Publications by authors named "Gail Keenan"

Background: Extensive time spent on documentation in electronic health records (EHRs) impedes patient care and contributes to nurse burnout. Artificial intelligence-based clinical decision support tools within the EHR, such as ChatGPT, can provide care plan recommendations to the perinatal nurse. The lack of explicit methodologies for effectively integrating ChatGPT led to our initiative to build and demonstrate our ChatGPT-4 prompt to support nurse care planning.

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Objectives: Examine electronic health record (EHR) use and factors contributing to documentation burden in acute and critical care nurses.

Materials And Methods: A mixed-methods design was used guided by Unified Theory of Acceptance and Use of Technology. Key EHR components included, Flowsheets, Medication Administration Records (MAR), Care Plan, Notes, and Navigators.

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With artificial intelligence (AI) rapidly advancing, advanced practice nurses must understand and use it responsibly. Here, we describe an assignment in which Doctor of Nursing Practice (DNP) students learned to use generative text AI. Using our program and course outcomes, developed from the 2021 American Association of Colleges of Nursing (AACN) Essentials competency for DNP students to learn and use AI, we reviewed the literature seeking examples using ChatGPT for the DNP informatics course.

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Nurses who provide the majority of hands-on care for hospitalized patients are disproportionately affected by the current state of electronic health records (EHRs), and little is known about their lived perception of EHR use. Using a mixed-methods research design, we conducted an in-depth analysis and synthesis of data from EHR usage log files, interviews, and surveys and assessed factors contributing to the nurse documentation burden in acute and critical at a large academic medical center. There remain substantial spaces where we can develop viable solutions for enhancing the usability of multi-component EHR systems.

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Objective: Our article demonstrates the effectiveness of using a validated framework to create a ChatGPT prompt that generates valid nursing care plan suggestions for one hypothetical older patient with lung cancer.

Method: This study describes the methodology for creating ChatGPT prompts that generate consistent care plan suggestions and its application for a lung cancer case scenario. After entering a nursing assessment of the patient's condition into ChatGPT, we asked it to generate care plan suggestions.

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Introduction: Globally 38.9 million children under age 5 have overweight or obesity, leading to type 2 diabetes, cardiovascular complications, depression, and poor educational outcomes. Obesity is difficult to reverse and lifestyle behaviors (healthy or unhealthy) can persist from 1.

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Background: Care plans documented by nurses in electronic health records (EHR) are a rich source of data to generate knowledge and measure the impact of nursing care. Unfortunately, there is a lack of integration of these data in clinical data research networks (CDRN) data trusts, due in large part to nursing care being documented with local vocabulary, resulting in non-standardized data. The absence of high-quality nursing care plan data in data trusts limits the investigation of interdisciplinary care aimed at improving patient outcomes.

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Background: Spiritual care has been associated with better health outcomes. Despite increasing evidence of the benefits of spiritual care for older patients coping with illness and aggressive treatment, the role of spirituality is not well understood and implemented. Nurses, as frontline holistic healthcare providers, are in a position to address patients' spiritual needs and support them in finding meaning in life.

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Objectives: Electronic health records (EHRs) user interfaces (UI) designed for data entry can potentially impact the quality of patient information captured in the EHRs. This review identified and synthesized the literature evidence about the relationship of UI features in EHRs on data quality (DQ).

Materials And Methods: We performed an integrative review of research studies by conducting a structured search in 5 databases completed on October 10, 2022.

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Background: The proliferation of health care data in electronic health records (EHRs) is fueling the need for clinical decision support (CDS) that ensures accuracy and reduces cognitive processing and documentation burden. The CDS format can play a key role in achieving the desired outcomes. Building on our laboratory-based pilot study with 60 registered nurses (RNs) from 1 Midwest US metropolitan area indicating the importance of graph literacy (GL), we conducted a fully powered, innovative, national, and web-based randomized controlled trial with 203 RNs.

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Current electronic health records (EHRs) are often ineffective in identifying patient priorities and care needs requiring nurses to search a large volume of text to find clinically meaningful information. Our study, part of a larger randomized controlled trial testing nursing care planning clinical decision support coded in standardized nursing languages, focuses on identifying format preferences after random assignment and interaction to 1 of 3 formats (text only, text+table, text+graph). Being assigned to the text+graph significantly increased the preference for graph (P = .

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Context: With the expansion of palliative care services in clinical settings, clinical decision support systems (CDSSs) have become increasingly crucial for assisting bedside nurses and other clinicians in improving the quality of care to patients with life-limiting health conditions.

Objectives: To characterize palliative care CDSSs and explore end-users' actions taken, adherence recommendations, and clinical decision time.

Methods: The CINAHL, Embase, and PubMed databases were searched from inception to September 2022.

