Improving information technology competencies: implications for psychiatric mental health nursing

Benefits of Digital Mental Health Care Interventions for Correctional Workers and Other Public Safety Personnel: A Narrative Review

Chronic exposure to stressors and potentially psychologically traumatic events contributes to the high prevalence of mental health disorders in correctional workers (CWs) and other public safety personnel (PSP). Digital mental health interventions are an accessible and scalable method of improving and maintaining the mental health of this population. The current review explores the benefits of digital mental health interventions for PSP-with a focus on CWs-and how these innovations can address the limitations in in-person mental health care. A systematic literature search of five databases (Medline, PsycInfo, Embase, CINAHL, Google Scholar) was conducted until March 2022. The search yielded 16 publications that focused on digital mental health interventions or care available to CWs and other PSP. The benefits of digital innovations were summarized into five categories which discussed (1) their ability to enhance accessibility and reduce stigma; (2) the provision of evidence-based and structured psychotherapy programs; (3) variability in the degree of therapist engagement; (4) the integration of proactive interventions; and (5) enhancing engagement by acknowledging unique experiences and interpersonal relationships. Although digital mental health technologies for CWs are still in their infancy, there is strong evidence to support their effectiveness in ameliorating symptoms of mental distress. Future research should consider how ethnicity, gender, culture, sexual orientation, and socioeconomic status can be integrated into these therapies and how the interplay between different stakeholders and organizations can impact the effectiveness of online therapies and programs.

If There's Something Strange in Your Neighbourhood, Who You Gonna Call? Perceived Mental Health Service User Suitability for Video Consultations

COVID-19 has placed additional challenges on mental health services. Video consultations (VCs) have provided a short-term solution to lockdown restrictions but could also increase long-term capacity to meet the anticipated rising demand. A total of 7752 VCs were conducted over six weeks. Thematic analysis of 474 online survey responses identified twenty patient attributes that influenced staffs’ decisions to offer VCs. Their opinions were diverse, at times contradictory, and not always evidence based. There was reasonable consensus (and published evidence to support) of the probable suitability of VC for patients who: are IT savvy and suitably equipped; are teenagers; live in remote/rural locations; have caring responsibilities; have anxiety disorders or express a preference. No consensus was reached regarding eight attributes and there was a corresponding paucity of evidence, indicating the need for further research. Conversely, old age; paranoia, sensory impairment/communication difficulties; high risk and trauma/PTSD (posttraumatic stress disorder) were generally seen as contraindicated by staff, despite published evidence of success elsewhere. It may be possible to overcome staff’s reticence to offer these groups VCs. As staff are effectively the gatekeepers to VC interventions, it is important to understand and support them to overcome reservations that are contrary to the empirical evidence base. This will ensure that their initial anxieties do not become unnecessary barriers to services for those most in need. As with all mental healthcare, such decisions should be made collaboratively, and on an individual basis.

Willingness to Use Digital Health Tools in Patient Care Among Health Care Professionals and Students at a University Hospital in Saudi Arabia: Quantitative Cross-sectional Survey

BACKGROUND

The adoption rate of digital health in the health care sector is low in many countries. A facilitating factor for successful implementation and adoption of digital health is acceptance by current and future health care professionals.

OBJECTIVE

This study was conducted to identify factors associated with willingness to use digital health tools in patient care among health care professionals and students.

METHODS

This was a quantitative cross-sectional survey study conducted among health care professionals and students at a university hospital in Riyadh, Saudi Arabia. A nonprobability convenience sampling procedure was used to recruit participants. Data were collected using a self-completed e-questionnaire that was distributed by email. Chi-square tests, t tests, and logistic regression were used to analyze the data.

