Participatory eHealth development to support nurses in antimicrobial stewardship
Open accessAbstract
BACKGROUND: Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put antimicrobial treatment into effect. To optimally support nurses in ASPs, they should have access to information that supports them in their preparation, administration and monitoring tasks. In addition, it should help them to detect possible risks or adverse events associated with antimicrobial therapy. In this formative study, we investigate how nurses' can be supported in ASPs by means of an eHealth intervention that targets their information needs. METHODS: We applied a participatory development approach that involves iterative cycles in which health care workers, mostly nurses, participate. Focus groups, observations, prototype evaluations (via a card sort task and a scenario-based information searching task) and interviews are done with stakeholders (nurses, managers, pharmacist, and microbiologist) on two pulmonary wards of a 1000-bed teaching hospital. RESULTS: To perform the complex antimicrobial-related tasks well, nurses need to consult various information sources on a myriad of occasions. In addition, the current information infrastructure is unsupportive of ASP-related tasks, mainly because information is not structured to match nurse tasks, is hard to find, out of date, and insufficiently supportive of awareness. Based our findings, we created a concept for a nurse information application. We attuned the application's functionality, content, and structure to nurse work practice and tasks. CONCLUSIONS: By applying a participatory development approach, we showed that task support is a basic need for nurses. Participatory development proved useful regarding several aspects. First, it allows for combining bottom-up needs (nurses') and top-down legislations (medical protocols). Second, it enabled us to fragmentise and analyse tasks and to reduce and translate extensive information into task-oriented content. Third, this facilitated a tailored application to support awareness and enhance patient safety. Finally, the involvement of stakeholders created commitment and ownership, and helped to weigh needs from multiple perspectives.
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Multiple authors in the included studies stated that ideally, multiple methods should be combined to paint a full picture of a prototype's usability.
“Second, authors stated that ideally, multiple methods should be combined to paint a full picture of a prototype’s usability”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [25]
To paint a complete picture of prospective end users' requirements for the eHealth technology, card sorting should be combined with other methods such as interviews or focus groups.
“Third, to paint a complete picture of prospective end users’ requirements for the eHealth technology, card sorting should be combined with other methods such as interviews or focus groups”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [25]
Multiple authors indicated that card sorting is a fast, efficient, and cheap method to gain insight into the structure of a to-be-developed eHealth technology, especially when conducted on the web.
“Multiple authors indicated that card sorting is a fast, efficient, and cheap method to gain insight into the structure of a to-be-developed eHealth technology, especially when conducted on the web”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [25]
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- Authors
- Wentzel, J., van Velsen, L., van Limburg, M., de Jong, N., Karreman, J., Hendrix, R., & van Gemert-Pijnen, J. J. E. W. C.
- Affiliations
- University of Twente (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Wentzel, Jobke
- Venue
- BMC Medical Informatics and Decision Making
- Published
- 2014-06-05
- Volume
- 14
- Issue
- 1
- Pages
- 45-45
- ISSN
- 1472-6947 (ISSN-L)
- PMC
- PMC4074392
- OpenAlex
- W2128748796
- Cited by
- 73
- References
- 23
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 8 · 2022: 8 · 2021: 6 · 2020: 10 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 8 · 2015: 7 · 2014: 5
- FWCI
- 7.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medical Informatics and Decision Making (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- University of Twente Research Information (publishedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- University of Twente Research Information (submittedVersion, cc-by)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- antimicrobial stewardship, nurses, digital health interventions, participatory development, antimicrobial resistance, information needs, task support, patient safety, information infrastructure, clinical protocols, stakeholder engagement
- MeSH terms
- Adult, Anti-Infective Agents, Humans, Health Knowledge, Attitudes, Practice, Nursing, Program Development, Focus Groups, Telemedicine, Practice Guidelines as Topic
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