Browsing by Author "Dubrowski, Adam"
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- ItemRemote Mentoring of Point-of-Care Ultrasound Skills to Inexperienced Operators Using Multiple Telemedicine Platforms: Is a Cell Phone Good Enough?(0000-00-00) Smith, Andrew; Addison, Reuben; Rogers, Peter; Stone-McLean, Jordan; Boyd, Sarah; Hoover, Kristopher; Pollard, Megan; Dubrowski, Adam; Parsons, MikeOBJECTIVES Telemedicine technology contributes to the teaching of point of care ultrasound US however expensive equipment can limit its deployment in resource challenged settings We assessed 3 low cost telemedicine solutions capable of supporting remote US training to determine feasibility acceptability and effectiveness We also explored the value of instructional videos immediately before telementoring METHODS Thirty six participants were randomly assigned to receive US mentoring in 1 of 3 telemedicine conditions multiple fixed cameras a smartphone and traditional audio with a live US stream Participants were then asked to perform a standardized US examination of the right upper quadrant under remote guidance We measured observer s global ratings of performance along with the mentor s and student s rating of effort and satisfaction to determine which of the 3 approaches was most feasible acceptable and effective During the second phase students were randomized to watch an instructional video or not before receiving remote coaching on how to complete a subxiphoid cardiac examination Effort satisfaction and performance from the independent observer s and student s perspective were surveyed RESULTS There was no significant difference between the different telemedicine setups from the observer s perspective however the mentor rated the smartphone significantly worse P 028 04 than other technologies Platforms were rated equivalent from the student s perspective No benefit was detected for watching an instructional video before the mentored task CONCLUSIONS Remote US skills can be taught equally effectively by using a variety of telemedicine technologies Smartphones represent a viable option for US training in resource challenged settings
- ItemThe role of organizational context and individual nurse characteristics in explaining variation in use of information technologies in evidence based practice.(2013-01-14) Doran, Diane; Haynes, Brian R; Estabrooks, Carole A; Kushniruk, André; Dubrowski, Adam; Bajnok, Irmajean; Hall, Linda McGillis; Li, Mingyang; Carryer, Jennifer; Jedras, Dawn; Bai, Yu Qing ChrisBACKGROUND There is growing awareness of the role of information technology in evidence based practice The purpose of this study was to investigate the role of organizational context and nurse characteristics in explaining variation in nurses use of personal digital assistants PDAs and mobile Tablet PCs for accessing evidence based information The Promoting Action on Research Implementation in Health Services PARIHS model provided the framework for studying the impact of providing nurses with PDA supported evidence based practice resources and for studying the organizational technological and human resource variables that impact nurses use patterns METHODS A survey design was used involving baseline and follow up questionnaires The setting included 24 organizations representing three sectors hospitals long term care LTC facilities and community organizations home care and public health The sample consisted of 710 participants response rate 58 at Time 1 and 469 for whom both Time 1 and Time 2 follow up data were obtained response rate 66 A hierarchical regression model HLM was used to evaluate the effect of predictors from all levels simultaneously RESULTS The Chi square result indicated PDA users reported using their device more frequently than Tablet PC users p 0 001 Frequency of device use was explained by breadth of device functions and PDA versus Tablet PC Frequency of Best Practice Guideline use was explained by willingness to implement research structural and electronic resources organizational slack time breadth of device functions positive effects and slack staff negative effect Frequency of Nursing Plus database use was explained by culture structural and electronic resources and breadth of device functions positive effects and slack staff negative Organizational culture positive breadth of device functions positive and slack staff negative were associated with frequency of Lexi PEPID drug dictionary use CONCLUSION Access to PDAs and Tablet PCs supported nurses self reported use of information resources Several of the organizational context variables and one individual nurse variable explained variation in the frequency of information resource use
- ItemSupporting evidence-based practice for nurses through information technologies.(2010-05-03) Doran, Diane M; Haynes, R Brian; Kushniruk, André; Straus, Sharon; Grimshaw, Jeremy; Hall, Linda McGillis; Dubrowski, Adam; Di Pietro, Tammie; Newman, Kristine; Almost, Joan; Nguyen, Ha; Carryer, Jennifer; Jedras, DawnPURPOSE To evaluate the usability of mobile information terminals such as personal digital assistants PDAs or Tablet personal computers to improve access to information resources for nurses and to explore the relationship between PDA or Tablet supported information resources and outcomes BACKGROUND The authors evaluated an initiative of the Nursing Secretariat Ontario Ministry of Health and Long Term Care which provided nurses with PDAs and Tablet PCs to enable Internet access to information resources Nurses had access to drug and medical reference information best practice guidelines BPGs and to abstracts of recent research studies METHOD The authors took place over a 12 month period Diffusion of Innovation theory and the Promoting Action on Research Implementation in Health Services PARIHS model guided the selection of variables for study A longitudinal design involving questionnaires was used to evaluate the impact of the mobile technologies on barriers to research utilization perceived quality of care and on nurses job satisfaction The setting was 29 acute care long term care home care and correctional organizations in Ontario Canada The sample consisted of 488 frontline nurses RESULTS Nurses most frequently consulted drug and medical reference information Google and Nursing PLUS Overall nurses were most satisfied with the Registered Nurses Association of Ontario RNAO BPGs and rated the RNAO BPGs as the easiest resource to use Among the PDA and Tablet users there was a significant improvement in research awareness values and in communication of research There was also for the PDA users only a significant improvement over time in perceived quality of care and job satisfaction but primarily in long term care settings IMPLICATIONS It is feasible to provide nurses with access to evidence based practice resources via mobile information technologies to reduce the barriers to research utilization