RESULTS

We found that 181 out of 218 health care professionals (83.0%; 75.6% [59/78] physicians; 87.1% [122/140] nurses) and 115 out of 154 students (74.7%; 80.0% [76/95] medical students and 66.1% [39/59] nursing students) were willing to use digital tools in patient care. Willingness to use digital tools was significantly associated with attitude (Adjusted Odds Ratios [AOR] 1.96; 95% CI 1.14-3.36) and self-efficacy (AOR 1.64; 95% CI 1.17-2.30) among health care professionals, and with current year of study (AOR 2.08; 95% CI 1.18-3.68) and self-efficacy (AOR 1.77; 95% CI 1.17-2.69) among students. No significant difference in willingness to use digital tools was found between physicians and nurses (P=.113), and between medical and nursing students (P=.079).

CONCLUSIONS

The findings of this study should encourage policy makers and hospital managers to implement relevant eHealth interventions within routine health care systems in Saudi Arabia. For successful implementation, digital health education programs should be implemented simultaneously, so that current and future health care professionals are able to develop required positive attitudes as well as practical skills and competencies.

Improving the informatics competency of critical care nurses: results of an interventional study in the southeast of Iran

BACKGROUND

Nursing informatics (NI) along with growth and development of health information technology (HIT) is becoming a fundamental part of all domains of nursing practice especially in critical care settings. Nurses are expected to equip with NI competency for providing patient-centered evidence-based care. Therefore, it is important and necessary to improve nurses' NI competency through educational programs for effective using of HIT. This study aimed to evaluate the impact of a training program on NI competency of critical care nurses.

METHODS

This interventional study was conducted in 2019. Stratified sampling technique was used to select 60 nurses working in critical care units of three hospitals affiliated with a large University of Medical Sciences in the southeast of Iran. These nurses were assigned randomly and equally to the control and intervention groups. NI competency was trained to the intervention group in a three-day workshop. Data were collected using demographic questionnaire and the adapted Nursing Informatics Competency Assessment Tool (NICAT) before and 1 month after the intervention. Rahman in the US (2015) developed and validated the original NICAT to assess self-reported NI competency of nurses with 30 items and three dimensions (Computer literacy, Informatics literacy Information management skills). The NICAT is scored on a five-point Likert scale and the overall score ranges from 30 to150. Two medical informatics specialists and eight nursing faculty members approved the validity of the adapted version of NICAT and its reliability was confirmed by Cronbach's alpha (95%).

RESULTS

All 60 participants completed the educational program and returned the completed questionnaire. Majority of participants in the intervention and control groups were female (83.30%), married nurses (70.90, 73.30%) aged 30-40 years (51.6, 35.5%). In the pretest stage, both intervention and control groups were competent in terms of the NI competency and its dimensions, and no significant difference was observed between them (p = 0.65). However, in the posttest, the NI competency and its dimensions in the intervention group significantly increased with a large effect size compared with the control group (p = 0.001). This difference showed that the intervention group was proficient in the posttest stage. The highest mean difference in the intervention group was associated with the informatics literacy dimension and the lowest mean difference was associated with the informatics management skills dimension.

CONCLUSIONS

The improved scores of NI competency and its dimensions after using the training program implied the effectiveness of this method in enhancing the NI competency of nurses working in the critical care units. The application of the training program in diverse domains of nursing practice shows its high efficiency. The project is fundamental for improving nurses' NI competency through continuous educational programs in Iran, other cultures and contexts.

A nurse-driven method for developing artificial intelligence in "smart" homes for aging-in-place

OBJECTIVES

To offer practical guidance to nurse investigators interested in multidisciplinary research that includes assisting in the development of artificial intelligence (AI) algorithms for "smart" health management and aging-in-place.

METHODS

Ten health-assistive Smart Homes were deployed to chronically ill older adults from 2015 to 2018. Data were collected using five sensor types (infrared motion, contact, light, temperature, and humidity). Nurses used telehealth and home visitation to collect health data and provide ground truth annotation for training intelligent algorithms using raw sensor data containing health events.

FINDINGS

Nurses assisting with the development of health-assistive AI may encounter unique challenges and opportunities. We recommend: (a) using a practical and consistent method for collecting field data, (b) using nurse-driven measures for data analytics, (c) multidisciplinary communication occur on an engineering-preferred platform.

