Development of a web-based care networking system to support visiting healthcare professionals in the community

BACKGROUND

The role of visiting health services has been proven to be effective in promoting the health of older populations. Hence, developing a web system for nurses may help improve the quality of visiting health services for community-dwelling frail older adults. This study was conducted to develop a web application that reflects the needs of visiting nurses.

METHODS

Visiting nurses of public health centers and community centers in South Korea participated in the design and evaluation process. Six nurses took part in the focus group interviews, and 21 visiting nurses and community center managers participated in the satisfaction evaluation. Focus group interviews were conducted to identify the needs of visiting nurses with respect to system function. Based on the findings, a web application that can support the effective delivery of home visiting services in the community was developed. An artificial intelligence (AI) algorithm was also developed to recommend health and welfare services according to each patient's health status. After development, a structured survey was conducted to evaluate user satisfaction with system features using Kano's model.

RESULTS

The new system can be used with mobile devices to increase the mobility of visiting nurses. The system includes 13 features that support the management of patient data and enhance the efficiency of visiting services (e.g., map, navigation, scheduler, protocol archives, professional advice, and online case conferencing). The user satisfaction survey revealed that nurses showed high satisfaction with the system. Among all features, the nurses were most satisfied with the care plan, which included AI-based recommendations for community referral.

CONCLUSIONS

The system developed from the study has attractive features for visiting nurses and supports their essential tasks. The system can help with effective case management for older adults requiring in-home care and reduce nurses' workload. It can also improve communication and networking between healthcare and long-term care institutions.

Researching the Effectiveness of an Online Human Trafficking Awareness Program Among Community Health Nursing Students

PURPOSE

To evaluate the effectiveness of an online human trafficking awareness program for healthcare providers.

DESIGN

Mixed-methods study.

METHODS

Sample (N=141) consisted of community health nursing students, who completed a pretest, watched one three-minute video a day for 20 days, and completed a posttest.

FINDINGS

Participants indicated their knowledge of human trafficking increased, attitudes toward victims improved, and competence and confidence engaging with victims increased. Satisfaction with program, and information utilization plans for practice were revealed.

CONCLUSIONS

Human trafficking awareness program was effective in increasing participants' knowledge, competence and confidence, and improving attitudes.

CLINICAL EVIDENCE

Educational intervention is a strategy to improve students' knowledge of human trafficking.

Effects of a Virtual Educational Intervention to Teach Interprofessional Collaboration to Community Health Nursing Students

PURPOSE

To evaluate the effectiveness of a virtual interprofessional collaboration in public health educational intervention.

DESIGN

Mixed-methods study.

METHODS

Sample (N =171) consisted of community health nursing students, who completed an assessment after watching six videos, illustrating how various disciplines collaborate in a public health department.

FINDINGS

Participants felt their interprofessional awareness, understanding, and collaboration intention increased; clarified discipline misconceptions, and application/utilization plans for this knowledge in practice were revealed.

CONCLUSIONS

Interprofessional collaboration in public health educational intervention was effective in increasing participants' interprofessional awareness, understanding, and intent to collaborate.

CLINICAL EVIDENCE

Educational intervention is a strategy to improve students' knowledge of interprofessional collaboration in public health.

Community-based short-term integrated palliative and supportive care reduces symptom distress for older people with chronic noncancer conditions compared with usual care: A randomised controlled single-blind mixed method trial

BACKGROUND

Globally, a rising number of people live into advanced age and die with multimorbidity and frailty. Palliative care is advocated as a person-centred approach to reduce health-related suffering and promote quality of life. However, no evidence-based interventions exist to deliver community-based palliative care for this population.

AIM

To evaluate the impact of the short-term integrated palliative and supportive care intervention for older people living with chronic noncancer conditions and frailty on clinical and economic outcomes and perceptions of care.

DESIGN

Single-blind trial with random block assignment to usual care or the intervention and usual care. The intervention comprised integrated person-centred palliative care delivered by multidisciplinary palliative care teams working with general practitioners and community nurses. Main outcome was change in five key palliative care symptoms from baseline to 12-weeks. Data analysis used intention to treat and complete cases to examine the mean difference in change scores and effect size between the trial arms. Economic evaluation used cost-effectiveness planes and qualitative interviews explored perceptions of the intervention.

SETTING/PARTICIPANTS

Four National Health Service general practices in England with recruitment of patients aged ≥75 years, with moderate to severe frailty, chronic noncancer condition(s) and ≥2 symptoms or concerns, and family caregivers when available.

