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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedWeiss CR, Roberts M, Florell M
Best Practices for telehealth in nurse-led care settings-a qualitative study.
This study explored the implementation of telehealth in nurse-led care models during the COVID-19 pandemic in Colorado. Through interviews with 18 providers and 30 patients, best practices such as: using multiple modalities, tailored triage and scheduling, safety measures, and managing patient relationships emerged. These findings indicate that telehealth can enhance equitable care delivery, particularly in diverse communities, with nurse leaders playing a vital role in its effective utilization.
AHRQ-funded; HS028085.
Citation: Weiss CR, Roberts M, Florell M .
Best Practices for telehealth in nurse-led care settings-a qualitative study.
Policy Polit Nurs Pract 2024 Feb; 25(1):47-57. doi: 10.1177/15271544231201417.
Keywords: Telehealth, Health Information Technology (HIT), Nursing, Provider: Nurse, COVID-19
Jeffery AD, Reale C, Faiman J
Inpatient nurses' preferences and decisions with risk information visualization.
The purpose of this study was to explore the effect of 4 different risk information formats on inpatient nurses' preferences and decisions with an acute clinical deterioration decision-support system. The researchers implemented a comparative usability evaluation in which participants provided responses to multiple user interface options in a simulated setting. Qualitative data was collected using think aloud methods, asking participants which action they would perform after each time point in 3 different patient scenarios. The 6 participants preferred the probability format over relative risk ratios (n = 2), absolute differences (n = 2), and number of persons out of 100 (n = 0). Participants preferred average lines, having a trend graph to supplement the risk estimate, and consistent colors between trend graphs and possible actions. Participants did not prefer too much text information or the presence of confidence intervals. The utilization of the probability format was related with higher concordance in actions taken by participants compared to the other 3 risk information formats.
AHRQ-funded; HS026395.
Citation: Jeffery AD, Reale C, Faiman J .
Inpatient nurses' preferences and decisions with risk information visualization.
J Am Med Inform Assoc 2023 Dec 22; 31(1):61-69. doi: 10.1093/jamia/ocad209..
Keywords: Provider: Nurse, Clinical Decision Support (CDS), Health Information Technology (HIT)
Ranusch A, Lin YJ, Dorsch MP
Role of individual clinician authority in the implementation of informatics tools for population-based medication management: qualitative semistructured interview study.
The objective of this study was to examine how individual authority of clinical pharmacists and anticoagulation nurses is affected by the implementation success of an electronic health record (EHR) direct oral anticoagulant (DOAC) Dashboard for safe DOAC medication prescribing. Researchers conducted semistructured interviews with pharmacists and nurses after the implementation of the EHR DOAC Dashboard at three clinical sites. Results showed that a high level of individual clinician authority was associated with high levels of key facilitators for effective use of the DOAC Dashboard; conversely, a lack of individual authority was associated with key barriers to effective use. The researchers concluded that increased individual clinician authority is a necessary antecedent to the effective implementation of an EHR DOAC Population Management Dashboard.
AHRQ-funded; HS026874.
Citation: Ranusch A, Lin YJ, Dorsch MP .
Role of individual clinician authority in the implementation of informatics tools for population-based medication management: qualitative semistructured interview study.
JMIR Hum Factors 2023 Oct 24; 10:e49025. doi: 10.2196/49025..
Keywords: Medication, Provider: Pharmacist, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Blood Thinners
Jeffery AD
Data science for nurses.
This “Practice Matters” article discusses how nurses can apply data science methods to improve nurses’ insight into care delivery. Data science in nursing is defined and the data science process is described in five steps: capture, maintain, process, analyze, and communicate. A table is included which highlights several recently published studies that leveraged data science methods in nursing-relevant projects. The article ends with a call to action.
AHRQ-funded; HS026395.
Citation: Jeffery AD .
Data science for nurses.
Am Nurse 2022 May; 17(5)..
Keywords: Provider: Nurse, Electronic Health Records (EHRs), Health Information Technology (HIT)
Gaughan AA, Walker DM, Sova LN
Improving provisioning of an inpatient portal: perspectives from nursing staff.
