1
|
Tran G, Kelly B, Hammersley M, Norman J, Okely A. The utility of website-based quality improvement tools for health professionals: a systematic review. Int J Qual Health Care 2024; 36:mzae068. [PMID: 38985665 PMCID: PMC11277856 DOI: 10.1093/intqhc/mzae068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/03/2024] [Accepted: 07/09/2024] [Indexed: 07/12/2024] Open
Abstract
As technology continues to advance, it is important to understand how website-based tools can support quality improvement. Website-based tools refer to resources such as toolkits that users can access and use autonomously through a dedicated website. This review examined how website-based tools can support healthcare professionals with quality improvement, including the optimal processes used to develop tools and the elements of an effective tool. A systematic search of seven databases was conducted to include articles published between January 2012 and January 2024. Articles were included if they were peer reviewed, written in English, based in health settings, and reported the development or evaluation of a quality improvement website-based tool for professionals. A narrative synthesis was conducted using NVivo. Risk of bias was assessed using the Mixed Methods Appraisal Tool. All papers were independently screened and coded by two authors using a six-phase conceptual framework by Braun and Clarke. Eighteen studies met the inclusion criteria. Themes identified were tool development processes, quality improvement mechanisms and barriers and facilitators to tool usage. Digitalizing existing quality improvement processes (n = 7), identifying gaps in practice (n = 6), and contributing to professional development (n = 3) were common quality improvement aims. Tools were associated with the reported enhancement of accuracy and efficiency in clinical tasks, improvement in adherence to guidelines, facilitation of reflective practice, and provision of tailored feedback for continuous quality improvement. Common features were educational resources (n = 7) and assisting the user to assess current practices against standards/recommendations (n = 6), which supported professionals in achieving better clinical outcomes, increased professional satisfaction and streamlined workflow in various settings. Studies reported facilitators to tool usage including relevance to practice, accessibility, and facilitating multidisciplinary action, making these tools practical and time-efficient for healthcare. However, barriers such as being time consuming, irrelevant to practice, difficult to use, and lack of organizational engagement were reported. Almost all tools were co-developed with stakeholders. The co-design approaches varied, reflecting different levels of stakeholder engagement and adoption of co-design methodologies. It is noted that the quality of included studies was low. These findings offer valuable insights for future development of quality improvement website-based tools in healthcare. Recommendations include ensuring tools are co-developed with healthcare professionals, focusing on practical usability and addressing common barriers to enhance engagement and effectiveness in improving healthcare quality. Randomized controlled trials are warranted to provide objective evidence of tool efficacy.
Collapse
Affiliation(s)
- Georgie Tran
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Bridget Kelly
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Megan Hammersley
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Jennifer Norman
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW 2502, Australia
| | - Anthony Okely
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW 2522, Australia
| |
Collapse
|
2
|
Cilluffo S, Bassola B, Lyons KS, Lee CS, Vellone E, Pucciarelli G, Clari M, Dimonte V, Lusignani M. The role of nurse-patient mutuality on self-care behaviours in patients with chronic illness. J Clin Nurs 2024. [PMID: 38685742 DOI: 10.1111/jocn.17181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/11/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
AIM To examine the role of nurse-patient mutuality on three self-care behaviours in chronic illness patients. DESIGN A cross-sectional multi-centre study was conducted. METHODS Mutuality was measured with the Nurse-Patient Mutuality in Chronic Illness scale which has the dimensions of developing and going beyond, being a point of reference and deciding and sharing care, and self-care was measured with the Self-care of Chronic Illness Inventory (SC-CII). Multivariable linear regression analyses were used to assess the contribution of three dimensions of mutuality on self-care maintenance, monitoring and management behaviours controlling for patient gender, age, education, number of medications, and presence of a family caregiver. RESULTS The sample included 465 inpatients and outpatients with at least one chronic illness. The three dimensions of mutuality had different roles in their influence on the three dimensions of self-care. Developing and going beyond was significantly associated with self-care maintenance and self-care monitoring behaviours. Point of reference was significantly associated with self-care maintenance behaviour. Deciding and sharing care was significantly associated with self-care monitoring and self-care management behaviours. CONCLUSION The mutuality between nurse and patient may be a novel area of research to support and improve patient self-care behaviours with implications for clinical practice and education. IMPLICATION FOR PROFESSION AND PATIENT CARE Mutuality between nurse and patient increases patient engagement, symptom recognition, decision-making process and patient-centred approach favouring the development of self-care behaviours. IMPACT Mutuality between nurse and patient is a new concept and its association with the patient outcomes could bring relevance to the nursing profession. Self-care behaviours are important in the management of chronic diseases, but are difficult to perform. Mutuality between nurse and patient influences the three different behaviours of self-care in chronic illness, for this reason it is important to increase the level of mutuality in this dyad. REPORTING METHOD STROBE checklist for cross-sectional studies was followed in this study. PATIENT OR PUBLIC CONTRIBUTION Patients were involved in the sample of the study.
