Mentoring Professionals to Use Digital Tools in Home Care.

Nurses use electronic information systems daily, and digital devices have been developed to enable patient to live at home as long as possible. This study aimed to test reverse mentoring for professionals working with digital tools in home care. An electronic survey was sent twice to nurses to collect their opinions about the tools they use. Based on the results from the first survey (N=184), the mentoring content focused on the use of information systems and digital tools. Respondents' experiences as information system users were more abundant than their experiences as digital tool users. Tools supporting independent living were seldom used, but safety devices and alarm monitoring were used daily. The mentoring meetings induced changes and encouraged participants to acquire skills related to the use of digital tools and to evaluate their work critically.

Licensed Practical Nurses' Perceptions of the Benefits of Information Systems in Social and Healthcare Services.

Licensed practical nurses (LPNs) are the second largest occupational group and the largest group in the social and healthcare sector in Finland, and they have an extensive working environment. Like other health and social care professionals, LPNs also use health information systems (HIS) and client information systems (CIS) in their daily work. The aim of this study was to describe LPNs' perceptions of the benefits of information systems in daily patient care. The information systems include the main HIS or CIS that the respondents mainly use in their work. The data comprised 3 866 LPNs' responses were collected via an online survey in 2022. Most of the LPNs work in social care using the Lifecare system. ESKO is used in public health care and was rated as the most popular system that LPNs use regarding the benefits of information systems. Highly experienced LPNs seem to rate the benefits of information systems higher than LPNs who have just started working.

Recommended target audience, course content and learning arrangements for teaching health informatics competencies: A scoping review.

Background: As healthcare depends on health information technology, there is a growing need for Health Informatics competencies in daily practice. This review aimed to explore how the teaching of education in HI has been arranged. 28 publications, published in English between 2016 and 2020 and obtained from selected bibliographic databases, were reviewed. The data was analyzed using deductive content analysis with the following pre-formulated topics: target audience, course content and learning arrangements. The results highlight three key competencies: documentation and communication, management, and understanding of health information technology. It underlines a blended teaching method to improve the competencies of healthcare professionals, graduates, undergraduates, and suggests adding active interactions, multi-professional interactions, and hands-on skills. This study highlights the importance of adapting to changes in healthcare, improving HI competencies in healthcare, and fostering positive digital experiences. It underlined the need for practical training, in theory and hands-on sessions, including key competencies in documentation and communication, management and health information systems.

Experiences of Electronic Health Records' and Client Information Systems' Use on a Mobile Device and Factors Associated With Work Time Savings Among Practical Nurses: Cross-Sectional Study.

BACKGROUND: The transmission of clinical information in nursing predominantly occurs through digital solutions, such as computers and mobile devices, in today's era. Various technological systems, including electronic health records (EHRs) and client information systems (CISs), can be seamlessly integrated with mobile devices. The use of mobile devices is anticipated to rise, particularly as long-term care is increasingly delivered in environments such as clients' homes, where computers are not readily accessible. However, there is a growing need for more user-centered data to ensure that mobile devices effectively support practical nurses in their daily activities. OBJECTIVE: This study aims to analyze practical nurses' experiences of using EHRs or CISs on a mobile device in their daily practice. In addition, it aims to examine the factors associated with work time savings when using EHRs/CISs on a mobile device. METHODS: A cross-sectional study using an electronic survey was conducted in spring 2022. A total of 3866 practical nurses participated in the survey based on self-assessment. The sample was limited to practical nurses who used EHRs or CISs on a mobile device and worked in home care or service housing within the social welfare or health care sector (n=1014). Logistic regression analysis was used to explore the factors associated with work time savings. RESULTS: The likelihood of perceiving work time savings was higher among more experienced EHR/CIS users compared with those with less experience (odds ratio [OR] 1.59, 95% CI 1.30-1.94). Participants with 0-5 years of work experience were more likely to experience work time savings compared with those who had worked 21 years or more (OR 2.41, 95% CI 1.43-4.07). Practical nurses in home care were also more likely to experience work time savings compared with those working in service housing (OR 1.95, 95% CI 1.23-3.07). A lower grade given for EHRs/CISs was associated with a reduced likelihood of experiencing work time savings (OR 0.76, 95% CI 0.66-0.89). Participants who documented client data in a public area were more likely to experience work time savings compared with those who did so in the nurses' office (OR 2.33, 95% CI 1.27-4.25). Practical nurses who found documentation of client data on a mobile device easy (OR 3.05, 95% CI 2.14-4.34) were more likely to experience work time savings compared with those who did not. Similarly, participants who believed that documentation of client data on a mobile device reduced the need to memorize things (OR 4.10, 95% CI 2.80-6.00) were more likely to experience work time savings compared with those who did not. CONCLUSIONS: To enhance the proportion of practical nurses experiencing work time savings, we recommend that organizations offer comprehensive orientation and regular education sessions tailored for mobile device users who have less experience using EHRs or CISs and find mobile devices less intuitive to use.

