Stakeholders’ perceptions of digital health platform ecosystem generativity

This paper discusses findings from a study of healthcare stakeholders’ perceptions of the enablers and barriers of core-periphery systems and solutions in the digital platform of a Private Tertiary Health Service (PTHS). Using critical realism as a lens, the study involved an embedded case study of three departments in PTHS. The findings show that the platformisation of digital health infrastructure enhanced generativity, including innovation, adoption, and scaling. Further, the research identified platform governance as the area that requires enhancements. This research adds to the limited literature on digital health platform ecosystems by revealing healthcare stakeholders’ perceptions. Our findings can inform strategy for health organisations seeking platformisation of their digital infrastructures. Further, state and national digital healthcare policymakers can use this research to address digital health platform ecosystems challenges, especially in the private sector

UTHealth Quality Symposium 2023 Abstracts-1

UTHealth Quality Symposium 2023 Abstract

Music Therapy in the NICU

This paper discusses the importance of implementing the use of music therapy in the NICU. Preterm infants experience procedures that cause stress, overstimulation, and a change in vital signs. The use of music therapy aids in protecting preterm infants. This paper discusses the implementation and evaluation process and the benefits, cost, and literature associated with this change

An Evidence-Based Approach to a Replacement Hospital Training Curriculum

Creation of a training and educational curriculum for a new or replacement facility is daunting in its own right, but without a repository of organizational knowledge cataloging the transfer of tacit to explicit knowledge from the organizations previous library of facility openings, the task becomes Herculean, with as many tasks and cast of characters as the original myths. Navigating the shoals, eddies and tides of the various aspects of this project revealed the need for a comprehensive knowledge management solution to training that is coupled with healthcare design principles and initiatives. This purpose of the DNP project is about the assessment, design, implementation and evaluation of a major training program to prepare for a new hospital opening

Use of the internet for information organization, distance learning, and specimen presentation

The advent of the internet has had an effect on the discipline of entomology. The history of the relationship between entomology and the internet is summarized, and several effects are examined in detail. One effect is to create an explosion of available information about insects and pest management, largely available on the world-wide web (WWW). A metadata-based solution to categorizing, searching and filtering this information is presented, along with a case study that used this solution to examine the value added by the use of metadata. In the case study website, one third of the users arrived at web pages containing entomological information by following links that were autogenerated based on metadata. Original software for extracting, assigning and managing metadata across sites is presented. A second effect is the enabling of new teaching methods, including the use of three-dimensional (3D) virtual reality insect models. Photographic 3D models were created using QuickTime VR and compared to standard teaching methodology. The QTVR models were significantly more effective. Lastly, the internet enables distance education. A web-based online introductory distance education course in entomology was constructed and offered for several years. Enrollment increased markedly over the time course was offered. Retention averaged 79% +/- 7.9% in the online section compared to 93% +/- 4.0% in the traditional section. Analysis of log files showed that problems with cheating during online evaluations was rampant, with 15 of 22 students cheating on one or both of the exams analyzed. Potentional solutions to this problem are presented.*;*This dissertation is a compound document (contains both a paper copy and a CD as part of the dissertation)

Human Milk at Discharge

Problem: In a 16-bed neonatal intensive care unit, there was a lack of support for lactating mothers. As infants were admitted, mothers experienced up to a 48-hour delay in lactation support to initiate breastfeeding or pumping. Aim of the Project: The aim of this project was to ensure lactating parents had adequate support for breastfeeding and pumping to increase human milk at discharge rate. Project interventions aligned with Ohio First Steps for Healthy Babies. Review of the Evidence: Evidence showed that human milk discharge rates improved with lactation support. Additionally, noted was a significant increase in exclusive breastfeeding, or a combination of breastfeeding and pumping, compared to infants receiving formula. Direct breastfeeding rate improvements were observed for mothers assisted by a certified lactation consultant. Project Design: A quality improvement project was implemented to improve human milk at discharge rates. The Ohio Health Change model was used to communicate the roles and responsibilities within the key stakeholder group. Three PDSA cycles were completed to test the implemented changes. Intervention: To educate on the benefits of human milk, initiation, and sustained breastfeeding and pumping, lactation support was provided. Furthermore, a unit-based lactation team was established, meeting with the mother-baby dyad daily upon admission. During admission, mothers were supported to provide milk and prepared to sustain breastfeeding successfully post-discharge. Charge nurses supported project interventions by ensuring breast pumps were at each bedside daily. Significant Findings/Outcomes: During the project period, human milk discharge rates improved by 7-13% from baseline. While this did not reach the 80% goal, it demonstrated that human milk consumption increased with support. Three process measures evaluated were breast pump compliance, lactation meeting compliance, and overall compliance with mothers providing human milk, which contributed to achieving the project\u27s outcome measure. Implications for Nursing: Nursing providers strive for effective care. Lactation support meets the Institute for Healthcare Improvement\u27s Triple Aim of improving parents\u27 satisfaction. Educating mothers on human milk benefits and supporting successful breastfeeding is crucial to improving healthcare outcomes for premature infants. This aligns with Six Aims for Healthcare Improvement, including safe, effective, patient-centered care and population health. Within 8 weeks, a unit-based lactation team improved human milk consumption to within 24 hours of discharge

The factors impacting Critical Care Nurses' decision-making processes in continuous renal replacement therapy.

