Telehomecare utilizes electronic communication technologies to support care when distance separates home health nurses from their patients. Telehomecare nurses, or Care Coordinators, use text-based technology to monitor chronically ill patients. Successful home health care outcomes depend on social and technical interactions within diverse patient, caregiver and nurse triad groups. No theory or analysis method for evaluating telehomecare service delivery as a multi-level system exists. Therefore, it is not known which characteristics of interpersonal relationships influence outcomes. This research examined trust, interdependence, communication and technology integration influence on outcomes of satisfaction and self-care. The Sociotechnical Systems Theory and Social Relations Model served as guides to explore individual, relational and group effects on patient quality outcomes. The purpose of this research is to examine the relationships among patients', caregivers' and nurses' social and technical characteristics and quality outcomes in telehomecare.Three VHA sites in the western U.S. participated in this descriptive, multi-level, correlational study. Forty-three groups comprised of patient, nurse and caregiver provided survey data on social and technical characteristics. Additionally, patients provided data on outcomes. All scales performed well, except trust. Results show statistically significant bivariate correlations demonstrate associations between characteristics and outcomes at multi-levels: interdependence with satisfaction at individual and dyad levels; communication with satisfaction at all levels of analysis and simple self care at individual levels; technology integration with satisfaction at group levels as wells as simple and complex self care at individual levels. The principle of joint optimization states that service delivery systems function optimally only if the social and technical characteristics of the subsystem groups fit the demands of each other and the environment. A measure of joint optimization is computed for outcome predictability using multiple regressions. Joint optimization for three social and one technical characteristic was shown to have significant influences on the patient's perception of being well cared for.Many implications of this research for nursing practice in telehomecare are discussed. Telehomecare nurses can use the results of this study to guide optimal practice methods to provide quality outcomes for their patients. This study provides a basis for further best practice research in telehomecare.

Thesis (M. Phil.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 126-131).

When an inexperienced nurse project manager is assigned to serve as a project manager for health information technology (HIT) tools, there is increased risk the project will not be completed on time, within budget, and in scope. An identified business need at a large military treatment facility was an educational tool to bridge the gap between nursing informatics and project management. The scholarly project was a Nursing Informatics Project Management Guidebook, which served as an educational tool to increase nurses' knowledge to serve in the HIT project manager role. With a quality improvement methodology, the outcome and impact sequence logic model was applied as the framework. The target population was the Clinical Informatics Sub-Committee, which was a multidisciplinary working group. The Nursing Informatics Project Management Guidebook included an introduction to nursing informatics, project management standards, 9 current scholarly articles, and links to professional organizations. There was also an overview of the roles and responsibilities of a nursing informatics project manager throughout the 5 acquisition lifecycle processes, which includes initiating, planning, executing, monitoring, and closing. Finally, essential terms were defined to assist in the completion of the assigned project on time, within budget, and in scope. An implication for positive social change was increased knowledge for nurses to serve as a HIT project manager, which advances the nursing profession with informed nurses to serve in the leadership position among multidisciplinary groups.

My research explores the cultural-political contributions of Nursing Informatics (NI) to the profession of nursing in the context of the Canadian health care system, specifically focused on classification systems as cultural artefacts. Adopting Aggers work on cultural studies as critical theory, (Agger, 1992), I challenged positivist assumptions generated within myself, in NI, and through the use of classification systems like the International Classification System Nursing Practice (ICNP®) (2001). My interest was to expose the impact that the application of standardization languages like ICNP® have on the potential political gains to nursing within health care decision-making structures. / Thesis (PhDNursing)--University of South Australia, 2005.

Thesis (M. Nurs.)--University of Hong Kong, 2004. / Also available in print.

This study is situated within the everyday practice of nurses around the world, engaged in discourse with colleagues through listserv discussion forums, and immersed in Schon's swampy lowlands of important problems. Taking computer-mediated communications (CMC) to be an integral part of nursing informatics, the study begins by examining the literatures on CMC and nurses' reflection on and in practice. The study is congruent with emerging mixed method research approaches within both nursing and the study of CMC, and comprises an electronic ethnography, coupled with the development of a model of reflection within nursing listerv discussions. Using a corpus of discussion threads from the NURSENET list, together with questionnaires,interviews and Virtual Focus Group discussions, all conducted by CMC over a six-year period, a tapestry ofa virtual community, united through discussion of shared practice issues, emerges. The narratives of everyday discussions dispel some of the urban myths of CMC and show the possibility of real social engagement. A model of reflection derived from Kim's phases of critical reflective inquiry and Johns'framework for reflection on action is used to examine a pilot sample of NURSE NET discussion threads. This pilot version of the model is shown to be insufficient to describe the reality of reflective discussion in this forum, and a revised model is developed, essentially inductively, from the data. This new model, tested against a larger sample of discussion threads, demonstrates a qualitatively different form of reflection from that encountered offline. The online reflection is a group, as opposed to an individual, process, is action-oriented, and shows a form of 'online reflection around action' as nurses engage in ongoing practice situations, as well as post hoc reflection on-action. It also provides evidence of nurses using the reflective discussions to change practice, and so illustrates reflection akin to that envisaged by Kemmis.