Discovering the importance of health informatics education competencies in healthcare practice. A focus group interview.

BACKGROUND: As healthcare and especially health technology evolve rapidly, new challenges require healthcare professionals to take on new roles. Consequently, the demand for health informatics competencies is increasing, and achieving these competencies using frameworks, such as Technology Informatics Guiding Reform (TIGER), is crucial for future healthcare. AIM: The study examines essential health informatics and educational competencies and health informatics challenges based on TIGER Core Competency Areas. Rather than examine each country independently, the focus is on uncovering commonalities and shared experiences across diverse contexts. METHODS: Six focus group interviews were conducted with twenty-one respondents from three different countries (Germany (n = 7), Portugal (n = 6), and Finland (n = 8)). These interviews took place online in respondents' native languages. All interviews were transcribed and then summarized by each country. Braun and Clarke's thematic analysis framework was applied, which included familiarization with the data, generating initial subcategories, identifying, and refining themes, and conducting a final analysis to uncover patterns within the data. RESULTS: Agreed upon by all three countries, competencies in project management, communication, application in direct patient care, digital literacy, ethics in health IT, education, and information and knowledge management were identified as challenges in healthcare. Competencies such as communication, information and communication technology, project management, and education were identified as crucial for inclusion in educational programs, emphasizing their critical role in healthcare education. CONCLUSIONS: Despite working with digital tools daily, there is an urgent need to include health informatics competencies in the education of healthcare professionals. Competencies related to application in direct patient care, IT-background knowledge, IT-supported and IT-related management are critical in educational and professional settings are seen as challenging but critical in healthcare.

Privacy concerns among the users of a national patient portal: A cross-sectional population survey study.

INTRODUCTION: Seeking and receiving care requires disclosure of personal information which is recorded as health data in electronic health records. Thereafter, restricting the flow of information is dependent on data protection, information security, ethical conduct, and law. Privacy concerns may arise as patients' options concerning privacy have been balanced to cater both the privacy of patients and the needs of healthcare, as well as secondary use of data. METHODS: This study examined privacy concerns among the users of a national patient portal in a representative sample of Finnish adults aged 20 to 99 years old (n = 3,731). We used logistic regression analysis with population weights to seek answers to which factors are associated with privacy concerns. The cross-sectional survey data was collected in 2020. RESULTS: Every third patient portal user had privacy concerns. Those who were 50 to 59 years old (p = 0.030) had privacy concerns more often than 20 to 49-year-olds. Those who had financial difficulties (p = 0.003) also had privacy concerns more often while those, who had good digital skills (p=<0.026), did not need guidance on telehealth service use (p=<0.001) and found telehealth service use to be beneficial (p = 0.008), had privacy concerns less often. CONCLUSION: The usefulness of telehealth seems to play an important role in privacy concerns. Another important factor is the skills required to use telehealth services. We encourage providing guidance to those who lack the necessary skills for telehealth service use. We also encourage putting effort not only into data protection and information security measures of telehealth services, but also into providing transparent and comprehensible privacy information for the service users as privacy concerns are common.

