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  • 1.
    Florin, Jan
    et al.
    Örebro University, School of Health and Medical Sciences. Department of Health and Social Sciences, Dalarna University, Falun.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Östlinder, Gerthrud
    Swedish Society of Nursing, Stockholm.
    Developing a national integrated classification of health care interventions in Sweden2005In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 74, no 11-12, p. 973-9Article in journal (Refereed)
    Abstract [en]

    Background: Existing classifications in Sweden of health care interventions used for quality assurance issues and for decisions on resource allocation does not capture all types of health care interventions. The work of professional groups like nurses, physiotherapists, and occupational therapists is partly invisible. There is a need to develop a classification of health care interventions that comprise all activity within the health care sector.

    Aim: To describe a multi-professional collaborative work on classification development and to provide suggestions for an organizing structure that can capture interventions in the health care services incorporating different professional perspectives.

    Results: The professional groups reached a common understanding about the use of the classification of The International Classification of Functioning, Disability and Health (ICF) as a unifying framework in the classification of health care interventions. Proposal was made for a revised structure of a current classification of interventions using ICD as unifying framework.

    Conclusion: The use of ICF as a unifying framework is seen as a fruitful way of overcoming professional differences, and by that supporting the process of reaching a common understanding and use of a common language when describing interventions in health care.

  • 2.
    Florin, Jan
    et al.
    School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Ehrenberg, Anna
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Björvell, Catrin
    Karolinska University Hospital, Stockholm, Sweden; Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    A comparison between the VIPS model and the ICF for expressing nursing content in the health care record2013In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 82, no 2, p. 108-17Article in journal (Refereed)
    Abstract [en]

    Background: Multi-professional standardized terminologies are needed that cover common as well as profession-specific care content in order to obtain a full coverage and description of the contributions from different health professionals' perspectives in health care. Implementation of terminologies in clinical practice that do not cover professionals' needs for communication might jeopardize the quality of care.

    Purpose: The aim of the study was to compare the structure and content of the Swedish VIPS model for nursing documentation and the international classification of function, disability and health (ICF).

    Method: Mapping was performed between key words and prototypical examples for patient status in the VIPS model and terms in the ICF and its framework of domains, chapters and specific terms. The study had two phases. In the first phase 13 key words for patient status in the VIPS model and the 289 terms (prototypical examples) describing related content were mapped to comparable terms in the ICF. In phase two, 1424 terms on levels 2-4 in the ICF were mapped to the key words for patient status in the VIPS model.

    Results: Differences in classification structures and content were found, with a more elaborated level of detail displayed in the ICF than in the VIPS model. A majority of terms could be mapped, but several essential nursing care concepts and perspectives identified in the VIPS model were missing in the ICF. Two-thirds of the content in the ICF could be mapped to the VIPS' key words for patient status; however, the remaining terms in the ICF, describing body structure and environmental factors, are not part of the VIPS model.

    Conclusion: Despite that a majority of the nursing content in the VIPS model could be expressed by terms in the ICF, the ICF needs to be developed and expanded to be functional for nursing practice. The results have international relevance for global efforts to implement unifying multi-professional terminologies. In addition, our results underline the need for sufficient coverage and level of detail to support different professional perspectives in health care terminologies.

  • 3. Fossum, Mariann
    et al.
    Alexander, Gregory L.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Ehrenberg, Anna
    Effects of a computerized decision support system on pressure ulcers and malnutrition in nursing homes for the elderly2011In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 80, no 9, p. 607-617Article in journal (Refereed)
    Abstract [en]

    Background: Computerized decision support systems (CDSSs) have been shown to help health care professionals to avoid errors and improve clinical practice and efficiency in health care. Little is known about its influence on nursing practice and outcomes for residents in nursing homes.

    Aim: The aim of this study was to evaluate the effects on the risk for and prevalence of pressure ulcers (PUs) and malnutrition of implementing a CDSS to improve prevention and care of PUs and also to improve nutrition in the elderly in nursing homes.

    Design setting and participants: The study used a quasi-experimental design with two intervention groups and one control group. A convenience sample of residents from 46 units in 15 nursing homes in rural areas in Norway was included. A total of 491 residents participated at baseline in 2007 and 480 residents at follow-up in 2009. Methods: The intervention included educational sessions in prevention of PUs and malnutrition for registered nurses (RNs) and nursing aides (NAs) in the two intervention groups. In addition, one intervention group (intervention group 1) had a CDSS integrated into the electronic healthcare record (EHR) based on two research-based risk assessment instruments: the Risk Assessment Pressure Scale (RAPS) for PU risk screening and the Mini Nutritional Assessment (MNA (R)) scale for screening nutritional status. In each participating nursing home trained RNs and NAs examined all residents who consented to participate on the RAPS and the MNA (R) scale. This examination included a skin assessment and details about PUs were collected.

    Results: The proportion of malnourished residents decreased significantly in intervention group 1 between the two data collection periods (2007 and 2009). No other significant effects of the CDSS on resident outcomes based on the RAPS and MNA (R) scores were found.

    Conclusion: CDSSs used by RNs and NAs in nursing homes are still largely unexplored. A CDSS can be incorporated into the EHR to increase the meaningful use of these computerized systems in nursing home care. The effects of CDSS on healthcare provider workflow, clinical decision making and communication about preventive measures in nursing home practice still need further exploration. Based on results from our study, recommendations would be to increase both sample size and the number of RNs and NAs who participate in CDSS education programs.

