Supporting health professionals through information and communication technologies: a systematic review of the effects of information and communication technologies on recruitment and retention

Development of a bovine continuing education program for early-career veterinarians to address clinical service shortage

There is currently a shortage of production animal veterinarians worldwide. Access to adequate continuing education (CE) increases retention of health-care workers in rural areas. However, little information is available about the preferences of bovine veterinarians in their first years after graduation. Our objective was to design a readily available CE program tailored for recent veterinary graduates working in bovine medicine. For this, we conducted a cross-sectional survey to identify early-career bovine veterinarian needs and their preferences to access CE conducted while practicing full time. Subsequently, we conducted a second survey to triangulate their responses with the opinions of experienced veterinarians, where the experienced veterinarians ranked the relevance of the CE topics that resulted from the early-career veterinarian survey. We received a total of 132 valid responses from US veterinarians in their first 5 years after graduation, and 32 responses associated with bovine veterinarians with 10 or more years of experience. Our results showed that a combination of distance education and workshops to practice hands-on skills was the preferred method for accessing CE among early-career veterinarians. Furthermore, recent graduates were willing to commit 1 to 2 h/wk to distance education. From the list of 20 topics identified by early-career veterinarians, the experienced veterinarians ranked "calf/heifer management" and "immunology and vaccinology" as the most relevant ones for practice. With the information gathered from these surveys, we designed, implemented, and piloted a 180-h CE program on bovine health management that is delivered over 2 yr through asynchronous distance education and annual hands-on workshops. Participant feedback has been very positive. Overall, the survey results will serve to develop CE programs targeted to bovine veterinarians in their first years of practice. Future research is needed to evaluate this program's success in retaining the bovine veterinary workforce within the United States, particularly in rural underserved areas.

Perceptions and needs regarding technologies in nursing homes: An exploratory study

Two of the most salient problems in nursing homes are the responsive behaviours and falls of older people living with Alzheimer's disease and related disorders. Intelligent videomonitoring and mobile applications are potential technologies that may help prevent and manage these problems. However, evidence for the needs for technologies in nursing homes is scarce. This study aimed to explore the perceptions and needs of care managers, and of formal and family caregivers in nursing homes regarding these potential technologies. With an exploratory qualitative design based on Rogers' diffusion of innovation theory, individual interviews and a content analysis were conducted. Results show that the potential users of these technologies consider them relevant in nursing homes. The characteristics that would make these technologies useful in nursing homes are described. These results could be used to develop useful technologies to improve the quality of clinical practice in nursing homes.

Impact of Information and Communication Technologies on Nursing Care: Results of an Overview of Systematic Reviews

Background

Information and communication technologies (ICTs) are becoming an impetus for quality health care delivery by nurses. The use of ICTs by nurses can impact their practice, modifying the ways in which they plan, provide, document, and review clinical care.

Objective

An overview of systematic reviews was conducted to develop a broad picture of the dimensions and indicators of nursing care that have the potential to be influenced by the use of ICTs.

Methods

Quantitative, mixed-method, and qualitative reviews that aimed to evaluate the influence of four eHealth domains (eg, management, computerized decision support systems [CDSSs], communication, and information systems) on nursing care were included. We used the nursing care performance framework (NCPF) as an extraction grid and analytical tool. This model illustrates how the interplay between nursing resources and the nursing services can produce changes in patient conditions. The primary outcomes included nurses’ practice environment, nursing processes, professional satisfaction, and nursing-sensitive outcomes. The secondary outcomes included satisfaction or dissatisfaction with ICTs according to nurses’ and patients’ perspectives. Reviews published in English, French, or Spanish from January 1, 1995 to January 15, 2015, were considered.

Results

A total of 5515 titles or abstracts were assessed for eligibility and full-text papers of 72 articles were retrieved for detailed evaluation. It was found that 22 reviews published between 2002 and 2015 met the eligibility criteria. Many nursing care themes (ie, indicators) were influenced by the use of ICTs, including time management; time spent on patient care; documentation time; information quality and access; quality of documentation; knowledge updating and utilization; nurse autonomy; intra and interprofessional collaboration; nurses’ competencies and skills; nurse-patient relationship; assessment, care planning, and evaluation; teaching of patients and families; communication and care coordination; perspectives of the quality of care provided; nurses and patients satisfaction or dissatisfaction with ICTs; patient comfort and quality of life related to care; empowerment; and functional status.

