The Interface of Genomic Technologies and Nursing

PURPOSES: (a) to summarize views of the interface of technology, genomic technology, and nursing; (b) provide an overview of current and emerging genomic technologies; (c) present clinical exemplars of uses of genomic technology in two disease conditions; and (d) list genomic-focused nursing research on genomic technologies. ORGANIZING FRAMEWORK: A discussion of genomic technology in the context of nurses' views of technology, the importance of genomic technology for nurses, linking the central dogma of molecular biology to state-of-the-art tests and assays, and nurses' current use of technologies. CONCLUSIONS: Human genome discoveries will continue to be an integral part of disease prevention, diagnosis, treatment, and management. These discoveries also have the potential for being integrated into nursing science. Genomic technologies are becoming a driving force in patient management, so that nurses will be unable to provide quality care without knowledge of the types of genomic technologies, the rationale for their use, and the possible sequelae that can result from genetic diagnosis or treatment. Many nurses already are using genomic technologies to conduct genomic-focused nursing research. The biobehavioral nature of much of this research further indicates the important contributions of nurses in genomics.     

Data mining as a tool for research and knowledge development in nursing

The ability to collect and store data has grown at a dramatic rate in all disciplines over the past two decades. Healthcare has been no exception. The shift toward evidence-based practice and outcomes research presents significant opportunities and challenges to extract meaningful information from massive amounts of clinical data to transform it into the best available knowledge to guide nursing practice. Data mining, a step in the process of Knowledge Discovery in Databases, is a method of unearthing information from large data sets. Built upon statistical analysis, artificial intelligence, and machine learning technologies, data mining can analyze massive amounts of data and provide useful and interesting information about patterns and relationships that exist within the data that might otherwise be missed. As domain experts, nurse researchers are in ideal positions to use this proven technology to transform the information that is available in existing data repositories into useful and understandable knowledge to guide nursing practice and for active interdisciplinary collaboration and research.     

Parse's theory as a model for practice: the cutting edge.

If nursing practice is the performing art of the science of nursing, then practice is guided by nursing theory and cannot be considered separately from it. Nursing theory based practice is the cutting edge of the discipline. Practice methods reflect the beliefs and values of the theories from which they evolve. Nurses' values and beliefs about human beings and health are incarnated in the way they practice. This article presents Parse's theory of human becoming as a model for practice; explicates the beliefs, values, and ethic of the practice method; analyzes the logical coherence of theory and method; illustrates the pragmatics of the method, and gives evidence of its soundness. The theory-research-practice triad developed by Parse articulates a paradigmatic view of the discipline as a whole with a view of the human being as a living unity freely choosing personal meanings in life situations. Parse's practice methodology provides nurses with a way of practicing with a focus on the quality of life as it is humanly lived. It is presented here as the practice component of an emergent theory-research-practice tradition on the cutting edge of nursing science.     

Care of the body: maintaining dignity and respect

Technology has always been part of nursing. The use of technology now, although it is more advanced and sophisticated than technologies of the past, will remain a crucial component of nursing practice. Nursing has the ability to successfully mediate the effects of technology in nursing practice. Regardless of the technological advancements, there are certain elements of practice in nursing, such as bathing, which have not changed in many was over the years. A reflection on the care of the body, both from a historical perspective and within a caring-healing-health paradigm informs nursing practice. The daily practice of tending to and comforting the patient through preservation of cleanliness requires skilled knowledge and a deliberate choice of action that honours the patient during this sensitive aspect of nursing practice.     

Ethical considerations for the utilization of tele-health technologies in home and hospice care by the nursing profession

Home care, including hospice care, is a growing component of the current healthcare system and pertains to care services that are provided to individuals, their family members, and caregivers in their own residence. Both domains face funding limitations as life expectancy and the segment of the population older than 65 years increase. Tele-health, defined as the use of advanced telecommunication technologies to enable communication between patients and healthcare providers separated by geographic distance, is perceived as a concept that can enhance both home and hospice care and address some of the current challenges. This article discusses ethical challenges associated with the utilization of tele-health technologies by the nursing profession in the home setting. These factors form a framework for the ethical considerations that result from the introduction of these technologies in nursing practice. Specifically, the article discusses the issue of privacy and confidentiality of patient data, informed consent, equity of access, promoting dependency versus independence, the lack of human touch and the impact of technology on the nurse-patient relationship, and the medicalization of the home environment. These issues constitute a road map both for nursing practitioners who are aiming to provide an efficient delivery of services in the home and for nursing administrators who are asked to make judgments about the use of tele-health technology as a supplement to traditional care and as a cost-saving tool.     

