Web-based interventions are considered to be the advancement made in the nursing practice due to the dynamic changes when it comes to technology and computer systems. In addition, the higher priority for the funding of the technological aspects in the field of nursing led to the discovery and development of various interventions that utilizes computers and technology (Im & Chang, 2013; Chee, Lee, Chee, & Im, 2014).
Web-based interventions refer to a self-guided intervention which was implemented and executed with the use of an online programs which can be operated using computers and internets. These programs can be accessed and used by different individuals who are seeking assistance related to health and even mental health. Majority of the web-based interventions aim to elicit a positive change when it comes to the knowledge, attitude, and practices of the patients or individuals (Murray, 2012; Sassen, Kok, Mesters, Crutzen, Cremers, & Vanhees, 2012).
Current studies have already identified the various advantages and disadvantages of using web-based interventions. The use of information and communication technology or eHealth has been a common practice among different health sectors from all over the world. Thus, to be able to address the current issues concerning the vaccination rates among the elderly, a web-based intervention will be proposed in this paper (Murray, 2012; Sassen, Kok, Mesters, Crutzen, Cremers, & Vanhees, 2012).
The development and implementation of an online vaccination screening schedule can be used to address and monitor the improvement of vaccination rates among the Hispanic elderly population aged 65-90 years old in a Community Health setting in Miami-Dade area. An online record system for the schedules of the vaccinations of the elderly population allow easy determination and identification of elderly individuals with incomplete vaccinations. These information and data can allow nurses to follow-up and visit elderly individuals to help increase or improve the vaccination rates among the chosen population.
Description of PICOT elements necessary for the proposed online intervention
For the proposed online intervention, the main population to be recruited are Doctor of Nursing Practice (DNP) nurses or nurses who practice or reside in the community setting in Miami-Dade area (P) who will be responsible for the encoding and analysis of the results and data that will be obtained from the online record system of the vaccinations of the elderly population of Hispanics which is the main population involved in the DNP project.
On the other hand, the intervention is the development and implementation of an online or web-based record system responsible for recording the vaccination schedules of the elderly Hispanic population in a Community setting in Miami-Dade area (I). To be able to properly take note of the effects and advantages of using an electronic record system, the vaccination rates of the Hispanic elderly noted by DNP nurses using the online record system will be compared to the vaccination rates of Hispanic elderly noted by the DNP nurses without using the online record system (C).
The comparison of the data obtained using the online record system and the data obtained without using the online record system can help determine the effectivity and efficiency of the web-based intervention proposed in this paper. The outcome to be measured in this web-based intervention is the effect of the electronic record system on the vaccination rates of the Hispanic elderly population aged 65-90 years old from a Community Setting in Miami-Dade area (O).
The efficiency and effectiveness of the online record system can also be noted and evaluated by allowing the DNP nurses who participated in the study to accomplish a satisfaction survey to be able to identify the strengths and weaknesses of the web-based intervention. The survey can also allow the DNP nurses to state their opinions and comments with regards to the accessibility and the usefulness of the web-based interventions. These comments can be used for the improvement of the web-based intervention in terms of effectivity, efficiency, and user-friendliness.
According to Murray (2012), the major components that should be considered in the implementation of web-based interventions are the contents of the program, the use of multimedia in the implementation process, the activities that are considered to be interactive online, and the evaluation or assessment of the intervention using a feedback survey. The implementation of these interventions are mainly for three clinical areas namely (1) self-management of health conditions which are classified to be long-term; (2) promotion of health through health education; and (3) mental health.
Currently, there are already numerous studies focusing on the different advantages and disadvantages of web-based and mobile interventions. In fact, interventions implemented through the use of websites and mobiles have already been considered as important tools and instruments when talking about the basic toolkits of health professionals and even researchers. It has been said that the delivery of web-based intervention allow easy evaluation and assessment of different participants to be able to evaluate the implementation of a particular health intervention in terms of effectiveness as a whole. According to the literature review and results of the study, it was found that the use of the checklist instrument developed by the group has the potential to greatly improve the reporting and evaluation of the validity and also the applicability of various trials that uses eHealth (Eysenbach & CONSORT-EHEALTH Group, 2011).
Reflection on the application from a Health Information Technology (HIT) perspective
Health Information Technology (HIT) is a branch of science that deals with the use of various strategies and interventions involved in health communication to help in the improvement of the health outcomes of populations along with the improvement of the quality of health care among different health organizations and institutions. The processes involved in health communication as well as information technology are considered to be vital in the field of health care and public health (Office of Disease Prevention and Health Promotion, 2016; Berkman, DeWalt, Pignone, et al., 2004).
The development and implementation of a web-based intervention such as the electronic vaccination screening records for this PICOT project aims to support patients and health care providers decide on the appropriate medical advice and decision appropriate to their condition. Additionally, web-based interventions also allow personalized self-management tools like electronic records system for vaccinations of elderly Hispanic population. Aside from these, the use of web-based interventions also allow the establishment of string and reliable social networks which can be beneficial in terms of the evaluation of the online application. Furthermore, interventions using websites and technologies also allow accurate, accessible, and actionable delivery of necessary health information needed for the improvement of the health status of patients (Office of Disease Prevention and Health Promotion, 2016; Berkman, DeWalt, Pignone, et al., 2004).
According to Gibbons of the American Health Information Management Association (2011), appropriate and adequate evaluation of the web-based interventions and the potential of various health information technology strategies can help address numerous health issues such as disparities among different healthcare groups. Additionally, the adoption and even utilization of the different barriers for the improvement of health status through the implementation of web-based interventions must be considered to properly assess the usefulness of health information technology in the field of nursing. The inclusion of the various barriers can help in the design, development, and even implementation of the necessary interventions and strategies (American Health Information Management Association, 2011).
The usage of various web-based interventions have been proven to be effective even in the perspective of health information technology. Since technology such as internet connection and software has been widely used in the past years, various health interventions involving these relatively new technology has been one of the main concerns in the recent years. The development of an electronic health record system focused on the screening of the vaccinations of elderly Hispanics in a Community in Miami-Dade area is in line with the goals and objectives set by the field of health information and technology. The application or web-based intervention can help DNP nurses identify the elderly individuals with incomplete vaccination status. Additionally, sharing of relevant data will also be easier and convenient because all of the necessary information can be obtained through the internet. This connection allows interprofessional collaboration and information dissemination especially when it comes to the assessment and the evaluation of the newly developed web-based intervention (Kuijpers, Groen, Aaronson, & van Harten, 2013).
Conclusion
The dynamic changes that can be found in the field of nursing especially when it comes to health information has been one of the main concerns of the health care sector. The continuous advancements in technology led to the importance of designing, developing, and implementing web-based interventions which are necessary to improve the health status of a population.
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