Effectiveness of nursing management information systems: a systematic review

Nurse Managers' Opinions of Information System Support for Performance Management: A Correlational Study

BACKGROUND

 Current information systems do not effectively support nurse managers' duties, such as reporting, resource management, and assessing clinical performance. Few performance management information systems are available and features in many are scattered.

OBJECTIVES

 The purpose of the study was to determine nurse managers' opinions of information system support for performance management.

METHODS

 An online questionnaire was used to collect data from nurse managers (n = 419). Pearson's correlation coefficients and linear regression were used to examine the relationships between variables, which were nurse managers' ability to manage resources, to report and evaluate productivity, and to assess nursing performance and clinical procedures.

RESULTS

 More than half of the managers used performance management systems daily. Managers (60%) felt that they can use information systems to follow the use of physical resources, and in general (63%), they felt that it is easy to perform searches with the systems used for following up activity. Nurse managers' ability to manage resources, to report productivity, and to assess nursing care performance were correlated significantly with each other.

CONCLUSION

 Currently, managers have to collect data from various systems for management purposes, as system integration does not support performance data collection. The availability of continuous in-service training had a positive effect on information system use.

Prevention of catheter-associated urinary tract infection in neurological post-operation patients: a best practice implementation project

OBJECTIVE

The objective of this evidence based implementation project was to promote evidence based practice in the prevention of catheter-associated urinary tract infection (CAUTI) in the neurology and neurosurgery units of a Taipei hospital.

INTRODUCTION

Catheter-associated urinary tract infection has been associated with increased morbidity, mortality, hospital costs and length of stay. Urinary drainage systems are often reservoirs of infection in patients, thus effective prevention of CAUTI requires an evidence-based approach. The CAUTI incidence in the neurosurgery units of the hospital was 1.86-2.69% urinary catheter days, which ranked as medium when compared to the entire hospital.

METHOD

A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool, based on eight audit criteria that represented best practice recommendations for CAUTI. A baseline audit of the neurology and neurosurgery units was performed, followed by the implementation of multiple strategies throughout a 20-week period. A follow-up audit was undertaken after this to assess changes in practice.

RESULTS

The post strategy implementation audit results indicated that compliance with clinical guideline recommendations improved considerably. Proper utilization of an appropriate closed drainage system and training of persons maintaining catheters achieved 100% compliance. The guideline recommendation that catheter and drainage bags be changed only when clinically indicated reached 94% compliance. Catheters removed within 24 hours postoperatively improved by more than 50% compliance. Compliance with systemic antimicrobials being clinically indicated and their use justified improved by 25% and documentation on a clinically appropriate indication for ongoing urinary catheterization improved by almost 33.3%.

CONCLUSIONS

The implementation project was successful in improving nurses' knowledge and skills related to the prevention of CAUTI. A variety of strategies, such as an education program, simple and clear instruments, collaboration with physicians in caring for patients with a high risk of CAUTI, and multiple educational materials can facilitate implementation of evidence based procedures in clinical practice.

Supporting factors of the implementation of clinical pathway approach in nursing care

OBJECTIVE

This study aimed to identify the supporting factors and the nurses' expectation related to the implementation of clinical pathway in nursing care at the hospital.

METHODS

A quantitative, cross-sectional, descriptive study was conducted at a medical-surgical unit of a hospital in Jakarta Indonesia. Participants were 100 nurses with minimal one-year work experience, selected using proportional purposive sampling method. Data were collected using a questionnaire and were analyzed descriptively.

RESULTS

The nursing care management factor was found to be of highest performance (90%), while the rest showed inadequate performances (24%, 14%, 39%, and 41%, respectively). Meanwhile, nurses expected to have improved nursing care information system (50%) and reward system (60%) to support the clinical pathway in nursing care.

CONCLUSIONS

Most of the supporting factors in the implementation of clinical pathway in nursing care were still suboptimal. Nurses' expectations on this issue indicate that there will be an improvement.