A gamified mobile health intervention for children in day surgery care : Protocol for a randomized controlled trial

Publisher Copyright: © 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.Aims: To describe a study protocol for a randomized controlled trial which will evaluate the effectiveness of a gamified mobile health intervention for children in whole day surgery care. Design: A study protocol for a two-arm randomized controlled trial. Methods: Participants will be randomly assigned to the intervention group (N = 62), in which patients receive routine care and play a mobile game designed for children or the control group (N = 62), in which patients receive routine care, including a mobile phone application that supports parents during the care path. The primary outcome is children's pre-operative anxiety, while the secondary outcome measures included fear and postoperative pain, along with parental satisfaction and anxiety. Data collection started in August 2020. Results: The results of the ongoing randomized controlled trial will determine whether the developed gamified mobile health intervention can be recommended for hospital use, and whether it could be used to educate children about their surgical treatment to decrease anxiety.Peer reviewe

A Multimodal Analgesic Virtual Reality Program to Reduce Opioid Exposure

The opioid crisis continues to be a public health concern. Traditionally, an opioid-centric approach treats postoperative pain. The following PICOT question guided this project: Will initiating a multimodal analgesic virtual reality quality improvement program (I) compared to current practice (C) decrease opioid requirements (O) in robotic hysterectomy patients (P) during the postoperative period (T)? Several articles promote non-opioid analgesia and non-pharmacological interventions, such as multimodal analgesia and virtual reality (VR) for pain management. This project reviewed pre- and post-implementation data after implementing new evidence-based multimodal analgesia and VR protocols. The project captured a total of 64 patients in the pre-implementation group. A total of 22 patients received both multimodal analgesia and VR in the post-implementation group. There was no statistically significant difference in total opioid consumption converted as morphine milligram equivalents (MME) between the pre-implementation and post-implementation groups. However, there was a statistically significant difference in multimodal analgesia administered in Pre-op between the pre-implementation and post-implementation groups. In conclusion, the execution of the multimodal analgesic VR program allowed for nursing adoption of novel evidence-based practices (EBP) and promoted the use of non-opioid and non-pharmacological interventions. Although the combination of multimodal analgesia and VR did not reduce opioid consumption, the practice of incorporating multimodal analgesia as a standard workflow improved

Level Up: The Use of Video Games in Healthcare

Video games have been primarily used for recreational purposes, however over the last few years the healthcare field has taken an interest in them. Traditionally, video games were primarily used for recreational purposes but as technology has evolved, video games are now being used to improve patient health outcomes and improve the way physicians and medical professionals practice medicine. While there may be some adverse effects associated with gaming, the benefits outweigh them. This paper discusses the positive impact video games have had in healthcare including, medical training, anxiety management, and physical therapy

Design and Usability Testing of an Augmented Reality (AR) Environment in Pharmacy Education—Presenting a Pilot Study on Comparison between AR Smart Glasses and a Mobile Device in a Laboratory Course

An essential feature of pharmacy education is the teaching of theoretical knowledge with the support of practical work in the laboratory. When properly utilized, laboratory activities have the potential to enhance students’ achievement, conceptual understanding, and positive attitudes towards learning. In this pilot study, an augmented reality (AR) environment was designed and introduced for teaching laboratory skills in pharmacy education at the university level. The AR environment was used by pharmacy students (n = 36), featuring gate questions, information screens, Quick Response codes, think-aloud questions, and instant feedback. The environment was utilized with smart glasses and mobile devices with the aim of comparing the support to students’ performance. User experience was evaluated through self-efficacy beliefs and anxiety towards the technology. As a result, students found the environment a useful supplement to traditional laboratory teaching. Smart glasses and mobile devices were both accepted with great positivity but neither being clearly preferred over the other. Smart glasses were noted to provide sufficient feedback in the right stages of work. In contrast, mobile devices promoted the learning process more than the smart glasses. The self-efficacy results for mobile device use were higher, especially related to device handling and operating the AR environment. The pilot study gives educators valuable insights on the usability of AR technology in guiding laboratory tasks, although future work should involve larger and more diverse samples, as well as different learning tasks

Mobile applications aimed at preparation for surgical procedures: a technological prospecting / Aplicativos móveis voltados ao preparo para procedimentos cirúrgicos: uma prospecção tecnológica