IntroductionContinuous Renal Replacement Therapy (CRRT) is a common treatment intervention in critical care units worldwide. It provides supportive therapy for critically ill patients with severe kidney dysfunction. Efforts to optimise its clinical effectiveness through modifying treatment regimens over recent years have proved largely unsuccessful. However, studies have not explored the human element of critical care nurses delivering CRRT.AimThis study is designed to understand the influences on critical care nurses’ decision-making in the management of CRRT. In doing so, develop and highlight areas where modifications in practices can be adopted, in order to improve both the patient and organisational quality indicators associated with CRRT delivery.MethodsThis study used an adaptive Interpretive Description approach. The study was conducted across four linked United Kingdom critical care units. Twenty- one (n=21) registered critical care nurses undertook the California Critical Thinking Disposition Inventory (CCTDI) and of these, 10 nurses were interviewed face to face in semi-structured audio recorded interview, which were then transcribed and thematically analysed.ResultsFour major themes influencing critical care nurses decision-making regarding CRRT were identified, with a further two contributing an overarching influence. These themes were the Individual; Organisational; Practice; Support, these themes were complex and intertwined and in themselves highlighted issues about Variability and Competing demands whilst delivering CRRT.DiscussionThe themes in this study showed an alignment with some of the findings from other critical care decision-making studies, including the influence of the individual nurse, experience, and support. However, this work has also been able to introduce significant new knowledge on the perceptions and insights of critical care nurses. These findings generate new knowledge and contextualise these understandings of individuals, the organisations, the wider interactions, and relationships between colleagues, and the CRRT technology, and provide insights to enable a holistic approach to understanding the provision of CRRT and potentially enable improvements in treatment delivery. In understanding these aspects, it has elucidated avenues for improvements in practice, identifying areas that can be engineered to improve CRRT practice and characterises elements within individuals which contribute to CRRT delivery.RecommendationsThis study draws up a number of recommendations from the themes identified, these recommendations focus on the ‘Individual’ and the ‘Organisational’ themes. They include the introduction of a harmonised training, educational and competency programmes with integrated in situ hi-fidelity simulation provision, alongside bespoke high quality clinical supervision, to facilitate critical care nurses self-awareness

Evaluation of a One-Day Meditech Magic Training Program for Registered Nurses and Licensed Practical Nurses in a long term care program

Background: An evaluation was completed on the One-Day Meditech Magic Training Program for Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) developed for the Long Term Care (LTC) Program. Methods: Both a literature review and consultation with stakeholders were completed to determine possible evaluation methods, expected outcomes, and ways to measure the effectiveness of the education program. A pretest/posttest design and questionnaire were chosen as the evaluation tools for this project. Results: No significant difference was found between the pretest and posttest total scores indicating that learners retained information from the orientation session (Z = -1.820, p = 0.069). Additional Wilcoxon matched-pairs signed rank tests were performed on the individual sections of the tests and revealed a significant decrease in the posttest scores for entering a Diagnostic Imaging requisition (Z = -1.975, p = 0.048). No other significant findings were present. Questionnaires were also analyzed revealing that most participants were pleased with the Meditech documentation education they received and did not indicate barriers that would affect electronic documentation. Conclusions: Further testing is required to ensure reliability and validity of the evaluation tools. Finally, caution is needed due to a small sample size. However, problematic documentation tasks were identified during the evaluation, and as a result both the training session and support materials will be improved as a result of this project

Social features of Web Assisted Tobacco Interventions (WATIS) : case studies

textWeb Assisted Tobacco Interventions (WATIs) are proliferating due to their cost effectiveness and their compatibility with a fast-paced lifestyle that needs to be time and space detached. Following a general trend in web assisted interventions, WATIs are increasingly incorporating social media features. Often though, because they are added post-facto to a solid preexisting foundation that privileges information delivery, the social media and the informational sections are developed independently: the social component has no impact on the informational content. This forms the basis of this study, which proposes to do a detailed analysis of a WATI recommended by a panel of experts in the area of smoking cessation. An emphasis will be given to the visibility of social media features and the degree to which content from the social media component contributed by users impacts the informational component generated by content experts. This analysis will be supported by instruments for data collection especially adapted/designed for this study. This dissertation proposal is at the cusp of disciplinary boundaries as its theoretical underpinnings are in the intersections of three domains: design, health, and social media. This interdisciplinary approach is necessarily reflected in the study's conceptual vii framework, which draws from constructs such as "design with intent", tailored health interventions, and social networks for participatory culture. As a result of the detailed analysis, and the author's own expertise in social media across other fields, a set of recommendations will be proposed for the design of WATIs with social features aiming at a greater impact of these on the evidence-based informational content.Radio-Television-Fil