Using web technologies for the lactation professional

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Using web technologies for the lactation professional

  1. 1. Running head: USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 1 Using Web Technologies in Lactation Healthcare Promotion Denise Breheny Queens University of Charlotte
  2. 2. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 2 Abstract The purpose of this paper is to elucidate how new technologies, and social media inparticular can be utilized by lactation health professionals in our promotion and support ofhealthy infant feeding practices. This is an important topic because although there is a presenceof breastfeeding information on the Internet, there is a paucity of research articles describing orsurveying the range of information technology, particularly Web 2.0 interactive and social mediain the lactation field. The typical American woman of child bearing age is typified by eitherGeneration X or Y, the first generations to experience electronic technology at an early age. Shehas come to rely on the convenience of the Internet for information. She will consult the Internetregularly for information to assist with her infant feeding choice decision. She may also consultthe Internet when she has a question or is experiencing difficulties with breastfeeding. This paperincludes examples of how lactation health education can effectively be communicated to thisgeneration of women through the use of the new interactive Web technologies. Through Web2.0, Blogs, Podcasts, YouTube, Social Networking, even Virtual Gaming, we must consider allthe information technologies currently available in our quest to educate and encouragebreastfeeding. Can the Internet’s interactive communication platforms provide a credible sourcefor breastfeeding information? A new paradigm is immerging to gain the attention and meet theneeds of these new generations on this important health topic.Key words: Web health education technologies, lactation/breastfeeding: Web pages, blogs,podcasts, social networking sites, Facebook, Twitter, YouTube.
  3. 3. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 3 Using Web Technologies in Lactation Healthcare Promotion Introduction Lactation healthcare education and promotion is focused on a specific population, thosewomen of childbearing age specifically the members of generations X (1961-1980) and Y(1981-2000). Many defined by these generations are looking for and expect quick fixes; they areregularly relying on gadgets and openly expect their own needs to be met first. We are at the agewhere we need to be wired for new technologies as well as being able to speak the shorthanddefining each new medium. Beyond the information technology challenge, the younger adultgenerations tend to turn a deaf ear to traditional health promotion marketing. As daily users ofelectronic forms of communication, they are most likely to turn to this media first. Thesegenerations are often doubtful of advice that comes from outside of their social contacts. Inorder to reach out to these generations, the lactation professional needs a shift in thinking abouthow we communicate to and with our audience. How can the utilization of technology,specifically the Internet, elicit excitement in lactation among these new mothers? Although there is a presence of information on breastfeeding and lactation on theInternet, in performing the literature search for this paper it was found that there is a dearth ofresearch articles describing or surveying the range of information technology, particularly Web2.0 interactive and social media technologies in the lactation field. In 2000, Riodan describedthe development of teaching strategies for her university-based graduate breastfeeding Internetcourse (Riordan, 2000). Although Dr. Riodan’s article did not discuss Web 2.0 technologies,this is the first published article found that integrated breastfeeding education and the use ofInternet Web technology. In this article she described the Internet as having “great potential” forlactation education. In 2002, Jordan & Jordan compiled a listing of Lactation Management
  4. 4. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 4Resources on the Internet (Jordan & Jordan, 2002). Their article discussed the many Internetsites which have emerged for the nursing mother and the lactation or other health professional.These sites include topics ranging from the emotional and economic benefits of breastfeeding, tothe biology of milk production, to a number of organizations which support breastfeeding. In2003, Cheng et al. discussed a Web-based breastfeeding education program developed for newparents who looked at whether the inclusion of graphics in the breastfeeding learning tool waspreferred over a text-only program (Cheng, Thompson, Smith, Pugh, & Stanley, 2003). In anarticle published by Nursing for Women’s Health, Miller et al. concluded that new motherscontinually consult public media in their search to gather information on infant feeding, andtherefore a