Objective: to analyze the main characteristics of mobile applications, available in virtual stores, which deal with the topic of performing surgical procedures. Method: Technological Prospecting, with a qualitative exploratory approach, carried out by searching for applications in the Apple Store® and Google Play® virtual stores, using the keywords: Surgical Center, Surgery, Surgery Simulator and Surgery Games, in Portuguese, English and Spanish. Categorical thematic analysis of the findings was performed. Results: 67 occurrences were classified into four categories: 'Applications intended to guide the surgical procedure', 'Applications about working in the operating room', 'Applications aimed at the health team', and 'Applications related to entertainment games'. Conclusions: the applications are aimed both at individuals seeking guidance on procedures and at healthcare professionals. However, there is a gap regarding specific preoperative guidelines for pediatrics, where no occurrence was recorded. Objetivo: analizar las principales características de las aplicaciones móviles, disponibles en tiendas virtuales, que abordan la temática de la realización de procedimientos quirúrgicos. Método: Prospección tecnológica, con enfoque exploratorio cualitativo, realizada mediante la búsqueda de aplicaciones en las tiendas virtuales Apple Store® y Google Play®, utilizando las palabras clave: Surgical Center, Surgery, Surgery Simulator y Surgery Games, en portugués, inglés y español. Se realizó un análisis temático categórico de los hallazgos. Resultados: Se clasificaron 67 ocurrencias en cuatro categorías: 'Aplicaciones de orientación para procedimientos quirúrgicos', 'Aplicaciones de trabajo en quirófano', 'Aplicaciones dirigidas al equipo sanitario' y 'Aplicaciones relacionadas con juegos de entretenimiento'. Conclusiones: Las aplicaciones están dirigidas tanto a personas que buscan orientación sobre procedimientos como a profesionales sanitarios. Sin embargo, existe una brecha con respecto a las pautas preoperatorias específicas para pediatría, donde no se registró ninguna ocurrencia. Objetivo: analisar as principais características dos aplicativos móveis, disponíveis em lojas virtuais, que tratam sobre a temática da realização de procedimentos cirúrgicos. Método: Prospecção tecnológica, de abordagem qualitativa do tipo exploratória, realizada por busca de aplicativos nas lojas virtuais Apple Store® e Google Play®, utilizando as palavras-chave: Centro Cirúrgico, Cirurgia, Simulador de cirurgia e Jogos de cirurgia, em português, inglês e espanhol. Realizou-se análise temática categorial dos achados. Resultados: 67 ocorrências foram classificadas em quatro categorias: ‘Aplicativos destinados à orientação para procedimento cirúrgico’, ‘Aplicativos sobre o trabalho em centro cirúrgico’, ‘Aplicativos voltados à equipe de saúde’, e ‘Aplicativos relacionados a jogos de entretenimento’. Considerações finais: os aplicativos voltam-se tanto para indivíduos que buscam orientações sobre procedimentos, quanto a profissionais da área da saúde. No entanto, há uma lacuna referente à orientações pré-operatórias específicas para pediatria, onde nenhuma ocorrência foi registrada. 

Toward a Discourse Community for Telemedicine: A Domain Analytic View of Published Scholarship

In the past 20 years, the use of telemedicine has increased, with telemedicine programs increasingly being conducted through the Internet and ISDN technologies. The purpose of this dissertation is to examine the discourse community of telemedicine. This study examined the published literature on telemedicine as it pertains to quality of care, defined as correct diagnosis and treatment (Bynum and Irwin 2011). Content analysis and bibliometrics were conducted on the scholarly discourse, and the most prominent authors and journals were documented to paint and depict the epistemological map of the discourse community of telemedicine. A taxonomy based on grounded research of scholarly literature was developed and validated against other existing taxonomies. Telemedicine has been found to increase the quality and access of health care and decrease health care costs (Heinzelmann, Williams, Lugn and Kvedar 2005 and Wootton and Craig 1999). Patients in rural areas where there is no specialist or patients who find it difficult to get to a doctor’s office benefit from telemedicine. Little research thus far has examined scholarly journals in order to aggregate and analyze the prevalent issues in the discourse community of telemedicine. The purpose of this dissertation is to empiricallydocument the prominent topics and issues in telemedicine by examining the related published scholarly discourse of telemedicine during a snapshot in time. This study contributes to the field of telemedicine by offering a comprehensive taxonomy of the leading authors and journals in telemedicine, and informs clinicians, librarians and other stakeholders, including those who may want to implement telemedicine in their institution, about issues telemedicine

Interventions to Support Mental Health among Those with Health Conditions that Present Risk for Severe Infection from Coronavirus Disease 2019 (COVID-19): A Scoping Review of English and Chinese-Language Literature

