Implementation of Smart Pump Technology With Home Infusion Providers: An Assessment of Clinician Workflow and Patient Satisfaction.
Ontology highlight
ABSTRACT:
SUBMITTER: Brown TD
PROVIDER: S-EPMC6237252 | biostudies-literature | 2018 Nov/Dec
REPOSITORIES: biostudies-literature
Publications
Implementation of Smart Pump Technology With Home Infusion Providers: An Assessment of Clinician Workflow and Patient Satisfaction.
Brown Thomas D TD Michael Martha M Grady David S DS
Journal of infusion nursing : the official publication of the Infusion Nurses Society 20181101 6
While hospitals have adopted smart pump technology (SPT) featuring drug libraries and medication safety software, most home infusion providers (HIPs) continue to use traditional infusion pumps that don't offer drug libraries or medication safety software. As infusion delivery is moving from the hospital to the home, the purpose of this study was to determine whether SPT was a feasible alternative at both a hospital-based and a rural HIP. HIP personnel were trained on an ambulatory infusion pump. ...[more]
Similar Datasets
Project description:This paper aims to develop a multisensor data fusion technology-based smart home system by integrating wearable intelligent technology, artificial intelligence, and sensor fusion technology. We have developed the following three systems to create an intelligent smart home environment: (1) a wearable motion sensing device to be placed on residents' wrists and its corresponding 3D gesture recognition algorithm to implement a convenient automated household appliance control system; (2) a wearable motion sensing device mounted on a resident's feet and its indoor positioning algorithm to realize an effective indoor pedestrian navigation system for smart energy management; (3) a multisensor circuit module and an intelligent fire detection and alarm algorithm to realize a home safety and fire detection system. In addition, an intelligent monitoring interface is developed to provide in real-time information about the smart home system, such as environmental temperatures, CO concentrations, communicative environmental alarms, household appliance status, human motion signals, and the results of gesture recognition and indoor positioning. Furthermore, an experimental testbed for validating the effectiveness and feasibility of the smart home system was built and verified experimentally. The results showed that the 3D gesture recognition algorithm could achieve recognition rates for automated household appliance control of 92.0%, 94.8%, 95.3%, and 87.7% by the 2-fold cross-validation, 5-fold cross-validation, 10-fold cross-validation, and leave-one-subject-out cross-validation strategies. For indoor positioning and smart energy management, the distance accuracy and positioning accuracy were around 0.22% and 3.36% of the total traveled distance in the indoor environment. For home safety and fire detection, the classification rate achieved 98.81% accuracy for determining the conditions of the indoor living environment.
| S-EPMC5539810 | biostudies-other
Project description:BackgroundThe use of smart speakers to improve well-being had been trialed in social care by others; however, we were not aware of their implementation in most care homes across a region in the Southwest of the United Kingdom. For the widespread adoption of new technology, it must be locally demonstrable and become normalized.ObjectiveThe aim of this study was to install smart speakers in care homes in a rural and coastal region and to explore if and how the devices were being used, the barriers to their implementation, and their potential benefits.MethodsEmail, workshops, drop-in sessions, phone, and cold calling was used to contact all 230 care homes, offering a free smart speaker and some advisory support. Care homes accepting the devices were asked to complete a feedback diary. Nonresponse rate for diary completion was high and was thus supplemented with a telephone survey.ResultsOver the course of 7 months, we installed 156 devices in 92 care homes for older people, 50 devices for people with physical or mental health needs, and 8 for others. The devices were used mainly for music but also for poetry, recipes, light controls, jokes, and video calls. Care home managers reported the benefits for the residents, including enhanced engagement with home activities, enjoyment, calming effects, and the acquisition of new skills. Implementation problems included internet connectivity, staff capacity, and skills.ConclusionsAffordable consumer devices such as smart speakers should be installed in all care homes to benefit residents. Voice-activated technologies are easy to use and promote interaction. This study indicates that implementation in care homes was possible and that smart speakers had multifaceted benefits for residents and staff. Most care homes in this region now use smart speakers for their residents, thereby normalizing this practice.
