The Omaha System as a Structured Instrument for Bridging Nursing Informatics With Public Health Nursing Education: A Feasibility Study

Technologies to support nursing students in learning Standardized Nursing Languages: A systematic literature review

AIM

This review identifies technologies used to teach Standardized Nursing Languages and their impact on nursing students' educational outcomes.

METHODS

A literature review, updated to June 14, 2024, was conducted by consulting the PubMed, CINAHL, Scopus, and Cochrane databases. The main inclusion criterion was primary studies in which technology was used to educate students on Standardized Nursing Languages.

RESULTS

Three types of technology were addressed: Computerized Aids and Electronic Devices, Decision Support Systems, and Diagnostic Reasoning Software. Most of these technologies were found to positively impact knowledge, performance, application of the nursing process, diagnostic accuracy, and clinical reasoning.

CONCLUSIONS AND IMPLICATIONS FOR NURSING EDUCATION

Integrating technology into nursing education enhances nursing students' skills and equips them to handle the digital aspects of modern health care. Technologies must support all stages of the nursing process, reinforce clinical reasoning, and offer timely feedback. Additionally, the presence of teachers during technology training is crucial to ensure proper functioning, provide technical support, manage the learning environment, and verify students' skills. Nursing students with technological skills will become nurses capable of producing complete and quality clinical documentation and supporting their professional achievements.

Determining awareness of and readiness for standardized nursing languages in a mid-level midwestern hospital and associated school of nursing

PURPOSE

The purpose of this study was to examine knowledge, attitude, and barriers toward care planning documentation practices with standardized nursing languages (SNLs) of nurses and nursing students at a midwestern healthcare system, comparing student and nurse responses.

METHODS

Cross-sectional surveys were given over a 2-month period with nurses and nursing students at different sites in a midwestern healthcare system, using convenience sampling. The Knowledge, Attitude, and Barriers to Using Standardized Nursing Languages and Current Practices Survey was adapted for use and re-tested for validity/reliability (Content Validity Index 0.81-1.00; Cronbach alpha = 0.82-0.99) with 28 Likert scale items measuring knowledge, attitude, and barriers. Descriptive statistics, composite scores, correlations, t-tests, and multiple regression were used to analyze the concepts of the tool.

FINDINGS

134/400 RNs responded (34%); 109/116 students responded (93.9%). Data analyses indicate adequate to superior levels of knowledge related to SNLs and NANDA International, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), collectively referred to as NNN (NANDA, NIC, & NOC), positive attitudes toward SNLs/NNN and for adopting SNLs/NNN into documentation practices, but moderate to great barriers for implementation in practice. Barriers included lack of financial resources for change, lack of mentors, and lack of mandates to use SNLs. Students scored significantly higher than nurses in attitude only.

CONCLUSIONS

Perceptions of nurses and student nurses for current documentation indicate awareness of inadequacy in existing systems and willingness to change existing systems for standardized languages, with perceived barriers to change/implementation of SNLs. Students were more positive about SNLs than nurses.

IMPLICATIONS FOR NURSING PRACTICE

Major implications for nursing are to reevaluate electronic documentation systems and determine how to insert and easily apply SNLs in these systems, such that nursing care documentation is standardized, interoperable, effective, time-saving, and attainable.

Creating a quadruple aim model for nursing education

Baccalaureate nursing education is moving to adopt the new American Association of Colleges of Nursing Essentials for Professional Nursing Education. As identified in two of the six domains of the essentials, graduates need to be prepared to address population health and utilize informatics and healthcare technologies. Community/public health nursing also has eight domains for generalist nurses linked to population health which will help prepare a skilled nursing workforce for the 21st century. The Institute for Healthcare Improvement's Triple Aim which evolved into the Quadruple Aim is focused on improving health outcomes within healthcare delivery. Through a literature review, a need for a Quadruple Aim model for nursing education was identified. Mirroring the Institute for Healthcare Improvement's Triple Aim for healthcare delivery, a Quadruple Aim for Nursing Education Model was developed. The model dimensions include (1) Population-focused Care, (2) Maximize Student Learning Experience, (3) Cost-effective Pedagogy, and (4) Nurse Educator Well-being. The Quadruple Aim for Nursing Education Model supports nursing education to prepare future nurses effectively and efficiently bridging population health concepts and issues with nursing informatics. Nurse educators are encouraged to utilize the model to transform nursing education.

