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The surge in electronic information in healthcare has impacted multiple aspects of nursing, including education, recruitment, daily operations, and documentation of patient care. However, one study evaluating the presence of nursing on hospital websites across 5 countries found that only 22% of websites contained specialty areas of nursing. Items such as accomplishments, awards, accolades, and links to other websites were rarely present (Chen & Liu, 2010).
The World Federation of Critical Care Nurses (WFCCN) is an international organization with more than 500,000 nurses representing 42 countries worldwide. This organization recently published the results of a survey to profile activities as well as concerns of critical care nurses and organizations worldwide. Services provided by organizations were ranked in importance. Websites were ranked second, surpassed only by the availability of national conferences (World Federation of Critical Care Nurses, 2014). These results illustrate the importance of information availability in an electronic format.
The development of websites for critical care nurses has been described. Objectives included providing access to resource information (Cacciata, 2011; Corliss, 2008; Thompson, 2011), videos (Corliss, 2008), and links to other sites, such as professional organizations and vendors, as examples (Cacciata, 2011).
Description:
In 2013, an adult critical care website was developed to be a central repository of electronic resources to address the complex needs of adult critical care patients among 5 ICU’s and across 2 buildings on one campus. One goal was to provide current “just-in-time” resources for point of care application for nurses and other members of the interprofessional team. Historical staff communication methods (meetings, e-mails, resource binders, skills fairs) became inadequate to meet patient care needs due to attendance challenges, lost e-mails and outdated information. Skills fairs incurred overtime. From its inception, the website was developed with a comprehensive menu of options including updates, resource documents, links, and videos.
A multimedia adult critical care website was developed utilizing Adobe Dreamweaver, Adobe Photoshop and Grass Valley Edius editing software. It is a stand-alone section within a left side navigation accordion of a nursing service website. Security is enabled by the use of a firewall; yet access is granted on campus without the use of a password. Conformity with institutional website visual standards was ensured. Staff can immediately access the website from their computers at the bedside used for electronic documentation. Finally, changes/updates are able to be accommodated quickly by a Webmaster.
An updates page is the default tab of the website. Photos of different critical care nurses are featured on this page. Links to upcoming professional development opportunities are placed here. There are also sections for kudos and congratulations for clinicians who have achieved accomplishments such as awards, advancements, passing a certification exam, or completing a degree program.
Utilizing Xythos content management software, links to documents are available on a separate tab. A menu of single documents or folders of documents is available in alphabetical order. Examples of resources uploaded onto the website include resource notebooks (trauma manual, continuous renal replacement therapy, cardiothoracic surgery protocol), handouts and powerpoints from inservices, summaries of EBP reviews, and forms/checklists that are utilized in routine practice (preceptor feedback tool, transport checklist).
Links to other evidence-based resources and professional organizations are located on one web-page tab. One example is online modules from vendors whose products or equipment are utilized in the ICU. Another example is professional organizations that offer a myriad of information and education for clinicians.
Many procedures, skills, or equipment operations were videotaped, edited and linked to the website. This included all skills identified on the department’s competency checklist as high-risk and low-volume. This format ensures that information on these skills are available 24/7. Therefore, in a situation, for example, in which a nurse must perform a skill for which she requires a refresher, a brief video can be quickly viewed. Sixteen of the videos on the website that are designated as high-risk and low-volume are flagged. Each year, viewing of these videos is mandatory. After viewing the videos, a post test is completed, and placed in each employee’s file. The post test is modified each fiscal year and linked to the video tab.
Evaluation and Outcomes:
One of the activities completed to gain rapid support and interest in the website was an official debut of an “outtakes” video. This was a compilation of mistakes and other funny anecdotes caught on tape while filming the videos. Clinicians enjoyed viewing their coworkers in this video, and word spread quickly about the video additions to the website. Other venues for dissemination of information about the website included e-mail, shared leadership councils, and one-on-one in person demonstrations.
None months post implementation, staff were queried regarding the usefulness and helpfulness of the website. The majority of respondents (n=39; 94.7%) had accessed the website at least once since it went live. On a scale of 1-4 with 4 being the most useful or helpful, staff rated the website with an average of 3.61 for both ratings. Comments from the survey tool included “excellent resource”, “well done and an excellent orientation tool”, and “It’s a fantastic website! Kudos to the creators”.
Implications:
Rapid access to evidence-based resources at point of care is essential in today’s complex, fast-paced, technology-driven, and high-stress environments. Nurses working in hospitals locally, regionally, and worldwide can utilize information technology and share best practices to develop creative informative resources for point of care clinicians.
See more of: Evidence-Based Practice Sessions: Oral Paper & Posters