RESULTS

50 patients were randomly assigned to receive usual care (n = 26, mean age 86.0 years) or the intervention and usual care (n = 24, mean age 85.3 years), and 26 caregivers (control n = 16, mean age 77.0 years; intervention n = 10, mean age 77.3 years). Participants lived at home (n = 48) or care home (n = 2). Complete case analysis (n = 48) on the main outcome showed reduced symptom distress between the intervention compared with usual care (mean difference -1.20, 95% confidence interval -2.37 to -0.027) and medium effect size (omega squared = 0.071). Symptom distress reduced with decreased costs from the intervention compared with usual care, demonstrating cost-effectiveness. Patient (n = 19) and caregiver (n = 9) interviews generated themes about the intervention of 'Little things make a big difference' with optimal management of symptoms and 'Care beyond medicines' of psychosocial support to accommodate decline and maintain independence.

CONCLUSIONS

This palliative and supportive care intervention is an effective and cost-effective approach to reduce symptom distress for older people severely affected by chronic noncancer conditions. It is a clinically effective way to integrate specialist palliative care with primary and community care for older people with chronic conditions. Further research is indicated to examine its implementation more widely for people at home and in care homes.

TRIAL REGISTRATION

Controlled-Trials.com ISRCTN 45837097 Tweetable abstract: Specialist palliative care integrated with district nurses and GPs is cost-effective to reduce symptom distress for older people severely affected by chronic conditions.

Community and family nurse: Present keys, future challenges

It is the mission of the Community and Family Nurse through an integral and holistic approach to accompany people from cradle to death in developing their health potential, and promote different family, work and social environments to facilitate this development. Throughout history, various international, European and national organizations have regulated the figure of the Community and Family Nurse, and now their functions, powers and professional performance are fully regulated. The Community and Family Nurse can respond to the needs of a changing population and take on new responsibilities in management and research. Their extensive basic and advanced skills gathered under a rigorous training programme, benefit the health system, the nursing profession, citizenry and its communities. Many challenges remain for the Health Departments of each Autonomous Region to make it possible for this specialty to develop its full potential for improving care.

Translating Team-Based Breastfeeding Support into Primary Care Practice

BACKGROUND

Team-based care facilitates efficient, evidence-based, patient-centered practice. An outpatient, integrated lactation consultant (LC) and primary care provider (PCP) model improves breastfeeding support, yet practices need assistance with implementation.

METHOD

Based on experience with team-based breastfeeding support at a suburban practice serving mainly well-educated and privately insured families, we constructed and piloted a 6-step needs assessment that informed implementation of the model at a federally qualified health center (FQHC). Practice assessment included baseline data collection of practice newborn volume, breastfeeding intent, breastfeeding rates, provider survey, and financial variables. Postimplementation outcome measurements included provider satisfaction and visit volume.

RESULTS

Analysis using newborn volume, breastfeeding intent, and average insurance reimbursement enabled business calculation, which estimated additional 400 visits per year and revenue to cover staff training costs. The baseline provider survey (n = 20) assessed knowledge, practice resources, and barriers. The main barriers identified to providing lactation support were "not enough time" (80%) and patients "not receiving adequate help" (80%) with 58% noting "inadequate LC staffing at the clinic." After team-based LC/PCP implementation, monthly lactation visit volume doubled. Provider postintervention assessment surveys (n = 20) demonstrated a positive response with providers reporting a perception of "providing better breastfeeding support" (100%) and that "patients had a positive breastfeeding support experience" (84%).

CONCLUSION

Team-based LC and PCP health care is a promising approach for delivering efficient, patient-centered, face-to-face counseling and support. Practice assessment informs financial feasibility and confirms provider interest in change. An integrated LC/PCP model can be implemented in a FQHC while enhancing patient breastfeeding support and provider satisfaction.

[Development and Effects of Social Learning Theory Based Eye-Health Program for Preschoolers]

PURPOSE

The purpose of this study was to develop an eye-health program based on social learning theory (EPST) of preschoolers and evaluate its effectiveness.

METHODS

A nonequivalent control group pre-post test design was utilized and 141 six-year-old preschoolers and their parents participated (experimental group=69, control group=72) in the study. The EPST in this study included eye-health education and eye exercises. Attention, memory, replay, motivation, reinforcement, and self-efficacy were used as interventional strategies. To examine the effectiveness of EPST, proficiency in eye-health activities, refractive power, and visual acuity were measured before and after the intervention. Data were analyzed with SPSS WIN 21.0 using the Shapiro-Wilk test, χ²-test, Mann-Whitney U test and Wilcoxon signed rank test.

RESULTS

Following the intervention, eye-health activities, refractive power, and visual acuity significantly improved in the experimental group compared to the control group.

CONCLUSION

The results of this study suggest that EPST is effective in improving eye-health activities, refractive power, and visual acuity in preschoolers, and its wider implementation in educational institutions will promise improved eye-health among preschoolers.

Construction and usability of community health nursing database in rural north-eastern Thailand

INTRODUCTIONS

Digitization could be incorporated in rural areas of resource-poor countries because information gathered by nurses working on-site could be better used.