Research Types and New Trends on the Omaha System Published From 2012 to 2019: A Scoping Review

The Omaha System is a popular and standard term used in community health. This scoping review aimed to update the research types and identify new usage trends for the Omaha System through articles published between 2012 and 2019. The bibliography databases PubMed, CINAHL, Scopus, PsycInfo, Ovid, and ICHUSHI and the Omaha System's Web site were used to search for publications. Research articles published between 2012 and 2019 that included "Omaha System" in the title or abstract and were written in English or Japanese were included in this review. After excluding duplicate articles, 305 articles were screened and 82 were included in our analysis. There was a median of 10.3 articles per year. The percentages for each type of use of the Omaha System to "analyze client problem," "analyze clinical process," "analyze client outcomes," and "advanced classification research" were 18.3%, 12.2%, 23.2%, and 4.9%, respectively. The reclassification of the type "others" (41.5%) included "use the Omaha System data for assessment for other than clients," "use the Omaha System data as structured data," "encode by the Omaha System code," "adopt the OS framework," "clinical information system," and "literature review." This newly reclassified category will help capture future research trends using the Omaha System.

The Application of the Omaha System in Community Rehabilitation Nursing for Patients With Stroke and Previous Falls

Objective

This study aimed to explore the use of the Omaha System in rehabilitation and nursing methods and the effects on patients within the community who had experienced stroke and previous falls.

Methods

This study enrolled 42 patients who had experienced stroke and previous falls and had returned to the community after being discharged from the Department of Neurology and Rehabilitation of the Affiliated Hospital of Nanchang University from January to July 2018. The patients were randomly divided into two groups: an experimental group (n = 21) and a control group (n = 21). Patients in the control group received routine community rehabilitation care, and patients in the experimental group received community rehabilitation care on the basis of the Omaha System. Intervention lasted for 1 year. The Omaha outcome score, the ability to perform activities of daily living (ADL) (measured via the Modified Barthel Index [MBI]), and the incidence of falls for each group were compared before and after the intervention.

Results

After 1 year of intervention, the Omaha outcome score and MBI of both groups were higher than before; the Omaha outcome score and MBI of the experimental group were higher than those of the control group; the differences were statistically significant (P < 0.05). No fall occurred in either of the two groups.

Conclusion

The Omaha System can comprehensively evaluate the health problems of patients, guide nursing intervention, and quantitatively evaluate the effect of nursing intervention; it is therefore worthy of promotion.

Application of the OMAHA System in the education of nursing students: A systematic review and narrative synthesis

AIM

The aim of this systematic review was to synthesize evidence on the application of the Omaha System in the education of nursing students and to provide advice for educators to apply the Omaha System to practice and research effectively and meaningfully.

BACKGROUND

It is a necessary part of nursing education to provide students with informatics experience. The Omaha System is a standardized nursing terminology designed to enhance practice, documentation, and information management.

DESIGN

A systematic review and narrative synthesis.

METHODS

Studies from eight databases (PubMed, Web of Science, Embase, CINAHL, PsycINFO, China Biology Medicine disc, CNKI, Wanfang Data) were systematically retrieved. Twenty-three articles were found and synthesized.

RESULTS

Existing studies showed that the Omaha System was mainly applied in student community practice as a tool for guiding practice and collecting information, and the practice data were used by educators to analyse the outcomes of nursing education. Recently, the Omaha System was introduced into the classroom environment and achieved positive results in terms of teaching. Students' feedback on the use of the Omaha System was generally positive.

CONCLUSIONS

The Omaha System can be an active teaching and learning tool for nursing education, and further research is needed to explore and realize its potential in the field of education.

NurseVR: Development of a Serious Virtual Reality Game for Medication Preparation and Administration Training

The use of simulation for nursing education has several advantages. The present study aimed to develop and validate a serious virtual reality game for medication preparation and administration training. This is a methodological study in which a serious virtual reality game named NurseVR was developed and evaluated by teachers and students of a nursing course. In NurseVR, the player presents himself or herself in a simulated hospital environment to prepare and administer a medication. From then on, all the steps to be taken are the player's free choice according to what was learned in the classroom, making the game the closest to reality. High levels of positive agreement to statements concerning the validity of the game were found between students and teachers. The virtual immersion proposal was an innovative tool, and the validation results of the final version of NurseVR allow its use for nursing training.

Use of academic electronic medical records in nurse education: A scoping review

BACKGROUND

Use of academic electronic medical records is internationally recognised as a means for preparing health professional students for the digital healthcare environment. Reported practice benefits include skills for electronic documentation, health informatics, point-of-care clinical decision support systems, as well as preparation for information technology-enabled clinical settings, while challenges include lack of access to simulation software, faculty-related barriers, limited finances and educational software costs. However, little is known about best practices related to its use within pre-licensure or entry-to-practice nursing curricula and impact on clinical practice outcomes.

