first nursing qualification may be linked to pre-registration, pre-licensure or undergraduate education; the term used depending on the country. The authors are drawn from the International Medical Informatics Association special interest group, Nursing Informatics (IMIA-NI) Education Working Group and represent New Zealand, the United States of America, England, Australia, Finland and Canada.

Using a Checklist in Robotic-Assisted Laparoscopic Radical Prostatectomy Procedures.

Robotic surgical systems are relatively new in New Zealand and have been used mainly for laparoscopic radical prostatectomy. Checklists are successfully used in other industries and health care facilities, so we developed a checklist for use during robotic-assisted laparoscopic radical prostatectomy (RALRP) procedures. After a two-month trial using the checklist, we calculated the completeness of each phase of the checklist as a percentage of the number of completed checklists versus total number of compliant checklists in that phase. Operating room personnel participated in an audiotaped focus group and discussed their perceptions about using the RALRP checklist. We collected, transcribed, and reviewed the focus group discussion and thematically analyzed the responses, which confirmed that the checklist served as a guideline and reminder during the setup. Additionally, staff members associated the checklist with improved OR readiness, minimized workflow interruption, improved efficiency, and positive changes in confidence and teamwork.

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.

Geo-spatial Informatics in International Public Health Nursing Education.

This poster describes results of an undergraduate nursing informatics experience. Students applied geo-spatial methods to community assessments in two urban regions of New Zealand and the United States. Students used the Omaha System standardized language to code their observations during a brief community assessment activity and entered their data into a mapping program developed in Esri ArcGIS Online, a geographic information system. Results will be displayed in tables and maps to allow comparison among the communities. The next generation of nurses can employ geo-spatial informatics methods to contribute to innovative community assessment, planning and policy development.

Feasibility of Using the Omaha System for Community-level Observations.

OBJECTIVES: The purpose of this study was to determine the feasibility of using a standardized language, the Omaha System, to capture community-level observations to facilitate population assessment and electronic information exchange. The objectives were: (1) to evaluate the feasibility of using the Omaha System at the community level to reflect community observations and (2) to describe preliminary results of community observations across international settings. DESIGN AND SAMPLE: Descriptive. A dataset of 284 windshield surveys (community observations) completed by nursing students in five countries: Mexico, New Zealand, Norway, Turkey, and the United States. MEASURES: The Omaha System Problem Classification Scheme provided standardized terms for assessment of communities in an online checklist of 11 problems and their respective signs/symptoms. RESULTS: Feasibility was demonstrated: students were able to describe community observations using standardized terminology from the Omaha System. Preliminary results describe variations in community signs and symptoms by location. CONCLUSIONS: The Omaha System appears to be a useful tool for community-level observations and a promising strategy for electronic exchange of population health assessments.

Nursing informatics in new zealand: from history to strategy.

As technological advances saw computers become more common, nurses in New Zealand were inspired to look for ways to harness the use of computers and other technologies to aid patient care and their practice. This paper traces the history of the development of nursing informatics in New Zealand from the earliest days in the 1980s through to the present, when nurses have leadership roles in informatics and are represented at the highest levels in national decision making, thereby influencing the development of national strategies. Nurses have developed a strong informatics profile through working collaboratively with other organizations, yet ensuring that the interests of nurses are maintained. In addition, the support from international nursing informatics pioneers and New Zealand nurses contribution to the international nursing informatics community is highlighted.

Creating teaching objects: a case study of delivering recorded narrations in nursing education.

This article evaluates the use of PowerPoint presentations and recorded narrations (developed and saved as Flash content using software called Articulate Presenter) as a tool to help postgraduate nursing students taking a pharmacology course to learn key pharmacological and pharmacotherapeutic concepts. Students found that the teaching objects, provided as additional resources to assist students in learning about difficult concepts, supported them in their learning. Additionally, students reported that while they appreciated the provision of the teaching objects, the objects lacked an interactive component and did not replace interaction with the teacher. Articulate Presenter, as a tool to create a recorded narration, was easy for the teacher to use and promoted teacher independence in the creation of teaching objects.

Creating teaching objects: a case study of delivering recorded narrations in nursing education.

This article evaluates the use of PowerPoint presentations and recorded narrations (developed and saved as Flash content using software called Articulate Presenter) as a tool to help postgraduate nursing students taking a pharmacology course to learn key pharmacological and pharmacotherapeutic concepts. Students found that the teaching objects, provided as additional resources to assist students in learning about difficult concepts, supported them in their learning. Additionally, students reported that while they appreciated the provision of the teaching objects, the objects lacked an interactive component and did not replace interaction with the teacher. Articulate Presenter, as a tool to create a recorded narration, was easy for the teacher to use and promoted teacher independence in the creation of teaching objects.

Validation of the Impact of Health Information Technology (I-HIT) Scale: an international collaborative.

In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the I-HIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the I-HIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative's validation of the I-HIT Scale completed to date.