Factors influencing health information technology adoption in Thailands community health centers Ap文档格式.docx

Factors influencing health information technology adoption in Thailands community health centers Ap文档格式.docx

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sacceptanceofEPR.DeterminantsweretestedusinganextendedversionoftheTechnologyAcceptanceModel.

Design

Nursingstaffmembers（NAsandRNs）completedasurveyquestionnaireabouttheuseofEPRinhealthcare,andtheirexperiences,perceptionsandattitudesregardingEPR.

Settings

AllnursingstaffmemberswereworkinginDutchhospitals,psychiatricorganizations,careorganizationsformentallyretardedpeople,homecareorganizations,nursinghomesorhomesfortheelderly.

Participants

ThestudypopulationisanationallyrepresentativeDutchresearchsample,furtherreferredtoastheNursingStaffPanel.ThePanelconsistsofapermanentgroupofNursingAssistants（NAs）andRegisteredNurses（RNs）,whoarepreparedtofillinapostalquestionnairetwiceayearonaverage.InJanuary2009,685participantscompletedthequestionnaire.

Results

NursingstaffmembersassociateEPRwithimprovedcare,especiallyqualitativelybetterandsafercare.Theyalsoexpectanincreaseincostsofcare,whileanticipatingonlyarelativelysmallriseinthenumberofpatientsthatcanbecaredfor.Ingeneral,theeffectsofEPRontheworkcircumstancesofnursingstaffareexpectedtobenegative.Job-relatedcharacteristicswerefoundtobedeterminantsofattitudestowardsusingEPR.ArelativelypositiveattitudetowardsEPRwasfoundinthreecategoriesofnursingstaffinparticular,i.e.staffworkingatleast30 

hperweek,staffalreadyusingEPRandstaffworkinginhospitals.Nursingstaffinmanagementpositionsalsotendtohaveamorepositiveattitude.WhentheTechnologyAcceptanceModelwastested,attitudestowardsEPRwereprimarilyassociatedwithjob-relatedcharacteristicsandperceivedusefulnesswithrespecttoqualityofcare.

Conclusions

TheimplementationstrategiesforEPRneedtotakeaccountofthejobcharacteristicsoftheintendedfutureusers.Ifimplementationistobesuccessful,itisimportantthattheusersunderstandthebeneficialeffectsofEPRonthequalityofcare.

ArticleOutline

1.Introduction

1.1.Aimofthepaper

2.Methods

2.1.Participants

2.2.Questionnaire

2.3.Statisticalanalyses

3.Results

3.1.PerceivedusefulnessofEPR

4.Discussionandconclusion

4.1.Discussionoffindings

4.2.Methodologicalconsiderations

4.3.Theoreticalimplications

4.4.Practicalimplications

4.5.Conclusion

References

CapstoneExperience:

AnalysisofanEducationalConceptforNursing 

JournalofProfessionalNursing

theUnitedStates,nursingeducationpreparesregisterednursesforpracticethroughgenericprogramsofstudythatvaryinlengthfrom2to4years.Allhavedifferinggraduationrequirementsandpurportedstudentoutcomes.Often,baccalaureate-preparednurseswithaliberalartsfoundationarerequiredtocompleteacomprehensive“capstoneexperience,”whichmayfacilitatedegreedifferentiationupongraduation.However,thereislittleconsensusinhighereducationregardingthedefiningaspectsofsuchanexperience.Thepurposeofthisarticleistoanalyzeandclarifytheconceptofcapstoneexperienceinthecontextofbaccalaureatenursingeducation.Usingatraditionalapproachofconceptanalysis[Walker,L.O.,&

Avant,K.C.（2004）.Strategiesfortheoryconstructioninnursing（4thed.）.UpperSaddleRiver,NJ:

Pearson],anextensivereviewofpertinentliteraturewascompleted.Asaresult,criticalordefiningattributes,antecedents,andconsequencesofcapstoneexperiencesweredetermined.Caseexamples,includingarealmodelcase,highlighttheseaspects,andadefinitionofcapstoneexperienceisoffered.Implicationsfornursingeducation,research,andpracticeareprovided,andausefullistofevaluativecriteriaforcapstoneexperiencesispresented.

