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Radbron E, McCance T, Middleton R, Wilson V. Using data from mHealth apps to inform person-centred practice: A discussion paper. Contemp Nurse 2024; 60:96-105. [PMID: 38368623 DOI: 10.1080/10376178.2024.2316604] [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: 08/15/2023] [Accepted: 02/04/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND mHealth applications (apps) are tools that can enhance research by efficiently collecting and storing large amounts of data. However, data collection alone does not lead to change. Innovation and practice change occur through utilisation of evidence. The volume of data collected raises questions regarding utilisation of data by nurses and midwives, and how data from mHealth apps can be used to improve person-centred practice. There is limited empirical evidence and a lack of direction from global health authorities to guide nurses and midwives in this area. AIM To describe strategies for nurses and midwives that could enhance the effective use of data generated by mHealth apps to inform person-centred practice. The purpose of this paper is to stimulate reflection and generate actions for data utilisation when using mHealth apps in nursing research and practice. METHODS This discussion paper has been informed by current evidence, the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, and research experience as part of doctoral study. FINDINGS Before engaging in data collection using mHealth apps, nurses and midwives would benefit from considering the nature of the evidence collected, available technological infrastructure, and staff skill levels. When collecting data and interpreting results, use of a team approach supported by engaged leadership and external facilitation is invaluable. This provides support to operate apps, and more importantly use the data collected to inform person-centred practice. CONCLUSIONS This paper addresses the limited available evidence to guide nurses and midwives when using mHealth apps to collect and use data to inform practice change. It highlights the need for appropriate technology, external facilitative support, engaged leadership, and a team approach to collect meaningful evidence using mHealth apps. Clinicians, leaders, and researchers can apply the strategies provided to enhance the use of mHealth apps and ensure translation of evidence into practice.
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Affiliation(s)
- Emma Radbron
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Tanya McCance
- Institute of Nursing and Health Research, Ulster University, Belfast, UK
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Valerie Wilson
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
- South Western Sydney Local Health District (SWSLHD), Ingham Institute for Applied Medical Research, Liverpool, Australia
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Radbron E, Middleton R, Wilson V, McCance T. How nurses and midwives engage with patient experience data to inform person-centred quality and safety improvements. J Clin Nurs 2021; 31:3464-3476. [PMID: 34897879 DOI: 10.1111/jocn.16173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore how nurses and midwives engage with patient experience data collected via a mobile health app to inform person-centred practice improvements. BACKGROUND A large amount of data is collected in healthcare, yet there is limited evidence outlining how nursing and midwifery staff utilise patient experience data to inform person-centred quality and safety improvements. METHODS This study utilised action research, underpinned by Practice Development methodology and has been reported using the SQUIRE 2.0 checklist. Six clinical units (medical short stay, acute medical, surgical, oncology/haematology, day surgery and maternity) in a large health district in Australia engaged in three cycles of data collection using a mobile health app. The app captured patient experience data relating to the person-centred KPIs developed and tested by McCance et al. (2012). Staff used the data to develop and evaluate person-centred practice. RESULTS A number of improvements in scores and practice occurred through engaging with the data in a cyclical way. All six clinical units saw an improvement in four or more of the KPIs in the patient survey results from cycle one to cycle three, with two clinical units improving in all eight. On average across the six units, there was also an increase in time nurses/midwives were visible to their patients, an increase in clinical documentation reflecting the patients' needs and what was important to them, an increase in positive comments and a decrease in negative comments in patient stories. CONCLUSION This study shows that collecting and utilising data from the person-centred KPIs in a collaborative and cyclical way lead to enhanced patient experience and the development and implementation of person-centred quality and safety improvements. RELEVANCE TO CLINICAL PRACTICE Capturing and utilising data that are meaningful to nursing/midwifery teams in a cyclical, action-orientated approach result in person-centred practice improvements that enhance the experience of those that are receiving and delivering patient care.
