How do registered nurses (P) working in a hospital setting that provides technology for the patients (I) perceive (O) that technology affects their clinical time management?

Student #1
Technology plays a major role in health care especially for the clinicians, they use technology for documentation, examinations, providing care and completing procedures. Now there is technology available for patients, this technology provides the patient access to their medical charts, access to their physician via video conference and also to provide information to their physician through applications. However, it is often up to the registered nurse to provide the education and instruction on how to access and use the technology.

PICOT Question

How do registered nurses (P) working in a hospital setting that provides technology for the patients (I) perceive (O) that technology affects their clinical time management?

Article:
Patmon, F. L., Gee, P. M., Rylee, T. L., & Readdy, N. L. (2016). Using interactive patient engagement technology in clinical practice: A qualitative assessment of nurses’ perceptions. Journal of Internet Research, 18(11), 30. https://doi.org/10.2196/jmir.5667

The authors report that they used a focused rapid ethnographic evaluation methodology to gather the data for this study. Credibility- Purposive sampling was used which included only those nurses who used the interactive patient engagement technology (IPET) on a daily basis. To obtain a variation different departments were included some from the emergency department, some from the birthing center and nursing leaders from these units were also interviewed. Dependability: -At least two researchers were available for each interview, observed data and interview data were documented, and then combined at the end of each day. Confirmability:- Three members of the research team were responsible for organization of all the data and field notes after data collection. The data was analyzed for patterns, and began initial coding, data was uploaded to a qualitative an analysis software where statements were organized and systematically indexed. Transferability: – Results provided 4 major findings that IPET was a good distraction for patients, IPET affects both patients and nurses, IPET has implications for clinical practice, and IPET training may improve usage of the system.

Student #2
PICOT Question
In primary care practices (P), does access to medical laboratory services (I) compared to no access (C) improve patient diagnosis and treatment (O) over time (T)?
Qualitative Evidence
Medical laboratory services play a vital role in the health care delivery system. Medical laboratory testing is essential to the overall care system through its role in the clinical decision process. According to Aakre et al. (2013), laboratory testing influences as high as 70% of physicians’ critical clinical decision-making. Lack of access to laboratory services or inefficiencies in laboratory processes can heavily affect patient safety and patient care. Is there evidence to support the effectiveness of laboratory services at improving patient outcomes and at controlling disease? Tadeu and Geelhoed (2016) at the Health Directorate of Tete Province in Mozambique, reviewed documents, conducted interviews, and focus group discussions to explore the role of laboratory in primary health care settings in term of accessibility, perceived service quality, and disease control.
Study Design and Method
Tadeu and Geelhoed (2016) used a qualitative research methodology to examine the role of laboratory services in primary health care on access. In addition, the authors took a phenomenological research design approach to assess physicians’ perceptions about service quality and disease control. A purposive sampling technique was used to select three primary health facilities with and three without laboratory access based on available services, accessibility, and size.
Data Trustworthiness
Tadeu and Geelhoed (2016) insured trustworthiness of their study by using well-trained research assistants to facilitate all interviews in local language. The authors use a cross-validation process between researchers to help enhance the external validity of the study. While the nonprobability purposive sampling procedure used by Tadeu and Geelhoed limited the external validity or generalization of the study, it increased the internal validity. Furthermore, all interviews were conducted until thematic saturation was reached. This process increased the internal validity or credibility of the study. Although Tadeu and Geelhoed used a small sample size for their study, they were able to gain an understanding of the concepts of interest, confirming the appropriateness of the researchers’ sample size. Tadeu and Geelhoed also reported achieving data saturation, a grounded theory approach, ensuring the adequacy and quality of their study.
Study Results and Clinical Significance
Tadeu and Geelhoed (2016) reported a higher level of health service utilization and better disease management in the health facilities with access to a laboratory when compared to the facilities with no laboratory. More diseases were diagnosed and more treatment regimens were initiated in the health facilities with a laboratory. In addition, clinicians’ perceptions about the availability of laboratory services were reported as essential to the delivery of high quality care and better disease management. This study was important at addressing the PICOT question because it showed the key role laboratory services play in ensuring better health care delivery. Bringing access to high-quality, affordable laboratory testing to everyone and help improve the quality and cost of healthcare should be high on the global health agenda.
References
Aakre, K., Langlois, M., Watine, J., Barth, J., Baum, H., Collinson, P., . . . Oosterhuis, W. (2013). Critical review of laboratory investigations in clinical practice guidelines: proposals for the description of investigation. Clinical Chemistry and Laboratory Medicine, 51(6), 1217-1226. https://doi.org/10.1515/cclm-2012-0574
Tadeu, B., & Geelhoed, D. (2016). “This thing of testing our blood is really very important”: a qualitative study of Province, Mozambique.International Journal for Equity in Health , 15(133), 1-11. https://doi.org/10.1186/s12939-016-0418-5