The role of technology in critical care nursing

Title.  The role of technology in critical care nursing.
Aim.  This paper is a report of a study to identify the meaning for critical care nurses of technology related to weaning from mechanical ventilation and to explore how that technology was used in practice.
Background.  The literature concerned with the development of critical care (intensive care and high dependency units) focuses mainly on innovative medical technology. Although this use of technology in critical care is portrayed as new, it actually represents a transfer of technology from operating theatres.
Method.  An ethnographic study was conducted and data were collected on one critical care unit in a large teaching hospital over a 6-month period in 2004. The methods included participant observation, interviews and the collection of field notes.
Findings.  The overall theme 'The nursing–technology relation' was identified. This comprised three sub-themes: definition of technology, technology transferred and technology transformed. Novice nurses took a task-focussed approach to weaning, treating it as a 'medical' technology transferred to them from doctors. Expert nurses used technology differently and saw its potential to become a 'nursing technology'.
Conclusion.  Nurses need to examine how they can adapt and to 'reconfigure' technology so that it can be transformed into a nursing technology. Those technologies that do not fit with nursing may have no place there. Rather than simply extending and expanding their roles through technology transfer, nurses should transform those technologies that preserve the essence of nursing and can contribute to a positive outcome for patients.     

Factors associated with the perceptions of eHealth technology of Chinese nurses and nursing students

AimThe current study sought to assess the perceptions of eHealth technology of nurses and nursing students in China and to examine the association between these perceptions and demographic factors.BackgroundDespite the increasing use of eHealth technologies in China and across the globe, the perceptions of practicing and student nurses remain minimally explored. Findings from such an inquiry can potentially inform actions and policies to improve the uptake of eHealth technologies among Chinese nurses.DesignThis was a cross-sectional study with a real-time online survey.MethodsA convenience sample of 1338 nurses and nursing students from Mainland China participated in the study. Their perceptions of eHealth technology were collected using the Chinese version of the Perceptions of eHealth Technology Scale. The Kruskal-Wallis test and multiple linear regression analysis were used to examine the relationship between demographic variables (age group, gender, occupation, education level, position and clinical experience) and perceptions of eHealth technology. All study procedures adhered to the STROBE guidelines.ResultsMost participants were aged between 20 and 29 (55.8%). Nearly half (42.5%) were frontline clinical nursing staff, some were nursing students (36.2%), academic nursing staff (12.3%) and clinical nursing management staff (9.0%). Regardless of the differences in their demographic characteristics, the participants had higher mean scores in “Perception of eHealth applications” and lower mean scores in “Knowledge of eHealth technology”. Participants with doctoral degree had a higher mean total score and higher sub-scale scores in knowledge of eHealth technology, perception of the advantages of eHealth technology and perception of eHealth applications; and the lowest scores in perception of the disadvantages of eHealth technology and perception of eHealth applications. Occupation, position and clinical experience were found to be the demographic characteristics associated with eHealth perceptions, before adjusting for age and gender. Education level was associated with eHealth perceptions regardless of adjustment.ConclusionOverall, participants had higher scores on perceptions of eHealth applications but lower scores on knowledge of eHealth technology. Considering the association between education and all subscales and overall scores, it may be essential to implement continuing professional education for nurses to improve their knowledge of eHealth applications. Encouragement to use available eHealth digital technologies may also be helpful to improve perceptions of eHealth.     

Technology and nursing education: a scenario for 1990

An examination of predictions concerning the future of American society provides a basis for building a scenario for nursing education in the USA. Trends influencing the future of society and professional nursing education include the tendency towards a planet-wide society, changing orientations towards individual towns and cities, changes in the occupational structure and in use of energy, and technological breakthroughs in electronics and genetics.
Central to new technologies is the computer. Computerized systems of education and networks of such systems are now technically possible. Although capital resources for such systems may be scarce, eventually the substitution of capital for the even more expensive human labour may force the use of greater technology in education. Teacher acceptance is the greatest challenge to increased use of technology in education. Increased use of technology may force better instruction. Increased technology does not presuppose a less humanistic education.     