Collapse
Affiliation(s)
- Silvia Cilluffo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- School of Nursing, Niguarda Hospital, University of Milan, Milan, Italy
| | - Barbara Bassola
- School of Nursing, Niguarda Hospital, University of Milan, Milan, Italy
| | - Karen S Lyons
- Connell School of Nursing, Boston College, Boston, Massachusetts, USA
| | - Christopher S Lee
- Connell School of Nursing, Boston College, Boston, Massachusetts, USA
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Clari
- Department of Public Health and Paediatrics Sciences, University of Turin, Turin, Italy
| | - Valerio Dimonte
- Department of Public Health and Paediatrics Sciences, University of Turin, Turin, Italy
| | - Maura Lusignani
- School of Nursing, Niguarda Hospital, University of Milan, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
3
|
Ester Molina Beltran E, Neuzillet C, Chorin F. La préhabilitation, un nouveau parcours préopératoire pour améliorer la condition des patients. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2024; 69:18-21. [PMID: 38614513 DOI: 10.1016/j.soin.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2024]
Abstract
The maintenance and optimization of functional capacities before, during, and after treatment are major challenges for frailty persons as cancer's patients. It is now known that physical activity in prehabilitation plays a crucial role in limiting, among other things, post-operative complications. The benefits have already been demonstrated in various studies, including a decrease in hospitalization duration, an increase in cardiorespiratory endurance, improvement in quality of life, and better fatigue management. It is observed that patients who undergo prehabilitation are those who recover their preoperative capacities the fastest. However, it is estimated that only one-third of patients with access to prehabilitation improve their physical capacities.
Collapse
Affiliation(s)
| | - Cindy Neuzillet
- Institut Curie, 35 avenue Dailly, 92210 Saint-Cloud, France; Université Versailles Saint-Quentin-en-Yvelines, 47 boulevard Vauban, 78047 Guyancourt, France
| | - Frédéric Chorin
- France Université Côte d'Azur, Laboratoire motricité humaine expertise sport santé (Lamhess), Campus STAPS-Sciences du Sport, 261 boulevard du Mercantour BP3259, 06205 Nice cedex 03, France
| |
Collapse
|
4
|
O'Connor S, Vercell A, Wong D, Yorke J, Fallatah FA, Cave L, Anny Chen LY. The application and use of artificial intelligence in cancer nursing: A systematic review. Eur J Oncol Nurs 2024; 68:102510. [PMID: 38310664 DOI: 10.1016/j.ejon.2024.102510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Artificial Intelligence is being applied in oncology to improve patient and service outcomes. Yet, there is a limited understanding of how these advanced computational techniques are employed in cancer nursing to inform clinical practice. This review aimed to identify and synthesise evidence on artificial intelligence in cancer nursing. METHODS CINAHL, MEDLINE, PsycINFO, and PubMed were searched using key terms between January 2010 and December 2022. Titles, abstracts, and then full texts were screened against eligibility criteria, resulting in twenty studies being included. Critical appraisal was undertaken, and relevant data extracted and analysed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. RESULTS Artificial intelligence was used in numerous areas including breast, colorectal, liver, and ovarian cancer care among others. Algorithms were trained and tested on primary and secondary datasets to build predictive models of health problems related to cancer. Studies reported this led to improvements in the accuracy of predicting health outcomes or identifying variables that improved outcome prediction. While nurses led most studies, few deployed an artificial intelligence based digital tool with cancer nurses in a real-world setting as studies largely focused on developing and validating predictive models. CONCLUSION Electronic cancer nursing datasets should be established to enable artificial intelligence techniques to be tested and if effective implemented in digital prediction and other AI-based tools. Cancer nurses need more education on machine learning and natural language processing, so they can lead and contribute to artificial intelligence developments in oncology.
