Using Narrative Fictions to Describe Nurses’ Experiences of Computing

Nurses, it is claimed, do not engage with articles about Information Technology, although the evidence is that they have poor knowledge of many of the issues involved in the use of information and technology in practice, and poor computer skills. Three pieces of research into nurses and computers have been used to create fictional narratives of nurses’ engagement with computers. They are presented in this way to encourage nurses to read the accounts, to reflect on their own attitudes and practice, and to aid the exploration of alternative possibilities. The basis of this approach is explored, along with the process of producing the narrative fictions

Stop the World Wide Web, I want to get off

Background Increasing number of patients are using the Internet for health information (National Statistics 2007). Traditionally professionals have been the information gatekeepers; key questions were around what information patients should be given. Reviews of information on the Internet have been focused towards analysing the quality of information e.g. Eysenbach et al [1] and Breckons et a 2008[2] Whilst this debate is important patients do not always want this professional centric world and are quietly seizing the agenda. If the professionals are not giving them the information they want, they are going and finding it for themselves. Neither patients nor professionals however yet understand enough about the new options that the Internet affords to be able to develop a shared understanding of how to make best use of it. Web 1.0 brought debate around the quality of the information made available. Web 2.0 however brings the additional complexity of knowing where the information is before it can be questioned. One weakness of some research into health information on the Internet is that a quite common research method is to carry out searches and then analyse the top results (e.g. Biddle et al[3]), which tends to exclude information from Web 2.0 sites. Objective Healthcare professionals are one of the main sources of information for patients; their knowledge of information sources will affect their ability to support their patients. The objective of this research was to explore professionals’ use of the Internet for patient information. Methods A questionnaire was distributed to healthcare professionals attending CPD sessions at an English university. Participation was voluntary, and students assured that this did not affect the session they were attending. The researcher was not involved with the session. Results. In total there were 51 completed the questionnaires. 71% of respondents were nurses. The majority (94%) thought the Internet was a good source of health information. Their use of the Internet was however limited. Most (85%) often used email, far fewer often used instant messaging (29%) or discussion boards (20%). Only 23% reported having an Athens account, the Health Service system for accessing online journals. Few (18%) would usually recommend a website to patients, 33% would never do so. Even less, 8% would usually recommend an online support group, over half (57%) would never do so. Not only were these professionals not recommending the Internet to their patients, they were not using it to locate patient information themselves. Only 16% said they usually used websites that allowed them to create tailored information leaflets for their patients, 32% never using these sites. Conclusion Although these healthcare professionals thought the Internet was a good source of health information this belief was not matched by their actions. Less than one third usually recommended the Internet to their patients, more never did so. Nor were they using the Internet to meet their own information needs. Healthcare professionals education needs to include the Internet as a patient information source so that they are able to advise and support their patients

Web users' information retrieval methods and skills

When trying to locate information on the Web people are faced with a variety of options. This research reviewed how a group of health related professionals approached the task of finding a named document. Most were eventually successful, but the majority encountered problems in their search techniques. Even experienced Web users had problems when working with a different interface to normal, and without access to their favourites. No relationship was found between the number of years' experience Web users had and the efficiency of their searching strategy. The research concludes that if people are to be able to use the Web quickly and efficiently as an effective information retrieval tool, as opposed to a recreational tool to surf the Internet, they need to have both an understanding of the medium and the tools, and the skills to use them effectively, both of which were lacking in the majority of participants in this study

Nurses, computers and pre-registration education

Nursing informatics, the use of information and technology, to support the work of the nurse, is an essential part of the modern nurses’ job. In the UK this is supported by a range of National Health Service policy documents over the past decade, starting with Information for Health in 1998. Research carried out over this period has however found that nurses lack the necessary skills and knowledge to use computers effectively, and that pre-registration education does not fully prepare student nurses for this aspect of the role of the nurse. This paper presents the results of a longitudinal study carried out with a cohort of nursing students, which found that although the students lacked computer skills and knowledge at the start of their programme they were willing to engage with this agenda. Two factors were found to be necessary for students to use the available IT on placement. One was a belief that they had the skills to use the computers; the other was a supportive environment that encouraged their use. Unfortunately only a minority of students reported that they had experienced a supportive environment

The Internet and Patient Information

Although the internet has only been around for a relatively short period of time, its influence on both clinicians and patients alike is growing rapidly. Carol Bond, Senior Lecturer in Health Informatics at Bournemouth University, examines the internet and its relationship with patient information

Telehealth as a tool for independent self-management by people living with long term conditions

Telehealth is seen as a key component of 21st century healthcare, and studies have explored its cost effectiveness and impact on hospital admissions. Research has been carried out into how to best implement it, and the barriers to its adoption. The impact of telehealth on self-management however has been a neglected area. An evaluation of the implementation of a telehealth programme in one area in the South of England found that some patients were using the telehealth equipment provided to enhance their own self management abilities. Whilst the nurses managing the scheme felt that they had an education role they did not involve their patients in setting goals. The patients equally did not feel that were being educated by their nurses. Patients were using the monitoring equipment independently of the nurses and the scheme to support their self-management strategies. Therefore the concept of graduating from telehealth once good self-management is established needs to be rethought. Patients in this study experienced less face to face contact with their nurse, but also reported that they were happy with the changes. This suggests that for some patients the contact with the nurse may well be able to be reduced or withdrawn however removing the monitoring equipment will remove the very tools essential to continued self-management

Nurses and Computers: An international perspective on how nurses are, and how they would like to be, using ICT in the workplace, and the support they consider that they need.

The use of IT in nursing (nursing informatics) is increasing, and has the potential to improve patient care. Research, and the experience of the author, have shown however that nurses lack basic IT skills and informatics knowledge. This study sought to explore what nurses’ want from IT in the workplace, and how pre-registration education can help to prepare nurses for working in this changing environment. The study, undertaken in New Zealand, a country also seeking to drive forwards its use of IT in healthcare, found that nurses want systems that save them time, and equipment readily available at the patients’ bedside. Nurses who had recently completed their pre-registration programmes tended to have better skills than nurses who had trained some time ago. Nurses who lacked skills, or confidence, wanted support available that understood the role of nurse, and could provide help when it was needed. Nursing schools in New Zealand tend to have a lecturer leading nursing informatics. Nursing informatics is included in pre-registration education programmes, and I was able to see several innovative developments supporting this. Qualified nurses and students generally considered that pre-registration programmes should include information security, legal and ethical issues and supporting patients in meeting their information needs as well as basic IT skills