CONCLUSIONS

Practical frameworks to guide nurse investigators integrating clinical data with sensor data for training machine learning algorithms may build capacity for nurses to make significant contributions to developing AI for health-assistive Smart Homes.

Setting priorities for EU healthcare workforce IT skills competence improvement

A major challenge for healthcare quality improvement is the lack of IT skills and knowledge of healthcare workforce, as well as their ambivalent attitudes toward IT. This article identifies and prioritizes actions needed to improve the IT skills of healthcare workforce across the EU. A total of 46 experts, representing different fields of expertise in healthcare and geolocations, systematically listed and scored actions that would improve IT skills among healthcare workforce. The Child Health and Nutrition Research Initiative methodology was used for research priority-setting. The participants evaluated the actions using the following criteria: feasibility, effectiveness, deliverability, and maximum impact on IT skills improvement. The leading priority actions were related to appropriate training, integrating eHealth in curricula, involving healthcare workforce in the eHealth solution development, improving awareness of eHealth, and learning arrangement. As the different professionals' needs are prioritized, healthcare workforce should be actively and continuously included in the development of eHealth solutions.

Employees' attitudes towards welfare technology in substance abuse treatment in Finland

Aim:

The significance of welfare and health technology has been highlighted in recent years. However, employees’ attitudes towards welfare technology in substance abuse treatment have received little attention. This article examines employees’ readiness to introduce welfare technology in substance abuse treatment and their attitudes towards its use.

Design:

The theoretical framework of this study is based on Ajzen’s (1991, 2001) theory of planned behaviour, and the ongoing discussion about the adoption of new technology in healthcare. The research data (N = 129) were collected in the form of an electronic questionnaire in Finland in 2015.

Results:

The results are consistent with the theory of planned behaviour and previous studies on the acceptance of information systems in healthcare. Employees’ readiness to introduce new welfare technology applications and devices in substance abuse treatment is influenced by their personal appreciation of welfare technology, the expectations of their colleagues and supervisors, as well as their own perceptions of their capacity to learn to use the applications.

Conclusions:

The study found some links between demographic factors and cognitions related to welfare technology. In particular, employees with a healthcare background are more inclined to adopt the technology than other employees in substance abuse treatment. In addition, a person’s age has a negative relationship with their perceived technology management. However, age has no significant connection with attitudes and no direct independent effect on the readiness to introduce a new welfare technology. Lastly, the results show that previous positive experiences of welfare technology make it easier to introduce new technologies.

Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record

BACKGROUND

Information technologies such as websites, mobile phone applications, and virtual reality programs have been shown to deliver innovative and effective treatments for mental illness. Much of the research studying electronic mental health interventions focuses on symptom reduction; however, to facilitate the implementation of electronic interventions in usual mental health care, it is also important to investigate the perceptions of clients who will be using the technologies. To this end, a qualitative analysis of focus group discussions regarding the Mental Health Engagement Network, a web-based personal health record and smartphone intervention, is presented here.

METHODS

Individuals living in the community with a mood or psychotic disorder (n = 394) were provided with a smartphone and access to an electronic personal health record, the Lawson SMART Record, for 12 to 18 months to manage their mental health. This study employed a delayed-implementation design and obtained both quantitative and qualitative data through individual interviews and focus group sessions. Participants had the opportunity to participate in voluntary focus group sessions at three points throughout the study to discuss their perceptions of the technologies. Qualitative data from 95 focus group participants were analysed using a thematic analysis.

RESULTS

Four overarching themes emerged from focus group discussions: 1) Versatile functionality of the Lawson SMART Record and smartphone facilitated use; 2) Aspects of the technologies as barriers to use; 3) Use of the Mental health Engagement Network technologies resulted in perceived positive outcomes; 4) Future enhancement of the Lawson SMART Record and intervention is recommended.

