Dispatches from the hi-blogs.info krew

Session OP124 – Patient Preferences (0945 – 1145) Monday 06.29.09 June 29, 2009

I’m blogging this session because Margaret Hansen, good friend and colleague, is the last presenter in this session. Also I am interested in this topic to a degree. I hope to attend other sessions later in the day and blog these as the opportunity presents.

The opening presenter (R. Helleso) discusses the work of her and her colleagues in Norway, titled “Severity of illness – implication for information management by patients”. Patients in this study are chronic heart insufficiency NYHA 3 or 4 classification requiring post-hospital care after d/c home. A qualitative approach was used in this study. Sub-themes of system of information were how information given, when and what information the patient received. Process of information had two categories are as follows: what patient did with information (who got/received ‘it’) and patient comprehension of information (dependent on personal attributes such as recall, memory function, and so forth). Patient information management process had sub-themes of different strategies (why wanted information) and role of the next of kin (helped patient manage information such as script filling, as well as how much the kin would do with information). Summation thoughts included information not sufficient, timely or appropriate for patients; ‘fuzzy’ role of nurses in the information process role; patient compensates for lack of information exchange between providers (interesting conclusion). There is a need for customizing information, involving next of kin in a systematic fashion, balance information strategy & need for autonomy and bridge info gap in health care.

Second speaker is J. Bichel-Findlay and colleagues from Australia presenting “Health information systems and imrpoved patient outcomes: Do nurses see the connection?” Another research study presented to the audience. Focused on emergency department (ED, ER, etc.) environment. Nurses needs in this environment include lack of agreement and std’d language and diverse needs of information management. Describes environment in NWS health (location in Australia where study took place) – many many patients, large number of EDs, and so forth. No metrics regarding documentation and so forth. Used tool to measure how EDIS as tool is better or worse (pro’s and con’s) via opposite phrased statements in survey. Significant results highest level of education, most positive, were postgraduates in several areas as experience (middle range of 5-8 years). Appears to be a shift in nurses views of technology from negative to tolerance (from literature review). Conclusions include perception of EDIS and organizational performance of staffing rtion increasing and work resturing, but no perception of data ownership, data value impact on patient outcomes nor the bigger picture of EDIS in technology and health. Most postive respondents were 20-34 with 5-8 yrs and post-graduate and 35 order and such were not. Author’s contact email is jenbic@tpg.com.au.

Third presenter is S. Tsuru and colleagues from Japan, titled “Structuring clinical nursing knowledge using PCAPS: patient condition adaptive path system”. PCAPS is a tool to visualize clinical/nursing information / knowledge. Very graphical / quantified sort of model involving high level of graphics to depict flow and so forth. Very much a systems approach to visualize and structure clinical processes. Currently addresses over 19 topics and 113 areas. Ischemeic heard disease visualized via root cause analysis as well as other examples of colon cancer and such. Very technical and or complex approach to a complex problem.

Next is V. Barnoy and colleagues from Israel, titled “Nurses attitudes towards the informed patient”. Focus of research is on patient and not nurse as previous presenters offered during this session. Previous research in this area on providers (physicians and nurses) and so study wanted to look at the ‘power shift’ to patients. Most of shift related to, at least anecdotally, the growth of the web. Study wanted to know nurses attitudes towards savvy-patients (knowledgeable patients). Factors possibly impacting attitude of nurses might include professional esteem, prior exposure to patients preferring net available med information as well as ‘net self-efficacy’ of the nurses. Only presenting on these 3 items here. Scales used to ‘measure’ attitudes of study participants. Prior exposure connected to more positive attitudes towards the internet; the number of encounters made no difference on this, indicating quality of experience (aka ‘1st experience’) importance. Professional exteem & attitudes does not seem to intimidate the nurse regarding such patients. More use of internet associated with more positive use and less intimidation perceived by nurses using the ‘net. Age negatively correlated, which might be expected. Conclusions include the 1st impression of the patient with the nurse had consequences and or long-range retention by the nurse about the patient. Published in Nursing Outlook, 56:31, 2008, too. Q&A with audience for about 5 minutes followed the presentation.

Closing out the list is M. Hansen and colleagues from the US, titles “The potential of 3-D virtual worlds in professional nursing education”. I admit a vested interest in this study as I am one of the co-authors. She’s providing a ‘brief’ overview of the use of virtual worlds in nursing education. Not sure of this but think the presentation is also available on SlideShare (http://www.slideshare.com) and search on ‘Margaret Hansen’. Examples include work of John Miller at Tacoma, Washington, US, Juliana Brixey at Kansas University (KUMC Center for Healthcare Informatics), SecondLife project at University of Wisconsin Oshkosh College of Nursing. She also includes numerous site examples. Theoretical frameworks used by Margaret include Roger’s Diffusion of Innovations and Siemens’ Connectivism Learning (not what you know but who). Q&A followed. Great presentations by all! Lunch time ;’)