This study aimed to address knowledge gaps related to the prevention and management of mental health responses among those with a condition that presents risk of severe COVID-19 infection. A scoping review that mapped English and Chinese-language studies (2019–2020) located in MEDLINE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Sociological Abstracts, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Airiti Library was undertaken. Search terms related to COVID-19, mental health, and physical health were used and articles that included all three of these factors were extracted (n = 77). With the exception of one hospital-based pilot study, there were no intervention studies targeting mental health in those at risk of severe COVID-19 infection. Promising practices such as integrated care models that appropriately screen for mental health issues, address health determinants, and include use of digital resources were highlighted. Patient navigator programs, group online medical visits, peer support, and social prescribing may also support those with complex needs. Future policies need to address digital health access inequities and the implementation of multi-integrated health and social care. Furthermore, research is needed to comprehensively assess multi-integrated interventions that are resilient to public health crises.This paper is an extended version of our conference paper published in Proceedings of the 3rd International Electronic Conference on Environmental Research and Public Health—Public Health Issues in the Context of the COVID-19 Pandemic: online, 11–25 January 2021

Evaluating the impact of Inpatient Pain Management Interactive Systems

University of Minnesota Ph.D. dissertation. August 2019. Major: Health Informatics. Advisors: Genevieve Melton-Meaux, Michael Pitt. 1 computer file (PDF); xii, 86 pages.The management of patients’ pain is essential for improving the overall quality of patient care. Equally important, is the patient’s role in managing their pain and the health system’s role in creating the ideal environment that supports high quality patient-centered care. Accordingly, many hospitals have and are investing in patient engagement technology systems aimed in supporting patients in their pain management care process. Despite the decade-plus existence of pain interactive entertainment systems, which are designed to distract patients from pain during treatment, their role in the management of pain remains understudied. Some of these interactive systems, in addition to their entertainment features, also include other functions to deliver standardized patient education and support the integration of patient-reported pain assessments into the electronic health record (EHR). However, despite technological advances that support this integration, this functionality is rarely implemented and researchers have rarely studied the effects of adopting interactive pain management systems (IPMS) in the inpatient setting. The objectives of this body of research are to address this gap in knowledge by evaluating various aspects of IPMS. The study was conducted in four phases: 1) examining the current evidence around and the state of IPMS, 2) evaluating the effect of a novel IPMS at the University of Minnesota Masonic Children’s Hospital (UMMCH), 3) characterizing user experience and satisfaction with use of IPMS and 4) understanding the population that utilizes the inpatient IPMS for the management of pain. We conducted a systematic literature review across seven databases to understand the current state of IPMS in an inpatient setting and examine their clinical outcomes. Out of the reviewed full-text articles, 17 were eligible and included in the final qualitative synthesis. Overall, there were two main types of IPMS within the inpatient setting; stand- alone systems and integrated platform systems. Reports examined a variety of outcome measures, including changes in patient-reported pain levels, patient engagement, user satisfaction, changes in clinical workflow, and changes in documentation. In our second study, we conducted a mixed methods case study approach to describe the development of a IPMS at the UMMCH and to evaluate the impact of implementation on clinical workflow, patient use, and compliance with nursing documentation of their pain reassessments. We employed a retrospective analysis of 56,931 patient records covering pre- and post- implementation. Despite nursing pain reassessment documentation being relatively low, implementation of the system led to a statistically significant increase in the overall nurse documentation and resulted in patient access to nonpharmacologic strategies to eliminate pain. In our third study, benefits and challenges on the use of an inpatient IPMS were identified by parents and nurses. Overall, there was a cohesive agreement among users regarding the impact of the IPMS in engaging and empowering patients/families, increasing patient satisfaction, and creating a communication platform, with the most usefulness feature being “Support of Timely Pain Reassessments”. Thematic content analysis was conducted to analyze nurse responses and identify high level themes. Six themes emerged related to “Benefits” from using the system: Phone Reminders, EHR Automatic Documentation, Decision Support, Patient Empowerment, Sense of Connection and Non-Medication Resources. There were also 12 “Challenges”: Uncertainty of Patient Rating Scores, Training Needs, Distraction, Discourage Best Practice, Low Utilization, Low Utilization Due to Environmental Factors, System Design Limitations, Pain Scale Discrepancy, Low Utilization Due to Patient Factors, Patient/Family Dissatisfaction, Workflow and Duplicate Charting Requirement. The ability to identify user experience associated with the use of these systems, potentially assists in designing IPMS to maximize positive impact on clinical outcomes and care quality. Finally, by conducting a retrospective analysis of inpatient records, our fourth study demonstrated differences in the patients’ IPMS usage among different hospital units based on the care and medical service these units provide and an increased usage was associated with the time of medication administration. Overall, this research collectively demonstrated the benefits of IPMSs and showed the potential of these systems in improving the patient and provider experience and the quality of care. Evaluating the effects of these systems on clinical outcomes, patient satisfaction, hospital workflow, and barriers and facilitators associated with the use of these systems is an important component in developing meaningful health information technology (HIT) systems to engage patients and address pain