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Background: Poor usability is a primary cause of unintended consequences related to the use of electronic health record (EHR) systems, which negatively impacts patient safety. Due to the cost and time needed to carry out iterative evaluations, many EHR components, such as clinical decision support systems (CDSSs), have not undergone rigorous usability testing prior to their deployment in clinical practice. Usability testing in the predeployment phase is crucial to eliminating usability issues and preventing costly fixes that will be needed if these issues are found after the system's implementation.

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Clinical Decision Support (CDS) systems, patient specific evidence delivered to clinicians via the electronic health record (EHR) at the right time and in the right format, has the potential to improve patient outcomes. Unfortunately, outcomes of CDS research are mixed. A potential cause lies in its testing.

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Despite increasing evidence of the benefits of spiritual care and nurses' efforts to incorporate spiritual interventions into palliative care and clinical practice, the role of spirituality is not well understood and implemented. There are divergent meanings and practices within and across countries. Understanding the delivery of spiritual interventions may lead to improved patient outcomes.

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Objectives: Intervention fidelity is imperative to ensure confidence in study results and intervention replication in research and clinical settings. Like many brief protocol psychotherapies, Dignity Therapy lacks sufficient evidence of intervention fidelity. To overcome this gap, our study purpose was to examine intervention fidelity among therapists trained with a systematized training protocol.

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Background: Limited studies have synthesized evidence on nurses' perceptions of recommended fall prevention strategies and potential differences between those and the practiced strategies.

Purpose: To synthesize evidence about nurses' perceptions of recommended fall prevention strategies for hospitalized adults.

Methods: Using PubMed, 50 records underwent abstract and full-text screening, and 10 studies were retained.

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The aim of this article was to describe a novel methodology for transforming complex nursing care plan data into meaningful variables to assess the impact of nursing care. We extracted standardized care plan data for older adults from the electronic health records of 4 hospitals. We created a palliative care framework with 8 categories.

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Article Synopsis
  • The article discusses the need for a standardized training protocol for Dignity Therapy (DT) to ensure consistent implementation across different therapists.
  • It outlines a comprehensive training method that includes preparatory reading, in-person training, practice sessions, and ongoing feedback, resulting in the successful training of 18 therapists.
  • The established protocol focuses on enhancing key components of DT, enabling better adherence to the therapy process and allowing for more effective training in future research and clinical settings.
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Introduction: Changes in nursing, health care, and education warrant continued pedagogical innovations. Faculty are challenged to develop many innovative strategies in the clinical and simulation laboratory setting. Intentional simulation-based learning experiences are one method to prepare new graduates for nursing practice.

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Background: Proper training and follow-up for patients new to continuous glucose monitor (CGM) use are required to maintain adherence and achieve diabetes-related outcomes. However, CGM training is hampered by the lack of evidence-based standards and poor reimbursement. We hypothesized that web-based CGM training and education would be effective and could be provided with minimal burden to the health care team.

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Background: It has been reported that many hospitals in the United States have fragmented and ineffective ordering, administration, documentation, and evaluation/monitoring of nutrition therapies. This paper reports on a project to investigate if perceived hospital staff awareness and documentation of nutrition support therapies (NSTs) improves by including them as part of the medication administration record (MAR).

Methods: Surveys were conducted with nursing staff, physicians, and dietitians before and after adding NSTs to the MAR to evaluate the perceived impact on the outcome of interest.

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Objective: The purpose of this article is to describe the current nursing problem list subset of Systematized Nomenclature of Medicine Clinical Terms (NPLS) coverage of the American Nurses Association (ANA) recognized standardized nursing terminologies (SNTs) and to identify potential ways to expand and enhance the utility of this list.

Materials And Methods: The study is a cross-sectional exploratory design. We mapped the content of the North American Nursing Diagnosis Association International (NANDA-I) (2018-2020), International Classification for Nursing Practice (ICNP) (2017 AB), Clinical Care Classification (CCC) (2018 AA), and Omaha System (2007AC) terminologies with each other and into NPLS (August 2017 edition) using Unified Medical Language System (UMLS) (release 2018AA) as the intermediary.

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Background: The presence of cognitive impairment (CI) among hospitalized older adults (aged 85 years and older) could interfere with the identification and treatment of other important symptoms experienced by these patients. Little is known, however, about the nursing care provided to this group. Contrasting the nursing care provided to patients with and without CI may reveal important insights about symptom treatment in the CI population.

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Background: Currently, it is rare for nursing data to be available in data repositories due to the quality of nursing data collected in clinical practice. To improve the quality of nursing data, the American Nurses Association recommends the use of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) for coding nursing problems, interventions, and observations in electronic health records.

Objective: To determine "what is known about the use of SNOMED terminology (Pre-SNOMED CT and SNOMED CT) in nursing".

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