This study’s aim was to identify and describe practices important for provisioning an inpatient portal from the perspectives of nursing staff and provide insight to enable hospitals to address challenges related to provisioning workflow for the inpatient portal accessible on a tablet. Qualitative interviews were conducted at 26 inpatient units in six hospitals within The Ohio State University Wexner Medical Center (OSUWMC) with 210 nursing staff members following the introduction of tablets providing access to an inpatient portal, MyChart Bedside (MCB). Provisioning rates were divided into tertiles to create three levels of provisioning performance. Higher-performing units showed three critical strategies that contributed to MCB tablet provisioning success: (1) establishing a feasible process for MCB provisioning; (2) having persistent unit-level MCB tablet champions; and (3) having unit managers actively promote MCB tablets.
AHRQ-funded; HS024767; HS024091; HS024379.
Citation: Gaughan AA, Walker DM, Sova LN .
Improving provisioning of an inpatient portal: perspectives from nursing staff.
Appl Clin Inform 2022 Mar;13(2):355-62. doi: 10.1055/s-0042-1743561..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse
Abraham CM, Zheng K, Norful AA
Use of multifunctional electronic health records and burnout among primary care nurse practitioners.
This study investigated whether there is an association with the use of multifunctional electronic health records (EHRs) with nurse practitioner (NP) burnout in primary care practices. The study used cross-sectional survey data secondary analysis collected from NPs in Pennsylvania and New Jersey. The NPs completed surveys measuring burnout, use of multifunctional EHRs, demographics, and characteristics of their practice. Of 396 NPs included, 25.3% reported burnout, but the use of multifunctional EHRs did not increase primary care NP burnout.
AHRQ-funded; HS027290.
Citation: Abraham CM, Zheng K, Norful AA .
Use of multifunctional electronic health records and burnout among primary care nurse practitioners.
J Am Assoc Nurse Pract 2021 Dec;33(12):1182-89. doi: 10.1097/jxx.0000000000000533..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Provider: Nurse, Primary Care
Kutney-Lee A, Brooks Carthon M, Sloane DM
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Researchers examined associations between electronic health record (EHR) usability and nurse job and surgical patient outcomes. Data from the American Hospital Association, state patient discharges, and nurse surveys were linked in a cross-sectional analysis. The researchers found that employing EHR systems with suboptimal usability was associated with higher odds of adverse nurse job outcomes and surgical patient mortality and readmission.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Brooks Carthon M, Sloane DM .
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Med Care 2021 Jul;59(7):625-31. doi: 10.1097/mlr.0000000000001536..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Outcomes, Nursing, Provider: Nurse
Womack DM, Hribar MR, Steege LM
Registered nurse strain detection using ambient data: an exploratory study of underutilized operational data streams in the hospital workplace.
Registered nurses (RNs) regularly adapt their work to ever-changing situations but routine adaptation transforms into RN strain when service demand exceeds staff capacity and patients are at risk of missed or delayed care. The purpose of this study was to assess the utility of ambient workplace data, defined as time-stamped transaction records and log file data produced by non-electronic health record care delivery tools (e.g., nurse call systems, communication devices), as an information channel for automated sensing of RN strain.
AHRQ-funded; HS026370.
Citation: Womack DM, Hribar MR, Steege LM .
Registered nurse strain detection using ambient data: an exploratory study of underutilized operational data streams in the hospital workplace.
Appl Clin Inform 2020 Aug;11(4):598-605. doi: 10.1055/s-0040-1715829..
Keywords: Provider: Nurse, Provider, Health Information Technology (HIT), Workforce, Burnout
Yuan CT, Nembhard IM, Kane GC
The influence of peer beliefs on nurses' use of new health information technology: a social network analysis.
Implementation of health information technology fails at an alarming rate because intended users often choose not to use it. In this study, the investigators examined the relationship between an individual's system use and the beliefs of his or her peers. The investigators concluded that their findings indicated a significant role of social networks in implementation, and specifically that shared beliefs between an individual and his or her peer network may be critical to implementation success, more so than the beliefs across the entire peer group.
AHRQ-funded; HS022201.
Citation: Yuan CT, Nembhard IM, Kane GC .