| S-EPMC8726051 | biostudies-literature
Project description:BackgroundWorkflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic.ResultsWe present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture.ConclusionsWe describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform.
| S-EPMC3079703 | biostudies-literature
Project description:BackgroundThe hospitalist workday is cognitively demanding and dominated by activities away from patients' bedsides. Although mobile technologies are offered as solutions, clinicians report lower expectations of mobile technology after actual use.ObjectiveThe purpose of this study is to better understand opportunities for integrating mobile technology and apps into hospitalists' workflows. We aim to identify difficult tasks and contextual factors that introduce inefficiencies and characterize hospitalists' perspectives on mobile technology and apps.MethodsWe conducted a workflow analysis based on semistructured interviews. At a Midwestern US medical center, we recruited physicians and nurse practitioners from hospitalist and inpatient teaching teams and internal medicine residents. Interviews focused on tasks perceived as frequent, redundant, and difficult. Additionally, participants were asked to describe opportunities for mobile technology interventions. We analyzed contributing factors, impacted workflows, and mobile app ideas.ResultsOver 3 months, we interviewed 12 hospitalists. Participants collectively identified chart reviews, orders, and documentation as the most frequent, redundant, and difficult tasks. Based on those tasks, the intake, discharge, and rounding workflows were characterized as difficult and inefficient. The difficulty was associated with a lack of access to electronic health records at the bedside. Contributing factors for inefficiencies were poor usability and inconsistent availability of health information technology combined with organizational policies. Participants thought mobile apps designed to improve team communications would be most beneficial. Based on our analysis, mobile apps focused on data entry and presentation supporting specific tasks should also be prioritized.ConclusionsBased on our results, there are prioritized opportunities for mobile technology to decrease difficulty and increase the efficiency of hospitalists' workflows. Mobile technology and task-specific mobile apps with enhanced usability could decrease overreliance on hospitalists' memory and fragmentation of clinical tasks across locations. This study informs the design and implementation processes of future health information technologies to improve continuity in hospital-based medicine.
| S-EPMC8767475 | biostudies-literature
Project description:BackgroundPublic involvement adds value to numerous aspects of health research, yet few studies have attempted to evaluate its impact on research. Evidence of such impact is needed to develop recommendations for best practice and ensure adequate resourcing.AimTo evaluate public involvement within a large interdisciplinary Science, Technology, Engineering and Mathematics (STEM) research project that focused on digital health.MethodsThe evaluation was conducted with members of the project's Public Advisory Groups (PAG) and with researchers who had participated in involvement activities. Two questionnaires were designed based on a public involvement value systems and clusters framework.ResultsResponses from members of the PAG (n = 10) were mostly positive towards normative values, which include moral, ethical and political aspects of involvement in research, and towards values concerning the conduct of public involvement and best practices. Researchers' responses (n = 16) indicated they felt that involvement was generally effective and increased the quality, relevance and generalizability of their work. However, their responses about the validity of involvement in research were varied. They also highlighted several challenges including how well public involvement impacted on research, how decisions made in the research might differ from the views generated from public involvement, and barriers to researchers' participation.Discussion and conclusionOur evaluation suggests that members of the public and the researchers value involvement. However, there is a need to consider how to embed public involvement to an even greater extent in STEM contexts and a need to address any barriers for researchers' own involvement.