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Affiliation(s)
- Emma Radbron
- PhD Candidate, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia.,Nurse Manager-iMPAKT Study, Nursing and Midwifery Research Unit Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Rebekkah Middleton
- Senior Lecturer, Faculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Valerie Wilson
- Professor of Nursing, Nursing and Midwifery Research Unit, Illawarra Shoalhaven Local Health District and University of Wollongong, Wollongong, New South Wales, Australia
| | - Tanya McCance
- The Mona Grey Professor of Nursing, Nursing Research & Development, University of Ulster, Jordanstown, Northern Ireland
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McCance T, Lynch BM, Boomer C, Brown D, Nugent C, Ennis A, Garcia-Constantino M, Clelland I, Edgar D, Radbron E, Wilson V. Implementing and measuring person-centredness using an APP for knowledge transfer: the iMPAKT app. Int J Qual Health Care 2021; 32:251-258. [PMID: 32211855 DOI: 10.1093/intqhc/mzaa018] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/17/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The aim of the study was to evaluate a technological solution in the form of an App to implement and measure person-centredness in nursing. The focus was to enhance the knowledge transfer of a set of person-centred key performance indicators and the corresponding measurement framework used to inform improvements in the experience of care. DESIGN The study used an evaluation approach derived from the work of the Medical Research Council to assess the feasibility of the App and establish the degree to which the App was meeting the aims set out in the development phase. Evaluation data were collected using focus groups (n = 7) and semi-structured interviews (n = 7) to capture the impact of processes experienced by participating sites. SETTING The study was conducted in the UK and Australia in two organizations, across 11 participating sites. PARTICIPANTS 22 nurses from 11 sites in two large health care organizations were recruited on a voluntary basis. INTERVENTION Implementing the KPIs and measurement framework via the APP through two cycles of data collection. MAIN OUTCOME MEASURES The main outcome was to establish feasibility in the use of the App. RESULTS The majority of nurse/midwife participants found the App easy to use. There was broad consensus that the App was an effective method to measure the patient experience and generated clear, concise reports in real time. CONCLUSIONS The implementation of the person-centred key performance indicators using the App enhanced the generation of meaningful data to evidence patient experience across a range of different clinical settings.
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Affiliation(s)
- Tanya McCance
- Faculty of Life and Health Sciences, Institute of Nursing and Health Research, Ulster, University Jordanstown, Shore Road, Belfast BT37 0QB, Northern Ireland
| | - Brighide M Lynch
- Faculty of Life and Health Sciences, Institute of Nursing and Health Research, Ulster, University Jordanstown, Shore Road, Belfast BT37 0QB, Northern Ireland
| | - Christine Boomer
- South Eastern Health & Social Care Trust, Ulster Hospital, Upper Newtownards Rd, Dundonald, Belfast BT16 1RH, Northern Ireland
| | - Donna Brown
- Faculty of Life and Health Sciences, Institute of Nursing and Health Research, Ulster, University Jordanstown, Shore Road, Belfast BT37 0QB, Northern Ireland
| | - Christopher Nugent
- School of Computing, Ulster, University Jordanstown, Shore Road, Belfast BT37 0QB, Northern Ireland
| | - Andrew Ennis
- School of Computing, Connected Health Innovation Centre (CHIC), Ulster, University Jordanstown, Shore Road, Belfast BT37 0QB, Northern Ireland
| | | | - Ian Clelland
- School of Computing, Ulster, University Jordanstown, Shore Road, Belfast BT37 0QB, Northern Ireland
| | - Denise Edgar
- Illawarra Shoalhaven Local Health District, Nursing Development and Research Unit, Academic Unit, Level 8, The Wollongong Hospital, NSW, 2500 Australia
| | - Emma Radbron
- School of Nursing, University of Wollongong, Wollongong, NSW, 2500 Australia
| | - Valerie Wilson
- Illawarra Shoalhaven Local Health District, Nursing and Midwifery Research Unit, Academic Unit, Level 8, The Wollongong Hospital, University of Wollongong, NSW, 2500 Australia
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Kumar R, Das A. The Potential of mHealth as a Game Changer for the Management of Sickle Cell Disease in India. JMIR Mhealth Uhealth 2021; 9:e25496. [PMID: 33847598 PMCID: PMC8080143 DOI: 10.2196/25496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/09/2021] [Accepted: 01/22/2021] [Indexed: 12/11/2022] Open
Abstract
Sickle cell disease (SCD) is a chronic genetic disease that requires lifelong therapy and monitoring. Low drug adherence and poor monitoring may lead to an increase in morbidities and low quality of life. In the era of digital technology, various mobile health (mHealth) apps are being tested for their potential in increasing drug adherence in patients with SCD. We herewith discuss the applicability and feasibility of these mHealth apps for the management of SCD in India.
