STANDARDIZATION IN NURSING PRACTICE: CROSSCONTEXTUAL INFORMATION SHARING

Cooperation and collaboration are an inherent part of the daily work performed at a hospital in general, and among nurses in particular. However, the technologies that support these work practises are still inadequate. In this case study, we explore the standardization process in nursing practice, and how standards are used across departments in a hospital environment in order to share information and knowledge. We explore what issues are at stake when standard care plans are used across organizational boundaries. Moreover, we examine the following: a) the adjustment of nursing classification in local practice; b) the tension between different standards; and c) the use of standard plans as a bridge to share information across various context

Nursing Terminologies as Evolving Large-Scale Information Infrastructures

This paper describes the slowly evolving nature of large-scale terminology-based information infrastructures. The strategic aim of implementing standardized terminologies is to share and compare information within and across domain-specific and organizational boundaries. We are particularly interested in working classification systems focused on specific domains’ and classes, and even more specifically in reference terminologies with the capability to interconnect different existing classification systems. We examine this empirically through a threefold case based on data from three Norwegian university hospitals, where we also track a national recommendation of a reference terminology. The reference terminology, which was initially promoted as a means to achieve integration and harmonization, is increasingly perceived as competing with other terminologies. This “gateway” has been presented as a purely technical and politically neutral system, but may be more complex in reality: such integration processes require considerable adaptations, negotiations, and manual maintenance

How Does Nursing Staff Perceive the Use of Electronic Handover Reports? A Questionnaire-Based Study

Following the implementation of electronic nursing records in a psychogeriatric ward, we examined nursing staff's attitudes and perceptions to the implementation of an electronic handover routine. A web-based anonymous and secure questionnaire was distributed by e-mail to all nursing staff at a psychogeriatric ward at a university hospital. Most respondents were satisfied with the electronic handover, and they believed they managed to keep informed by the new routine. The simultaneous introduction of a morning meeting, to ensure a forum for oral professional discussion, was a success. A minority of staff did not fully trust the information conveyed in the electronic handover, and a significant proportion expressed a need for guidance in using the system. Staff that had a high level of trust in written reports believed these saved time, had little trouble finding time and a place to read the reports, and were more positive to the new handover routine

The interplay between global standards and local practice in nursing

Submitted manuscript version. Published version available at https://doi.org/10.1016/j.ijmedinf.2013.02.005.Purpose: The paper assesses the extent, form, and transformation of global nursing classifications (NANDA) in a nursing practice during a period of 5 years. Method: A longitudinal case study was used to trace implementation, adoption and use of nursing classifications as an integral part of an electronic nursing module. A mixed method of data collection was used, including semi-structured interviews, observation and document analysis. Results: A surprisingly high proportion of nursing diagnoses was consistent with the global standard, in spite of a gradual increase of user-generated concepts. This is elaborated more thoroughly through a co-constructing perspective, emphasizing how the global standard and the practice mutually shaped each other over several years. Conclusion: Standardization is an iterative process that is performed in close relationship with practice. The mutual interrelation between formal classifications (NANDA) and local practices are co-constructed in a dynamic interplay that evolves over time. In such a process, the use of local classifications and local strategies can be a means to bridge the gap between these two extreme points. Highlights: ► Extensive use of standardized classification after implementation of electronic care plan. ► Local classifications evolved during long-term use. ► Co-construction of classifications was used to bridge the gap between global classifications and local needs

Co-constructing standards in nursing

Avhandlingen presenterer en kvalitativ studie av innføring og bruk av standarder i sykepleie og bygger på empiriske studier fra ulike sykehusmiljø. Standardisering er ofte ansett som en viktig forutsetning for å oppnå sømløs integrasjon ved bruk av informasjons – og kommunikasjonsteknologi (IKT) i helsesektoren. Terminologier og retningslinjer blir ofte utviklet av internasjonale organisasjoner som involverer omfattende prosesser for å ivareta faglige og helsepolitiske krav. Når standarder blir tatt i bruk blir de en del av en lokal arbeidspraksis som er preget av et dynamiske miljø som transformeres i takt med utvikling av ny kunnskap, teknologi og samarbeidsstrukturer. Fokuset for avhandlingen er i dette spenningsfeltet og gir først og fremst økt teoretisk og empirisk innsikt i de gjensidige tilpasningene mellom universelle standarder og lokal praksis (ko-konstruksjon). Videre gir studien innsikt i de koordinerende egenskaper ved bruk av standarder som en integrert del av arbeidspraksis og kan også ha betydning for design og utvikling av prosesstøttende EPR systemer

Exploration of ethical issues in the implementation of digital monitoring technologies in health care services

The study is based on a research and innovation project on adoption and use of digital monitoring in municipal care services. The evolving use of technology is considered to meet future challenges in health and care services. However, the use of technological solutions in this context has also led to several challenges, and in this study, we focus on the ethical consequences of using welfare technology. Implementation projects are particularly relevant in this context because different stakeholders with different interest, values, assumptions need to collaborate closely and build integrated solutions to make such projects successful. Furthermore, it is a challenge to predict future consequences of using emerging technologies and we argue that ethical assessments must be part of the implementation process

Exploration of ethical issues in the implementation of digital monitoring technologies in municipal health care services

The study is based on a research and innovation project on adoption and use of digital monitoring in municipal care services. The evolving use of technology is considered to meet future challenges in health and care services. However, the use of technological solutions in this context has also led to several challenges, and in this study, we focus on the ethical consequences of using welfare technology. Implementation projects are particularly relevant in this context because different stakeholders with different interest, values, assumptions need to collaborate closely and build integrated solutions to make such projects successful. Furthermore, it is a challenge to predict future consequences of using emerging technologies and we argue that ethical assessments must be part of the implementation process

Improving the Use of Simulation in Nursing Education: Protocol for a Realist Review

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