Advocating for Greater Usability in Clinical Technologies: The Role of the Practicing Nurse.

Health care, especially ICUs, rely on multiple types of technology to promote the best patient outcomes. Unfortunately, too often these technologies are poorly designed, causing errors, additional workload, and unnecessary frustration. The purpose of this article is to (1) empower nurses with the needed usability and usability testing vocabulary to identify and articulate clinical technology usability problems and (2) provide ideas on ways nurses can advocate to have an impact on positive change related to technology usability within a health care organization.

Nurse Knowledge Exchange Plus: Human-Centered Implementation for Spread and Sustainability.

Background: Kaiser Permanente implemented a new model of nursing communication at shift change-in the bedside nursing report known as the Nurse Knowledge Exchange (NKE) in 2004-but noted variations in its spread and sustainability across medical centers five years later.

Methods: The six core elements of NKEplus were as follows: team rounding in the last hour before shift changes, pre-shift patient assignments that limit the number of departing nurses at shift change, unit support for uninterrupted bedside reporting, standardization for report and safety check formats, and collaboration with patients to update in-room care boards. In January 2011 Kaiser Permanente Southern California (KPSC; Pasadena) began implementing NKEplus in 125 nursing units across 14 hospitals, with the use of human-centered design principles: creating shared understanding of the need for change, minimum specifications, and customization by frontline staff.

Evidence for the existing American Nurses Association-recognized standardized nursing terminologies: a systematic review.

Objective: To determine the state of the science for the five standardized nursing terminology sets in terms of level of evidence and study focus.

Design: Systematic review.

Data Sources: Keyword search of PubMed, CINAHL, and EMBASE databases from 1960s to March 19, 2012 revealed 1257 publications.

Expanding potential of radiofrequency nurse call systems to measure nursing time in patient rooms.

Objective: The objective of this study was to determine the utility and feasibility of using data from a nurse call system equipped with radiofrequency identification data (RFID) to measure nursing time spent in patient rooms.

Background: Increasing the amount of time nurses spend with hospitalized patients has become a focus after several studies demonstrating that nurses spend most of their time in nondirect care activities rather than delivering patient care. Measurement of nursing time spent in direct care often involves labor-intensive time and motion studies, making frequent or continuous monitoring impractical.

Kaiser Permanente's performance improvement system, Part 4: Creating a learning organization.

Background: In 2006, recognizing variations in performance in quality, safety, service, and efficiency, Kaiser Permanente leaders initiated the development of a performance improvement (PI) system. Kaiser Permanente has implemented a strategy for creating the systemic capacity for continuous improvement that characterizes a learning organization. Six "building blocks" were identified to enable Kaiser Permanente to make the transition to becoming a learning organization: real-time sharing of meaningful performance data; formal training in problem-solving methodology; workforce engagement and informal knowledge sharing; leadership structures, beliefs, and behaviors; internal and external benchmarking; and technical knowledge sharing.