BACKGROUND

For effective management of community health information, the usage and maintenance of digital records are important. Digitization of information provides essential information for informing health policy.

AIM

To develop a sustainable database to effectively collect and manage community health information and nursing practice.

METHODS

This study used a mixed method design. Phase 1 involved the development of a database system through repeated systematic focus group discussions with community health nurses. Phase 2 involved a practical trial examination of the developed system with both objective and subjective evaluations.

RESULTS

A nursing database system was developed with templates designed for the major health problems of communities. The templates were composed of multiple-choice items and a free-text field that allowed records to be more detailed than handwritten records and maintained in standardized formats. This enables accumulation of data that were less likely to be influenced by the variance of ability in each nurse.

DISCUSSION AND CONCLUSION

A multifaceted evaluation of the database system suggested that it could improve the efficiency of information management and contribute to the improvement of nursing care quality through standardization of the recording pattern.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The nursing database will enable high-quality information storage that will potentially better inform health and healthcare policies as well as enable visualization of data concerning nursing care challenges and activities within the relevant communities. This information is essential for policy development and implementation in areas of human and fiscal resource allocations and meeting training/education needs.

Perceptions of nursing students after performing an individual activity designed to develop their critical thinking: The "critical card" tool

Critical thinking in Health Sciences is among the transversal competences in the Nursing Degree. The critical card is a tool of individual learning, designed to develop critical thinking, and set in the process of environmental health learning. Every student must perform the activity to obtain the highest qualification in Community Health Nursing subject. The aim of this project was to evaluate this learning tool using the students' perceptions after its performance. The evaluation was based on the answers to a questionnaire obtained from the third course students of Nursing Degree at the University of Zaragoza. The questionnaire was made up of 14 Likert-type questions, grouped in four dimensions. The student participation rate was higher than 50%. The analysis of the questionnaire obtained 67,8% positive answers. The variability between dimensions ranged between 49% of positive answers for application in other subjects and 87% of positive answers for the improvements applicable to the instrument. The students coincided in indicating that the critical card is a useful learning tool and could be applicable in other subjects. However, the weight it is given in the global evaluation of the subject is considered to be too low, considering the time used to complete the activity.

The training of specialists in Family and Community Health Nursing according to the supervisors of the teaching units

OBJECTIVE

To analyze the current situation of the training of specialists in family and community nursing from the perspective of nurses responsible for teaching units.

METHODS

Exploratory analysis using nominal group technique of the contributions made by representatives of 19 multidisciplinary teaching units in family and community care from 11 Spanish autonomous communities. They categorized and weighted those contributions.

RESULTS

The emerging categories on the strengths and difficulties encountered related to the tutors, the environment where the training took place, the structure of the teaching unit, the organization of the teaching and the official programme of the speciality, the external supports and the theoretical training.

CONCLUSIONS

Training in Family and Community Nursing is an opportunity to improve primary health care to train in news and necessary but complex skills. Support is required for training to be effective and the specialty and training should be made known. Tutors are a key part of this process.

Community health nurses' HIV health promotion and education programmes: a qualitative study

BACKGROUND

Globally, nurses practice in many settings with people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS), taking an increasing share of the professional burden of care and helping to reduce morbidity and mortality. International literature is sparse about Thai community nurses providing primary healthcare programmes for people with HIV.

AIM

This study aimed to describe background, experiences and strategies of community nurses regarding their design and delivery of programmes for people living with HIV and AIDS in Chiang Mai Province, Thailand.

DESIGN

This study used a qualitative mixed-methods study employing a qualitative survey and in-depth interviews.

METHODS

Twenty community health nurses from 18 small community hospitals completed a survey comprising demographic data and 13 open-ended questions. Four of them later engaged in in-depth interviews using the same questions. Survey, interview data and field notes were analysed using interpretive content analysis.

FINDINGS

Four themes and six sub-themes portrayed participants' rich experiences and knowledge of HIV health promotion and education; challenges of daily work, discrimination and ethical issues; success through programme diversity comprising promotion of community volunteerism, networking and relationships; and holistic connections with Thai cultural traditions and Buddhism.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Findings help to recognize the diversity, uniqueness and contributions of Thai community nurses regarding culturally appropriate health promotion and education programmes for people living with HIV and AIDS. Findings inform nurses and health officials in and outside of the country to complement innovation in future HIV health promotion and education programmes.

LIMITATIONS

Our sample came from one province of Thailand. Findings might not be reflective of nurses elsewhere.

IMPLICATIONS FOR HEALTH AND NURSING POLICY

Three decades of collective experience in providing holistic and multifaceted HIV and AIDS nursing care, education and health promotion by community health nurses have the potential to effect new and existing policies and protocols on HIV community care in Thailand, but more research is required for this.