OBJECTIVE

This review sought to explore how academic electronic medical records are used in entry-to-practice nursing curricula.

DESIGN

A scoping review guided by the Joanna Briggs Institute three-step search strategy, exploring existing publications and grey literature.

INCLUSION CRITERIA

Quantitative and qualitative studies related to use of academic electronic medical records in pre-licensure nurse education.

INFORMATION SOURCES

A range of databases were searched including CINAHL, Medline, Proquest Central, ERIC, ScienceDirect, PubMed, IOS Press, as well as grey literature, reference lists and handsearching.

REVIEW METHODS

The search yielded 580 articles, from which inductive thematic analysis of 34 included studies was conducted.

RESULTS

Included articles were nine qualitative, 21 quantitative and five mixed methods studies. Most originated from the USA. Academic electronic medical records are mainly used to teach documentation, safe use of health technology, and for clinical preparation. Most are used for fundamental or junior levels courses, with problem-based learning and simulation embedded. Institution's technology resources and faculty capability are essential to implementation.

CONCLUSIONS

There is a need for more research that examines optimal timing and duration of use of academic electronic medical records in curricula, and their impact on critical thinking and clinical performance. Finally, there is a need to explore greater academic-clinical partnerships in the education process.

Education and Training on Electronic Medical Records (EMRs) for health care professionals and students: A Scoping Review

BACKGROUND AND OBJECTIVES

The ability of health care providers and students to use EMRs efficiently can lead to achieving improved clinical outcomes. Training policies and strategies play a major role in successful technology implementation and ongoing use of the EMR systems. To provide evidence-based guidance for developing and implementing educational interventions and training, we reviewed and summarized the current literature on EMR training targeting both healthcare professionals (HCP) and students.

METHODS

We used the Joanna Briggs Institute (JBI) approach for scoping reviews and the PRISMA extension of scoping reviews (PRISMA-ScR) checklist for reporting our review. 46 full-text articles that met the eligibility criteria were selected for the review. Narrative synthesis was performed to summarize the evidence using numerical and descriptive analysis. We used inductive content analysis for categorizing the training methods. Also, the modified version of the Kirkpatrick's levels model was used for abstracting the training outcome.

RESULTS

Five types of training methods were identified: one-on-one training, peer-coach training, classroom training (CRT), computer-based training (CBT), and blended training. A variety of CBT platforms were used, including a prototype academic electronic medical record system (AEMR), AEMR/simulated EMR (Sim-EMR), mobile based AEMR, eLearning, and electronic educational materials. Each training intervention could have resulted in several outcomes. Most outcomes were related to levels 1-3 of the Kirkpatrick model that involves learners (n = 108), followed by level 4a that involves organizations (n = 7), and lastly level 4b that involves patients (n = 1). The outcomes related to participants' knowledge (level 2b) was the most often measured training outcome (n = 44).

CONCLUSIONS

This review presents a comprehensive synthesis of the evidence on EMR training. A variety of training methods, participants, locations, strategies, and outcomes were described in the studies. Training should be aligned with the particular training needs, training objectives, EMR system utilized, and organizational environment. A training plan should include an overall goal and SMART (Specific, Measurable, Achievable, Realistic, Tangible) training objectives, that would allow a more rigorous evaluation of the training outcomes.

Transforming learning: Applying community and systems level interventions through a poster project

BACKGROUND

Public health nursing practice is population-focused with a goal of improving health outcomes. Nurse educators are challenged to identify teaching-learning strategies to transform students' perspectives and knowledge of public health concepts.

PURPOSE

The purpose of the poster project was to evaluate students' ability to meet Quad Council Coalition Competency Review Task Force competencies for public health nursing.

METHODS

Teams of students identified an issue, investigated epidemiological data, searched literature, linked the issue to a Healthy People 2020 objective, defined the societal health construct, identified evidence-based interdisciplinary actions, and drew a conclusion based on the synthesis of evidence. The Quad Council Public Health Nursing domains and competencies provided a crosswalk design for faculty to evaluate teams' ability to plan and implement population-focused actions within the poster project.

RESULTS

Teams met one or more competencies in six out of eight domains. Domains I-IV, VI, and VIII were met by 100%, domain V was met by 60%, and domain VII was met by 25% of the teams.

DISCUSSION

Ownership of the poster translated into teams demonstrating creative approaches and expertise in identifying actions to address societal health outcomes.

CONCLUSION

 The societal health construct poster is an effective pedagogical approach that encourages teams to become change agents at the community and systems level.