Care Challenge is a platform designed to support nursing innovation. By offering prizes of project funding to help nurses get their ideas off the ground, or by providing media production to get recognition and further expand the project. Not only does the website offer to help, it offers a platform for nurses to share their ideas with the global nursing community. This will hopefully inspire others and lead to connections between nurses and ideas that can change the world.

Disclaimer: Sanofi (sponsor of Care Challenge) is a client of mine - so please judge the initiative with this in mind. However, know that I started working with them advising them for free because I think the platform is needed in nursing and healthcare, but I'm sure you know that I like sharing ideas.

When I saw this device, the Bruin Biometrics Sub-Epideral Moisture Scanner I was intrigued. Being able to identify pressure ulcers at an even earlier stage would be very interesting. Then I remembered technology still does not address behaviour. Therefore, the device would only really use if it did mean that health care providers were better implementing pressure ulcer prevention protocols.

For those of you who don't know a pressure ulcer is a breakdown of the skin and vascular tissue to to a lack of circulation. It is usually caused by mobility, moisture and friction issues. It is now considered a preventable illness and has very serious risks to a patient. The reason they are considered preventable, is often with simple interventions such as regular turning of patients, changing moist bedding, and reducing friction they can be reduced and prevented. The reality though is healthcare providers need the knowledge and the time to actually do this.

Regarding this device, my thought is this. It would be fantastic, but the increase cost to purchase and train staff may lead to a tighter budget that increases staff load and actually prevents them from taking the time to implement the measures to reduce and prevent pressure ulcers. This is not a guarantee, but often with technology we think about the potential and not the limitation.

I think with all technology we need to remember what IMPACT a device will have. Does it help with the required behaviour or is it just impacting marginally around the behaviour. Where would the better spend in money be for patients.

Peggy White RN MN
Program Manager - Health Outcomes for Better Information and Care (HOBIC) program

Documentation is a fact of life in nursing. However, electronic documentation and standardized nursing data is an exciting an relatively new field. As the Program Manager for HOBIC, Peggy White, works for the Ontario Ministry of Health and Longterm Care on integration of nursing based indicators into clinical documentation. As someone that has worked with a variety of nursing organizations and nurses on integrating nursing sensitive measures in clinical documentation Peggy has a lot to share with nurses and nursing students.

Resources

• Canada Health InfoWay
• SNOMED CT (Systematized Nomenclature of Medicine--Clinical Terms)

Research

• The Nursing Health Outcomes Project. (2005) White, Pringle, Doran, and Hall.
• Nursing-sensitive outcomes data collection in acute care and long-term-care settings. (2006) Doran, Harrison, Laschinger, Hirddes, Rukholm, Sidani, Hall, Tourangeau

Questions

Peggy White: What are you doing as a nurse to learn about standardization of data and what it means to your practice?

Rob Fraser: Have you worked with C-HOBIC or learned about it in school?

Over the last decade in nursing, the discipline of informatics has seen and witnessed some exponential changes. The word ‘informatics’ had been used in practice and literature since the mid-1970s, and was picked up by nursing in the early 1980s. As nursing entered the late 1990s, the term ‘eHealth’ began to collect support as the catch-all term used to describe practically anything that crossed between health and technology. With the rise and plateau of the eHealth vernacular both in professional and lay audiences in the latter part of this decade, other neologisms have gained momentum within healthcare – namely, Web 2.0 and social media.

To both insiders and outsiders, this confusing mixture of verbage to describe the use of technology and innovation in healthcare has long confounded individuals attempting to describe ‘what they do’. In my discussions with colleagues of the Ontario Nursing Informatics Group , I have realized that I am not the only person out there who sometimes does not know how to describe this informatics/eHealth/social media mixing pot.

A few months ago I began to critically question why I chose to use certain words, in specific writings or situations. For instance, why would I choose to use the word informatics, as opposed to eHealth to describe a hospital information system? Or, why would I select eHealth as opposed to informatics to outline the use of PDAs in clinical care? I didn’t really have an answer until I started looking at the network of actors (both human and non-human) that formulated and inscribed my past and present thought processes.

So, as you can see through my concept listing, the blurring of the terms exists at many entangled socio-political-technological levels. The ability tease apart the differences are rather difficult at the best of times and sometimes a moot endeavor. Context is probably the best predictor of what term to use, but even that rule of thumb can be flawed. In my short time (respectively) within the profession, I’ve had the opportunity to see terminology come, go, evolve, die, and be replaced with an entirely new cross-section of lexicon. Sadly, I doubt the future will bring any clarity to this issue.