versatile approach to breastfeeding education was needed which included the use ofthe Internet to promote positive media messages (Miller, Cook, Brooks, Heine, & Curtis, 2007).In an editorial note for the Journal of Human Lactation (JHL), Heinig called for lactationprofessionals to “lean how changing demographics may affect how we currently approachbreastfeeding promotion and support” (Heinig, 2009, p. 263). Dr. Heinig continued hercommentary in the subsequent JHL editor’s note, stating that the Internet, especially with thenew Web 2.0 technologies, provided opportunities for mass communication at a reduced cost(Heinig, 2009). She discussed how we now are not restricted to educational systems forlearning, that new options have become relevant with the new interactive technologies availablethrough Web sites, social networking sites, e-mails, etc. which are engaged in both thegeneration and receipt of information. She also expressed her concerns in “the ability of mystudents and the public to discern fact from fiction (Heinig, 2009, p. 395).” Although this topichas been ignored in the past publication of articles and research devoted to the integration ofinformation technologies specifically with the goal of increasing the incidence and duration of
  5. 5. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 5breastfeeding, now is the time for this topic to be explored by lactation professionals. This paperpresents a few of the most popular Web 2.0 technologies available, we need to research howthese emerging technologies might be best utilized in the communication of breastfeedinginformation to the nursing mother. Breastfeeding Breastfeeding is the preferred feeding method for infants and has been supported byprofessional health organizations including the American Academy of Pediatrics (AAP) due toits many health benefits to both the mother and the child. Breastfeeding first was included as anelement of the United States Healthy People (USHP) in 1978 (U.S. Department of Health andHuman Services [USDHHS], 2000). The current USHP goals for 2010 are that at least seventy-five percent of mothers exclusively breastfeed during the postpartum period, at least fifty percentof these women will continue for at least six months old, with twenty-five percent continuing onuntil the infant is one year of age. Unfortunately, the exclusive breastfeeding rate among newmothers has fallen short of these goals. According to the statistics available through the NewMothers Survey last conducted by Ross Products in 2003; exclusive breastfeeding initiation wasmerely sixty-six percent, and fewer then thirty-three percent of new mothers were stillexclusively breastfeeding at six months (Ross Products Division, Abbott Laboratories [Abbott],2003). Hoyer & Pokorn, (1998) showed in their study that mothers who continued breastfeedinglonger were better informed on this health topic, and generally make this decision before givingbirth. Providing a means of easy access to information through information technologies couldhave an impact on increasing the actual numbers of mothers meeting the goals of USHP2010.Through the adoption of new and emerging information technologies (IT) such as: Web 2.0,Blogs, Podcasts, Twitter, Social networks and other IT, we may be able to offer an revamped
  6. 6. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 6health educational strategy to help mothers to gain the supportive and assistive breastfeedinginformation necessary to encourage initiation as well as promote a longer duration ofbreastfeeding. Defining the User Population Taking a look at the current demographics—those of the greatest number of childbearingages—have been defined as Generations X and Y. Generation X (X’ers) were born between the1960s and the Mid- 1980s. This generation was raised as latchkey children because both parentswere likely to work outside the home. They were raised in the era of television andcommunication which involves technology is appealing to them. Technology made majoradvances during the period that X’ers were growing up, and has been embraced by thisgeneration. They were the first generation introduced to computers and became comfortablewith new electronic forms of communication (Kramer, 2010). Generation Y (also known as themillennials) were born between the 1980’s and 2005. The millennial generation tends to comefrom more protective environments having been shielded by their parents from economicdifficulties, violence and terrorism. They seek a personal touch for support, understanding,communication and feedback. Multiculturalism, text messaging and the Internet have alwaysbeen a part of their lives (Kramer, 2010). Both the X’ers and millennials are considered digitalnatives, a term coined to define “those who choose to use technology for numerous tasks; adaptsas the tools change; and may have either grown up with technology or adopted it as an adult”(Herther, 2009, p. 16). As digital natives they often seek out the Internet as the first place togather information, especially health information and advice.
