Computers, informatics, nursing : CIN
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Medication errors in hospitals are common and often lead to patient harm, contributing to increased costs and hospital length of stay. Bar-code medication administration can improve patient safety by leveraging technology to improve accuracy throughout the medication administration process. This study was designed to determine whether implementation of a bar-code medication administration process could improve the safety of medication administration. ⋯ There was a marked increase in use of the Workstation on Wheels at the bedside as well as real-time documentation. Use of the electronic medication administration record to retrieve medications did not increase after implementation. Medication errors showed a slight rate increase after bar-code medication administration was introduced.
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Previous research has suggested that a teaching strategy integrating problem-based learning and simulation may be superior to traditional lecture. The purpose of this study was to assess learner motivation and life skills before and after taking a course involving problem-based learning and simulation. The design used repeated measures with a convenience sample of 83 second-year nursing students who completed the integrated course. ⋯ Subscales of learner motivation and life skills, intrinsic goal orientation, self-efficacy for learning and performance, problem-solving skills, and self-directed learning skills significantly increased both from pretest to postsimulation test and from post-problem-based learning test to post-simulation test. The results demonstrate that an integrating problem-based learning and simulation course elicits significant improvement in learner motivation and life skills. Simulation plus problem-based learning is more effective than problem-based learning alone at increasing intrinsic goal orientation, task value, self-efficacy for learning and performance, problem solving, and self-directed learning.
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Decision support at the point of care has been demonstrated to be an effective tool in providing a safe environment and improving patient outcomes. The operating room is typically an area where advanced technology is introduced to nurses on a regular basis. This quality improvement project focused on preventing a peripheral nerve injury, which is an example of a postoperative adverse event that is considered preventable. ⋯ The components of this project involved a preliminary and postproject surveys on peripheral nerve injury knowledge, an educational presentation, and a retrospective random review of nursing documentation in the operating room electronic health records. Project results demonstrated a significant increase in nursing documentation of peripheral nerve injury interventions (63%-92%) and a positive attitude toward their exposure to basic decision support (P = .046). Recommendations for future studies and establishing a standardized coding system for peripheral nerve injury identification were identified.
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Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. ⋯ At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.
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Randomized Controlled Trial
Using interactive computer simulation for teaching the proper use of personal protective equipment.
The use of personal protective equipment is one of the basic infection control precautions in health care. The effectiveness of personal protective equipment is highly dependent on adequate staff training. In this project, a computer simulation program, as a supplement to conventional training approaches, was developed to facilitate the learning of the proper use of personal protective equipment. ⋯ Fifty healthcare workers were randomly assigned into two groups: one received conventional personal protective equipment training only (control group), whereas the other also received the same conventional training but followed by using the developed simulation program for self-learning (experimental group). Their performance was assessed by personal protective equipment donning and doffing evaluation before and after the training. The results showed that the computer simulation program is able to improve the healthcare workers' understanding and competence in using personal protective equipment.