What nurses want: diffusion of an innovation.

We investigated the usability of personal digital assistants (PDAs) to improve research utilization and timely access to electronic practice information to assist in clinical decisions. Nurses used a decision support tool on a PDA to collect point-of-care outcomes data. Follow-up interviews documented usability. Nurses liked the portability and size of the PDA, as well as ease of use of the PDA software. Electronic decision support tools at point of care have the potential to improve nurses' research utilization and quality of care.

Evidence in the palm of your hand: development of an outcomes-focused knowledge translation intervention.

AIM: The aim of the project was to develop an electronic information gathering and dissemination system to support both nursing-sensitive outcomes data collection and evidence-based decision-making at the point-of-patient care. BACKGROUND: With the current explosion of health-related knowledge, it is a challenge for nurses to regularly access information that is most current. The Internet provides timely access to health information, however, nurses do not readily use the Internet to access practice information because of being task-driven and coping with heavy workloads. Mobile computing technology addresses this reality by providing the opportunity for nurses to access relevant information at the time of nurse-patient contact. METHOD: A cross-sectional, mixed-method design was used to describe nurses' requirements for point-of-care information collection and utilization. The sample consisted of 51 nurses from hospital and home care settings. Data collection involved work sampling and focus group interviews. FINDINGS: In the hospital sector, 40% of written information was recorded onto "personal papers" at point-of-care and later transcribed into the clinical record. Nurses often sought information away from the point-of-care; for example, centrally located health records, or policy and procedure manuals. In home care, documentation took place in clients' homes. The most frequent source of information was "nurse colleagues." Nurses' top priorities for information were vital signs data, information on intravenous (IV) drug compatibility, drug references, and manuals of policies and procedures. IMPLICATIONS: A prototype software system was designed that enables nurses to use handheld computers to simultaneously document patients' responses to treatment, obtain real-time feedback about patient outcomes, and access electronic resources to support clinical decision-making. CONCLUSION: The prototype software system has the potential to increase nurses' access to patient outcomes information and evidence for point-of-care decision-making.

Focus on clinical best practices, patient safety and operational efficiency.

Moving from a paper-based medication management environment to completely on-line processes was a major change for nurses--the largest group of employees and, ultimately, MOE/MAR users. Nursing's involvement and their experiences are analyzed.

Evaluation of a client care delivery model, Part 2: Variability in client outcomes in community home nursing.

Using similar variables, Part II explores variation in client outcomes such as OMAHA knowledge, behavior, and SF-36 scores. Medical and nursing diagnoses explained large variations in client outcomes. Clients cared for by degree-prepared nurses improved knowledge and behavior scores. Unanticipated case complexity was negatively associated with client outcome even with nursing intervention. The study revealed that "for every unit increase in assignment of baccalaureate-prepared nurses, clients will on average demonstrate an 80% greater likelihood of improvement in knowledge scores and a 120% greater likelihood of improvement in behavior scores in relation to their health condition at discharge." This two-part study has offered insight into the controllable variables influencing the cost and quality of home care services.