Access to information resources at the point of care is a necessary prerequisite to the provision of safe and high quality advanced practice nursing (APN) care. The proposed project builds upon Columbia University School of Nursing's successful student clinical log project in which APN students document clinical encounters on personal digital assistants (PDAs) and access selected patient safety-related resources resident on their PDAs. The purpose of APN Access to Electronic Resources for Safety & Quality (APN AcE Resources for Safety & Quality) is to provide tailored desktop and wireless access to web-based information resources related to patient safety and quality of care for APN students, faculty, and preceptors. Aggregate data from our student clinical log project document that approximately 60% of APN students' clinical encounters are with persons from racial or ethnic minority groups, primarily African Americans and Hispanics. Many are also of low socioeconomic status. The needs assessment for APN AcE Resources for Safety & Quality suggests that the number of encounters in which the diagnosis and management of tobacco abuse, obesity, and depression is documented is far below the prevalence in the population served. Moreover, adverse events and near misses are not currently documented in the APN student clinical log. Unmet information needs have been linked to patient safety issues and care that is inconsistent with the best evidence. Consequently, the project has the potential to improve the safety and enhance quality of care in underserved populations, particularly racial and ethnic minorities and the urban poor. The primary project objectives are to: 1. Develop and implement a tailored interface to selected web-based resources for patient safety and quality care in underserved populations, including low literacy materials for use with patients 2. Enhance the information retrieval competencies, including those related to wireless access, of APN students, faculty, and preceptors related to patient safety and quality care in underserved populations 3. Evaluate the use, usability, and usefulness of AcE Resources for Safety & Quality Project evaluation methods include usability testing (heuristic evaluation and think aloud protocol), analysis of resource usage log files, surveys (training session assessments, perceived usability and perceived usefulness of AcE Resources for Safety & Quality, and informatics competencies), self-reports (adverse events and near misses), encounter audits (adverse events and near misses) and database queries (quality of care for smoking cessation, obesity management, and depression). The relationships among resource use, nurse behavior, and patient care will be examined using correlational and regression analyses. ? ? ?
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