| S-EPMC6351410 | biostudies-literature
Project description:PurposeSmart home devices have great potential to improve the quality of life and independence of older people, positively impacting their health, safety, and comfort. However, Chinese research in this field is still in its early stages. Therefore, more comprehensive and in-depth studies are needed to comprehend the various aspects influencing the acceptance and use of smart homes by older users.Patients and methodsThis study adopted the Technology Acceptance Model (TAM) and included perceived usefulness, perceived ease of use, usage intention, intergenerational technology support, perceived value, and perceived risk as extension variables to delve deeper into the behavioral intentions of older users in smart home services. The study used a convenience sampling method to randomly distribute 236 questionnaires among older adults over the age of 60 in the school's community and neighboring urban communities who have experience in smart home use and who can complete human-computer interactions either independently or with the help of others, mainly focusing on the four sections: user characteristics, family situation, experience of use, and usage intention. The study used structural equation modeling (SEM) and factor analysis to analyze the completion of questionnaires. Finally, we conducted a validation analysis of the rationality and scientificity of the model and derived the six dimensions of the model of the influencing factors on the use of smart home products by the elderly and the weight sizes of their corresponding 13 influencing factors.ResultsThe results show that perceived usefulness and perceived ease of use have a positive effect on users' intention to use smart homes. Perceived ease of use has a positive effect on the perceived usefulness of smart homes. In addition, intergenerational technology support, perceived value, and perceived risk impact users' perceived usefulness and perceived ease of use of the smart home.ConclusionThis research aims to describe the factors influencing older users' willingness to use smart homes. The findings are not only significant for the elderly in China but also of broad value to other regions and countries facing similar demographic challenges. The development of smart homes not only involves the elderly but is also closely related to all segments of society. The government should increase policy support and guide more social forces to participate in the development of the smart home industry. Service providers and designers should fully understand the demand situation and user experience of target users to develop easy-to-use smart home solutions. At the same time, smart homes, as intelligent products for the elderly, need to focus not only on the basic needs of the elderly such as material life and home safety, but also on the spiritual needs of elderly users. Children or caregivers should always pay attention to the psychological state of the elderly and actively guide them to use smart homes to help them realize their self-worth. We look forward to more research focusing on this area in the future and further exploring the specific issues and solutions involved.
| S-EPMC10971693 | biostudies-literature
Project description:This paper develops a new hybrid, open-source, cross-platform 3D smart home simulator, OpenSHS, for dataset generation. OpenSHS offers an opportunity for researchers in the field of the Internet of Things (IoT) and machine learning to test and evaluate their models. Following a hybrid approach, OpenSHS combines advantages from both interactive and model-based approaches. This approach reduces the time and efforts required to generate simulated smart home datasets. We have designed a replication algorithm for extending and expanding a dataset. A small sample dataset produced, by OpenSHS, can be extended without affecting the logical order of the events. The replication provides a solution for generating large representative smart home datasets. We have built an extensible library of smart devices that facilitates the simulation of current and future smart home environments. Our tool divides the dataset generation process into three distinct phases: first design: the researcher designs the initial virtual environment by building the home, importing smart devices and creating contexts; second, simulation: the participant simulates his/her context-specific events; and third, aggregation: the researcher applies the replication algorithm to generate the final dataset. We conducted a study to assess the ease of use of our tool on the System Usability Scale (SUS).
| S-EPMC5469526 | biostudies-other
Project description:The regional smart specializations include the innovative activities within a common science-economy-technology sector, which open the opportunities to gain a competitive advantage. The original procedure of science-economy-technology concordance matrix development on an example of smart specializations of the Silesian Voivodeship was presented in the paper. The procedure developed includes recognition of the research and economic components of the regional smart specialization and the connection between the economic components of the regional specialization and the technological innovation through the international patent classification. It also comprises recognition of key enabling technologies (KETs) and high technologies (of high R&D intensity) other than KET in the economic and technological dimensions of innovation as well as the high R&D intensity services in the economic dimension of innovation. The in-depth expert analyses with the application of the Delphi method were also taken into account. The methodological approach developed and the visualization method applied are both of cognitive and practical importance since they contribute significantly to the creation of efficient development policies, to the enhancement and facilitation of cross-sectoral cooperation, and to the focusing on the fields of key importance in terms of the competitive advantage of a region.