  7. 7. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 7 Web 2.0 New interpretations of Internet informatics emerged with the concept of Web 2.0. Web2.0 was first used by O’Reilly and others as a description for technologies which use thecollective input from the Web’s community towards maximizing the information availablethrough the provision of user based content (O’Reily, 2005). Along with Web 2.0 a newparadigm emerged with the patient not as just a patient or client, but the patient as a consumer orpurchaser of health care and health care information. These new health consumers (gen X &Y)have strong likes and dislikes which are influenced and shaped by the information availablethrough social communication. For these generations turning to the Internet has provided apowerful importance on decision making, particularly health decisions because of the Internet’sability to provide social opinions and communications. According to Craig Lefebvre, Web 2.0 isn’t a place where people visit, “but ratherdestinations where they go to get things done—Flickr and YouTube to share photos and videos,MySpace and Bolt2 to meet and network with people who share similar interests.” (Lefebvre,2007, p. 33). With the advent of Web 2.0, particularly the participative Internet (known associal media), Web sites became more dynamic and communication more participatory withinformation sharing, video data, and text data and social media all supporting the formatprovided by the originator. This provided a rich medium for health information and healthlearning often sought by consumers because the Web offers privacy and flexibility for consumersin meeting their educational needs. Social networking participation has more than quadrupled in recent years according toJones and Fox (2009). Research comparing Web-based programs with traditional health learninghas shown that patient consumers enjoy interacting with computers, they also have better recall
  8. 8. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 8of the information they were pursuing. The interactivity of Web based information, the instantfeedback and recommendations available can be especially helpful in reaching mothers-to-bewhen they are making feeding choices, and mothers seeking information to sustain breastfeeding.Social Media Interactive social media includes: Podcasts, Blogs, Cell phones, Texting, InstantMessaging and Social Networking. The new social medias are providing a wave of newtechnology for healthcare as well as real-life examples of how media-based offering are gettingresults. Social networking sites like MySpace, Facebook and YouTube are connecting billions ofnetwork consumers. Today there are entire sites created to share health care information. Takefor example DailyStrength.org (DailyStrength.org, n.d.). This site offers more that 500 supportgroups online, one for every health issue and life challenge from Abstinence to ZellwegerSyndrome, and yes even a support group for breastfeeding with more than 700 members (http://www.dailystrength.org, accessed November 14th, 2010). Once registered, the new member hasaccess to the various support groups for commentary or advice. There is also additionalfeedback available through links to their Facebook and Twitter sites. A recent survey looked at the numbers of participants drawn purposely to various socialmedia sites for health related information. Social networking sites were shown to attract thewidest amount of utilization, accessed by twenty-three percent of Internet users (Chou, Hunt,Beckjord, Moser, & Hesse, 2009). According to Eysenbach, these trends are expected to growespecially as personal wireless devices become more mainstreamed (2008). Already with theadvent of smart phones and iPads, more and more individuals have Internet access within theirhands reach and are turning to social media sites on a regular basis.
  9. 9. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 9 With respect to influencing feeding decision making and increasing the duration ofbreastfeeding, lactation professionals need to create incentives, reduce barriers, and open upmore opportunities to sustain healthy feeding behaviors. Social media as a medium ofcommunication to breastfeeding mothers provides the lactation professional with an excellentplatform for the dissemination of breastfeeding information and discussion while providingcommentary to posts. Since these sites are accessed continually this is an excellent place toprovide assistance to the mother-to-be, or breastfeeding mother as an intermediary, andproviding links to sites which can supply an additional credible network of breastfeedinginformation.Blogs Mothers of Generation X may be more willing to listen to their peers than seek the adviceof older lactation professionals. For these women getting advice from blogs or discussion boardsmay accommodate their needs. The Blog is one of the fastest-growing tools for communicationon the Web, Blog is short for Weblog (Jensen, 2003). The term "Weblog" was first coined byJorn Barger in 1997, and was shortened to the popular “Blog” a few years later (Wortham,2007). Blogs encourage self reflection and therefore are generally anecdotal in any informationobtainable in this form. According to Susannah Fox, “e-communities and Blog sites are not justabout emotion but about maximizing the network to improve people’s health” (Fox, n.d.). Shebelieves it is why people are compelled to share personal information—that it is to benefit others—to provide support for strangers, to help and connect. Compared to social networking sites, Blogs attract a smaller audience (7% of Internetusers) for health related content (Chou et al., 2009). Never-the-less blogs with good informationand bad information will continue to be consulted by many viewers as evidenced by site visit