The influence of peer beliefs on nurses' use of new health information technology: a social network analysis.
Soc Sci Med 2020 Jun;255:113002. doi: 10.1016/j.socscimed.2020.113002..
Keywords: Health Information Technology (HIT), Provider: Nurse, Provider
Wilson N, Jehn M, Kisana H
Nurses' perceptions of implant barcode scanning in surgical services.
Health policy changes have prompted hospital systems to assess implementation of implant barcode scanning systems to capture unique device identifiers. The aims of this project were to assess predictors of operating room nurses' acceptance of a new implant barcode scanning system, describe operating room nurses' perceptions of the system value, and identify operating room nurses' perceived gaps in system implementation.
AHRQ-funded; HS022340.
Citation: Wilson N, Jehn M, Kisana H .
Nurses' perceptions of implant barcode scanning in surgical services.
Comput Inform Nurs 2020 Mar;38(3):131-38. doi: 10.1097/cin.0000000000000579..
Keywords: Provider: Nurse, Provider, Surgery, Health Information Technology (HIT)
Tan M, Lipman S, Lee H
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
The impact of the electronic medical record (EMR) on nursing workload is not well understood. The objective of this descriptive study was to measure the actual and perceived time that nurses spend on the EMR in the operating room during cesarean births. The investigators found that on average, nurses spent 40% of their intraoperative time on the EMR during cesarean births, and this time burden was distributed across the perioperative period.
AHRQ-funded; HS023506.
Citation: Tan M, Lipman S, Lee H .
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
J Patient Saf 2019 Dec;15(4):e82-e85. doi: 10.1097/pts.0000000000000467..
Keywords: Electronic Health Records (EHRs), Labor and Delivery, Provider: Nurse, Health Information Technology (HIT), Provider, Pregnancy
Kang Y, Taylor JO, Osterhage K
Home care nurses' perspectives regarding health information management among older adults.
The purpose of this qualitative study was to determine how home healthcare nurses (HCNs) obtain and provide health information, to describe the perspective of HCNs regarding older adult personal health information (PHI), and to identify the potential role of technology in older adult health information transfer. Researchers conducted and analyzed phone interviews with 17 HCNs from two home healthcare agencies. Results showed these five themes: 1) common practices of obtaining health information; 2) barriers to obtaining health information; 3) ideal ways to obtain and provide health information; 4) use of patient portals; and 5) HCNs' use of technology for health information exchange. Most HCNs reported that it would be difficult for older adult patients to update their PHI without assistance, but HCNs lack the time and resources to assist older adults in PHI management activities.
AHRQ-funded; HS022106.
Citation: Kang Y, Taylor JO, Osterhage K .
Home care nurses' perspectives regarding health information management among older adults.
Home Healthc Now 2019 Nov/Dec;37(6):319-27. doi: 10.1097/nhh.0000000000000796..
Keywords: Home Healthcare, Elderly, Health Information Technology (HIT), Provider: Nurse, Provider
Sockolow PS, Bass EJ, Ynag Y
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
This study investigated the availability and quality of information used by nurses in a rural home health care agency during patient admission. Twelve in-home admissions were observed and the nurses were interviewed before and after the admissions process. Content and quality of documents available to the nurses was analyzed and needed documents were not uniformly present. They rarely received visit pattern or medication management information. These results show the need for a high quality electronic health record system.
AHRQ-funded; HS024537.
Citation: Sockolow PS, Bass EJ, Ynag Y .
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
Stud Health Technol Inform 2019 Aug 21;264:798-802. doi: 10.3233/shti190333..
Keywords: Rural Health, Home Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Provider
Kroth PJ, Morioka-Douglas N, Veres S
Association of electronic health record design and use factors with clinician stress and burnout.
The authors sought to determine which electronic health record (EHR) design and use factors are associated with clinician stress and burnout and to identify other sources that contribute to this problem. Surveying ambulatory primary care and subspecialty clinicians from 3 institutions, they found that, although EHR design and use factors are associated with clinician stress and burnout, other challenges, such as chaotic clinic atmospheres and workload control, explain considerably more of the variance in these adverse clinician outcomes.
AHRQ-funded; HS022065.
