D029 Annotated Bibliography

D029 Annotated Bibliography

Name

 Western Governors University

D029 Informatics for Transforming Nursing Care

Prof. Name

Date

Annotated Bibliography

Factors Influencing the Use of Electronic Personal Health Records (ePHRs)

What are electronic personal health records (ePHRs) and what functionalities do they provide?

Electronic personal health records (ePHRs) are secure, patient-facing digital systems that provide individuals with access to selected components of their health information. These systems typically enable patients to review laboratory results, medication histories, and visit summaries while also supporting two-way communication with healthcare providers. Common functionalities include appointment scheduling, prescription refill requests, and the ability to share health data with authorized caregivers or clinicians. By facilitating real-time access to personal health information, ePHRs promote patient autonomy, improve continuity of care, and support a more participatory model of healthcare delivery.

What factors affect patients’ use of ePHRs?

Evidence synthesized from a systematic review of 97 studies identified more than 150 variables influencing ePHR adoption, with 18 factors emerging as particularly significant. These determinants span demographic characteristics, socioeconomic conditions, health status, technological access, individual perceptions, and concerns related to privacy and data security. Collectively, these factors shape both initial adoption and sustained engagement with ePHRs.

Factor Category	Key Influencing Elements
Demographic	Sex, ethnicity, marital status, language proficiency, geographic location
Socioeconomic	Income level, educational attainment, employment status, overall socioeconomic position
Health-Related	Self-reported health status and presence of chronic conditions
Technological and Access	Internet availability, computer or mobile device access, digital literacy, frequency of internet use
Perceptions and Awareness	Awareness of ePHRs, perceived usefulness, perceived ease of use
Privacy and Security Concerns	Trust in data protection, confidentiality, and system security

Patients are more likely to engage with ePHRs when they possess adequate digital skills, perceive tangible benefits, and trust the system’s ability to safeguard sensitive health information.

What is the significance of these factors for stakeholders?

For healthcare organizations, policymakers, and health information technology developers, understanding these influencing factors is essential for effective ePHR implementation. Addressing disparities in digital access, simplifying system interfaces, and proactively communicating privacy safeguards can substantially improve adoption rates. Tailoring ePHR design and outreach strategies to diverse patient populations supports equitable access, strengthens patient engagement, and contributes to improved health outcomes (Abd-alrazaq et al., 2019).

Using Virtual Simulation to Teach Evidence-Based Practice (EBP) in Nursing Education

What types of virtual simulations are used in nursing education to teach evidence-based practice?

Nursing education commonly employs two categories of virtual simulation to support instruction in evidence-based practice. Screen-based simulations utilize interactive software featuring avatars or live actors to present realistic clinical scenarios. Virtual reality simulations (VRS), in contrast, rely on immersive headset technology to place learners within three-dimensional clinical environments. Both approaches allow students to apply research evidence, clinical judgment, and decision-making skills in simulated patient care situations.

How do virtual simulations and virtual reality simulations benefit nursing students?

Virtual simulation technologies provide a risk-free learning environment where students can practice clinical reasoning without endangering patients. These tools are particularly valuable when access to clinical placements is limited, as they ensure consistent exposure to complex scenarios. Repeated engagement with simulations enhances students’ confidence, critical thinking abilities, and competence in applying evidence-based interventions, thereby strengthening their readiness for real-world clinical practice.

What conclusions were drawn about the integration of virtual simulations in nursing curricula?

A rapid review of 37 case studies demonstrated that both screen-based and immersive virtual simulations positively influence undergraduate nursing students’ learning outcomes related to evidence-based practice. The findings support the systematic integration of virtual simulation technologies into nursing curricula as a means of improving educational quality, fostering clinical competence, and preparing students to deliver high-quality, evidence-informed patient care (Cant et al., 2022).

Development and Impact of an Inpatient Staffing Dashboard

What was the purpose of the inpatient staffing dashboard project?

The inpatient staffing dashboard initiative at Loma Linda University Medical Center was developed to enhance staffing efficiency and transparency. The primary objective was to provide nursing leadership with real-time, data-driven insights that support informed staffing decisions and optimal resource allocation across clinical units.

How was the dashboard designed and integrated?

The dashboard was created through collaboration between nursing staffing personnel and information systems analytics specialists. Multiple design iterations were developed and refined based on user feedback. The final product was embedded within Epic Hyperspace and SharePoint platforms, ensuring seamless integration into existing clinical workflows and enabling role-based access for different users.

What features does the dashboard provide?

