1. Facilitating student learning with electronic health care data management: Outcomes from the Nightingale Tracker Project Phyllis M. Connolly, RN, CS, PhD, Co-Project Director, NT, San Jose State University, San Jose, CA Mary Jo Gorney-Moreno, RN, PhD, Co-Project Director, NT, San Jose State University, San Jose, CA Victoria L. Elfrink RN,C, PhD, Project Manager, FITNE, Athens, Ohio

2. Nightingale Tracker Project Based on the perceived changing needs of nursing education, the Helene Fuld Health Trust funded a three year research and development project named the Nightingale Tracker.

3. San Jose State University, San Jose, California California population- 32 million 383 thousand Gross State Product would make it the 7th largest country in world

4. Student Subjects SJSU School Of Nursing zGeneric Baccalaureate & Advanced Placement for RNs & LVNs zGraduate Programs: Family Nurse Practitioner; CNS; Gerontology, School Nurse; Educator and Administration options zInnovator in integrating community-based instruction in the curriculum, all students have at least 71/2 weeks in Med/Surg home care, at least one OB and Peds home care experience prior to going into community health semester

5. Student Subject Make-Up zPopulation Served yWidely diverse in cultural, and ethnic background y450 undergraduate students, 100 graduate ytypically 60 (MH) 90 students in CH course in clinical groups of 10 students per section -

6. Type of Clinical Rotation zNursing 147B-Practicum IV-Spring 97 yFirst Semester of Senior Year yCommunity Health Experience xHome Visits & Community Agencies zAll students had prior home care experience and had at least one lecture on the Omaha system zNursing 147A-Practicum IV Fall 98 - Spring 00 yCommunity Mental Health Experience y3 Transdisciplinary Collaboration Sites yNurse Managed Center, Community

8. Student Demographics Fall 98 - Spring 2000 zN = 37 zUndergraduates Juniors and seniors zAge range 22 - 46 zMost commuters zPrior computer training 40 - 50% none zAll used word processing

9. Fall 99 & Spring 2000-Information Technology Competencies zAll students had word processing experience-multiple years. zAll students had experience with email. z50% of students had experience with electronic patient documentation. z55% of students had a formal course on computers, however half of those students only had courses in highschool.

10. Student Evaluation Tools zNT User Characteristics zNT Impact Questionnaire, Pre; post teaching; 6 weeks; and final zWeekly NT log zTraining session evaluation tool zCourse satisfaction tool

11. Population Served F 98 - S 00 zPersons with serious mental illness ySchizophrenia yBipolar Disorder yAffective Disorders zCommunity health clients Nurse Managed Center z30 different clients z481 episodes of care

12. Omaha Nursing Documentation System Domains Interventions zI. Environmental zII. Psychosocial zIII. Physiological zIV. Health Related Behaviors z I. Health Teaching Guidance, Counseling z II. Treatments & Procedures z III. Case Management z IV. Surveillance

13. Domain II. Psychosocial IV. Health Related Behaviors zCommunication with community resources zSocial contact zRole change zInterpersonal relationship zSpiritual distress zGrief zEmotional stability zHuman sexuality zCaretaking/parenting zNeglected child/adult zAbused child/adult zGrowth & development z Nutrition z Sleep and rest patterns z Physical activity z Personal hygiene z Substance use z Family planning z Health care supervision z Prescribed medication regimen z Technical procedure

14. Client Problems Encountered z25 of the 44 Omaha problems were identified z3 most frequent problems yInterpersonal relationship (50%) ySocial Contact (44%) yEmotional stability(25%)

15. Problems Most Frequently Encountered F 98 - S 00

16. Interventions for Problems

17. Omaha Rating Scale

18. CCF #9075, Problem 07, Social Contact, F 98 - S 99 zKnowledge: 1 zBehavior: 2 zStatus: 2 z Knowledge: 3 z Behavior: 3 z Status: 3 Initial Rating Final Rating

19. CCF # 9075, Problem 42, Medication Regimen, Fall 98 zKnowledge2 zBehavior2 zStatus2 z Knowledge3 z Behavior3 z Status3 Initial Rating Final Rating

20. CCF # 9547, Problem 09, Interpersonal Relationships, Spring 2000 zKnowledge2 zBehavior2 zStatus2 z Knowledge4 z Behavior4 z Status4 Initial Rating Final Rating

21. Client Population Trends zFinding 1: Population has multiple health problems requiring primary health care zFinding 2: Reinforces need for sustaining social support and long term rehabilitation

22. Evidence Based Nursing Education Trend zIncrease the use of our Nurse Managed Centers which provide opportunity for continuity of care for persons with chronic health care problems zAssess the curriculum for relevance for meeting needs for primary care

23. Outcomes: Information Technology Competencies zElectronic information processing skills zIncreased efficiency in documentation zA unique experience with cutting-edge technology zBetter prepared for job market zIncreased confidence in using technology zIncreased use of internet zImproved health care delivery

24. Student Outcomes zIncreased communication with faculty zActively engaged in research zImproved client care zIncreased professionalism (client’s view) zIncreased understanding of relationship between research and practice zPublication opportunity zAwards and recognitions

25. Student Reflections z Frustration during early use z Improved care z Use in other courses z Actual participation in research z Sense of connectivity with faculty

26. Advice For Other Students zHave patience zActive participation--use it zBe flexible zUse creative thinking zHave fun zIntegrate technology

27. Faculty Outcomes zImproved teaching effectiveness zPublications & presentations yCase Study on-line zImproved student evaluations zBetter supervision of students zIncreased technology skills zCollaboration opportunities zParticipation in research zSubmission TOP grant zRedesigning the learning paradigm to include formal education & clinical experiences in IT.

28. Challenges zTraining zMaintaining equipment zPhone lines at sites zHardware zData collection zSecuring more technical human resources zInvolving more faculty

29. Future Plans for Integration zUtilize with additional courses, pilot faculty and 1-2 students yPhysical Assessment (Semester 5) yNurse Practitioner Students (Fall 2000) yRN to BSN students (Semester 7 & 8) ySemester 8 clinical zAdd resources to web browser zDissemination

30. Implications for Future Research zBetter understanding of factors contributing to user frustration. zDistinguishing among factors that promote better student/faculty communication. zMeasuring differences in critical thinking skills.