Advanced Practice Nurses' Meaningful use of electronic health records

Do Patient Engagement IT Functionalities Influence Patient Safety Outcomes? A Study of US Hospitals

OBJECTIVE

Patient engagement using health information technology (IT) functionalities can be a powerful tool in managing their own care for better health outcomes. Therefore, this study explores whether patient engagement IT functionalities and electronic health record (EHR) can affect patient safety outcomes.

DESIGN

Using longitudinal study design for general acute care hospitals within the United States, we examine the interaction effects of EHR and patient engagement IT functionalities on patient safety outcomes (adverse incident rate) using a generalized estimating equation.

SETTING

Our national sample consisted of 9759 hospital-year observations from 2014 to 2018. Overall, we found a significant association between adverse incident rate and patient engagement level and EHR adoption level.

RESULTS

On average, as the combined effects of patient engagement level and EHR adoption level increases, the adverse incident rate decreases by approximately 0.49 (P < .01). Incorporating patient engagement functionalities is becoming an essential tool to improve health outcomes and will play an instrumental role in meeting meaningful use standards.

CONCLUSIONS

Our study provides insights into the potential synergy between a hospital's existing EHR maturity and patient engagement health IT functionalities in affecting organizational performance. Organizational culture and capabilities pertinent to adopting patient engagement health IT functionalities infrastructure should be established first to provide the impetus for this synergy.

Closing the Loop on Electronic Referrals: A Quality Improvement Initiative Using the Care Coordination Model

Primary care providers refer nearly one-third of their patients to specialty care services. Despite provider recommendations, approximately 1 in 4 referrals are never completed. Incomplete referral rates are higher among vulnerable and medically underserved individuals. Sixty-seven percent of federally qualified community health centers report difficulty obtaining specialty care appointments and incomplete referral rates as high as 73%. Effective electronic referral processes can improve health outcomes, reduce waste, and mitigate risks. Using the Care Coordination Model as its framework, this quality improvement initiative implemented evidence-based interventions aimed at improving patient support and organizational accountability for electronic referrals.

Patient Satisfaction With Electronic Health Record Use by Primary Care Nurse Practitioners

The purpose of this research study was to determine if satisfaction and communication between the patient and the nurse practitioner are affected by allowing patients to view their electronic health records during the history portion of the primary care office visit compared with patients who do not view their records. A cross-sectional, experimental design was utilized for this study. The intervention group was shown several components of the electronic health record during the history portion of the nurse practitioner assessment. This group's scores on a patient satisfaction survey were compared with those of the control group, who were not shown the electronic health record. The study findings suggest that the introduction of the electronic health record does not affect patients' satisfaction related to the office visit by the nurse practitioner.

Health promotion practices delivered by primary health care nurses: Elements for success in Finland

AIM

The aim of this study was to identify and reach a consensus on the elements needed for the success of health promotion practices delivered by registered nurses (RNs) who receive clients in primary health care among primary health care participants in eastern Finland.

BACKGROUND

Advanced practice nurses are a reaction to the changing health needs of society. These nurses have come to play a significant part in improving health-promotive care in the primary health care setting.

METHODS

A mixed method two-stage Delphi technique was applied.

RESULTS

A health-promoting organizational culture (e.g., the respectful management of health promotion) and nurses' health orientation and development (e.g., nurses' professional growth and work well-being) were found as the main elements required for the success of the health promotion practices in primary health care.

CONCLUSIONS

A health-promoting organizational culture with the strategic and respectful leadership of health promotion is significant in the implementation of the health promotion practices delivered by RNs in primary health care.