COMPUTER APPLICATION THAT SUPPORT NURSING RESEARCH Literature searches, reliable search engines and databases 1. Cinahl plus with full text ○ Cumulative index to nursing and allied health ○ Provides authoritative coverage of the literature related to nursing and allied health 2. Cochrane library ○ Collection of databases ○ Contain independent evidence on which to base clinical treatment decisions 3. Embase: Exerpta medical database ○ Databse in biomedicine ○ Excels in its coverage of pharmaceutical research ○ From 1974 to present 4. EBSCOHOST ○ Research platform ○ Offers high- quality articles licensed from reputable publishers recognized by library professionals 5. HAPI - Health and Psychosocial Instruments ○ Database that provides Information on measurement instruments 6. Medline through OVID ○ National library of Medicine’s premier bibliographic database Medline via pubmed ● Pubmed - service of national library of medicine ○ Provides access to medline citations Nursing Reference center plus ● Master nursing best practices ● Source EB-information for nurses ● Complements cinahl 7. Psych INFO ○ Now called APA ○ Abstract and index of psychology and the psychological aspects of related disciplines 8. Sage research methods ○ Contains information on research methods 9. Scopus ○ Provides 100% medline coverage ○ With interoperability with ScienceDirect, Engineering Village, and Reaxys 10.Web of science ○ Largest citation database in science, engineering, medicine, and technology ○ Provided by the institute for scientific information (ISI) 11.Additional databases ○ Google scholar ○ Health source: Nursing/Academic Edition ○ Sociological Abstracts ○ Virginia Henderson international nursing library Data Collection and Statistical Tools ● Utmost importance ● Data are the raw materials statisticians work on ● Data are gathered in order for the researcher to study their characteristics the variable 2 types of variables or data ● Qualitative variables - represent quality, character, or kind, NOT amount ● Quantitative variables - present quantity ○ 2 types of quantitative variables ■ Discrete - counted using integral ■ Continuous - counted using decimals ● Independent variables - cannot be affected the predictor ● Dependent variables - the one being predicted Scales of Measurement of Data ● The process of assigning a numerical value - measurement Types ● Nominal - categorical ○ Name ○ All qualitative variables are measured this way ○ Without particular order or rank ● Ordinal - imposition of ranks or inequalities ○ Less than or greater than measurements ○ Social class, income bracket, letter grades, body frames, birth order, contest winners ● Interval Data - indicate actual amount ○ Does not include greater than or less than relationship ○ Has a limit of measurement ○ Temperature, score, etc. ● Ratio - similar to interval but has absolute zero ○ Include all usual measurements ○ Length, height, weight, area, volume, density, etc. ○ Highest level of measurement Methods of Data Collection 1. Online Questionnaire ○ Usually done face to face ○ 15-20 mins to finish questionnaire ○ Has shifted towards online due to covid pandemic ○ Google forms, microsoft forms Functions of Google forms and microsoft forms ● Question and answer types ○ Diverse options and features ○ Microsoft forms is limited ■ Branching is not easy ■ You have to add from 3 dot menu ● Sharing and Collaboration ○ Both have it ● Templates ○ Google forms better ● Themes ○ Microsoft forms better ● Embedding video and other media ○ Google forms better ● Uncommon features ○ QR code ○ File upload - google forms has, microsoft forms does not ○ Built in spreadsheet support ■ Both have it, google has cloud storage 2. Digital polls 3. Survey monkey 4. Data processing and Database application ● Spreadsheet ● SPSS/PSPP - Statistical package for social sciences software platform ○ Leading statistical software for advanced statistical analysis ○ PSPP - developed by GNU operating software - free replacement of SPSS ● SAS - statistical analysis software ○ For organizations ○ Business analysts, statisticians, data scientists, researchers, and engineers ● NVIVO ○ Qualitative data analysis software ○ Centralize data from multiples sources Data Presentation ● Textual - paragraph to explain data ● Tabular - for summary and comparison of data ● Graphical - visual representation ● IMRAD report ○ Introduction, methods, results, discussion ○ Introduction - why it was necessary ■ Discuss the motivation ■ Discuss current state ■ Then reveal a gap in the field ■ Present hypothesis at the end ○ Methods ■ Include population, sample, methods, and equipment ■ Should allow readers to duplicate your study ■ Use subheadings ■ Written in past tense and passive voice ■ Last read section ○ Results ■ Past tense ○ Discussion ■ Summarize findings ■ Connect them to other research ■ Discuss limitations and suggestions for future research ○ Abstract ■ Comes at the beginning, but made at the end ■ Short overview of entire paper ○ Reporting vs commenting ■ In results- simply report ■ In discussion - comment on them ● Common problems in IMRAD drafts ○ Abstract does not provide clear statement of findings ○ Introduction doesn't communicate why it is important ○ Methods is not detailed ○ Results provides comments instead of simply reporting results APPLICATIONS OF NURSING INFORMATICS (CLINICAL) ● Virtual health care ○ Establishes opportunities for communicating health info Application of nursing informatics in clinical settings Assessment ● Digitalization- helps in gathering information ● Largest source of assessment data ○ Ongoing nursing assessment Patient monitoring ● Ensure high-level of quality patient care ● Arrhythmia monitoring ● Modern and sophisticated computerized ICU monitoring