Case Study

A blended learning environment as utilised in a masters level subject was critiqued through the lenses afforded by Salmon and Goffman. The authors bring perspectives of student and teacher and combine personal recollection with discussion board postings to make sense of the experience and recommendations for teaching in a blended environment.

Implications for Nursing Research and Generation of Evidence

A sound informatics infrastructure is essential to optimise the application of evidence in nursing practice. A comprehensive review of the infrastructure and associated research methods is supported by an extensive resource of references to point the interested reader to further resources for more in depth study. Information and communication technology (ICT) has been recognized as a fundamental component of applying evidence to practice for several decades. Although the role of ICT in generating knowledge from practice was formally identified as a nursing informatics research priority in the early 1990s (NINR Priority Expert Panel on Nursing Informatics, 1993), it has received heightened interest recently. In this chapter, the authors summarize some important trends in research that motivate increased attention to practice-based generation of evidence. These include an increased emphasis on interdisciplinary, translational, and comparative effectiveness research; novel research designs; frameworks and models that inform generation of evidence from practice; and creation of data sets that include not only variables related to biological and genetic measures, but also social and behavioral variables. The chapter also includes an overview of the ICT infrastructure and informatics processes required to facilitate generation of evidence from practice and across research studies: (1) information structures (e.g., re-usable concept representations, tailored templates for data acquisition), (2) processes (e.g., data mining algorithms, natural language processing), and (3) technologies (e.g., data repositories, visualization tools that optimize cognitive support). In addition, the authors identify key knowledge gaps related to informatics support for nursing research and generation of evidence from practice.

Nursing Informatics History and its Contributions to Nursing Knowledge

The history of nursing informatics whilst arguably starting with Florence has exploded into a tale of frenetic activity in the last 30 years. This tale is told in this chapter. The evolution of a nursing minimum data set and evolution of a shared language internationally is rightfully positioned as critical to the future of nursing. The argument is structured around the benefit of a sound informatics infrastructure that enables nurses to Care, Share and Compare. Direction of future development needed is discussed in light of the evolution of the nursing role as knowledge worker.

Communication and Nursing Relationships

Communication and relationships are central to nursing. The non-linear quality of communication is discussed and the challenge for nursing to carry quality communication into a technology enriched environment considered. Basic features of communication are laid out.

Nursing Knowledge

What is nursing knowing? Is it scientific knowing or practical thinking? This chapter discusses what we know of thinking in the western philosophical tradition and how this can be brought to bear on this complex question. The thinking adventure situates mindfulness and praxis as essential elements of nurse practice.

Case Study

Research Matchmaker is a public health innovation that will lead to community centered research focused on social determinants of health. Research Matchmaker has been developed to bring communities, practitioners and researchers together to focus on community determined health needs. The rationale and development process is discussed.

Case Study

The MHEC-RAP project involves the innovative application of video conferencing to mental health assessment in rural NSW. The preliminary evaluation findings of the project are presented. Mental health emergencies in rural and remote settings cause particular problems and are not amenable to conventional health service solutions. Patients and local health care staff may be isolated from specialist mental health staff and from acute inpatient services. Decisions to transport patients for specialist assessments or treatment may be required at night or at weekends and may involve families, police, ambulance services and local health staff. Such decisions need to be made promptly but carefully and the ability to obtain a specialist assessment may assist in making a decision about how best to care for the patient bearing in mind the need to provide a responsive, high quality and safe service to patients and local clinicians. In this chapter we examine a novel approach which uses audio-visual technology to conduct remote emergency mental health patient assessment interviews and provide consultations to local clinicians in rural communities in western NSW. The Mental Health Emergency Care – Rural Access Project or ‘MHEC-RAP’ was developed in 2007 following a series of consultations held in rural towns and implemented in 2008 within the Greater Western Area Health Service (GWAHS), New South Wales, Australia. GWAHS is a primary example of a rural and remote health service. It serves 287,481 people (8.3% of whom are Indigenous Australians) in an area that is 445,197sq km or 55% of the state of New South Wales (Australian Bureau of Statistics, 2001; Greater Western Area Health Service, 2007, 2009). The communities within GWAHS are mostly small, the towns are widely dispersed and local services are “limited by distance, expense, transport, and the difficulty of recruiting health professionals to these areas” (Dunbar, 2007 page 587). The chapter focuses on the design of the service, its implementation and its performance in the first year. We conclude with a discussion about the service, its broader relevance, transferability and its sustainability.

Translation of Evidence into Practice

Translation of evidence into practice requires conscious effort. Theories are presented and critically discussed as potential clues of how to best pull evidence into practice and reap rewards for the effort. Translation is considered in the context of the individual practitioner, institution and nursing profession. The role of informatics is situated in these contexts.

Case Study

The development of tools and the promotion of the use of the tools to electronically record mental health outcomes in New Zealand are presented. The primary utility of outcomes data is discussed as part of person centred care and recovery.

Telenursing

Evidence is emerging that the use of the information and communication technologies (ICT) in healthcare settings facilitates better quality care. In general terms telenursing is the use of technology for delivering nursing care at distance. Evidence suggests that telenursing applications can be effective in both healthcare and non-institutional settings. Nurses’ readiness to utilize telenursing applications is an important prerequisite for the wider use of this tool. This chapter examines the best evidence for telenursing practices and reviews the studies relating to the nurses knowledge, perceptions and expectations on using technology in their routine practice.