  10. 10. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 10counters and feedback, which may provide a better assessment of blogosphere penetration.Often gen X’ers and millennials tend to view a majority consensus of agreement as sufficientevidence to support their infant feeding practice and beliefs (Heinig, 2009). Bloggers have beenobserved to act as important communication stakeholders—not only for the dissemination ofinformation, but also for the capability of directing visitors through opinion and hyperlinks(Lefebvre, 2007). A Blog, as a part of a professional lactation practice either private, physicianor hospital based, could provide useful information on current lactation promotions or events;thus providing a more substantial presence in the web based community where the X’er andmillennial would be seeking information and where they routinely interact on a daily or weeklybasis. The Blog can be very influential in the choices these generations make about healthbehaviors.Twitter In a systematic review conducted by Fry and Neff (2009) there were positive findingsthat providing prompts via email, computer or telephone effectively enhanced diet, weight lossand exercise behaviors (Fry & Neff, 2009). Even more positive effects were associated with theuse of messages specifically tailored to the receiver. Twitter could become a great tool forlactation professionals. Twitter was started as an experiment in 2006 and incorporated in 2007(www.twitter.com). Twitter permits short messages of a maximum of 140 characters which canbe sent to followers which are called Tweets. In the health field Tweets have already beenutilized by researchers to demonstrate patterns of flulike symptoms in communities prior to anoutbreak, allowing health systems to become more aware (Scanfeld, Scanfeld, & Larson, 2010). Twitter can be used for direct messaging which is useful for health communicationswhich may be sensitive in nature. For example a lactation professional could moderate content
  11. 11. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 11and intervene in the case of inappropriate or potentially hurtful messages. The lactationprofessional could also utilize Twitter as a source for motivation and inspiration by providingreinforcement for positive changes, motivation during weak moments or frustration with feedingpractices, and in celebration of successes. As an intervention a lactation professional couldprovide structured Tweet messages or reminders to influence positive breastfeeding healthbehaviors.Pod Cast, YouTube Lactation professionals can use audio or video presentations on the Web as another formof breastfeeding health education. YouTube was created by three former PayPal employees in2005 and was named Invention of the Year by Time magazine in 2007 (Hopkins, 2006).YouTube provides incredible technology which allows for inexpensively produced short lengthvideos to become available on the Web. Many large health organizations are already utilizing thepower of social media sites such as YouTube, in response to economic pressure and competition,there are already more than 421 hospital YouTube channels (Bennett, 2010). The beauty of thissocial media is that it doesn’t need to be restricted to just the large corporation. Smaller andprivate practices could utilize the power of a video to make a considerable contribution to thealready vast amount of information available on the Internet. By placing evidence basedinformation promoting the lactation professional and breastfeeding, these messages couldprovide just the information someone needed to get through a tuff spot. Finding patients willingto participate in a video which would be posted on the Internet could be a challenge, butaccording to Ruth Ann Hale, Director of Media and Community Relations at MethodistUniversity, “most patients asked are quite willing to participate in events that will help educateothers with their medical condition.” (“Are you Twittering, getting friends on Facebook, and
  12. 12. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 12YouTube? “, 2009). Of course it is important to take measures to protect the patient’s privacybefore positing a video on the Internet. It is also important to make sure the patient was fullyengaged and positively on board. There are also companies such as InJoy video productions thatcan provide short video productions specifically tailored to individual needs (PersonalConversation, 2010). Imagine videoing a snippet, a test weight for example, from aconsultation--this might be just what a mother needed to see to make the decision to actuallyfollow-up with a consultation. This is a great way to get across messages to the Xers andMillennials.Second Life Second Life (SL) is an online virtual reality world created by Linden Research in 2003.Users are called residents and can create their own virtual selves which are called avatars and caninteract within a simulated 3-D environment in their virtual “Second Life.” The residents canexplore their virtual world by visiting islands or virtual lands. The content of Second Life is alluser generated. In 2008 there were over 15 million registered users and over 1 million are activeusers (Linden Research, Inc., 2009). The average age of the user is 32 (Beard, Wilson, Morra, &Keelan, 2009). Anonymity and interactivity is encouraged by SL and because of this manydifferent health care agencies, organizations, companies and private groups have chosen SL forone of their Web 2.0 communication strategies (Beard, Wilson, Morra, & Keelan, 2009). Thehealth related activities on SL are focused in education and awareness sites, support sites, healthtraining sites, marketing and promotion of health services sites and research. For lactationestablishing a presence in the education and awareness sites could provide an approach todisseminating information through prepared messaged, bulletin boards, broadcast multi-mediaproductions including health videos, slideshows and presentations with links to Web pages.
