Acceptance and Use of Information Technology among Nurses in Psychiatric Hospitals

Hoitajien informaatioteknologian hyväksyntä ja käyttö psykiatrisissa sairaaloissa Informaatioteknologian (IT) käyttö ei ole ollut kovin merkittävässä roolissa psykiatrisessa hoitotyössä, vaikka IT sovellusten on todettu vaikuttaneen radikaalisti terveydenhuollon palveluihin ja hoitohenkilökunnan työprosesseihin viime vuosina. Tämän tutkimuksen tavoitteena on kuvata psykiatrisessa hoitotyössä toimivan hoitohenkilökunnan informaatioteknologian hyväksyntää ja käyttöä ja luoda suositus, jonka avulla on mahdollista tukea näitä asioita psykiatrisissa sairaaloissa. Tutkimus koostuu viidestä osatutkimuksesta, joissa on hyödynnetty sekä tilastollisia että laadullisia tutkimusmetodeja. Tutkimusaineistot on kerätty yhdeksän akuuttipsykiatrian osaston hoitohenkilökunnan keskuudessa vuosien 2003-2006 aikana. Technology Acceptance Model (TAM) –teoriaa on hyödynnetty jäsentämään tutkimusprosessia sekä syventämään ymmärrystä saaduista tutkimustuloksista. Tutkimus osoitti kahdeksan keskeistä tekijää, jotka saattavat tukea psykiatrisessa sairaalassa toimivien hoitajien tietoteknologiasovellusten hyväksyntää ja hyödyntämistä, kun nämä tekijät otetaan huomioon uusia sovelluksia käyttöönotettaessa. Tekijät jakautuivat kahteen ryhmään; ulkoiset tekijät (resurssien suuntaaminen, yhteistyö, tietokonetaidot, IT koulutus, sovelluksen käyttöön liittyvä harjoittelu, potilas-hoitaja suhde), sekä käytön helppous ja sovelluksen käytettävyys (käytön ohjeistus, käytettävyyden varmistaminen). TAM teoria todettiin käyttökelpoiseksi tulosten tulkinnassa. Kehitetty suositus sisältää ne toimenpiteet, joiden avulla on mahdollista tukea sekä organisaation johdon että hoitohenkilökunnan sitoutumista ja tätä kautta varmistaa uuden sovelluksen hyväksyntä ja käyttö hoitotyössä. Suositusta on mahdollista hyödyntää käytännössä kun uusia tietojärjestelmiä implementoidaan käyttöön psykiatrisissa sairaaloissa.The use of information technology (IT) has not played a very significant role in psychiatric nursing although on recent years the development of IT applications has radically affected health care delivery and the work processes of nurses. The objective of this study project is to create recommendations on the best practices for improving the acceptance and use of IT among nurses working in psychiatric hospitals. The study consisted of five phases using a combination of descriptive statistical and qualitative methods. The data were collected during the period 2003-2006 among health care staff working on nine acute psychiatric wards. The Technology Acceptance Model (TAM) was used to structure the research process and to enhance the understanding of the acceptance and use of IT among nurses. The study showed that there are eight main factors which could improve the acceptance and use of IT among nurses working in psychiatric hospitals if these factors are taken account when new IT applications are implemented in daily practice. The factors were divided into two groups; external variables (resource allocation, collaboration, computer skills, IT education, training, patient-nurse relationship) and ease of use and usefulness of the application (instructions for using the application, usability of the application). The TAM theory was useful in interpreting the findings. The recommendations developed contain measures by which is possible to improve the commitment of management and nurses, thereby ensuring the acceptance and use of new IT application in nursing practice. The recommendations can be implemented in practice when new IT applications are introduced in psychiatric hospitals.Siirretty Doriast

The use of electronic communication for patient-professional interaction – nursing staff’s point of view

Patient care in hospital wards is decreasing dramatically; more and more often, it takes place at home and in outpatient clinics. New ways to communicate are thus needed between patients and professionals. The use of electronic devices is one possible solution to facilitate the communication and support modern care.The purpose of the study was to describe nursing staff’s skills and experiences on the use of electronic communication for interaction with patients. The study also looks at factors promoting and hindering the use of electronic communication. The study used a descriptive design including both qualitative and quantitative components. The data were collected among nursing staff (N=567, n=123) working in outpatient clinics in spring 2012 with an electronic questionnaire.Computer and electronic communication skills among nursing staff were at a moderately good level. They had most experience in the use of email and text messages. Electronic devices were used at all stages of the nursing process. Three main categories were formed to describe promoting and hindering factors for the use of electronic communication: user-related factors; technology- and organization-related factors; and nursing- and communication-related factors. According to the participants, electronic devices are necessary and useful tools in interacting with patients. Patients’ personal characteristics and information security problems were perceived as the most significant hindering factors.The use of technology benefited both the nursing staff and patients in communication. The nurses’ experiences on the use of electronic communication were not very extensive as emails and text messages were the most commonly used methods

