Browsing by Author "Kushniruk, André"
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- ItemEvidence in the palm of your hand: development of an outcomes-focused knowledge translation intervention.(2007-06-07) Doran, Diane M; Mylopoulos, John; Kushniruk, André; Nagle, Lynn; Laurie-Shaw, Brenda; Sidani, Souraya; Tourangeau, Ann E; Lefebre, Nancy; Reid-Haughian, Cheryl; Carryer, Jennifer R; Cranley, Lisa A; McArthur, GregAIM The aim of the project was to develop an electronic information gathering and dissemination system to support both nursing sensitive outcomes data collection and evidence based decision making at the point of patient care BACKGROUND With the current explosion of health related knowledge it is a challenge for nurses to regularly access information that is most current The Internet provides timely access to health information however nurses do not readily use the Internet to access practice information because of being task driven and coping with heavy workloads Mobile computing technology addresses this reality by providing the opportunity for nurses to access relevant information at the time of nurse patient contact METHOD A cross sectional mixed method design was used to describe nurses requirements for point of care information collection and utilization The sample consisted of 51 nurses from hospital and home care settings Data collection involved work sampling and focus group interviews FINDINGS In the hospital sector 40 of written information was recorded onto personal papers at point of care and later transcribed into the clinical record Nurses often sought information away from the point of care for example centrally located health records or policy and procedure manuals In home care documentation took place in clients homes The most frequent source of information was nurse colleagues Nurses top priorities for information were vital signs data information on intravenous IV drug compatibility drug references and manuals of policies and procedures IMPLICATIONS A prototype software system was designed that enables nurses to use handheld computers to simultaneously document patients responses to treatment obtain real time feedback about patient outcomes and access electronic resources to support clinical decision making CONCLUSION The prototype software system has the potential to increase nurses access to patient outcomes information and evidence for point of care decision making
- ItemGroup differences in physician responses to handheld presentation of clinical evidence: a verbal protocol analysis.(2007-09-12) Lottridge, Danielle M; Chignell, Mark; Danicic-Mizdrak, Romana; Pavlovic, Nada J; Kushniruk, André; Straus, Sharon EBACKGROUND To identify individual differences in physicians needs for the presentation of evidence resources and preferences for mobile devices METHODS Within groups analysis of responses to semi structured interviews Interviews consisted of using prototypes in response to task based scenarios The prototypes were implemented on two different form factors a tablet style PC and a pocketPC Participants were from three user groups general internists family physicians and medicine residents and from two different settings urban and semi urban Verbal protocol analysis which consists of coding utterances was conducted on the transcripts of the testing sessions Statistical relationships were investigated between staff physicians and residents background variables self reported experiences with the interfaces and verbal code frequencies RESULTS 47 physicians were recruited from general internal medicine family practice clinics and a residency training program The mean age of participants was 42 6 years Physician specialty had a greater effect on device and information presentation preferences than gender age setting or previous technical experience Family physicians preferred the screen size of the tablet computer and were less concerned about its portability Residents liked the screen size of the tablet but preferred the portability of the pocketPC Internists liked the portability of the pocketPC but saw less advantage to the large screen of the tablet computer F 2 44 4 94 p 012 CONCLUSION Different types of physicians have different needs and preferences for evidence based resources and handheld devices This study shows how user testing can be incorporated into the process of design to inform group based customization
- ItemThe relationship of usability to medical error: an evaluation of errors associated with usability problems in the use of a handheld application for prescribing medications.(2004-09-13) Kushniruk, André; Triola, Mark; Stein, Ben; Borycki, Elizabeth; Kannry, JosephThis paper describes an innovative approach to the evaluation of a handheld prescription writing application Participants 10 physicians were asked to perform a series of tasks involving entering prescriptions into the application from a medication list The study procedure involved the collection of data consisting of transcripts of the subjects who were asked to think aloud while interacting with the prescription writing program to enter medications All user interactions with the device were video and audio recorded Analysis of the protocols was conducted in two phases 1 usability problems were identified from coding of the transcripts and video data 2 actual errors in entering prescription data were also identified The results indicated that there were a variety of usability problems with most related to issues of ease of use In addition other problems were identified which were related to limitations of the content of the program In examining the relationship between usability problems and errors it was found that certain types of usability problems were closely associated with the occurrence of specific types of errors in prescription of medications Implications for the improvement of safety of health care information systems are discussed
- 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
- ItemTele-ICU - a Canadian review.(2011-02-21) Shahpori, Reza; Kushniruk, André; Hebert, Marilynne; Zuege, DanBased on the learnings and experiences from implementations in the United States telemedicine may offer certain advantages to help address some of the challenges faced by the Canadian critical care community resulting from staff shortages and increasing demands for quality care The initial and operating costs of the technology and its impact on direct bedside care are perceived to be significant drivers of resistance to its wide spread implementation This qualitative review of the available literature summarizes the opportunities and challenges with the potential use of telemedicine to enhance the delivery of critical care services in Canada
- ItemWhat nurses want: diffusion of an innovation.(2008-03-17) Di Pietro, Tammie; Coburn, Geraldine; Dharamshi, Narissa; Doran, Diane; Mylopoulos, John; Kushniruk, André; Nagle, Lynn; Sidani, Souraya; Tourangeau, Ann; Laurie-Shaw, Brenda; Lefebre, Nancy; Reid-Haughian, Cheryl; Carryer, Jennifer; McArthur, GregWe investigated the usability of personal digital assistants PDAs to improve research utilization and timely access to electronic practice information to assist in clinical decisions Nurses used a decision support tool on a PDA to collect point of care outcomes data Follow up interviews documented usability Nurses liked the portability and size of the PDA as well as ease of use of the PDA software Electronic decision support tools at point of care have the potential to improve nurses research utilization and quality of care