systems Nursing -generated assessment data ● Source data capture ○ Means gathering data and info about patients where it originates - with the patient ● Electronic source data capture (eSource) ○ Accessing research data directly from EHRs ■ Application ■ Mobile computers ■ Barcode scanner/ RFID reader ● Computer data entry ○ Must occur wherever patients are found ● Point of care information system ○ Goals of moving to point of care systems ■ Minimize spent documenting patient information ■ Eliminate redundancies and inaccuracies of charted information ■ Improve timeliness of data communication ■ Optimize access to information ■ Provide information required by the clinician to make the best possible patient care decisions ● Points to consider when adoption of Point of care systems ○ Must allow the nurse to interact with min information system ○ Must interface with existing hospital information system ○ Open system concept is valuable to nurses considering point of care ○ Must have small footprint ○ Must be easy to use and must adapt to variety of nursing environments ○ Must be easily disinfected and cleaned between patients ○ Require a variety of ways for entering data ○ Must go wherever the patient is ○ Must be represented in ways that can be quickly used and easily understood by nurses Documentation ● Ideal nurses notes should generally be lengthy, problem focused narrative, handwritten, and unbiased observations. ● 2 approaches ○ Digital library of frequently used phrases to describe patient’s condition ○ Branching questionnaire ● Advantages of automated documentation of nursing observation ○ Content standardization ○ Improved standards of compliance ○ Increased efficiency ○ Enhanced timeliness ○ Expanded accessibility ○ Augmented data archive ● Goal of retail EMR ○ Help providers practice autonomously, streamlining administrative functions, while suggesting clinically appropriate actions generated from evidence-based practice guidelines and clinical documentation Data issues The shift to electronic documentation ● EHR ○ Digital version of patient data that is found in traditional patient records ● EMR ○ Legal record that describes single encounter or visit created in hospitals and outpatient health care settings that is the sources of data for the EHR ● Promise of EHR ○ Make positive impact on the quality of patient care through interprofessional collaboration with improved data availability and information synthesis ○ Improving patient safety through the use of clinical decision support Risk and benefits of electronic health records Benefits ● Quick access to medical information ● Improved management of chronic diseases ● Reminders of follow up tests ● Reduce unnecessary repetitions of diagnostic testing ● Saving money ● May use standardized evidence based protocols for nursing care. ○ Where nurses can access the most current evidenced-based protocol to se potential nursing interventions ○ Can improve documentation, assessment, and intervention ○ Providing reminders to chart specific symptoms ro to chart the administration of PRN medcations Risks ● People outside may access confidential information Privacy, confidentiality, and security mechanism ● Electronic documentation has legal risks ● Possible for anyone to access computer station ● Protection is top priority ● Ensuring appropriate access is responsibility of all working in health care ● Most security mechanisms use combination of logical and physical restrictions ● Some include firewall, antivirus, and spyware detection software ● Firewall ○ Combination of hardware and software that protects private network resources ● Physical security measures ○ Putting computers or file servers in restricted areas ○ Limited benefit, if using mobile phones or wireless devices Handling and disposing of information ● Destroy anything that is printed when the information is no longer needed ● De-Identify PHI ● Destroy all papers containing PHI Planning ● Automated care planning ○ Kardex - used to hand off or endorse patient care ○ NCP - usually outdated when entered in Kardex ○ Notations - may be a source of faulty communication ● Alternative ○ Care maps/ pathways for meeting patient needs, store them in the computer then adapt them to individual patients ● Advantages of automated care plans or pathways over traditional care plans ○ Time is saved by eliminating handwriting ○ Accountability is increased ○ Errors and omissions are decreased ○ Consistency of care plan is increased ○ Judgements for nursing care no longer delegated to whoever walks into a room to care for a patient Decision support systems ● Help nurses maintain and maximize their decision making responsibilities ● Standardized care plans do not enhance nurse decision making; they discourage active decision making ● Decision support systems can never replace the need for nurses with expert clinical and decision making skills Implementation ● Digital devices rarely help in giving nursing service ● Computers are used in other phases in nursing process Evaluation ● Digital devices evaluate nursing care through real-time auditing How nursing informatics improves patient care ● Easier to manage health care workflows ● Improved coordination ● Enhanced patient outcomes Aligning nursing best practice with clinical workflows and care ● Nursing informaticist are often involved in process design, clinical workflow, reviews, and new diagnostics and treatment plans ● They determine the actions that will lead to the most patient-centered, value based care Data is the lifeblood of nursing informatics Providing training and learning based on the objective data Selecting and testing new medical devices Reducing medical errors and costs Enhancing end to end treatment and continuity of care