Tietoturvallinen sähköposti tyypin 1 diabeetikon omahoidon ja diabeteshoitajan työn tukena – käyttökokeilun tuloksia

TiivistelmäDiabeteksen hoidon onnistumisessa keskeisessä roolissa on hoidonohjaus ja potilaan itsehoito. Jotta kasvavalle diabetesta sairastavien ryhmälle voidaan taata tehokas ja potilasta yksilöllisesti tukeva hoidonohjaus, on kehitettävä uusia menetelmiä ohjauksen toteuttamiselle.Tämän selvityksen tavoitteena oli arvioida tietoturvallisen sähköpostin soveltuvuutta diabeteshoitajan ja tyypin 1 dia-beetikon väliseen yhteydenpitoon sekä potilaan omahoidon tuen että hoitajan vastaanottotoiminnan näkökulmasta.Tietoturvallisen sähköpostin käytön arviointi toteutettiin marraskuussa 2015 runsaan puolen vuoden käyttökokemuksen jälkeen sekä diabeetikkojen että diabeteshoitajan näkökulmasta. Aineistoksi kerättiin sähköpostiviestit, joista tarkasteltiin lähetysaikoja, viestien määriä ja sisältöjä. Kokeiluun osallistuneille diabeetikoille (N=15, n=9) lähetettiin sähköinen kysely Webropol -linkkinä. Kysely toteutettiin avoimin kysymyksin, joita täydensi muutama strukturoitu kysymys. Lisäksi diabeteshoitaja seurasi palvelun käytön merkitystä hoitajavastaanoton toimintaan. Potilaat olivat käyttäneet tietoturvallista sähköpostia diabeteksen hoitoon liittyvien ongelmien selvittämiseen, omasta terveydentilastaan kertomiseen, tiedon tarpeeseen omahoidon toteuttamisesta, insuliinipumpun käyttöön liittyviin asioihin, tarvikkeiden tilauksiin ja vastaanottoaikojen tilaamiseen ja muuttamiseen. Diabeteshoitaja kuvasi käyttäneensä tietoturvallista sähköpostia potilaan omahoidon ohjaukseen, verensokeriseurantojen arviointiin, kannustamiseen ja tukemiseen. Lisäksi hän oli välittänyt potilaille tarvikkeita ja vastaanottoaikoja. Sovellusta pidettiin sekä potilaiden että diabeteshoitajan näkökulmasta pääasiassa helppokäyttöisenä sekä hyvin soveltuvana diabeteshoidossa ei-akuuttien asioiden hoitamiseen. Joitakin teknisiä ongelmia koettiin esimerkiksi käyttöön liittyvän koodin välittämisessä.Tietoturvallinen sähköposti toi diabetesta sairastavalle uuden potilaslähtöisemmän ja ajasta riippumattoman tavan olla yhteydessä ammattilaiseen. Diabeteshoitajan työhön sähköposti toi uuden tavan toimia. Sekä diabeetikoiden että diabeteshoitajan näkökulmasta tietoturvallinen sähköposti hoidon tukena koettiin onnistuneena palvelumuotona. Palvelun avulla oli mahdollista vastata potilaiden kokemiin pitkäaikaissairauden seurantaan ja omahoitoon liittyviin haasteisiin ja ongelmakohtiin.Guidance of care and patients’ self-care have a central role in the success of diabetes care. New methods must be developed for patient education in order to ensure effective, supportive and individual care for the growing population of diabetics.The aim of this study was to evaluate the suitability of secure e-mail communication between the diabetes nurse and type 1 diabetics from the perspective of patients’ self-care support and nurse’s practice.The evaluation of the use of secure e-mail communication was carried out in November 2015 after more than six months’ experience from the perspective of people with diabetes and the diabetes nurse. The e-mail messages were collected and their arrival times, counts and contents were reviewed. An electronic survey using a Webropol link was sent to the patients (N=15, n=9) participating in the project. The survey was conducted using open-ended questions supplemented by a few structured items. In addition, the diabetes nurse followed the relevance of the use of the service on her practice.The patients had used the secure e-mail for management of problems related to treatment of diabetes, to tell about their own health, for self-care knowledge needs, issues related to insulin pump use, ordering supplies, and for making and changing appointments. The diabetes nurse used secure e-mail for controlling patient self-care, for evaluation of blood glucose controls, and for encouragement and support. In addition, she relayed supplies to patients and changing appointments. The application was mainly considered easy to use by both patients and the diabetes nurse, as well as being well suited for dealing with non-acute matters in diabetes care. There were some technical problems; for example, in transmitting the password which the patients needed to use the system.The secure e-mail system gave patients with diabetes a new patient-centred and time-independent way to be connected with a health care professional. The use of e-mail also provided the diabetes nurse with a new way to work. The secure e-mail system was seen as a successful service from the perspective of both people with diabetes and diabetes nurse. The service made it possible to meet the challenges and problems related to monitoring and self-care experienced by patients.