  13. 13. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 13 An example can be found in the Women’s Health Center at the Ann Myers Medial Center(http://slhealthy.wetpaint.com/page/Ann+Myers+Medical+Center). This was founded by Dr.Ann Buchanan in honor of her mother Ann Myers. The site was originally developed to supportthe education for medical students through virtual learning and has operated in SL since 2007.The virtual hospital later added simulations open to the SL community, and is moderated by reallife physicians and nurses who donate their time. The open access areas provide information onsome medical equipment, conditions, procedures or departments. The Women’s Health Centeroffers women who have or are worried about breast cancer, the possibility to experience some ofthe diagnostics associated with breast cancer in a virtual environment. They offer a pink chair,that guides a woman through a breast self exam. There are numbered question marks which theclient can click to ask the resident on duty for more information. This type of technology couldbe applied toward the delivery of lactation information in a virtual world. A mother couldobserve a virtual lactation consultation and click on questions that she might have that requiremore personal attention or to gain a possible referral to a professional in her area. In 2007 Second Health (SH) was established for public engagement research by theImperial College London. SH is spread out over 8 islands within SL as an experiment to providepeople with a vision for future healthcare delivery. Some sites within SL actually offer one-on-one appointments with doctors, nurses, medical librarians, therapists, and other health careprofessionals (Beard et al., 2009). Because of the anonymity this platform encourages, SLprovides an excellent forum for the discussion of health related materials through support groupsand moderated discussions. The transfer of behaviors from SL to real life has implications for further advancingbreastfeeding rates in the future. As pointed out by in an article in Time Magazine our self
  14. 14. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 14confidence is reflected into our Avatar, but having anonymity allows our confidence to flourishand this can be reflected in our real world encounters (Dell, 2008). According to Dell, ourAvatar’s health behaviors in the virtual world transcend to real-life behaviors in the real world.Research has shown that patients “primed” for health procedures through participation in virtualexperiences help to reduce anxiety and provide a better understanding of the health care systemprior to a clinic or hospital visit (Gustafson, Shaw, Isham, Dillon, & Spartz, 2008). One of themajor problems with promoting breastfeeding is its lack of visibility (therefore acceptance),especially in Western cultures. Making it more visible even in a virtual world could increase andpromote its acceptability in the real world. The Downside of Web Technologies Despite the many positive aspects of Social Media for the promotion of breastfeedinginformation, there is also a downside. For example a Google search of the keyword“breastfeeding” on November 14, 2001, yielded over one million hits. Links could direct theuser to not only traditional Websites, but also images, videos, and breastfeeding blogs. Theadvice available can range from credible to misleading and even dangerous. Although manyadults state that they would trust their doctors (or other health professional) more than they trustthe Internet, often the Internet is consulted first. When actually queried, only eleven percent ofpatients actually went to their doctors, but a huge forty-eight percent consulted the Internet firstover their health question or need (Eysenbach, 2008). Most adults are aware that the credibilityof health information found on the Internet is important. According to the Pew Internet SurveyReport, health information seekers were shown to be vigilant in checking the source of theinformation, and were concerned about getting unreliable information from an online source(Eysenbach, 2008).