Approach

IdentificationofAllPossibleUsesoftheConcept

ReviewoftheLiterature

AntecedentsandConsequences

PresentationofCases

ModelCase

BorderlineCase

ContraryCase

EmpiricalReferents

ImplicationsforNursing

Education

Research

Practice

Conclusion

Acknowledgements

HealthITSuccessandFailure:

RecommendationsfromLiteratureandanAMIAWorkshop 

JournaloftheAmericanMedicalInformaticsAssociation

WiththeUnitedStatesjoiningothercountriesinnationaleffortstoreapthemanybenefitsthatuseofhealthinformationtechnologycanbringforhealthcarequalityandsavings,soberingreportsrecallthecomplexityanddifficultiesofimplementingevensmaller-scalesystems.Despitebestpracticeresearchthatidentifiedsuccessfactorsforhealthinformationtechnologyprojects,amajority,insomesense,stillfail.Similarproblemsplagueavarietyofdifferentkindsofapplications,andhavedonesoformanyyears.TenAMIAworkinggroupssponsoredaworkshopattheAMIAFall2006Symposium.Itwasentitled“AvoidingTheF-Word:

ITProjectMorbidity,Mortality,andImmortality”andfocusedonthisunder-addressedproblem.Participantsdiscussedcommunication,workflow,andquality;

thecomplexityofinformationtechnologyundertakings;

theneedtointegrateallaspectsofprojects,workenvironments,andregulatoryandpolicyrequirements;

andthedifficultyofgettingallthepartsandparticipantsinharmony.Whilerecognizingthattherestillaretechnicalissuesrelatedtofunctionalityandinteroperability,discussionaffirmedtheemergingconsensusthatproblemsareduetosociological,cultural,andfinancialissues,andhencearemoremanagerialthantechnical.Participantsdrewonlessonsfromexperienceandresearchinidentifyingimportantissues,actionitems,andrecommendationstoaddressthefollowing:

what“success”and“failure”mean,whatcontributestomakingsuccessfulorunsuccessfulsystems,howtousefailureasanenhancedlearningopportunityforcontinuedimprovement,howsystemsuccessesorfailuresshouldbestudied,andwhatAMIAshoulddotoenhanceopportunitiesforsuccesses.Theworkshoplaidoutaresearchagendaandrecommendedactionitems,reflectingtheconvictionthatAMIAmembersandAMIAasanorganizationcantakealeadershiproletomakeprojectsmorepracticalandlikelytosucceedinhealthcaresettings.

Introduction

WorkshopDevelopment

WorkshopThemes

What“Success”Is

WhatMakesItSoHard—Communication,Workflow,andQuality

WhatWeKnow—LessonsfromExperience

AMIAActionRecommendations

ResearchandPublication

BestPractices

Advocacy

Certification

DatabasesandKnowledgeIntegration

AssessmentofMedicalImagingandComputer-AssistSystems:

LessonsfromRecentExperience 

AcademicRadiology

Inthelast2decadesmajoradvanceshavebeenmadeinthefieldofassessmentmethodsformedicalimagingandcomputer–assistsystemsthroughtheuseoftheparadigmofthereceiveroperatingcharacteristic（ROC）curve.Inthemostrecentdecadethismethodologywasextendedtoembracethecomplicationofreadervariabilitythroughadvancesinthemultiple–reader,multiple–case（MRMC）ROCmeasurementandanalysisparadigm.Althoughthisapproachhasbeenwidelyadoptedbytheimagingresearchcommunity,someinvestigatorsappearaversetoit,possiblyfromconcernthatitcouldplaceagreaterburdenonthescarceresourcesofpatientcasesandreaderscomparedtotherequirementsofalternativemethods.Thepresentcommunicationargues,however,thattheMRMCROCapproachtoassessmentinthecontextofreadervariabilitymaybethemostresource–efficientapproachavailable.Moreover,alternativeapproachesmayalsobestatisticallyuninterpretablewithregardtoestimatedsummarymeasuresofperformanceandtheiruncertainties.TheauthorsproposethattheMRMCROCapproachbeconsideredevenmorewidelybythelargercommunitywithresponsibilitiesfortheintroductionanddisseminationofmedicalimagingtechnologiestosociety.Generalprinciplesofstudydesignarereviewed,andimportantcontemporaryclinicaltrialsareusedasexamples.

•Background

•Industry/FDAExperiencewithDigitalMammography

•ROCAnalysis

•MRMCROCMeasurementParadigm

•MRMCROCandDigitalMammography

•TheArrivalofSystemsforComputer–AssistedReading

•InBehalfoftheIndirectDesign

•LimitationsoftheIndirectDesign

•CADforDetectionofSolitaryPulmonaryNodulesonChestFilms

•ResourceRequirements:

IndirectDesignversusMRMCROC

•BackgroundforSizingMRMCROCStudies

•FromFundamentalEssentialstoBestPractices

•FundamentalEssentials

•SomeResourcesAvailableforIndustrySponsors

•Toward“BestPractices”

•AContemporaryBias

•TheLifeCycleandtheLargerPicture

•Conclusions

•References

Nursingstudent–patientrelationship:

Experiencesofstudentsandpatients 

NurseEducationToday

Thisstudydealtwithnursingstudents’andpatients’experiencesoftheirrelationship.Qualitativedatawerecollectedconductingsemi-structuredinterviewswith30nursingstudentsand30patientsonmedical