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Affiliation(s)
- Ravindra Kumar
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | - Aparup Das
- ICMR-National Institute of Research in Tribal Health, Jabalpur, India
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Critchley HOD, Babayev E, Bulun SE, Clark S, Garcia-Grau I, Gregersen PK, Kilcoyne A, Kim JYJ, Lavender M, Marsh EE, Matteson KA, Maybin JA, Metz CN, Moreno I, Silk K, Sommer M, Simon C, Tariyal R, Taylor HS, Wagner GP, Griffith LG. Menstruation: science and society. Am J Obstet Gynecol 2020; 223:624-664. [PMID: 32707266 PMCID: PMC7661839 DOI: 10.1016/j.ajog.2020.06.004] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/13/2020] [Accepted: 06/03/2020] [Indexed: 12/11/2022]
Abstract
Women's health concerns are generally underrepresented in basic and translational research, but reproductive health in particular has been hampered by a lack of understanding of basic uterine and menstrual physiology. Menstrual health is an integral part of overall health because between menarche and menopause, most women menstruate. Yet for tens of millions of women around the world, menstruation regularly and often catastrophically disrupts their physical, mental, and social well-being. Enhancing our understanding of the underlying phenomena involved in menstruation, abnormal uterine bleeding, and other menstruation-related disorders will move us closer to the goal of personalized care. Furthermore, a deeper mechanistic understanding of menstruation-a fast, scarless healing process in healthy individuals-will likely yield insights into a myriad of other diseases involving regulation of vascular function locally and systemically. We also recognize that many women now delay pregnancy and that there is an increasing desire for fertility and uterine preservation. In September 2018, the Gynecologic Health and Disease Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development convened a 2-day meeting, "Menstruation: Science and Society" with an aim to "identify gaps and opportunities in menstruation science and to raise awareness of the need for more research in this field." Experts in fields ranging from the evolutionary role of menstruation to basic endometrial biology (including omic analysis of the endometrium, stem cells and tissue engineering of the endometrium, endometrial microbiome, and abnormal uterine bleeding and fibroids) and translational medicine (imaging and sampling modalities, patient-focused analysis of menstrual disorders including abnormal uterine bleeding, smart technologies or applications and mobile health platforms) to societal challenges in health literacy and dissemination frameworks across different economic and cultural landscapes shared current state-of-the-art and future vision, incorporating the patient voice at the launch of the meeting. Here, we provide an enhanced meeting report with extensive up-to-date (as of submission) context, capturing the spectrum from how the basic processes of menstruation commence in response to progesterone withdrawal, through the role of tissue-resident and circulating stem and progenitor cells in monthly regeneration-and current gaps in knowledge on how dysregulation leads to abnormal uterine bleeding and other menstruation-related disorders such as adenomyosis, endometriosis, and fibroids-to the clinical challenges in diagnostics, treatment, and patient and societal education. We conclude with an overview of how the global agenda concerning menstruation, and specifically menstrual health and hygiene, are gaining momentum, ranging from increasing investment in addressing menstruation-related barriers facing girls in schools in low- to middle-income countries to the more recent "menstrual equity" and "period poverty" movements spreading across high-income countries.
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Affiliation(s)
- Hilary O D Critchley
- Medical Research Council Centre for Reproductive Health, The University of Edinburgh, United Kingdom.
| | - Elnur Babayev
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Serdar E Bulun
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Iolanda Garcia-Grau
- Igenomix Foundation-Instituto de Investigación Sanitaria Hospital Clínico, INCLIVA, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, School of Medicine, University of Valencia, Valencia, Spain
| | - Peter K Gregersen
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY
| | | | | | | | - Erica E Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI
| | - Kristen A Matteson
- Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - Jacqueline A Maybin
- Medical Research Council Centre for Reproductive Health, The University of Edinburgh, United Kingdom
| | - Christine N Metz
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY
| | - Inmaculada Moreno
- Igenomix Foundation-Instituto de Investigación Sanitaria Hospital Clínico, INCLIVA, Valencia, Spain
| | - Kami Silk
- Department of Communication, University of Delaware, Newark, DE
| | - Marni Sommer
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Carlos Simon
- Igenomix Foundation-Instituto de Investigación Sanitaria Hospital Clínico, INCLIVA, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, School of Medicine, University of Valencia, Valencia, Spain; Beth Israel Deaconess Medical Center, Harvard University, Boston, MA; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
| | | | - Hugh S Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
| | - Günter P Wagner
- Department of Ecology and Evolutionary Biology, Department of Obstetrics, Gynecology and Reproductive Sciences, Systems Biology Institute, Yale University, New Haven, CT; Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
| | - Linda G Griffith
- Center for Gynepathology Research, Massachusetts Institute of Technology, Cambridge, MA
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