  15. 15. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 15 Günther Eysenbach has coined the phrase Apomediation which he feels characterizes theway in which the Web 2.0 technologies allow its users to identify trustworthy and credibleinformation and services (Eysenbach, 2008). He feels that through the use of apomediation, thatthere are tools for example: eBay feedback, or consumer ratings, which can help the user tojudge the credibility of the information being viewed. Through apomediation the user isinfluenced by how others view the information as creditable, it also helps the user navigatethrough an onslaught of information available today through digital medial. One problem withapomediation is that mass opinion may be regarded as fact; however, it is still an open questionas to how much these “opinions” and “experiences” conflict with researched evidence, and inhow they may be misleading or helpful to the information seeker. Health professionals are also using apomediation to guide them towards relevantinformation on the Web according to Eysenbach (2008). Through the use of devices such asshared bookmarks, and bookmarking tools lie CiteULike, Connotea or WebCite professionalscan share information or receive pointers to recently published relevant literature with otherprofessionals in pursuit of the same information. In the end, caveat emptor as all Web basedmedia is liable to fraud and scams. Recommendations According to the literature new mothers are consulting the Internet and utilizing thesocial media obtainable through Web 2.0 technologies on a regular basis to gather informationon breastfeeding, and feeding choices. Promoting breastfeeding information on the platformsmost used by this age group can allow this information wider dissemination to the targetpopulation. There needs to be more research into how these new technologies are currently
  16. 16. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 16utilized and can be utilized in the future. We also need to look at the effectiveness of theseinteractive Web technologies in impacting the numbers of women that exclusively breastfeed,and in breastfeeding for a longer duration. Summary As developed in this paper various forms of Internet social media presents differentopportunities for health education and communication, this is particularly true for the lactationprofessional. As health information of all kinds becomes increasingly accessible over theInternet and as the mother-to-be or new mother seeks information on infant feeding choices, andcontinued duration of breastfeeding increases; the likeliness increases that these mothers willturn to the Internet as they seek and expect to receive more information about breastfeeding withexplicit instructions about the next steps in their care. About one-third of the existing sites on theInternet are devoted to health care, and there already are many sites devoted to breastfeedinginformation (Sandrich, 2000). This survey of social media available through Web 2.0 interactivetechnology shows there is a significant potential in these social medias to improve thecommunication of breastfeeding information to the expecting and new mothers. The role of thelactation professional in providing quality information to this captive audience has been largelyunexplored, and there is a need to make a highly visible and credible presence, as well as studythe impact. When considering novel applications, it is important to consider the target audience andtheir fondness for the use of technology. Are we as the lactation professional harnessing theability to educate our population of mothers about the issues and problems that are relevant tothem? Are we engaging them in positive and meaningful ways? Is there any entertainmentvalue in what we offer? Have we empowered this mother-to-be or new mother as a result of
  17. 17. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 17their experiences with our programs, products or services? Finally, are we taking advantage ofour now empowered consumer to become our web spokesperson or evangelist? These are thefive E’s (education, engagement, entertainment, empowerment and evangelist) needed foradapting breastfeeding promotion to the next generations of consumers (Lefebvre, 2007).Programs designed to utilize the emerging social media technologies are needed to increasebreastfeeding education through positive media messages. This might be the best new approachfor increasing breastfeeding rates among women in the United States. Final Class Summary I expected to learn a lot from this paper and I did. Up until this class I had heard all thebuzz words for Wiki, YouTube, Social Networking sites and Blogs, but never had reallyexplored content or possibilities that these types of media would be useful as a form of healtheducation. My use of the internet was primarily for shopping, school and research. Through theresearch conducted for this project I realized the importance of Web 2.0 technologies, and howthese social medias are impacting every environment of our lives and are influencing ourlearning preferences and how the delivery of information is changing. Through my learning experiences in class discussions and reading I have received abetter knowledge of how information is acquired, processed and disseminated, which is thefoundation of informatics. I first only thought of computers, when I thought of nursinginformatics. I now have a better understanding of how informatics does include computertechnology, but it is more than just an understanding of the use of software and interpretation ofdata obtained from computers. Informatics is the interpretation of information from data intousable information from all sources of information including technology and research based data.