Collapse
Affiliation(s)
- Siobhan O'Connor
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Amy Vercell
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom; The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, United Kingdom.
| | - David Wong
- Leeds Institute for Health Informatics, University of Leeds, Leeds, United Kingdom.
| | - Janelle Yorke
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom; The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, United Kingdom.
| | - Fatmah Abdulsamad Fallatah
- Department of Nursing Affairs, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | - Louise Cave
- NHS Transformation Directorate, NHS England, England, United Kingdom.
| | - Lu-Yen Anny Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
5
|
Mellerick A, Akers G, Tebbutt N, Lane T, Jarden R, Whitfield K. Nurse-led emergency department avoidance model of care for patients receiving cancer therapy in the ambulatory setting: a health service improvement initiative. BMC Health Serv Res 2023; 23:710. [PMID: 37386474 DOI: 10.1186/s12913-023-09693-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/13/2023] [Indexed: 07/01/2023] Open
Abstract
AIMS The Symptom and Urgent Review Clinic was a service improvement initiative, which consisted of the implementation and evaluation of a nurse-led emergency department (ED) avoidance model of care. The clinic was developed for patients experiencing symptoms associated with systemic anti-cancer therapy in ambulatory cancer settings. METHODS The clinic was implemented in four health services in Melbourne, Australia across a six-month period in 2018. Evaluation was by prospective data collection of the frequency and characteristics of patients who used the service, pre- and post-survey of patient reported experience, and a post-implementation survey of clinician engagement and experience. RESULTS There were 3095 patient encounters in the six-month implementation period; 136 patients were directly admitted to inpatient healthcare services after clinic utilization. Of patients who contacted SURC (n = 2174), a quarter (n = 553) stated they would have otherwise presented to the emergency department and 51% (n = 1108) reported they would have otherwise called the Day Oncology Unit. After implementation, more patients reported having a dedicated point of contact (OR 14.3; 95% CI 5.8-37.7) and ease of contacting the nurse (OR 5.5; 95% CI 2.6-12.1). Clinician reported experience and engagement with the clinic was highly favorable. CONCLUSION The nurse-led emergency department avoidance model of care addressed a gap in service delivery, while optimizing service utilization by reducing ED presentations. Patients reported improved levels of satisfaction with ease of access to a dedicated nurse and advice provided.
Collapse
Affiliation(s)
- Angela Mellerick
- Olivia Newton John Cancer Centre, Studley Road, Heidelberg, VIC, 3084, Australia.
- Victorian Government Department of Health, Victoria, Australia.
- Austin Health, Heidelberg, VIC, Australia.
| | - Georgina Akers
- Victorian Government Department of Health, Victoria, Australia
| | - Niall Tebbutt
- Olivia Newton John Cancer Centre, Studley Road, Heidelberg, VIC, 3084, Australia
- Austin Health, Heidelberg, VIC, Australia
- The University of Melbourne, Melbourne, VIC, Australia
| | - Tyler Lane
- Victorian Government Department of Health, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Rebecca Jarden
- Austin Health, Heidelberg, VIC, Australia
- The University of Melbourne, Melbourne, VIC, Australia
| | | |
Collapse
|
6
|
Tipton JM. Assessment and management of nausea and vomiting in cancer survivors. Nurse Pract 2023; 48:30-38. [PMID: 37097100 DOI: 10.1097/01.npr.0000000000000039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
ABSTRACT Nausea and vomiting may occur in cancer survivors during or independent of treatment. A complete assessment is necessary to determine the etiology and to plan specific and successful interventions. NPs have a key role in managing cancer survivors' symptoms and determining the best supportive care.
Collapse
Affiliation(s)
- Janelle M Tipton
- Janelle M. Tipton is a clinical assistant professor in the School of Nursing at Purdue University in West Lafayette, Ind
| |
Collapse
|
7
|
Ahmed S, LePage K, Benc R, Erez G, Litvin A, Werbitt A, Chartier G, Berlin C, Loiselle CG. Lessons Learned from the Implementation of a Person-Centred Digital Health Platform in Cancer Care. Curr Oncol 2022; 29:7171-7180. [PMID: 36290841 PMCID: PMC9600520 DOI: 10.3390/curroncol29100564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 01/13/2023] Open
Abstract
The SARS-CoV-2 (COVID-19) pandemic has accelerated the development and use of digital health platforms to support individuals with health-related challenges. This is even more frequent in the field of cancer care as the global burden of the disease continues to increase every year. However, optimal implementation of these platforms into the clinical setting requires careful planning and collaboration. An implementation project was launched between the Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Ouest-de-I'Île-de-Montreal and BELONG-Beating Cancer Together-a person-centred cancer navigation and support digital health platform. The goal of the project was to implement content and features specific to the CIUSSS, to be made available exclusively for individuals with cancer (and their caregivers) treated at the institution. Guided by Structural Model of Interprofessional Collaboration, we report on implementation processes involving diverse stakeholders including clinicians, hospital administrators, researchers and local community/patient representatives. Lessons learned include earlier identification of shared goals and clear expectations, more consistent reliance on virtual means to communicate among all involved, and patient/caregiver involvement in each step to ensure informed and shared decision making.