Citation: Kroth PJ, Morioka-Douglas N, Veres S .
Association of electronic health record design and use factors with clinician stress and burnout.
JAMA Netw Open 2019 Aug 2;2(8):e199609. doi: 10.1001/jamanetworkopen.2019.9609..
Keywords: Burnout, Stress, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider: Clinician, Provider: Physician, Provider: Nurse
Kutney-Lee A, Sloane DM, Bowles KH
Electronic health record adoption and nurse reports of usability and quality of care: the role of work environment.
This study assessed the role of electronic health record (EHR) adoption and work environment for nurses. If the EHR system has positive usability ratings it impacts quality of care. Over 12,000 nurses in 353 hospitals were surveyed.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Sloane DM, Bowles KH .
Electronic health record adoption and nurse reports of usability and quality of care: the role of work environment.
Appl Clin Inform 2019 Jan;10(1):129-39. doi: 10.1055/s-0039-1678551..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing, Provider: Nurse, Quality of Care
Auger KA, Shah SS, Tubbs-Cooley HL
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
The purpose of this study was to determine whether a single nurse-led telephone call after pediatric discharge decreased the 30-day reutilization rate for urgent care services and enhanced overall transition success. The investigators concluded that although postdischarge nurse contact did not decrease the reutilization rate of postdischarge urgent health care services, the method showed promise to bolster postdischarge education.
AHRQ-funded; HS024735.
Citation: Auger KA, Shah SS, Tubbs-Cooley HL .
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
JAMA Pediatr 2018 Sep;172(9):e181482. doi: 10.1001/jamapediatrics.2018.1482..
Keywords: Care Coordination, Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Healthcare Delivery, Healthcare Utilization, Hospital Discharge, Outcomes, Provider, Provider: Nurse, Telehealth, Transitions of Care
Yao Y, Ahn H, Stifter J
Continuity index measures in the acute care hospital setting: an analytic review and tests using electronic health record data and computer simulation.
This study examined continuity index measures in the acute care hospital setting. These measures can be used to examine the influence of nurse staffing patterns on patient outcomes. The researchers examined the behavior of continuity indexes as applied to clinical practice data that were collected with the Hands-On Automated Nursing Data System (HANDS) and data from computer simulation. The findings provided a deep understanding of the conceptual foundations and properties of various continuity measures.
AHRQ-funded; HS015054; HS023072.
Citation: Yao Y, Ahn H, Stifter J .
Continuity index measures in the acute care hospital setting: an analytic review and tests using electronic health record data and computer simulation.
J Nurs Meas 2018 Apr 1;26(1):20-35. doi: 10.1891/1061-3749.26.1.20..
Keywords: Transitions of Care, Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Provider, Hospitals, Outcomes
Ancker JS, Edwards A, Nosal S
Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system.
In this study, the investigators tested hypotheses arising from two possible alert fatigue mechanisms: (A) cognitive overload associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and (B) desensitization from repeated exposure to the same alert over time. The investigators found that clinicians became less likely to accept alerts as they received more of them, particularly more repeated alerts. There was no evidence of an effect of workload per se, or of desensitization over time for a newly deployed alert.
AHRQ-funded; HS021531.
Citation: Ancker JS, Edwards A, Nosal S .
Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system.
BMC Med Inform Decis Mak 2017 Apr 10;17(1):1-9. doi: 10.1186/s12911-017-0430-8..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Nurse, Provider: Physician
Gerber DE, Beg MS, Duncan T
Oncology nursing perceptions of patient electronic portal use: a qualitative analysis.
The purpose of this study was to identify nursing staff reactions to and perceptions of electronic portal use in a cancer setting. Two focus groups were conducted and theoretical thematic content analysis of data was performed. The investigators concluded that nursing staff reactions to electronic portals were predominantly related to the impact on clinical workload and patient safety and expectations.
AHRQ-funded; HS022418.
Citation: Gerber DE, Beg MS, Duncan T .
Oncology nursing perceptions of patient electronic portal use: a qualitative analysis.
Oncol Nurs Forum 2017 Mar 1;44(2):165-70. doi: 10.1188/17.Onf.165-170..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider, Provider: Nurse