  • 4.
    Fossum, Mariann
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Svensson, Elisabeth
    Örebro University, Örebro University School of Business.
    Hansen, Linda M.
    Ehrenberg, Anna
    Effects of a computerized decision support system on care planning for pressure ulcers and malnutrition in nursing homes: an intervention study2013In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 82, no 10, p. 911-921Article in journal (Refereed)
    Abstract [en]

    Background: Nursing documentation is essential for facilitating the flow of information to guarantee continuity, quality and safety in care. High-quality nursing documentation is frequently lacking; the implementation of computerized decision support systems is expected to improve clinical practice and nursing documentation.

    Aim: The present study aimed at investigate the effects of a computerized decision support system and an educational program as intervention strategies for improved nursing documentation practice on pressure ulcers and malnutrition in nursing homes.

    Design, setting and participants: An intervention study with two intervention groups and one control group was used. Fifteen nursing homes in southern Norway were included. A convenience sample of electronic healthcare records from 46 units was included. Inclusion criteria were records with presence of pressure ulcers and/or malnutrition. The residents were assessed before and after an intervention of a computerized decision support system in the electronic healthcare records. Data were collected through a review of 150 records before (2007) and 141 records after the intervention (2009).

    Methods: The nurses in intervention group 1 were offered educational sessions and were trained to use the computerized decision support system, which they used for eight months in 2008 and 2009. The nurses in intervention group 2 were offered the same educational program but did not use the computerized decision support system. The nurses in the control group were not subject to any intervention. The resident records were examined for the completeness and comprehensiveness of the documentation of pressure ulcers and malnutrition with three data collection forms and the data were analyzed with non-parametric statistics.

    Results: The implementation of the computerized decision support system and the educational program resulted in a more complete and comprehensive documentation of pressure ulcer- and malnutrition-related nursing assessments and nursing interventions.

    Conclusion: This study provides evidence that the computerized decision support system and an educational program as implementation strategies had a positive influence on nursing documentation practice.

  • 5. Hägglund, Maria
    et al.
    Scandurra, Isabella
    Centre for eHealth, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden.
    Koch, Sabine
    Scenarios to Capture Work Processes in Shared Home Care – from analysis to application2010In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 79, no 6, p. 126-134Article in journal (Refereed)
    Abstract [en]

    Background

    Shared homecare is increasingly common, and in order to develop ICT that support such complex cooperative and interdisciplinary work it is crucial to obtain an understanding of work processes at the clinical level before the development is initiated. It is also crucial, but difficult, to correctly transfer this insight to the development team.

    Method

    User-centered scenario building in interdisciplinary working groups is applied for capturing cooperative work routines, information demands, and other central preconditions in shared homecare.

    Results

    Use of scenarios for analysis of cooperative work and as information carrier is described via a case from the multi-disciplinary OLD@HOME project. Both current and future work scenarios were elicited. To illustrate the process of transforming scenarios into more technical descriptions (use cases), and finally into an application, examples showing the transparency in resulting use cases and in the implemented system are provided.

    Conclusion

    In this case study, scenarios proved to be useful not only in initial system development phases but throughout the entire development process, improving accessibility and assessment of end user needs. For the development team, scenarios assisted in solving usability issues, and served as a basis for describing use cases and for further system development. More importantly, the shared care scenarios ensured the provision of different perspectives on common work processes, which are often neglected in conventional requirements specifications. This also improved understanding between different clinical groups and between clinicians and developers.

  • 6.
    Tsertsidis, Antonios
    et al.
    Örebro University, Örebro University School of Business.
    Kolkowska, Ella
    Örebro University, Örebro University School of Business.
    Hedström, Karin
    Örebro University, Örebro University School of Business.
    Factors influencing seniors’ acceptance of technology for ageing in place in the post-implementation stage: A literature review2019In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 129, p. 324-333Article in journal (Refereed)
    Abstract [en]

    Purpose: To identify factors that influence the acceptance of technology for ageing in place by seniors in the post-implementation stage. This review is among very few that focus on acceptance in post-implementation phase.

    Methods: A literature review. We searched six databases (Cinahl, Medline, PsycINFO, PubMed, Science Direct, Scopus). Inclusion criteria were: 1) original and peer-reviewed research written in English, 2) Articles published in 2010–2018, 3) Empirical research papers, 4) Research in which participants are seniors aged above 60 years, 5) Research aimed at investigating factors that influence the acceptance of digital technology for ageing in place, 6) Research conducted in home environment, 7) Focus on post-implementation stage.

    Results: Twenty-three out of 2181 papers were included. The results show that acceptance of technology in the post-implementation stage is influenced by 36 factors, divided into six themes: concerns/problems regarding technology (technical errors, etc.), experienced positive characteristics of technology (e.g., ease of use factors, privacy implications), expected benefits of technology (e.g., increased safety, companionship, increased security, etc.), need for technology (e.g., perceived need to use), social influence (e.g., influence by peers, family or surroundings) and characteristics of older adults (e.g., past experiences/attitudes, physical environment). The articles considered different types of technology: health monitoring, ADL, safety and communication. The level of technology readiness for digital technologies supporting ageing in place in post-implementation stage is still low within the scientific literature, since only seven out of 23 articles studied mature technologies (TRL 8–9 of the technology readiness level scale). The majority of the studies were conducted in Western Europe or the US, and only two were conducted in other regions (Australia, and Taiwan). Qualitative and quantitative methods were equally used in the analysed articles.

    Conclusions: Acceptance of technology in the post-implementation stage is influenced by multiple factors. An interesting finding was that the seniors’ views of technology change between the pre- and post-implementation stages. Some negative concerns that appeared in the pre-implementation stage appear as positive characteristics in the post-implementation stage. In the post-implementation stage, seniors realize the wide variety of benefits that technology can have on their lives. We expect that findings of this review can be utilised by academics and policy-makers for gaining insights for further research and successful implementation of technology for ageing in place.

1 - 6 of 6
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