Lessons Learned from an Interprofessional European Summer School in Health Informatics.

The aim of this European interprofessional Health Informatics (HI) Summer School was (i) to make advanced healthcare students familiar with what HI can offer in terms of knowledge development for patient care and (ii) to give them an idea about the underlying technical and legal mechanisms. According to the students' evaluation, interprofessional education was very well received, problem-based learning focussing on cases was rated positively and the learning goals were met. However, it was criticised that the online material provided was rather detailed and comprehensive and could have been a bit overcharging for beginners. These drawbacks were obviously compensated by the positive experience of working in international and interprofessional groups and a generally welcoming environment.

Nursing Informatics' Contribution to One Health.

OBJECTIVES: To summarise contemporary knowledge in nursing informatics related to education, practice, governance and research in advancing One Health. METHODS: This descriptive study combined a theoretical and an empirical approach. Published literature on recent advancements and areas of interest in nursing informatics was explored. In addition, empirical data from International Medical Informatics Association (IMIA) Nursing Informatics (NI) society reports were extracted and categorised into key areas regarding needs, established activities, issues under development and items not current. RESULTS: A total of 1,772 references were identified through bibliographic database searches. After screening and assessment for eligibility, 146 articles were included in the review. Three topics were identified for each key area: 1) education: "building basic nursing informatics competence", "interdisciplinary and interprofessional competence" and "supporting educators competence"; 2) practice: "digital nursing and patient care", "evidence for timely issues in practice" and "patient-centred safe care"; 3) governance: "information systems in healthcare", "standardised documentation in clinical context" and "concepts and interoperability", and 4) research: "informatics literacy and competence", "leadership and management", and "electronic documentation of care". 17 reports from society members were included. The data showed overlap with the literature, but also highlighted needs for further work, including more strategies, methods and competence in nursing informatics to support One Health. CONCLUSIONS: Considering the results of this study, from the literature nursing informatics would appear to have a significant contribution to make to One Health across settings. Future work is needed for international guidelines on roles and policies as well as knowledge sharing.

Nurses' Informatics Competency Assessment of Health Information System Usage: A Cross-sectional Survey.

Nurses' informatics competencies are nurses' professional requirements to guarantee the quality of patient care and affect nurses' use of health information systems. The purpose of this survey was to describe nurses' perceptions of their informatics competencies regarding health information system usage. A previously tested web-based questionnaire with multiple-choice questions was sent to nurses whose e-mail address was available through three Finnish Nursing Associations (N = 58 276). A total of 3610 nurses working in Finland responded. Both descriptive and explanatory statistics were used to analyze the data. The three dependent variables "nursing documentation," "digital environment," and "ethics and data protection" were formulated from the data. Nurses' overall informatics competency was good. The "ethics and data protection" competency score was higher than that of "nursing documentation" or "digital environment." Recently graduated nurses and nurses working in outpatient care, virtual hospital, examination, or operation had highest "digital environment" competency score. Health information system experience was associated with "nursing documentation." Nurses are highly qualified health information systems users. However, the competency requirements generated by rapidly expanding digitalization have challenged nurses. It is important to increase educational programs for nurses of how to use digital devices, and how to support patients to use digital services.

Digital Skills Among Elderly Care Workers.

The aim of our study was to determine the current status of digital skills of elderly care workers (n=169) at well-being services. A survey was sent to elderly services providers in the municipalities (n=15) of North Savo, Finland. Respondents' experience as client information systems users was higher than that as assistive technologies users. Devices supporting independent living were seldom used, but safety devices and alarm monitoring were used daily.

Nursing informatics competence profiles and perceptions of health information system usefulness among registered nurses: A latent profile analysis.