The effect of digitalization on the career intentions of nursing students: A cross-sectional study

AimWe investigate how the confirmation of expectations about digital technology in the workplace affects the career intentions of nursing students. We also explore the role of task fit in mediating (1) digital technology satisfaction and job satisfaction and (2) digital technology satisfaction and career intentions.BackgroundThe turnover of graduating geriatric nursing students is very high and rising. To support the work of nursing staff, elderly care institutions are beginning to adopt digital technologies that aid in nursing tasks. However, it is unclear whether students’ perceptions of those digital technologies have an impact on their career intentions.DesignThis is a cross-sectional study.MethodsWe recruited 549 geriatric nursing students. Data were collected from December 2022 to March 2023. The questionnaire included seven sections: expectation confirmation, perceived usefulness, perceived safety, digital technology satisfaction, task fit, job satisfaction and career intentions. The validity and reliability of the model were confirmed.ResultsThe results show that the confirmation of students’ expectations for the digital technology used in elderly care services has a positive impact on their career intentions. However, the results do not confirm the impact of perceived security on digital technology satisfaction, or the effect of job satisfaction on career intentions.ConclusionElderly care institutions and educators should monitor the current state of the digital work environment to ensure that it can adequately support students in their work. They should ensure the use of advanced and appropriate technology tools in teaching and clinical environments to provide a richer and more vivid learning experience. These initiatives can support nursing students in their transition from school to practice and increase their willingness to stay in the profession.     

Reluctant horses at the digital river

Mastery of the changing bank of information needed to practice at the cutting edge will require the exploitation of emerging informatics and communication technologies. Whether their limitless promise will be embraced or forgone will depend as much on human as on technological practice.     

Validity and reliability of the scientific review process in nursing journals – time for a rethink?

As pressure to publish increases in the academic nursing world, journal submission numbers and rejection rates are soaring. The review process is crucial to journals in publishing high quality, cutting‐edge knowledge development, and to authors in preparing their papers to a high quality to enable the nursing world to benefit from developments in knowledge that affect nursing practice and patient outcomes and the development of the discipline. This paper does not intend to contribute to the debate regarding the ethics of reviewing, but rather seeks to explore notions of how the quality of the reviewing process can be enhanced to benefit authors, the reviewers, and the state of nursing knowledge. Furthermore, a call is made to editors to devise strategies for aiding reviewers to attain higher validity and reliability within the reviewing process by establishing clear standards and expectations and to ensure published work is judged against industry norms for quality.     

Information technology: changing nursing processes at the point-of-care

Changing societal demographics, increasing complexity in healthcare knowledge, and increasing nursing shortages have led healthcare strategists to call for a redesign of the healthcare system. Embedded within most redesign recommendations is the increased use of technology to make nursing practice more efficient. However, information technology (IT) has the potential to go beyond simple efficiency increases. If IT is perceived truly as a part of the redesign of healthcare delivery rather than simply the automation of existing processes, then it can change nursing processes within institutions and furthermore change the point-of-care between nurses and patients. Nursing adoption of technology within the workplace is a result of the interactions between technical skills, social acceptance, and workplace culture. Nursing needs for information not only influence their adoption of particular technologies but also shape their design. The objective of this article is to illustrate how IT can change not only nursing practice and processes but also the point-of-care. A case study of the use of IT by nurses in telehomecare is presented and administrative implications are discussed.     

Benefits and costs of integrating technology into undergraduate nursing programs

Advances in technology over the last decade have resulted in increased opportunities for educators to become more innovative in classroom and clinical teaching. These innovations have allowed students and faculty to access essential clinical information at the point of care/need. By capitalizing on technologies such as personal digital assistants and course delivery shells, faculty and students have both portable and remote access to information that can guide practice and learning activities in clinical, classroom, and distance settings. For instance, a student can use a personal digital assistant to research a patient's new medication at the bedside, study course information, access references during class in response to a question, or download clinical materials from home. Although the benefits of having ready access to information seem obvious, there are costs and strategic planning activities associated with implementing these projects. Clearly, the objective of any academic nursing program is to develop skills among students so they can efficiently access information and use that information to guide their nursing practice. To do so, academic nursing administrators must have the forethought to envision how new technologies can support achieving this goal as well as the ability to put in place the infrastructure supports needed for success. This article presents a case study of how one institution developed the necessary infrastructure and garnished the appropriate resources to implement an ambitious technology initiative integrated throughout a large undergraduate nursing program. In addition, how the integration of technology, online and mobile, can enhance clinical learning will be discussed.     

