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Nurse-Driven Website Empowers Nurses to Improve Patient Care

By By Julie Beck, RN, MSN, MPH, APRN-BC and Lisa Barbarotta, MSN, AOCNS, APRN-BC
 
PUBLISHED THURSDAY, JANUARY 1, 1970
Yale Smilow School of NursingJulie Beck
Julie Beck,
RN, MSN, MPH, APRN-BC

Lisa Barbarotta
Lisa Barbarotta,
MSN, AOCNS, APRN-BC
 
Julie Beck is Oncology Nurse Practitioner and Cancer Care Coordinator with the VA Connecticut Healthcare System in West Haven and Clinical Nurse III at the Smilow Cancer Hospital at Yale-New Haven. Lisa Barbarotta is an Oncology Nurse Practitioner for the Hematology/Oncology Service at the Smilow Cancer Hospital.Strategic Partnership
Improving communication, building relationships, coordinating activities among units, and engaging staff members are not only ways to create a more positive working environment, they are critical for maintaining patient safety. Engaged nurses are more likely to notice and take action when there is an opportunity to improve patient care.1

In 2010, the Oncology Nursing Cluster of Smilow Cancer Hospital at Yale-New Haven in Connecticut identified the need for an informative website to support oncology nurses. The cluster consists of staff nurses who represent each of the inpatient and outpatient units within Smilow Cancer Hospital as part of the shared governance structure for nurses at Yale-New Haven Hospital (YNHH). With the support of senior leadership, two oncology nurses who were members of the Staff Nurse Council of YNHH took on the task of creating the website.

The idea was to create a comprehensive resource designed to achieve multiple, integrated goals. Building from our own nursing experiences, we further developed the concept by soliciting suggestions from staff and oncology nurse educators. We were trained in Web design by hospital information technology staff. After final administration review and approval, the oncology nursing website went live in March of 2011. The goals of the oncology nursing website include:
  • Evidence-based information at the bedside: Our core goal was to improve patient care by helping Smilow nurses anticipate patient problems and provide better patient and family education by making available in real time at the bedside, searchable and printable teaching tools, such as best practices information, nurse-driven research projects, and links to policies, procedures, journal articles, and websites.
  • Clinical advancement: The website includes resources to facilitate career advancement, such as tools for new nurses, a monthly education calendar, and links to journal articles and information about certification.
  • Team building and improved inter-unit communication: This is a forum to celebrate achievements of individual nurses and nurse-generated innovations and spotlight unit quality initiatives and profiles of oncology nurses who serve as role models for others. We post staff-generated monthly slide shows so that nurses in each unit can get to know each other and learn about safety and quality initiatives on their sister units.
  • Management communication: A mechanism to disseminate timely, consistent information and for management to communicate new policy directives.
Next, we needed to build awareness and usage. We sought to draw people in by making the site easy to access by any nurse from the clinical workstation, pleasing to look at, and easy to navigate. We encourage repeat usage by rewarding users with useful, entertaining, up-to-date information.

The cluster members created a presentation “road show,” which they took to each unit in Smilow to build awareness of the website and to teach staff members how to access and use the information featured on it. Information on the site was incorporated into new staff orientation. A direct link/permanent icon was established to the site from the homepage of most of the clinical workstations at YNHH, permitting easy access to the site. The website is updated weekly with ongoing support from the University Information Technology Service and Yale University Medical School librarians.

As part of our ongoing effort to improve the site’s effectiveness, we conducted a staff survey after the site was online for a year. We surveyed 56 nurses— more than 25% of the total staff. We included nurses from all eight inpatient and outpatient clinics, including both day and night shifts. We found that 90% of the nurses surveyed (n = 49) had visited the site over the prior 3 months.

Table. Use of Oncology Nursing Website

Frequency of Use of Website N %
Regularly 36 64
Occasionally 14 25
Never 6 10
Ease of Navigating Website N %
Easy 37 66
Unanswered 19 34
Resources Accessed
by Website
N %
Certification 32 58
Clinical Placement Info
Educational Opportunities
28 50
Journal Articles 25 44
Printable Tools for New Nurses 23 41
Based on survey results, users tend to be new nurses and nurses who are OCN-certified. Nurses who pursue certification may also be more likely to investigate educational opportunities via the website. Users averaged 11 years as a registered nurse and were split relatively evenly between experienced and novice nurses; 64% of the nurses reported using it in everyday practice. See the Table for frequency of use, ease of navigation, and the specific resources the nurses reported they accessed.

The oncology nursing website, a central source for information and teaching tools, both for new and experienced nurses at Smilow, has become the mode of communication for YNHH. New websites have been created for other nursing specialties using the design and content of our website as a template. The goal of the YNHH Staff Nurse Council is for each of the 13 nursing disciplines to have a cluster website created by nurses in their units.

The authors would like to acknowledge Amy Brown with Information Technology, who trained us in Web design, and Denise Hersey from the Yale Medical School Library, who provided technical support for creation of the Journal Article Bank.

Additional Readings:

  1. Minutes and Presentations of Staff Nurse Council Monthly Meetings 2011. http://www.nursecredentialing.org/Magnet.aspx.
  2. Barnard A, Nash R, O'Brien M. Information literacy: Developing lifelong skills through nursing education. J Nurs Educ. 2005;44(11):505-510.
  3. Cimino J, Jianhua L, Graham M, et al. Use of online resources while using a clinical information system. AMIA Annu Symp Proc. 2003;175-179.
  4. Cobb J. Comparison of oncology nurses and physician use of the internet for continuing education. J Contin Educ Nurs. 2003;34(4):184-188.
  5. Dee C, Stanley EE. Information-seeking behavior of nursing students and clinical nurses: Implications for health sciences librarians. J Med Libr Assoc. 2003;93(2):213-222.
  6. Estabrooks C, O'Leary K, Ricker K, Humphrey C. The internet and access to evidence: How are nurses positioned? J Adv Nurs .2003; 42(1):73-81.
  7. Gosling A, Westbrook J, Coiera E. Variation in the use of online clinical evidence: A qualitative analysis. Int J Med Inform. 2003;69(1:1-16.
  8. Morris-Docker S, Tod A, Harrison J, Wolstenholme D, Black R. Nurses' use of the internet in clinical ward settings. J Adv Nurs. 2004;48(2):157-166.
  9. Munoz-Izquierdo A, Puchades-Simo A, Marco-Gisbert A, et al. Access to the internet among nurses and type of information sought. Enferma Clin. 2008;18(1):18-25.
  10. Tannery N, Wessel C, Epstein B, Gadd C. Hospital nurses' use of knowledge-based information resources. Nurs Outlook. 2007;55(1):15-19.
  11. Willmer M. How nursing leadership and management interventions could facilitate the effective use of ICT by student nurses. J Nurs Manag. 2007;15(2):207-13.
  12. Wozar J, Worona P. The use of online information resources by nurses. J Med Libr Assoc. 2007;91(2):216-221.

    Reference

    1. Simpson RL. Engaged nurses lead way to improved outcomes via technology. Nurs Adm Q. 2010;34(3):268-273.
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