AIMS: To identify different nursing informatics competence (NIC) profiles in nurses, examine the factors associated with profile memberships and examine the associations of the derived profiles with the nurses' perception of the usefulness of a health information system (HIS). DESIGN: A cross-sectional study. METHODS: A sample of 3610 registered nurses responded to a nationwide survey in March 2020. A latent profile analysis was performed to identify NIC profiles based on three competence areas: nursing documentation, working in digital environment, and ethics and data protection. A multinomial logistic regression was carried out to examine the associations of demographic and background variables with the profile membership. Linear regression analyses were carried out to examine the association between the profile membership and perceived HIS usefulness. RESULTS: Three NIC profiles were identified and labelled as low, moderate and high competence groups. A younger age, recent graduation year, sufficient orientation and high-rated proficiency as an HIS user were associated with nurses belonging to a high or moderate competence group relative to a low competence group. Competence group membership was associated with perceived HIS usefulness. The high competence group consistently expressed the highest usefulness of the HIS and the low competence group the lowest. CONCLUSION: Tailored training and support should be provided for nurses with different levels of informatics competence, thereby facilitating their ability to respond to increasingly digitalized work. This could contribute to higher usefulness of the HIS in terms of supporting the nurses' work tasks and promoting the quality of care. IMPACT: This was the first study exploring latent profiles of informatics competence in nurses. Insights from this study are useful for nursing management to identify different competence profiles of their employees, provide support and training to meet their needs, and promote the successful use of an HIS.

Longitudinal Profiles of Recovery-Enhancing Processes: Job-Related Antecedents and Well-Being Outcomes.

The present study aimed to examine longitudinal recovery profiles based on three recovery-enhancing processes, i.e., psychological detachment from work, physical exercise, and sleep. In addition, we examined whether job-related demands and resources predict profile membership and whether profile membership predicts well-being outcomes. The participants were Finnish employees (N = 664) who filled in an electronic questionnaire in three successive years. Latent profile analysis (LPA) revealed five stable profiles of recovery-enhancing processes across time: (1) physically inactive, highly detaching (15%), (2) impaired recovery processes (19%), (3) enhanced recovery processes (25%), (4) physically active, poorly detaching and sleeping (19%), and (5) physically active (29%). In addition, job-related antecedents and well-being outcomes showed unique differences between the five profiles identified. Altogether, our study takes recovery research a step forward in helping to understand how recovery-enhancing processes function simultaneously over the long-term and suggests that, from the perspective of well-being, detachment from work and good sleep are more crucial recovery processes than physical activity.

Medical device regulation (MDR) in health technology enterprises - perspectives of managers and regulatory professionals.

BACKGROUND: In the European Union (EU), there are over half a million medical devices, varying from pacemakers to software. Medical devices play an important role in health care as they are used in diagnosis, prevention, monitoring, prediction, prognosis, treatment, or to alleviate disease. Medical devices are regulated in the EU by the Medical Device Regulation (MDR), which came into force on 25 April 2017 and into application on 26 May 2021. The demand for regulation arose from the need to establish a transparent, robust, predictable, and sustainable regulatory framework. This study aims to examine how the managers and regulatory professionals in health technology enterprises perceived the application of the MDR and what were their information needs regarding the MDR. METHODS: A link to an online questionnaire was sent to 405 managers and regulatory professionals representing health technology enterprises in Finland. The study included 74 respondents. Descriptive statistics were used to describe and summarise the characteristics of the dataset. RESULTS: Information related to the MDR was fragmented and the necessary information was sought from multiple information sources, while the Finnish Medicines Agency (Fimea) was regarded as the most important source of information and training provider. To some extent, the managers and regulatory professionals expressed their dissatisfaction with the performance of Fimea. The managers and regulatory professionals were not very familiar with the ICT systems provided by the EU. The size of an enterprise affected how many medical devices it manufactures and generally affected the views about the MDR. CONCLUSIONS: The managers and regulatory professionals understood the role of the MDR regarding the safety and transparency of medical devices. The available information regarding the MDR did not properly fit the needs of users and there seemed to be a gap in information quality. The managers and regulatory professionals had some difficulties understanding the available information. Based on our findings, we believe it is paramount to evaluate the challenges faced by Fimea and how it could improve its performance. To some extent, the MDR is regarded as a burden for smaller enterprises. It is important to highlight the benefits of ICT systems and to develop them to better meet the information needs of enterprises.