I guess my take away point is to examine how you use certain terminology when describing innovation in healthcare. Neologisms are time limited and sometimes do not gain traction in the literature or practice language. It is probably wise to not fully align one’s self with a term that might only have a useful half-life of 3-4 years. I encourage you to attempt the reflective exercise I’ve tried above and let me know if any of your conceptualizations differ from mine – I’m interested to see how others conceptualize this mashup of terminologies used in describing the informatics discipline.

Peter Goossens RN PhD - email: p.j.j.goossens [at] saxion.nl

Nurse Expert - Dimence - Map

Professor in Mental Health - Saxion

Senior Researcher - Radboud University Nijmegen

Peter Goossens, a Dutch mental health nurse and researcher, and I sit down to discuss his research that helps bi-polar patients recognize on coming periods of mania and depression. We met at the Sigma Theta Tau 40th Biennial and discussed his fascinating research with mental health patients and their families. He has not only conducted excellent research he is allow a great ambassador for the profession of nursing, working to ensure the are able to fully able to support their patients and the nurses perspective is represented in national consortiums.

Research

• PubMed Search for Peter's Research
• Recognizing prodromes of manic or depressive recurrence in outpatients with bipolar disorder: A cross-sectional study (UPDATED SINCE ORIGINAL POST)

Peer reviewed articles

• Van der Voort T.Y., Goossens P.J.J., van der Bijl J.J. (2009) Alone together: a grounded theory study of experienced burden, coping, and support needs of spouses of persons with bipolar disorder. International Journal of Mental Health Nursing 18, 434-443
• Goossens, P.J.J., Hartong, E., Knoppert-van der Klein, E.A.M. & Van Achterberg T. (2008) Self-reported psychopathological symptoms and quality of life in outpatients with a bipolar disorder. Perspectives in Psychiatric Care, 44/4 275-284
• Goossens, P.J.J., Knoppert-van der Klein, E.A.M. & Van Achterberg T. Coping styles of outpatients with a bipolar disorder. (2008) Archives of Psychiatric Nursing, 22/5 245-253
• Goossens, P.J.J., Van Wijngaarden B., Knoppert-van der Klein, E.A.M. & Van Achterberg T. (2008) Family caregiving in bipolar disorder: caregiver consequences, caregiver coping styles, and caregiver distress. International Journal of Social Psychiatry, 54/4 303-316
• Jonker E., Goossens P.J.J., Steenhuis I.H.M. & Oud N.E., (2008) Patient aggression in clinical psychiatry: perceptions of mental health nurses. Journal of Psychiatric and Mental Health Nursing, 15, 492-499
• Goossens, P.J.J., Beentjes, T.A.A., de Leeuw, J.A.M., Knoppert-van der Klein, E.A.M. & Van Achterberg T. (2008) Nursing bipolar disorder outpatients: what nurses actually do. Archives of Psychiatric Nursing, 22/1, 3-11
• Van der Voort T.Y., Goossens P.J.J., van der Bijl J.J. (2007) Burden, coping and needs for support of caregivers for patients with a bipolar disorder: A systematic review. Journal of Psychiatric and Mental Health Nursing 14, 679-687
• Goossens, P.J.J., J.A.M., Knoppert-van der Klein, E.A.M, Kroon. H, & Van Achterberg T. (2007) Self- reported care needs of outpatients with a bipolar disorder in The Netherlands: Journal of Psychiatric and Mental Health Nursing. 14, 549-557
• Goossens, P. J. J., Van Achterberg T. & Knoppert van der Klein E.A.M. (2007) Nursing processes used in the treatment of patient with a bipolar disorder. International Journal of Mental Health Nursing. 16, 168-177

International presentations, both oral and posters

• Goossens P.J.J. Self management in Bipolar Disorder; recognizing prodromes of manic or depressive relapse STTI 20th biennial convention. Indianapolis; nov. 2009
• Goossens P.J.J., Van Achterberg T, Knoppert – Van der Klein E.A.M. Nursing processes used in the treatment of patients with bipolar disorder. ISPN conference. Greenville; April 2009.
• Van der Voort T.Y., Goossens P.J.J., Van der Bijl J.J. Together-and-still-alone: Qualitative research on burden, coping and needed support of spouses of patients with a bipolar disorder. ISBD conference. New Delhi; jan. 2008

Questions

• Peter Goossens:  Who is performing an assessment and teaching of a client's ability to recognize early warning signs of their bi-polar disorder? Are you able to do this as a nurse?
• Robert Fraser: For nurses outside of mental health, do you have tools to self manage mental health disorders and support patient's self-care?

