Panel: Educating Future IS Researchers

As the information systems discipline grows, so do the number of programs offering graduate research degrees. These include honors (or fourth year) with research components, masters by research, and doctoral degree programs. Within these programs, we expect students to gain a deep understanding of developments and thinking about information systems and information management from both academia and practice. At the same time, we require them to obtain research skills and practice rigorous research. Thus students are faced with a quantum leap in expectations and required skills. In research, the onus on students is high: they need to find a referent discipline, select a research method and paradigm, defend the research relevance, and fulfil the requirements of adding to a body of knowledge. Frequently students are starting these programs with limited or no prior research training and with under-developed critical thinking skills. How do we maximize theses or dissertation completion rates? How can we structure programs to ensure that research is not forgotten on the library shelves, but rather forms the basis of a research career, that grows into a useful contribution to the body of knowledge? In posing these questions, we are suggesting that Ph.D. education is more than merely writing a thesis; it includes the initiation of scholars into the community of IS researchers

Interprofessional interactions influence nurses\u27 adoption of handover improvement

Aim: The purpose of this study was to explore clinician experiences of adopting quality improvement tools to standardise interprofessional (anaesthetist-to-nurse) handover communication when patients arrive in the post-anaesthetic care unit (PACU). Method: In this study, factors that impacted PACU nurses\u27 adoption of the quality improvement tools were explored using pre- and postimplementation, semi-structured focus group interviews. Interview data was analysed using the PARiHS1 (context, evidence and facilitation) framework as a deductive analysis tool. Results: PACU nurses recognised that PACU handover from anaesthetists to PACU nurses was suboptimal and described the tools as useful for their practice. However, PACU nurses frequently cited fear of anaesthetists\u27 reactions as reasons not to insist on the use of the handover improvement tools. PACU nurses at Hospital 2 identified lacking "authority" (Hospital 2 FG 2) in the OR as hindering their willingness to use the tools against these behaviours. In comparison, visible support from leadership at Hospital 1 was described as encouraging nurses to be "assertive" (Hospital 1 FG 2) and take charge of their patients\u27 care. Conclusion: PACU nurses perceived the handover tools were useful and helped them identify gaps in handover practice; however, PACU nurses described difficult relationships as hindering communication effectiveness and discouraging their adoption of the tools. However, strong leadership and organisational support of change emerged as essential to mitigate the effects of these difficult relationships

An exploration of patients’ experience of nurses’ use of point-of-care information technology in acute care

The rapid introduction of technology into acute healthcare settings, specifically the presence of point-of-care health information technology at patients’ bedsides, is expected to impact patients’ healthcare experience by altering nurse-patient interactions. This research was a multi-method naturalistic pilot study designed to explore patients’ perception of their interactions with nurses using bedside point-of-care health information technology in acute care. Data were collected using observation, interviews and surveys. Twenty-four participants were purposefully recruited from medical and surgical wards, to capture variability in their self-reported confidence with information technology; 29% were not confident, 38% were somewhat confident and 33% were completely confident with information technology. Participants’ mean age was 68.6 years (SD 11.1) and 63% were male. Qualitative observation, interview and survey data showed some nurses directly involved patients and explained or demonstrated how the point-of-care health information technology was being used to complement and enhance their care; while others used the point-of-care health information technology as an electronic documentation tool without engaging their patients. Patients’ experiences of point-of-care health information technology differed with their self-reported confidence with information technology; those with complete information technology confidence were better at recognising the potential and opportunities for point-of-care health information technology to support self-directed care than those with less confidence using information technology. Some participants reported that the use of point-of-care health information technology impeded interpersonal communication with nurses. Participants recognised the benefits of point-of-care health information technology to support clinical practice but generally desired greater engagement with the nurses when they used the system

Online Interest Groups: Virtual Gathering Spaces to Promote Graduate Student Interaction

This article discusses a 15 month educational innovation project, the objective of which was to investigate the perceptions of health profession students about their participation in a program-wide virtual community gathering space (Clinical Interest Groups) during their online graduate studies. Participants were students in two graduate programs who joined online forum discussions of the Clinical Interest Groups. The project was developed as action research and employed an exploratory, descriptive methodology to generate data from three sources: participant responses to a 15-item Likert type questionnaire, five open-ended questions included on the questionnaire, and online postings contributed by participants to the forum discussions. Findings of use to online educators are that the Clinical Interest Groups provided a gathering place in which graduate students could discuss common interests and support one another, and that participation in the groups was limited due to competing demands on students’ time from other commitments

Patients’ experiences with home parental nutrition: A grounded theory study

YesBackground & aims Parenteral nutrition (PN) provides nourishment and hydration as an intravenous infusion to patients with intestinal failure (IF). The aim of the study is to generate theory that explains the experiences of adult patients living with home parenteral nutrition (HPN) and complex medication regimens. Methods A grounded theory methodology was used to explore the experiences of twelve patients receiving HPN. A semi-structured interview was conducted and recorded in each participant's home setting. Each interview was transcribed verbatim. The simultaneous process of data collection and analysis was followed reflecting the principles of the constant comparative approach. Results A total of 15 patients gave written consent, with 12 of them agreeing to be interviewed. All the participants had previously undergone surgery as a result of chronic ill health or sudden illness. Analysis revealed two core categories: stoma and HPN, and these were supported by the subcategories: maintaining stoma output, access to toilets, managing dietary changes, maintaining the HPN infusion routine, access to technical help to set up an HPN infusion, mobility with HPN equipment and general health changes. The strategy of living with loss was demonstrated by all the participants, and this was supported by the action strategies of maintaining daily activities and social interactions. Conclusions This study generates new understanding and insight into the views and experiences of patients receiving HPN in the UK. The findings from these participants have been shown to resonate with the Kubler-Ross Model [1] of the five stages of grief. The theory of living with loss was generated by the use of a grounded theory methodology. This small scale exploratory study reveals opportunities for improvements in practice to be considered by the nutrition support team (NST) and other healthcare professionals involved in the patient's hospital stay prior to discharge on HPN