The Use of Digital Health Services Among Patients and Citizens Living at Home: Scoping Review.

BACKGROUND: The development of digital health services reflects not only the technical development of services but also a change in attitude and the way of thinking. It has become a cornerstone for engaging and activating patients and citizens in health management while living at home. Digital health services are also aimed at enhancing the efficiency and quality of services, while simultaneously providing services more cost-effectively. In 2020, the COVID-19 pandemic accelerated worldwide the development and use of digital services in response to requirements for social distancing and other regulations. OBJECTIVE: The aim of this review is to identify and summarize how digital health services are being used among patients and citizens while living at home. METHODS: The Joanna Briggs Institute (JBI) methodology for scoping reviews was used as guidance. A search conducted in 3 databases (CINAHL, PubMed, Scopus) resulted in 419 papers. The reporting was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review (PRISMA-ScR), and the analysis of the included papers was performed using a framework consisting of 5 clusters describing the use of digital health services. After screening and excluding papers that did not match the inclusion criteria, 88 (21%) papers from 2010 to 2022 were included in the final analysis. RESULTS: Results indicated that digital health services are used in different situations and among different kinds of populations. In most studies, digital health services were used in the form of video visits or consultations. The telephone was also used regularly for consultations. Other services, such as remote monitoring and transmitting of recorded information and the use the of internet or portals for searching information, were observed as well. Alerts, emergency systems, and reminders were observed to offer possibilities of use, for example, among older people. The digital health services also showed to have potential for use in patient education. CONCLUSIONS: The development of digital services reflects a shift toward the provision of care regardless of time and place. It also reflects a shift toward emphasis on patient-centered care, meaning activating and engaging patients in their own care as they use digital services for various health-related purposes. Despite the development of digital services, many challenges (eg, adequate infrastructure) still prevail worldwide.

Daily sleep in relation to subjective and physiological stress in an occupational context: Daily vigour as a mediator.

Studies on the stress-sleep relationship consistently demonstrate negative effects of stress on sleep. The reversed relation, however, has received less research attention. Also, field studies on physiological stress are scarce. The aim of this day-level diary study was to examine daily relationships between sleep quality and quantity, and subjective and physiological stress in an occupational context. Moreover, we examined daily vigour as an underlying mechanism of the sleep-stress relationship. Participants were 167 knowledge workers who filled in daily questionnaires measuring sleep quality and quantity, morning vigour and subjective afternoon stress on Tuesdays and Thursdays for 5 weeks. Physiological stress was assessed with cortisol decline from morning peak to evening, and with blood pressure in the afternoon. Multilevel path analysis results showed that better sleep quality and longer sleep hours predicted increased vigour the following morning, which in turn predicted lower subjective stress in the afternoon. Sleep quality and quantity were not related to physiological stress neither directly nor indirectly via morning vigour. On the basis of our results, sleep should be considered as a factor affecting vigour which in turn seems to lower stress.

Needs-based off-job crafting across different life domains and contexts: Testing a novel conceptual and measurement approach.

Shaping off-job life is becoming increasingly important for workers to increase and maintain their optimal functioning (i.e., feeling and performing well). Proactively shaping the job domain (referred to as job crafting) has been extensively studied, but crafting in the off-job domain has received markedly less research attention. Based on the Integrative Needs Model of Crafting, needs-based off-job crafting is defined as workers' proactive and self-initiated changes in their off-job lives, which target psychological needs satisfaction. Off-job crafting is posited as a possible means for workers to fulfill their needs and enhance well-being and performance over time. We developed a new scale to measure off-job crafting and examined its relationships to optimal functioning in different work contexts in different regions around the world (the United States, Germany, Austria, Switzerland, Finland, Japan, and the United Kingdom). Furthermore, we examined the criterion, convergent, incremental, discriminant, and structural validity evidence of the Needs-based Off-job Crafting Scale using multiple methods (longitudinal and cross-sectional survey studies, an "example generation"-task). The results showed that off-job crafting was related to optimal functioning over time, especially in the off-job domain but also in the job domain. Moreover, the novel off-job crafting scale had good convergent and discriminant validity, internal consistency, and test-retest reliability. To conclude, our series of studies in various countries show that off-job crafting can enhance optimal functioning in different life domains and support people in performing their duties sustainably. Therefore, shaping off-job life may be beneficial in an intensified and continually changing and challenging working life.