| S-EPMC4678074 | biostudies-other
Project description:BackgroundHome dialysis confers similar survival and greater quality of life than in-center hemodialysis for adults with ESKD but remains underutilized. We examined challenges and facilitators to implementation of home dialysis and identified stakeholder-centered strategies for improving it.MethodsWe conducted a qualitative, cross-sectional, multisite evaluation that included five geographically dispersed Veterans Health Administration (VHA) home dialysis programs. Participants included patients with ESKD receiving home dialysis, their informal caregivers, and home dialysis staff. Semistructured telephone interviews were conducted and audio-recorded from 2017 through 2018, to assess perceived barriers and facilitators to patient home dialysis use in VHA. Transcribed interviews were analyzed thematically by each participant group.ResultsParticipants included 22 patients receiving home dialysis (18 on peritoneal dialysis [PD] and four hemodialysis [HD]); 20 informal caregivers, and 19 home dialysis program staff. Ten themes emerged as challenges to implementing home dialysis, of which six (60%) spanned all groups: need for sterility, burden of home dialysis tasks, lack of suitable home environment, physical side effects of home dialysis, negative psychosocial effects of home dialysis, and loss of freedom. Four themes (40%), identified only by staff, were insufficient self-efficacy, diminished peer socialization, geographic barriers, and challenging health status. Twelve themes emerged as facilitators to implementing home dialysis, of which seven (58%) spanned all groups: convenience, freedom, avoidance of in-center HD, preservation of autonomy, adequate support, favorable disposition, and perceptions of improved health. Two themes (17%) common among patients and staff were adequate training and resources, and physical and cognitive skills for home dialysis. Recommendations to promote implementation of home dialysis common to all participant groups entailed incorporating mental health care services, offering peer-to-peer coaching, increasing home visits, providing health data feedback, and reducing patient burden.ConclusionsStakeholder-centered challenges were rigorously identified. Facilitators and recommendations can inform efforts to support home dialysis implementation.
| S-EPMC8986044 | biostudies-literature
Project description:IntroductionPrevious studies comparing satisfaction with electronic and elastomeric infusion pumps are limited, and improvements in size and usability of electronic pumps have since occurred. The Comparing Home Infusion Devices (CHID) study plans to assess patient and nurse satisfaction with an elastomeric and electronic pump for delivering intravenous antibiotic treatment in the home. Secondary objectives are to determine pump-related complications and actual antibiotic dose administered, evaluate temperature variation and compare pump operating costs.Methods and analysisThe CHID study will be a randomised, crossover trial. A trained research nurse will recruit patients with infectious disease aged ≥18 years and prescribed ≥8 days of continuous intravenous antibiotic therapy from the Royal Adelaide Hospital (RAH) (Adelaide, Australia). Patients will be randomised to receive treatment at home via an elastomeric (Baxter Infusor) or an electronic (ambIT Continuous) infusion pump for 4-7 days, followed by the other for a further 4-7 days. Patient satisfaction will be assessed by a 10-item survey to be completed at the end of each arm. Nurse satisfaction will be assessed by a single 24-item survey. Patient logbooks and case notes from clinic visits will be screened to identify complications. Pumps/infusion bags will be weighed to estimate the volume of solution delivered. Temperature sensors will record skin and ambient temperatures during storage and use of the pumps throughout the infusion period. Costs relating to pumps, consumables, antibiotics and servicing will be determined. Descriptive statistics will summarise study data.Ethics and disseminationThis study has been approved by the RAH Human Research Ethics Committee (HREC/16/RAH/133 R20160420, version 6.0, 5 September 2016). Study results will be disseminated through peer-reviewed publications and conference presentations. The CHID study will provide key insights into patient and provider satisfaction with elastomeric and electronic infusion pumps and inform future device selection.Trial registration numberACTRN12617000251325; Pre-results.
| S-EPMC5642663 | biostudies-literature