DISCUSSION

These qualitative data provide a valuable contribution to the understanding of how smarttechnologies can be integrated into usual mental health care. Smartphones are extremely portable andcommonplace in society. Therefore, clients can use these devices to manage and track mental health issuesin any place at almost any time without feeling stigmatized.

CONCLUSIONS

Assessing clients' perspectives regarding the use of smart technologies in mental health care provides an invaluable addition to the current literature. Qualitative findings support the feasibility of implementing a smartphone and electronic personal health record intervention with individuals who are living in the community and experiencing a mental illness, and provide considerations for future development and implementation.

Electronic health record use by nurses in mental health settings: a literature review

BACKGROUND

Electronic health records are being implemented in mental health clinical environments at an increasingly high rate. The primary clinicians who utilize this technology are nurses and physicians, with nurses constituting the largest user group. Implementing this technology is complex, especially in this unique context. Understanding the previous experiences of mental health nurses who use electronic health records is therefore important as a means of identifying strategies to best implement the technology.

OBJECTIVES

The purpose of this study is to review the literature on electronic health record use by nurses in mental health clinical settings in order to be able to provide recommendations for how this technology can be most effectively introduced.

DESIGN

A literature review was conducted. Ovid/MEDLINE®, PubMed, and the Cumulative Index to Nursing and Allied Health Literature were searched utilizing the following key words: " electronic health record", "electronic medical record", "clinical information system", "mental health", "nursing", and "psychiatry". Studies were screened for inclusion and exclusion criteria by two researchers.

RESULTS

Seven studies were included after duplicates were eliminated, and inclusion/exclusion criteria were applied.

CONCLUSIONS

The mental health setting is a unique environment in which special attention needs to be given during technology implementation. As mental health nurses may have less experience and comfort using technology in their practice, more and a longer duration of support during implementation may be required. Additional strategies to support successful EHR use are discussed.

Leading a Recovery-oriented Social Enterprise

Recovery-oriented mental health services promote the principles of recovery, such as hope and optimism, and are characterized by a personalized approach to developing consumer self-determination. Nurse leaders are increasingly developing such services as social enterprises, but there is limited research on the leadership of these programs. Leading a recovery-oriented mental health nurse social enterprise requires visionary leadership, collaboration with consumers and local health providers, financial viability, and commitment to recovery-focused practice. This article describes the framework of an Australian mental health nursing social enterprise, including the service attributes and leadership lessons that have been learned from developing program sustainability.

Team climate and attitudes toward information and communication technology among nurses on acute psychiatric wards

Objectives: To describe the association of team climate with attitudes toward information and communication technology among nursing staff working on acute psychiatric wards. Background: Implementation of ICT applications in nursing practice brings new operating models to work environments, which may affect experienced team climate on hospital wards. Method: Descriptive survey was used as a study design. Team climate was measured by the Finnish modification of the Team Climate Inventory, and attitudes toward ICT by Burkes' questionnaire. The nursing staff (N = 181, n = 146) on nine acute psychiatric wards participated in the study. Results: It is not self-evident that experienced team climate associates with attitudes toward ICT, but there are some positive relationships between perceived team climate and ICT attitudes. The study showed that nurses' motivation to use ICT had statistically significant connections with experienced team climate, participative safety (p = 0.021), support for innovation (p = 0.042) and task orientation (p = 0.042). Conclusion: The results suggest that asserting team climate and supporting innovative operations may lead to more positive attitudes toward ICT. It is, in particular, possible to influence nurses' motivation to use ICT. More attention should be paid to psychosocial factors such as group education and co-operation at work when ICT applications are implemented in nursing.