Milestones and Outcomes in Health and Human Services Informatics Education Programmes.

This chapter describes the milestones and outcomes of Health and Human Services Informatics (HHSI) education programmes at master and doctoral degree level. In Finland, since the year 2000 the programmes have been based on the International Medical Informatics Association (IMIA) recommendations on biomedical and health informatics and the master's degree programme has been twice accredited by the IMIA Accreditation Committee. The paradigm created to advance and support both education and research in the health and human services fields is used to analyse and synthesize the research focuses of students' theses and evaluate milestones. The outcomes of HHSI programmes are described using quantitative and qualitative data from a student administrative database and student theses. The research focuses and research methods were coded for master's and doctoral theses based on the HHSI paradigm. Experiences from the accreditations and feedback are summarized to provide insights for future development. Based on the results, recommendations for further development of the programmes are provided.

Using standardized nursing data for knowledge generation - Ward level analysis of point of care nursing documentation.

BACKGROUND: Standardized nursing terminology is a prerequisite for describing nursing care processes and generating knowledge for decision-making and management. The structure of the Finnish Care Classification (FinCC) facilitates documentation of nationally agreed core nursing data: nursing diagnoses, interventions, and outcomes. PURPOSE: To analyze the use of FinCC to assess patient care needs (nursing diagnoses), care implementations (interventions) and evaluation of the outcomes of nursing care in electronic health records. METHODS AND MATERIALS: The descriptive study applied purposeful sampling of nursing data from nursing data repositories in three surgical wards in tertiary and secondary care hospitals. The aggregated, anonymous ward level data from a six-month period was analyzed to show distributions within frequencies and means of component, main and subcategory level use of FinCC in the three hospitals. RESULTS: Each of the three levels of the FinCC (component, main and subcategory) were used for recording nursing care. In all hospitals, the three most used diagnosis components covered about one third of the use of all the 17 components. The five most used intervention components cover about one third of the components. The most often used components for diagnoses and interventions were Coordination of care and follow-up care, Pain Management, Activities of daily living and independence and Medication. The prevalence of different components and the main and subcategory level usage for both diagnoses and interventions varied between the hospitals. CONCLUSION: Standardized point-of-care nursing data makes patients' daily nursing care transparent. Structured, standardized, and point-of-care nursing data can be utilized to generate new knowledge of nursing care processes and nursing care practice at ward level.

The eHealth4all@eu Pipeline of Course Development: TIGER Recommendations in Action.

This study describes the eHealth4all@eu course development pipeline that builds upon the TIGER educational recommendations and allows a systematic development grounded on scientific and field requirements of competencies, a case/problem-based pedagogical approach and finally results in the syllabus and the course content. The pipeline is exemplified by the course Learning Healthcare in Action: Clinical Data Analytics.

Updating the Standardized Terminology for Nurses' Daily Documentation.

In Finland, the nationally unified and standardized nursing documentation model comprises the nursing process model and the Finnish Care Classification (FinCC). The aim of the study was to assess how well the further developed FinCC complies with actual nursing practices and how pragmatic and understandable it is. An e-questionnaire based on the revised version of the FinCC was sent to healthcare organizations (n=34) and Universities of Applied Sciences (n=14). Data was gathered and organized in Excel. Narrative comments were read and analyzed. The mean of questions of 17 components of both the FICND and the FICNI was over four (scale 1-5). The biggest revision of the FinCC is that different scales and evidence-based research have been utilized in the development of the terminology. Based on the findings, revisions have been made, and the new version, FinCC 4.0, will be published at the end of 2019.