Conclusions

The findings led to the identification of 19 indicators related to nursing care that are impacted by the use of ICTs. To the best of our knowledge, this was the first attempt to apply NCPF in the ICTs’ context. This broad representation could be kept in mind when it will be the time to plan and to implement emerging ICTs in health care settings.

Trial Registration

PROSPERO International Prospective Register of Systematic Reviews: CRD42014014762; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014014762 (Archived by WebCite at http://www.webcitation.org/6pIhMLBZh)

The influence of a telehealth project on healthcare professional recruitment and retention in remote areas in Mali: A longitudinal study

Objectives:

The telehealth project EQUI-ResHuS (in French, Les TIC pour un accès Équitable aux Ressources Humaines en Santé) aimed to contribute to more equitable access to care and support practice in remote regions in Mali. This study explored the evolution of perceptions concerning telehealth among healthcare professionals in the four district health centres that participated in the EQUI-ResHus project and identified variables influencing their perceptions of telehealth impact on recruitment and retention of health professionals.

Methods:

One year after a first survey (T1), a second data collection (T2) was carried out among healthcare professionals using a 91-item questionnaire. Questions assessing telehealth use and perceptions and perceived impact on recruitment and retention of healthcare professionals were rated on a 5-point Likert scale. A total of 10 independent variables were considered for the analyses. A Wilcoxon signed-rank test was performed to detect differences between T1 and T2, and a bivariate linear regression model for repeated measures was carried out to assess the impact of independent variables on dependent variables.

Results:

There were no noticeable changes in perceptions related to telehealth influence on recruitment and retention. Only access to information and communication technology significantly differed between T1 and T2 according the Wilcoxon rank test (p = 0.001). Perceived influence of telehealth on recruitment and retention was mostly explained by attitude towards telehealth, perceived effect on recruitment and retention and barriers to recruitment and retention.

Conclusion:

Based on our results, telehealth was perceived as having a positive influence but mostly indirect influence on healthcare professional recruitment and retention. Also, there were no major changes after 1 year of telehealth use.

The influence of a wound care teleassistance service on nursing practice: a case study in Quebec

BACKGROUND

Although telehealth is a promising solution for healthcare professionals who work in remote and rural regions, the influence of specific telehealth applications on the nursing workforce remains unknown. This case study aimed to explore the potential influence of a teleassistance service in wound care (the acronym in French is TASP) on nursing practices and on nurse retention in peripheral areas.

MATERIALS AND METHODS

We carried out an exploratory single case study based on 16 semistructured interviews with two promoters of TASP, five nursing managers, and nine nurses from three levels of expertise associated with this service.

RESULTS

According to participants, the main positive influences of TASP were observed in quality of care, professional autonomy, professional development, and decrease of professional isolation. Participants mentioned increased workload associated with global patient data collection at first consultation as a negative effect of TASP. Finally, three possible effects of TASP on nurse retention were identified: none or minimal, imprecise, or mostly positive.

CONCLUSIONS

This case study highlights the positive influence of TASP on several dimensions of nursing practice, in addition to its essential role in improving the quality of care. However, it is important to consider that the service cannot be considered as a solution to or replacement for the shortage of nurses.

Interventions for supporting nurse retention in rural and remote areas: an umbrella review

CONTEXT

Retention of nursing staff is a growing concern in many countries, especially in rural, remote or isolated regions, where it has major consequences on the accessibility of health services.

PURPOSE

This umbrella review aims to synthesize the current evidence on the effectiveness of interventions to promote nurse retention in rural or remote areas, and to present a taxonomy of potential strategies to improve nurse retention in those regions.

METHODS

We conducted an overview of systematic reviews, including the following steps: exploring scientific literature through predetermined criteria and extracting relevant information by two independents reviewers. We used the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) criteria in order to assess the quality of the reports.

FINDINGS

Of 517 screened publications, we included five reviews. Two reviews showed that financial-incentive programs have substantial evidence to improve the distribution of human resources for health. The other three reviews highlighted supportive relationships in nursing, information and communication technologies support and rural health career pathways as factors influencing nurse retention in rural and remote areas. Overall, the quality of the reviews was acceptable.

CONCLUSIONS

This overview provides a guide to orient future rural and remote nurse retention interventions. We distinguish four broad types of interventions: education and continuous professional development interventions, regulatory interventions, financial incentives, and personal and professional support. More knowledge is needed regarding the effectiveness of specific strategies to address the factors known to contribute to nurse retention in rural and remote areas. In order to ensure knowledge translation, retention strategies should be rigorously evaluated using appropriate designs.