Nursing Informatics 

Abstract: Meaningful use of electronic health records to coordinate care requires skillful synthesis and integration of subjective and objective data by practitioners to provide context for information. This is particularly relevant in the coordination of care for children with complex special healthcare needs. The purpose of this article is to present a conceptual framework and example of meaningful use within an innovative telenursing intervention to coordinate care for children with complex special healthcare needs. The TeleFamilies intervention engages an advanced practice nurse in a full-time care coordinator role within an existing hospital-based medical home for children with complex special healthcare needs. Care coordination is facilitated by the synthesis and integration of internal and external data using an enhanced electronic health record and telehealth encounters via telephone and videoconferencing between the advanced practice nurse and the family at home. The advanced practice nurse’s ability to maintain an updated plan of care that is shared across providers and systems and build a relationship over time with the patient and family supports meaningful use of these data.

Abstract: The study "Online Care" follows a municipal project "Online Welfare" where a nurse's presence in the citizen's own home was replaced by online communication. The paper is based on a citizen's perspective and seeks to develop meaningful workflow for the benefit of citizens with medical problems. The study examines five citizens' opinions on whether online communication in a meaningful way supports the citizens in what they associate with a good life. In addition, relatives and the citizen's nurse were interviewed individually concerning the same issues as the citizens. The study has been approved by the Danish System of Ethics in Science and is conducted in collaboration with Aalborg University, Aalborg Municipality and DanAge, (NGO). The municipality's goal of efficiency and financial savings regarding "Online Welfare" was not honored due to insufficient network infrastructure and technical problems. An adoption barrier was that the municipality did not determine the efforts and the goal of the project, who could benefit from participating and the requirements of the professionals and the organization including ethical considerations.It was difficult to find citizens who were willing to participate. Citizens, who were included in the study accepted and adopted the technology however, "Online Welfare" could not replace the care they used to receive. Therefore, the offer was perceived as an "appendix" which tended to meaninglessness by some of the citizens.The nurses' perception of nursing care and their limited IT skills was a barrier to acceptance, adoption and development of technology opportunities in nursing. The citizens' disability, the screen appearance, and the technology setup meant that the citizens perceived poor usability of the equipment. The study showed a change in workflow, as the cooperation between the citizen and the professional developed. New roles occurred for the professionals.The citizens had many ideas concerning the development of the technology and the study recommends that users are involved in the development and implementation of welfare technology and telemedicine. The relatively small sample size of the study shows findings that must be clarified by further research.

Abstract: BACKGROUND: Hip fracture is a serious health problem among older adults and often results in serious consequences such as disabilities. Informal caregivers (CGs) are particularly important for the successful recovery of older adult patients with hip fractures while they undergo surgical procedures and extensive rehabilitation therapies. In a previous study, we developed a comprehensive theory-based online hip fracture resource center for CGs and conducted a feasibility study. The 8-week online hip fracture resource center, including learning modules, moderated-discussion boards (DB), Ask-the-Experts, and virtual libraries, was used by CGs. PURPOSE: This study reports findings from a qualitative analysis of DB postings. METHODS: The data were analyzed using content analysis in conjunction with an inductive coding approach. The analyses yielded 6 themes and 3 categories related to hip fracture care (e.g., specific types of care provided by CGs). RESULTS/CONCLUSION: Findings suggest that DB forums can serve as a medium for CGs to share their experiences and to obtain support. Furthermore, DB forums can assist healthcare providers in identifying further opportunities to assist CGs. The study is limited to a small sample size in one hospital. Further studies are needed with larger samples in diverse settings.