Developing nurse educators' computer skills towards proficiency in nursing informatics

The purpose of this paper is to assess nurse educators' competence development in nursing informatics (NI) and to compare their competence to the NI competence of other healthcare professionals. Electronic health records (EHR) have been in use for many years. However, the adoption of the nursing care plan finally made it possible for nurses in Finland to develop a model for structured documentation with nursing terminology. A total of n = 124 (n = 85 pre-test and n = 39 post-test) participants from Universities of Applied Sciences (UAS), hospitals, hospitals' information management and health centres were surveyed with a e-questionnaire designed to assess the development of their NI competences during the nursing documentation development project. The questionnaire included 145 structured questions and 6 open questions. Data analysis focused on classification and comparison of NI competences through data description and statistical parameters using figures and tables. The basic NI competences of the nurse educators were good at the end of project and the nurse educators had better information literacy and information management competences than other participants. The information retrieval skills varied greatly, but they improved evenly towards the end. The nurse educators mastered better evidence-based nursing and use of nursing process models in their work.

Building nursing intellectual capital for safe use of information technology: a systematic review

Information technology is integral to health care delivery. Nurse leaders recognize the need to build intellectual capital (knowledge, skills, and experience) in use and oversight of electronic health records despite financial constraints on indirect care time. A systematic literature review was conducted to answer the question, "What are the best practices to build nursing intellectual capital for use of IT for safe clinical care?" Evidence was translated to support a planned electronic health record rollout.

Developing an internet-based support system for adolescents with depression

BACKGROUND

Depression is the most common mental health problem among adolescents. Despite policy guidance and governmental support to develop usable mental health services, there is still a lack of easily accessible and modern interventions available for adolescents in Finland's majority official language.

OBJECTIVE

Our objective was to develop a user-friendly and feasible Internet-based support system for adolescents with depression.

METHODS

The Internet-based support system for adolescents with depression was developed. To create this new intervention, some examples of existing interventions were studied, the theoretical basis for the intervention was described, and the health needs of adolescents identified. As an outcome of the process, the results were combined and the content and delivery of a new intervention will be described here.

RESULTS

Six individual weekly Internet-based support sessions were delivered by a tutor over a 6-week period of time and developed to form an intervention called Depis.Net. This was an Internet-based support system for adolescents with depression tailored to improve self-management skills and increase awareness of their own well-being and mental health. The intervention was accessible via an electronic platform, which was secured and password protected for users. The intervention on the Depis.Net website consisted of elements identifying adolescents' needs, and offering self-monitoring, access to health information and self-reflective written exercises. An educated nurse tutor gave written feedback to each adolescent via the electronic platform.

CONCLUSIONS

An Internet-based support system for adolescents with depression was developed using a systematic approach with four steps. This was done to ensure that the intervention had a sound theoretical background and at the same time caters flexibly for the problems that adolescents commonly face in their daily lives. Its potential for adolescents visiting outpatient clinics will be evaluated in the next phase by means of a randomized controlled trial.

Nursing informatics competencies required of nurses in Taiwan

PURPOSE

In today's workplace, nurses are highly skilled professionals possessing expertise in both information technology and nursing. Nursing informatics competencies are recognized as an important capability of nurses. No established guidelines existed for nurses in Asia. This study focused on identifying the nursing informatics competencies required of nurses in Taiwan.

METHODS

A modified Web-based Delphi method was used for two expert groups in nursing, educators and administrators. Experts responded to 323 items on the Nursing Informatics Competencies Questionnaire, modified from the initial work of Staggers, Gassert and Curran to include 45 additional items. Three Web-based Delphi rounds were conducted. Analysis included detailed item analysis. Competencies that met 60% or greater agreement of item importance and appropriate level of nursing practice were included.

RESULTS

N=32 experts agreed to participate in Round 1, 23 nursing educators and 9 administrators. The participation rates for Rounds 2 and 3=68.8%. By Round 3, 318 of 323 nursing informatics competencies achieved required consensus levels. Of the new competencies, 42 of 45 were validated. A high degree of agreement existed for specific nursing informatics competencies required for nurses in Taiwan (97.8%).

CONCLUSIONS

This study provides a current master list of nursing informatics competency requirements for nurses at four levels in the U.S. and Taiwan. The results are very similar to the original work of Staggers et al. The results have international relevance because of the global importance of information technology for the nursing profession.