Connectivity to computers and the Internet among patients with schizophrenia spectrum disorders : a cross-sectional study

Purpose: Information and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs). Patients and methods: A cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients' medical records and a self-reported, structured questionnaire. Data analysis included descriptive statistics. Results: In total, 297 patients were included in this study (response rate =96%). More than half of them (n=156; 55%) had a computer and less than half of them (n=127; 44%) had the Internet at home. Of those who generally had access to computers and the Internet, more than one-fourth (n=85; 29%) used computers daily, and > 30% (n=96; 33%) never accessed the Internet. In total, approximately one-fourth of them (n=134; 25%) learned to use computers, and less than one-third of them (n=143; 31%) were known to use the Internet by themselves. Older people (aged 45-65 years) and those with less years of education (primary school) tended not to use the computers and the Internet at all (P <0.001), and younger people and those with higher education were associated with more active use. Conclusion: Patients had quite good access to use computers and the Internet, and they mainly used the Internet to seek information. Social, occupational, and psychological functioning (which were evaluated with Global Assessment of Functioning) were not associated with access to and frequency of computer and the Internet use. The results support the use of computers and the Internet as part of clinical work in mental health care.Peer reviewe

Sleep improvement intervention and its effect on patients' sleep on the ward

Aim and objectiveThe aim of the study was to investigate how the sleep improvement interventions developed for the wards were associated with patients’ sleep. The objective was to promote patients’ sleep.BackgroundThe quality of sleep is vital for patients’ health and recovery from illness. However, patients generally sleep poorly during hospitalisation. Sleep-disturbing factors are connected to the hospital environment, patients’ physical illness, emotional state and the activities of the staff. Many sleep-disturbing factors can be influenced by appropriate nursing interventions.DesignA two-group intervention study including the development of nursing interventions aimed at supporting patients’ sleep. One group received a sleep promotion intervention and the other received standard care. Both groups evaluated their sleep in the morning.MethodsA survey of participants’ sleep evaluations was collected with the five-item Richards-Campbell Sleep Questionnaire. The data were analysed statistically. The STROBE checklist was used to report the study.ResultsFrom the participants’ perspective, sleep was better in the intervention group, even though statistically significantly only among men. The pain intensity correlated with sleep quality. The number of patients in the room or whether participants had had an operation had no effect on their sleep evaluations.ConclusionsInterventions targeted at supporting and promoting the sleep quality of hospital inpatients may be effective. They should be developed in collaboration with patients and nurses. Several nursing interventions can be proposed to promote better sleep among patients; however, more research is needed to confirm the results. Sleep promotion should include both standardised protocols and individualised sleep support.Relevance to clinical practiceInvesting in nursing interventions to promote patients’ sleep is important. Patients’ individual sleep-related needs should be part of their care plan. Training programmes that support nurses’ knowledge and skills of patients’ sleep promotion should be part of nursing education in healthcare organisations.</p

Factors determining nurses' knowledge of evidence-based pressure ulcer prevention practices in Finland: a correlational cross-sectional study

Background Pressure ulcers cause economic burden, human suffering, pain and decreased health-related quality of life in patients. Pressure ulcers are preventable in most cases, and nursing staff knowledge is a key factor in successful pressure ulcer prevention. Further evidence is needed to better tailor pressure ulcer prevention training programmes to the nursing staff.Aim To evaluate the level of nursing staff knowledge about evidence-based pressure ulcer prevention practices in both primary and specialised care, and to identify what factors determine nurses' knowledge levels.Methods A correlational, cross-sectional study was conducted from 2018 to 2019 in two hospital districts in Finland. The Pressure Ulcer Prevention Knowledge test was used to collect data, and the Attitude towards Pressure ulcer Prevention (APuP) instrument was used as a background variable. The data were statistically analysed with Wilcoxon and Kruskal-Wallis tests, Spearman correlations and multiple linear regression.Results The pressure ulcer prevention knowledge of the participating registered nurses, practical nurses and ward managers (N = 554) was on average 24.40 (max. 35.00). There was no difference in the participants' knowledge based on the type of unit in which they were working (primary or specialised care). The participants' attitudes (p Conclusions Special attention needs to be paid to the knowledge of those nurses working in positions that require lower levels of education and those who rarely take care of patients with pressure ulcers. Supporting nurses' positive attitudes towards pressure ulcer prevention should be an essential part of pressure ulcer prevention training. Nurses' self-evaluations of their training needs can be used to target training. The limitations of the study should be considered when generalising the results.</div