Window of opportunity for home care nurses: telehealth technologies

Multiple telehealth technologies are currently available for nurses working in home care and other community settings. Furthermore, the rate at which new electronic technologies, which can promote home care nursing, are introduced continues to increase. This article addresses the need for increased use of information technologies in home care nursing, describes how information technologies are changing the way we give nursing care, provides examples of telehealth nursing in home care, and discusses the future of telehealth technologies in nursing.     

A survey of nursing faculty needs for training in use of new technologies for education and practice

This study describes nursing faculty's use, knowledge of, and training needs associated with distance learning, simulation, telehealth, and informatics tools in nursing education and practice. Web-based surveys were completed by 193 faculty members from nursing schools in the western United States. More than half of the respondents were frequent users of distance learning and informatics tools. Approximately 66% of faculty reported they were competent with distance learning and informatics tools. Training and technical support for the use of distance learning was highest, yet 69% of faculty still reported a need for additional training. The availability of training and financial and technical support was associated with greater use of distance learning technologies (p < 0.05 for all). Although a key limitation of this survey was the overlapping definitions across the four technologies, the findings suggest nursing faculty perceive a need for training and support to effectively use educational technologies in nursing education.     

高等中医药院校本科涉外护理专业课程设置的研究

目的调查分析国内高等中医药院校涉外护理培养方案,旨在为其教学改革提供思路和方向,为中医特色护理专业对外交流培养模式的构建提出参考意见和建议。方法收集国内9所开办涉外护理教学的高等中医药院校涉外护理专业培养方案,通过比较研究和统计学分析,获取课程设置现状并分析不足。结果我国高等中医药院校涉外护理办学存在涉外培养目标定位尚待提高,课程模式创新不足,课程设置差异性大,中医护理特色不突出,涉外英语教学薄弱等不足。结论高等中医药涉外护理专业培养方案和教学方法有待进一步完善,人才培养应符合专业学科发展,聚焦国际护理前沿,体现中医护理特色,重视外语及跨文化能力培养,并需不断革新教学方法。     

Defining and integrating informatics competencies into a hospital nursing department

Expanding use of complex patient information management systems and communication technology in healthcare organizations requires nurses to possess core competencies that until recently were not considered as integral to practice as those of a strictly clinical nature. Organizational changes necessary to formally integrate informatics competencies into nursing practice require strong partnerships among facility nursing leaders, educators, and informaticists. The authors describe a strategic initiative one acute care organization used to develop nursing practice that ensures use of system tools to manage patient information, support clinical decision making, optimize workflow, and communicate with members of the care team. The initiative involved defining nursing computer and informatics management skills for the clinical system applications and technologies utilized in the organization and integrating the introduction, evaluation, and on going professional development of the defined informatics competencies into organizational processes and tools to support the bedside nurse.     

Exploring the technology readiness of nursing and medical students at a Canadian University

Technology readiness is a well-established construct that refers to individuals' ability to embrace and adopt new technology. Given the increasing use of advanced technologies in the delivery of health care, this study uses the Technology Readiness Index (Parasuraman, []) to explore the technology readiness of nursing and medical students from the fall 2006 cohort at Memorial University of Newfoundland. The three major findings from this study are that (i) rural nursing students are more insecure with technology than their urban counterparts, (ii) male medical students score higher on innovation than their female counterparts and have a higher overall technology readiness attitude than female medical students, and (iii) medical students who are older than 25 have a negative technology readiness score whereas those under 25 had a positive score. These findings suggest health care professional schools would be well served to implement curricular changes designed to support the needs of rural students, women, and those entering school at a non-traditional age. In addition, patterns such as those observed in this study highlight areas of emphasis for current practitioners as health care organizations develop continuing education offerings for staff.     

社区中风恢复期病人中医护理技术应用调查及影响因素分析

[目的]了解社区中风恢复期病人中医护理技术应用情况,探讨其影响因素。[方法]自行设计社区中医护理工作调查表和社区病人中风恢复期治疗调查表对136名护理人员和64例中风恢复期病人进行调查。[结果]136名护理人员同意在社区推进中医护理技术,同意率100%;愿意参加中医护理技术培训,参愿率100%;推进中医护理技术的影响因素为6类,构成比最高的是护士对技术不掌握,占23.32%;64例病人中愿意在社区就诊占比87.50%。[结论]中风恢复期病人愿意在社区就诊,但是目前社区能够为中风恢复期病人提供的中医康复护理偏少,不能够满足广大病人需求。应提升社区护士业务水平,加强中医护理知识培训,调动社区护士工作积极性,以推动当前社区中医护理工作的开展。