Doctor Educationis / Background: The increasing use of technology and informatics in the provision of nursing care encourages the consideration of whether final year undergraduate nursing students are prepared for the use of informatics in clinical care and what the current state of knowledge, skills and attitudes on nursing informatics is. Purpose of the study: The overall aim was to investigate the perceived relevance, competencies in nursing informatics and attitudes towards nursing informatics of the final year undergraduate nursing students at a selected University in the Western Cape. Methodology: A quantitative research approach using a descriptive survey design was used in the study. Self-administered questionnaires were used to investigate final year undergraduate nursing student’s perceived relevance of informatics skills for nursing, the perceived level of nursing informatics competence, and attitudes towards nursing informatics. Nursing students currently enrolled in the fourth year in their undergraduate bachelor nursing degree programme were the target population for this study (n=198). Frequencies of the perceived relevance of computers literacy skills, informatics literacy and information management skills for nursing, and competencies in computers skills, informatics literacy and information management skills and attitudes towards informatics were calculated and presented. Results: The findings suggested that even though only 28% (n=28) and 4% (n=4) of nursing students has attended computer and informatics classes respectively, 99% (n=99) confirmed that they perceive nursing informatics as relevant in nursing education and nursing practice. Computer literacy skills (4.23 sd 0.8) were rated more relevant

A need for improvement in nursing education regarding inpatient workflows and informatics skills was identified at this project site. Upon hire, nurses were required to complete a 4-hour basic class on the electronic health record (EHR) system, but this class did not include inpatient-nursing workflows needed to provide and facilitate care for patients. This project addressed the lack of EHR education on inpatient nursing workflows. The focus of this staff education project was an education class on inpatient nursing workflow provided to a nurse residency class. Sources of evidence were obtained through a literature search and pretest/post test data analysis. The literature used to support the project included articles on best practices for EHR education for nursing. The pretest and post test design was used to determine if there was an increase in EHR knowledge after the education. Benner's novice-to- expert model served as the framework. The mean total proficiency scores on inpatient nursing workflows in the EHR improved from pretesting to post testing, (6.8 to 7.8, p = 0.048). The study findings showed improvement in participants' average proficiency, knowledge, and clinical skills in the EHR. This project findings demonstrated the need for an inpatient nursing informatics workflow class for all nursing staff, and the findings supported an increase in education to facilitate workflow and care safety. This project promotes positive social change by improving curricula, raising awareness of how technology affects clinical care and practice, and encouraging continuous quality improvement through informatics education.

My research explores the cultural-political contributions of Nursing Informatics (NI) to the profession of nursing in the context of the Canadian health care system, specifically focused on classification systems as cultural artefacts. Adopting Aggers work on cultural studies as critical theory, (Agger, 1992), I challenged positivist assumptions generated within myself, in NI, and through the use of classification systems like the International Classification System Nursing Practice (ICNP®) (2001). My interest was to expose the impact that the application of standardization languages like ICNP® have on the potential political gains to nursing within health care decision-making structures.

Background Clinical placements are essential to nursing education, allowing students to gain live experience and knowledge of nursing in clinical environments prior to entering the healthcare workforce. Healthcare has increasingly integrated information and communication technology (ICT) into clinical environments, therefore ICT is also significant in nursing students’ clinical placements. However, research has revealed that despite its benefits, nurses and nursing students are unable to use ICT effectively for their practice and their learning. This may reflect one aspect of the challenges faced by nursing students as they learn during clinical placements. Therefore this research aims to analyse the dynamics of undergraduate nursing students’ learning and use of ICT during clinical placements. By doing so, this research seeks to develop theoretical models that can be used to improve clinical nursing education amidst the current technology era. - Research design This study was conducted in Seoul, South Korea. A qualitative-dominant mixed method strategy was adopted. Quantitative data was collected through the development of a modified Information Technology Attitude Scales for Health (ITASH), which was then administered to 508 nursing students from six different universities from October 2012 to December 2012. Constructivist grounded theory (CGT) guided qualitative data collection, which was achieved through sequence of four rounds of intensive individual and group interviews with 16 nursing students, 4 qualified nurses, and 2 university lecturers from April 2013 to June 2015 (a total of 23 individual interviews and 6 group interviews). The exploratory and confirmatory factor analyses of quantitative data analysis were supported by SPSS and LISREL, while the constant comparison approach of qualitative data was supported by Nvivo 10. - Findings The findings revealed: 1) nursing students’ learning dynamics through the qualitative research process based on CGT methodology, and 2) nursing students’ use of ICT during clinical placements based on the learning dynamics via both qualitative and quantitative research processes. In the learning dynamics, this study identified the nursing students’ cognitive learning and knowledge building process, and then the factors and dynamics influencing that process in the clinical environment. This was compared with classroom and simulation environments. Based on these dynamics, the factors and dynamics influencing the use of ICT for learning in the clinical environment was identified. An integration of the findings with supporting literature resulted in two theoretical models, the knowledge building dynamic (KBD) model and the contextual knowledge building dynamic (CKBD) model. These models assist in understanding the cognitive processes involved in an individual’s learning process, the influence of context and resulting dynamics on these processes, and subsequently, learning with ICT. - Conclusion This research expands on current nursing education literature by exploring the cognitive aspects of learning, specifically within the clinical environment. These are shaped by contextual factors such as socio-cultural factors, and their influence on students’ learning and use of clinical ICT. The theoretical models are relevant for several applications in educational assessment and design, policy, and in learning itself with the goal of improving the quality of patient care.