In the Living Room: Second Screens and TV Audiences

© The Author(s) 2015. This article is based on a small pilot project exploring the role, function, and meanings of second screens and companion apps for TV audiences that is contextualized by existing academic audience research. This is mapped alongside industry research and academic debate about second screens. The results illustrate some disjunction between industry expectations of usage and viewers' everyday experiences. I argue that industries' tendency to conflate "viewer" with "fan" indicates a less than nuanced understanding of the television/companion app audience. Further, the lean forward/lean back binary applied to digital media users and television audiences respectively points to a problematic not addressed in much industry literature, while the respondents for this research indicate a complex interplay between the pleasures of viewing that incorporates the social and the personal with the second screen and the TV text

Fundamentals of neurogastroenterology: Basic science

This review examines the fundamentals of neurogastroenterology that may underlie the pathophysiology of functional GI disorders (FGIDs). It was prepared by an invited committee of international experts and represents an abbreviated version of their consensus document that will be published in its entirety in the forthcoming book and online version entitled Rome IV. It emphasizes recent advances in our understanding of the enteric nervous system, sensory physiology underlying pain, and stress signaling pathways. There is also a focus on neuroimmmune signaling and intestinal barrier function, given the recent evidence implicating the microbiome, diet, and mucosal immune activation in FGIDs. Together, these advances provide a host of exciting new targets to identify and treat FGIDs, and new areas for future research into their pathophysiology

Evaluating the Implementation and Feasibility of a WebBased Tool to Support Timely Identification and Care for the Frail Population in Primary Healthcare Settings

Background: Understanding and addressing the needs of frail persons is an emerging health priority for Nova Scotia and internationally. Primary healthcare (PHC) providers regularly encounter frail persons in their daily clinical work. However, routine identification and measurement of frailty is not standard practice and, in general, there is a lack of awareness about how to identify and respond to frailty. A web-based tool called the Frailty Portal was developed to aid in identifying, screening, and providing care for frail patients in PHC settings. In this study, we will assess the implementation feasibility and impact of the Frailty Portal to: (1) support increased awareness of frailty among providers and patients, (2) identify the degree of frailty within individual patients, and (3) develop and deliver actions to respond to frailtyl in community PHC practice. Methods: This study will be approached using a convergent mixed method design where quantitative and qualitative data are collected concurrently, in this case, over a 9-month period, analyzed separately, and then merged to summarize, interpret and produce a more comprehensive understanding of the initiative’s feasibility and scalability. Methods will be informed by the ‘Implementing the Frailty Portal in Community Primary Care Practice’ logic model and questions will be guided by domains and constructs from an implementation science framework, the Consolidated Framework for Implementation Research (CFIR). Discussion: The ‘Frailty Portal’ aims to improve access to, and coordination of, primary care services for persons experiencing frailty. It also aims to increase primary care providers’ ability to care for patients in the context of their frailty. Our goal is to help optimize care in the community by helping community providers gain the knowledge they may lack about frailty both in general and in their practice, support improved identification of frailty with the use of screening tools, offer evidence based severity-specific care goals and connect providers with local available community supports

Improving Care for the Frail in Nova Scotia: An Implementation Evaluation of a Frailty Portal in Primary Care Practice

Abstract Background: Understanding and addressing the needs of frail patients has been identified as an important strategy by the Nova Scotia Health Authority (NSHA). Primary care (PC) providers are in a key position to aid in the identification of, and response to frailty as part of routine care. Unlike singular chronic conditions such as diabetes and hypertension which garner a disease-based approach and identification as part of standard practice, frailty is only just emerging as a concept for PC. The web-based Frailty Portal was developed to aid in the identification of, assessment and care planning for frail patients in PC practice. In this study we assess the implementation feasibility and impact of the Frailty Portal by: (1) identifying factors influencing the Frailty Portal’s use in community PC practice, and (2) examination of the immediate impact of the ‘Frailty Portal’ on frail patients, their caregivers and PC providers. Methods: A convergent mixed method approach was implemented among PC providers in community-based practice in the NSHA, Central Zone. Quantitative and qualitative data were collected concurrently over a 9-month period. A sample of patients who underwent assessment and/or their caregiver were approached for survey participation. Results: Fourteen community PC providers (10 family physicians, 4 nurse practitioners) completed 48 patient assessments and completed or begun 41 care plans; semi-structured interviews were conducted among 9 providers. Nine patients and 5 caregivers participated in the survey. PC providers viewed frailty as an important concept but implementation challenges were met, primarily with respect to the time required for use and lack of fit with traditional practice routines. Additional barriers included tool usability and accessibility, training and care planning steps, and privacy. Impacts of the tools use with respect to confidence and knowledge showed early promise. Conclusion: This feasibility study highlights the need for added health system supports, resources and financial incentives for successful implementation of the Frailty Portal in community PC practice. We suggest future implementation integrate the Frailty Portal to practice electronic medical records (EMRs) and target providers with largely geriatric practice populations and those practicing within interdisciplinary, collaborative primary healthcare (PHC) teams