Dashboard Component	Purpose
Main Page	Displays a real-time overview of overall staffing conditions
Staffing by Labor Mix	Compares planned staffing requirements with actual staffing levels
Productive vs. Nonproductive Hours	Tracks historical and projected staffing utilization
Filled Percentage by Position	Illustrates staffing fulfillment rates by role

What was the overall impact of the dashboard?

Implementation of the dashboard improved visibility into staffing patterns and empowered leaders to make evidence-based staffing decisions aligned with organizational goals. The collaborative design process enhanced user adoption, improved workforce efficiency, and contributed to maintaining high standards of patient care quality (Role et al., 2021).

Telehealth to Improve Delirium Screening in ICU Nurses

Why is delirium screening important in the ICU setting?

Delirium is a prevalent and serious condition among critically ill patients and is associated with increased morbidity, prolonged hospital stays, and higher mortality rates. Accurate and timely delirium screening in intensive care units is therefore essential to enable early intervention and prevent adverse outcomes.

How was telehealth utilized in this study?

The study employed a telehealth platform to remotely observe 13 ICU nurses conducting delirium assessments using the Confusion Assessment Method for the ICU (CAM-ICU). A geriatric specialist provided real-time feedback and coaching, allowing nurses to refine their assessment techniques during live patient interactions.

What challenges were identified in delirium assessment?

Several recurrent issues were identified, including improper use of the Richmond Agitation-Sedation Scale (RASS), incorrect administration of the CAM-ICU, limited understanding of patients’ baseline cognitive status, misuse of the “unable to assess” category, and uncertainty regarding assessment timing.

What were the outcomes of using telehealth for nurse training?

Following telehealth-based feedback, nurses demonstrated notable improvements in delirium assessment accuracy. Participants reported positive perceptions of remote coaching, underscoring telehealth’s potential as an effective strategy for continuous professional development and quality improvement in critical care settings (Sinvani et al., 2022).

Wearable and Mobile Applications in Preventative Healthcare

What multidisciplinary expertise is required for developing wearable health technologies?

The development of wearable health technologies necessitates collaboration among diverse disciplines, including electronic engineering, computer science, human-centered design, psychology, health sciences, and clinical medicine. This multidisciplinary approach ensures that devices are technically reliable, clinically meaningful, and user-friendly.

What types of wearable devices and biosensors are currently available?

Wearable health technologies range from consumer-oriented devices such as smartwatches and fitness trackers to specialized medical biosensors, including portable electrocardiographs and physiological monitoring patches. These devices commonly integrate with mobile applications to collect, visualize, and analyze health data in real time.

What are the benefits of wearable health technologies?

Wearable devices and mobile health applications promote preventive healthcare by enabling individuals to monitor physiological parameters, track physical activity, and engage more actively in health maintenance. Successful adoption depends not only on data accuracy but also on comfort, aesthetic appeal, and ease of use, which collectively enhance sustained user engagement.

What is the future direction for wearable health data?

One of the most significant challenges facing wearable health technology is the effective interpretation of large-scale data outputs. Future research and development efforts will focus on advanced analytics and decision-support tools that transform raw data into actionable insights, thereby supporting preventive interventions and improving long-term health outcomes (Huang et al., 2018).

References

Abd-alrazaq, A. A., Bewick, B. M., Farragher, T., & Gardner, P. (2019). Factors that affect the use of electronic personal health records among patients: A systematic review. International Journal of Medical Informatics, 126, 164–175. https://doi.org/10.1016/j.ijmedinf.2019.03.014

Cant, R., Cooper, S., & Ryan, C. (2022). Using virtual simulation to teach evidence-based practice in nursing curricula: A rapid review. Worldviews on Evidence-Based Nursing, 19(5), 415–422. https://doi.org/10.1111/wvn.12572

Role, J., Chao, H., Rosario, C., Ho, P., & Hodgkins, M. (2021). Inpatient staffing dashboard: A nursing-information technology collaborative project. Computers, Informatics, Nursing, 39(11), 772–779. https://doi.org/10.1097/CIN.0000000000000778

D029 Annotated Bibliography

Sinvani, L., Hertz, C., Chandra, S., Ilyas, A., Ardito, S., & Hajizadeh, N. (2022). Using telehealth to improve the accuracy of delirium screening by bedside critical care nurses. American Journal of Critical Care, 31(1), 73–76. https://doi.org/10.4037/ajcc2022773

Huang, W., Li, J., & Alem, L. (2018). Towards preventative healthcare: A review of wearable and mobile applications. Studies in Health Technology & Informatics, 251, 11–14.

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