  18. 18. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 18I was able to understand more fully how I can utilize informatics and technology in my currentrole as a lactation consultant, and in my current track as a Clinical Nurse Leader. Through our discussions I have learned that we need to become more competent ininformatics as a part of our practice. With the governmental goal that all medical records will beelectronic by the year 2014 and nurses will need to be ready and competent in working withelectronically based media. Not only do we need to plan for computer competency by providingthese components as a foundation of nursing education, practicing nurses will need to assesstheir current competencies and seek improvements in their overall information literacy skills. Aswe are mastering these skills we become more fluent with technology and are able to understandthe underlying concepts and apply problem solving and critical thinking (ACRL: InformationLiteracy Competency Standards for Higher Education, 2000). As nurses we need to find our voice and take more initiative in the development anddesign of systems which we are going to utilize in day to day practice. Tools should be usefuland not cumbersome or awkward, they also should be efficient and cost effective. As a class wediscussed what happens when provided with new equipment which is inefficient to our duties asnurses. We provide workarounds, which may be more dangerous to our patient’s care. Asnurses we should be engaged in the process of planning, design and implementation. We shouldalso be more vocal when clearly the product is not producing the desired outcome. This mayrequire us as nurses to be more personally involved in research which can support our thesis andprovide a plan based on facts and evidence and not just on feelings, or the way something hasalways been done. One suggestion brought up in our weekly forums by a classmate was thedevelopment of an IT nursing council. I agree that involving nurses in a hospital IT councilwould give nurses a larger voice in the decision process over IT policies initiatives, development,
  19. 19. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 19system designs and selection. Since nurses are fundamental in the utilization of this equipment,they should be actively involved in decisions concerning IT in nursing applications. One key learning experience was our discussions and reading about telehealth nursing. Inever really realized the impact of this medium to our nursing profession. It became clearthrough our discussions and readings that as health care becomes more and more expensive todeliver, telehealth options will become more available and reimbursable. In my CNL track andas a stakeholder in improved patient outcomes, I feel that telehealth is vital for patient caremanagement. For acute care management, having telephone support may enable the patient to bedischarged sooner, for chronic care continued follow-up with patients may help a patient to bemore compliant in their health care activities. Monitoring equipment which provides real timedata will allow for more timely and accurate decisions. Then care plans can be designed to helpthe patient with optimizing their health situation. Because this can be done remotely, telehealthcan not only be cost effective but also a tremendous time saver for quality outcomes. There are several future learning objectives identified within this course. One of thelargest is our need for continued nursing science. We discussed how many of us utilizeworkarounds; however, we are not completing research which could provide data that couldchange the practice. As nurses we need to discover the best and most effective uses oftechnology for promoting our various nursing missions. As a CNL research is integral to ourleadership role. As a CNL we need to provide evidence through research in continued support ofevidenced based practice as our foundation of practice. The use of evidence based factual dataallows us to advance practice based on knowledge generated from research. Utilization of informatics is considered one of the five core competencies for healthprofessionals (Greiner & Knebel, 2003). This competency needs to be addressed in nursing
  20. 20. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 20educational program. Curriculums must be constantly evaluated to see if they foster the use ofinformation literacy skills. Nurses should not wait until they are in the workplace to acquirethese critical skills. Likewise, nurses in practice need to maintain a competency in thetechnology they utilize on a day to day basis. This competency should be continually assessedand remediated when the needs arise. As professionals we should all strive to advance our skilllevels beyond the baseline competency levels. We are stakeholders and as such we shouldactively participate in becoming fluent in the information technologies that we come in contactwith and remain current with the ideas presented in nursing and scientific literature towardsincorporating this information into practice.
