International journal of medical informatics
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Comparative Study
Application of a low-cost web-based simulation to improve students' practical skills in medical education.
Practical sessions in undergraduate medical education are often costly and have to face constraints in terms of available laboratory time and practice materials (e.g. blood samples from animals). This makes it difficult to increase the time each student spends at the laboratory. We consider that it would be possible to improve the effectiveness of the laboratory time by providing the students with computer-based simulations for prior rehearsal. However, this approach still presents issues in terms of development costs and distribution to the students. ⋯ The simulation was well received by students in the EG, who felt more comfortable during the laboratory session, and it helped them to perform the exercise better, obtaining more accurate results, which indicates more effective training. EG students perceived the procedure as easier to perform, but did not report an improvement in the perceived difficulty in using the equipment. The increased reliability demonstrates that low-cost simulations are a good complement to the laboratory sessions.
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Nurses are increasingly using computerised decision support systems (CDSS) to support their practice. Previous studies have highlighted the importance organisational factors have on the successful implementation of new technologies in healthcare. However, it is unclear how the organisations where nurses work either facilitate or inhibit the successful use of CDSS. The aim of this paper is to explore what nurses and NHS (National Health Service) managers working in NHS organisations in England perceive as the organisational features facilitating the introduction and successful use of CDSS. ⋯ For nurses to use CDSS successfully, engagement by clinicians in the procurement and implementation of systems is useful. However, the data collected in this study suggest this is not necessary for successful implementation; nurses may still successfully introduce and use a CDSS if they perceive it to have benefits to their practice.
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Inappropriate medication among elderly people increases the risk of adverse drug-drug interactions, drug-related falls and hospital admissions. In order to prevent these effects it is necessary to obtain a profile of the patients' medication. A personal digital assistant (PDA) can be used as a medical decision support system (MDSS) to obtain a profile of the patients' medication and to check for inappropriate drugs and drug combinations, and to reduce medication errors. ⋯ We found that the LIFe-reader has the potential to be a useful and user-friendly MDSS for nurses in home care when obtaining profiles of the patients' medication regarding drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly. A regular scanning of the patients' drugs in their home might support nurses and general practitioners (GPs) in reducing the inappropriate use of drugs. If the LIFe-reader should be used in a larger scale among nurses, more content and functions are necessary.
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Health information technology has been shown to influence the communication patterns of healthcare providers. The goal of this study was to learn more about how healthcare providers communicate and exchange patient clinical information during patient handoffs (transfers) between units in an acute care setting. ⋯ The results of this exploratory study provide a foundation for future research examining how network structure and communication principles can be used to design health information technology that compliments the non-linear information gathering and dissemination behaviors of providers from multiple professions.
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Companies developing and commercializing Healthcare IT applications may decide to involve the users in the software development lifecycle in order to better understand the users' needs and to optimize their products. Unfortunately direct developers-users dialogues are not sufficient to ensure a proper understanding of the users' needs. It is also necessary to involve human factors specialists to analyze the users' expression of their needs and to properly formalize the requirements for design purposes. The objective of this paper is to present a case study reporting the collaborative work between HF experts and a company developing and commercializing a CPOE. This study shows how this collaboration helps resolve the limits of direct users involvement and usual problems pertaining to users' needs description and understanding. ⋯ This study demonstrates that the integration of users' representatives in the software lifecycle is a good point for the end users. But it remains insufficient to resolve the complex usability problems of the system. Such solutions require the integration of HF expertise. Moreover, such an involvement of HF experts may generate benefits in terms of reduction of (i) the number of iterative developments and (ii) the users' training costs.