Collapse
Affiliation(s)
- Saima Ahmed
- Division of Experimental Medicine, Faculty of Medicine and Health Sciences McGill University, Montreal, QC H4A 3J1, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Karine LePage
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Renata Benc
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Guy Erez
- Belong.life Inc., New York, NY 10001, USA
| | | | | | - Gabrielle Chartier
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Carly Berlin
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
| | - Carmen G. Loiselle
- Division of Experimental Medicine, Faculty of Medicine and Health Sciences McGill University, Montreal, QC H4A 3J1, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Ouest-de l’Île-de Montréal, Montreal, QC H3T 1E2, Canada
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H4A 3T2, Canada
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3A 2M7, Canada
- Correspondence:
| |
Collapse
|
8
|
Di Maio M, Basch E, Denis F, Fallowfield LJ, Ganz PA, Howell D, Kowalski C, Perrone F, Stover AM, Sundaresan P, Warrington L, Zhang L, Apostolidis K, Freeman-Daily J, Ripamonti CI, Santini D. The role of patient-reported outcome measures in the continuum of cancer clinical care: ESMO Clinical Practice Guideline. Ann Oncol 2022; 33:878-892. [PMID: 35462007 DOI: 10.1016/j.annonc.2022.04.007] [Citation(s) in RCA: 137] [Impact Index Per Article: 68.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/05/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- M Di Maio
- Department of Oncology, University of Turin, at A.O. Ordine Mauriziano Hospital, Turin, Italy
| | - E Basch
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - F Denis
- Institut Inter-régional de Cancérologie Jean Bernard (ELSAN), Le Mans, France; Faculté de Santé, Université de Paris, Paris, France
| | - L J Fallowfield
- Sussex Health Outcomes Research & Education in Cancer, Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, UK
| | - P A Ganz
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), USA
| | - D Howell
- Department of Supportive Care, Princess Margaret Cancer Centre Research Institute, Toronto, Ontario, Canada
| | - C Kowalski
- Department of Certification - Health Services Research, German Cancer Society, Berlin, Germany
| | - F Perrone
- Clinical Trial Unit, National Cancer Institute IRCCS G. Pascale Foundation, Naples, Italy
| | - A M Stover
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA; Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - P Sundaresan
- Sydney West Radiation Oncology Network, Westmead Hospital, Westmead, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia
| | - L Warrington
- Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, UK
| | - L Zhang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - K Apostolidis
- European Cancer Patient Coalition, Brussels, Belgium
| | | | - C I Ripamonti
- Oncology - Supportive Care in Cancer Unit, Department Oncology-Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Milan, Italy
| | - D Santini
- Medical Oncology Department, University Campus Bio-Medico, Rome, Italy
| |
Collapse
|
9
|
How technology can improve communication and health outcomes in patients with advanced cancer: an integrative review. Support Care Cancer 2022; 30:6525-6543. [PMID: 35411467 DOI: 10.1007/s00520-022-07037-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/04/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Patients facing an advanced cancer diagnosis require clear communication with their clinicians. Technology has been utilized in many different capacities to navigate communication in cancer care, but few authors examine the specific areas of communication from a theoretical perspective. The purpose of this literature review was to (1) identify articles focused on technology-based communication strategies to improve health outcomes in individuals with advanced cancer, and (2) using Epstein and Street's framework, identify areas in which technology-based communication has been used to improve health outcomes, and (3) identify gaps that exist in technology-based communication care in patients with advanced cancer. METHODS A systematic search was conducted which returned 446 articles. Using Epstein and Street's 2007 framework, the final sample was 39. RESULTS Nine clinical trials, 29 observational studies, and 1 case study were identified. The articles were categorized into one area within Epstein and Street's areas of communication. Many of the articles examined the patient's and provider's acceptability and feasibility of technology-based methods of communication, while other articles examined their efficacy. CONCLUSIONS While research studies were identified in each of the areas of communication, the majority of technology-based communication strategies were focused on the exchange of information between patients and their providers. Further research and the development of technology-based communication interventions assessed through clinical trials are needed in the areas of healing relationships and making decisions in cancer care. Additionally, the communication strategies found effective at improving health outcomes in advanced cancer should begin implementation into clinical practice, therefore reaching more patients.
Collapse
|