Chris Salgado RN, BN, MA

Program Leader - Children, Youth & Families Program

Vancouver Coastal Health

I really must apologize to Chris about this podcast. We had a great conversation in January last year (2009). We met at the Canadian Nursing Association - Nursing Leadership Conference. She had a very interesting idea about how to engage with nursing staff. She works in public health who have their fingers on the pulse of what familes, clients and communities partners need form nursing leadership. Using the World Cafe approach she was able to engage and pull ideas from key stakeholders of her nursing practice. Below are the pictures of what resulted from this approach.

Links

• The World Cafe

Research

• Standielf, R. B. (2000) The art of focused conversation: 100 ways to access group wisdom in the workplace. Gabriola Island, BC, Canada: New Society

Question

• Chris Salgado: What are your ideas that work for leading teams for changing practice?
• Robert Fraser: What was the last conference you were at that you had an opportunity to exchange ideas and share thoughts with others?

Dr Michael Gardam

Director of Infectious Disease Prevention and Control - Agency for Health Protection and Promotion

Director of Infection Prevention and Control - University Health Network

An experienced and passionate physician in the field of infection control, Dr Michael Gardam is now working with the Agency for Health Protection and Promotion on provincial issues of protection and control. After hearing him give a talk at Princess Margaret I knew I needed to speak with him. In this talk he shares major insights into how Ontario began to public reporting, what they are reporting, how that is perceived and the many issues around hand washing in hospitals.

Research

• Dr Gardam's publications (PubMed Search)
• Infection Prevention and Control in the Design of Healthcare Facilities
• The Changing Face of Critical Care
• Influence of Roles Models and Hospital Design on Hand Hygiene of Healthcare Workers

Links

• Ontario Public Reporting of MRSA and VRE
• Positive Deviance - The Basics
• Positive Deviance Article by Fast Company

Question:

• Dr Michael Gardam: What do you think about this (Positive Dieviance)? Are you interested in taking part?
• Robert Fraser RN: Did you know Ontario is reporting these infection rates? Do you know if your province or state is reporting any infection rates?

Lianne Jeffs RN, PhD(c)

Director Nursing & Clinical Research

Research Scientist - Li Ka Shing Knowledge Institute

In her current role at she contributes globally to evolving patient safety science as her program area of research is patient safety. Her work focuses on the generating knowledge on the design and delivery of safer health-care systems. In this interview we talk about the Research Advancing Practice initiative that was start at St Michael's Hospital to get clinical nurses to start generating research relevant to their areas of practice

Links

• Research and Reflection for RAP artists (2009) The Standard. College of Nurses of Ontario.
• The art and science of caring
• RNAO Leadership Award in Nursing Research - Lianne Jeffs Research Advancing Practice

Research

• Jeffs, L., Smith, O., Wilson, G., Kohn, M., Campbell, H., Maione, M.,
  Tregunno, D. & Ferris, E. (in press). Building Knowledge for Safer Care:
  Nursing Research Advancing Practice. Journal of Nursing Care Quality.
  24(3).
• Fineout-Overholt, E., Melnyk, B., Schultz, A. (2005) Transforming Health Care from the Inside Out: Advancing Evidence-Based Practice in the 21st Century, Journal of Professional Nursing, 21(6), 335-344.
  

Questions

• Lianne: Have you been involved in a similiar process or program? What are the difficulties, challenges and enablers where you are practicing and how do you bring research to your daily work?
• Rob: Do you see yourself as a researcher, and feel a need to contribute to nursing knowledge? If you hospital offered a program like this would you take part?

Dr. Claire Mallette RN, PhD

Director of Education, Placement and Development

University Health Network

Links

• UHN Facebook Group
• UHN Nursing Website

1. What do you want to know or see provided through sources like the UHN facebook group, what would bring you back?
2. Have you applied to any job advertisements from Facebook, has your organization been successfully recruited nurses through Facebook ads?