JMIR Nursing
Virtualizing care from hospital to community: Mobile health, telehealth, and digital patient care.
Editor-in-Chief:
Elizabeth Borycki, RN, PhD, FIAHIS, FACMI, FCAHS, Social Dimensions of Health Program Director, Health and Society Program Director, Office of Interdisciplinary Studies; Professor, School of Health Information Science, University of Victoria, Canada
CiteScore 5.2
Recent Articles
Background: Effective communication is vital in healthcare, especially for nursing students who are the future of healthcare delivery. In Iraq's nursing education landscape, characterized by challenges like resource constraints and infrastructural limitations, understanding communication modalities is crucial.
During the pandemic, health care providers implemented remote patient monitoring (RPM) for patients experiencing COVID-19. RPM is an interaction between health care professionals and patients who are in different locations, in which certain patient functioning parameters are assessed and followed up for a certain duration of time. The implementation of RPM in these patients aimed to reduce the strain on hospitals and primary care.
The ethics of artificial intelligence (AI) are increasingly recognized due to concerns such as algorithmic bias, opacity, trust issues, data security, and fairness. Specifically, machine learning algorithms, central to AI technologies, are essential in striving for ethically sound systems that mimic human intelligence. These technologies rely heavily on data, which often remain obscured within complex systems and must be prioritized for ethical collection, processing, and usage. The significance of data ethics in achieving responsible AI was first highlighted in the broader context of healthcare and subsequently in nursing. This presentation explores the principles of data ethics, drawing on relevant frameworks and strategies identified through a formal literature review. These principles apply to real-world and synthetic data in AI and machine learning contexts. Additionally, the data-centric AI paradigm is briefly examined, emphasizing its focus on data quality and the ethical development of AI solutions that integrate human-centered domain expertise. The ethical considerations specific to nursing are addressed, including four recommendations for future directions in nursing practice, research, and education and two hypothetical nurse-focused ethical case studies. The primary objectives are to position nurses to actively participate in AI and data ethics, thereby contributing to creating high-quality, relevant data for machine learning applications.
Nursing students’ learning during clinical practice is largely influenced by the quality of the guidance they receive from their nurse preceptors. Students that have attended placement in nursing home settings have called for more time with nurse preceptors and an opportunity for more help from the nurses for reflection and developing critical thinking skills. To strengthen students’ guidance and assessment and enhance students’ learning in the practice setting, it has also been recommended to improve the collaboration between faculties and nurse preceptors.
Although the use of artificial intelligence (AI)–based technologies, such as AI-based decision support systems (AI-DSSs), can help sustain and improve the quality and efficiency of care, their deployment creates ethical and social challenges. In recent years, a growing prevalence of high-level guidelines and frameworks for responsible AI innovation has been observed. However, few studies have specified the responsible embedding of AI-based technologies, such as AI-DSSs, in specific contexts, such as the nursing process in long-term care (LTC) for older adults.
Depression is one of the most common mental disorders that affects >300 million people worldwide. There is a shortage of providers trained in the provision of mental health care, and the nursing workforce is essential in filling this gap. The diagnosis of depression relies heavily on self-reported symptoms and clinical interviews, which are subject to implicit biases. The omics methods, including genomics, transcriptomics, epigenomics, and microbiomics, are novel methods for identifying the biological underpinnings of depression. Machine learning is used to analyze genomic data that includes large, heterogeneous, and multidimensional data sets.
eHealth interventions are becoming a part of standard care, with software solutions increasingly created for patients and health care providers. Testing of eHealth software is important to ensure that the software realizes its goals. Software testing, which is comprised of alpha and beta testing, is critical to establish the effectiveness and usability of the software. In this viewpoint, we explore existing practices for testing software in health care settings. We scanned the literature using search terms related to eHealth software testing (eg, “health alpha testing,” “eHealth testing,” and “health app usability”) to identify practices for testing eHealth software. We could not identify a single standard framework for software testing in health care settings; some articles reported frameworks, while others reported none. In addition, some authors misidentified alpha testing as beta testing and vice versa. There were several different objectives (ie, testing for safety, reliability, or usability) and methods of testing (eg, questionnaires, interviews) reported. Implementation of an iterative strategy in testing can introduce flexible and rapid changes when developing eHealth software. Further investigation into the best approach for software testing in health care settings would aid the development of effective and useful eHealth software, particularly for novice eHealth software developers.
As technology will continue to play a pivotal role in modern-day health care and given the potential impact on the nursing profession, it is vitally important to examine the types and features of digital health education in nursing so that graduates are better equipped with the necessary knowledge and skills needed to provide safe and quality nursing care and to keep abreast of the rapidly evolving technological revolution.
Increased workload, including workload related to electronic health record (EHR) documentation, is reported as a main contributor to nurse burnout and adversely affects patient safety and nurse satisfaction. Traditional methods for workload analysis are either administrative measures (such as the nurse-patient ratio) that do not represent actual nursing care or are subjective and limited to snapshots of care (eg, time-motion studies). Observing care and testing workflow changes in real time can be obstructive to clinical care. An examination of EHR interactions using EHR audit logs could provide a scalable, unobtrusive way to quantify the nursing workload, at least to the extent that nursing work is represented in EHR documentation. EHR audit logs are extremely complex; however, simple analytical methods cannot discover complex temporal patterns, requiring use of state-of-the-art temporal data-mining approaches. To effectively use these approaches, it is necessary to structure the raw audit logs into a consistent and scalable logical data model that can be consumed by machine learning (ML) algorithms.
This viewpoint paper explores the pedagogical implications of artificial intelligence (AI) and AI-based chatbots such as ChatGPT in nursing education, examining their potential uses, benefits, challenges, and ethical considerations. AI and chatbots offer transformative opportunities for nursing education, such as personalized learning, simulation and practice, accessible learning, and improved efficiency. They have the potential to increase student engagement and motivation, enhance learning outcomes, and augment teacher support. However, the integration of these technologies also raises ethical considerations, such as privacy, confidentiality, and bias. The viewpoint paper provides a comprehensive overview of the current state of AI and chatbots in nursing education, offering insights into best practices and guidelines for their integration. By examining the impact of AI and ChatGPT on student learning, engagement, and teacher effectiveness and efficiency, this review aims to contribute to the ongoing discussion on the use of AI and chatbots in nursing education and provide recommendations for future research and development in the field.
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