  21. 21. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 21 ReferencesACRL: Information Literacy Competency Standards for Higher Education. (2000). http://www.ala.org/ala/mgrps/divs/acrl/standards/informationliteracycompetency.cfmAre you Twittering, getting friends on Facebook, and YouTube?. (2009). Same-Day Surgery, 33 (11), 105-116.Beard, L., Wilson, K., Morra, D., & Keelan, J. (2009). A survey of health-related activities on Second Life. J Med Internet Res, 11(2):e17. doi: 10.2196/jmir.1192Bennett, E. (2010, October 19). Social Media resources for health care professionals from Ed Bennett [Web log message]. Retrieved from http://ebennettl.org/#ixzz13yqVtjGKCheng, W. P., Thompson, C. B., Smith, J. A., Pugh, L., & Stanley, C. (2003). A Web-based breastfeeding education program. The Journal of Perinatal Education, 12(1), 29-41.Chou, W. S., Hunt, Y. M., Beckjord, E. B., Moser, R. P., & Hesse, B. W. (2009). Social media use in the United States: Implications for health communication. J Med Internet Res, 11(4):e48. doi: 10.2196/jmir.1249DailyStrength.org. (n.d.). http://www.dailystrength.orgDell, K. (2008, May 12). How Second Life affects real life. Time. Retrieved from http://www.time.com/time/health/article/0,8599,1739601,00.htmlEysenbach, G. (2008). Credibility of health information and digital media: New perspectives and implications for youth. Cambridge, MA: The John D. and Catherine T. MacArthur Foundation Series on Digital Media and Learning.Eysenbach, G. (2008). Medicine 2.0: Social networking, collaboration, participation, apomediation, and openness. J Med Internet Res, 10(3)(e22). doi: 10.2196/jmir.1030
  22. 22. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 22Fox, S. (n.d.). What is the ROI on love. Retrieved from http://e- patients.net/archives/2010/09/what-is-the-roi-on-love.htmlFry, J. P., & Neff, R. A. (2009). Periodic prompts and reminders in health promotion and health behavior interventions: Systematic review. J Med Internet Res, 11(2):e16. doi: 10.2196/jmir.1138Greiner, A. C., & Knebel, E. (Eds.). (2003). Health professions education: A bridge to quality. Washington, D.C.: Institute of Medicine.Gustafson, D., Shaw, B., Isham, A., Dillon, D., & Spartz, J. (2008). Exploring the potential of the Web-based virtual world of Second Life to improve substance abuse treatment outcomes. Retrieved from http://www.rwjf.org/pr/product.jsp?id=34428Heinig, M. J. (2009). Breastfeeding promotion for generations X and Y: Why the old ways won’t work. J Hum Lact, 25(3), 263-265. doi: 10.1177/0890334409341450Heinig, M. J. (2009). Lactation consultants in the larger world: Upcoming challenges and opportunities in the next 10 years. J Hum Lactation, 25(4), 395-396. doi: 10.1177/0890334409351695Herther, N. K. (2009, Nov/Dec). Digital natives and immigrants: What brain research tells us. Online, 15-21.Hopkins, J. (2006, October 11). Surprise! There’s a third YouTube co-founder. USA Today. Retrieved from http://www.usatoday.com/tech/news/2006-10-11-youtube-karim_x.htmHoyer, S., & Pokorn, D. (1998). The influence of various factors on breastfeeding in Solvenia. Journal of Advanced Nursing, 27, 1250-1256.Jensen, M. (2003). Emerging alternatives: A brief history of Weblogs. Columbia J Rev. Retrieved from http://cjrarchives.org/issues/2003/5/blog-jensen.asp?printerfriendly=yes.
  23. 23. USING WEB TECHNOLOGIES IN LACTATION HEALTHCARE 23Jones, S., & Fox, S. (2009). Generations online in 2009 (Report). Retrieved from http://www.pewinternet.org/Reports/2009/Generations-Online-in-2009.aspx:Jordan, D. N., & Jordan, J. L. (2002). Lactation management resources on the Internet. Health Care on the Internet, 6(3), 63-72. doi: 10.1300/J38v06n03-07Kahn, G. (1993). Computer-based patient education: A progress report. MD Computing, 10, 93-99.Kramer, L. W. (2010). Generational diversity. Dimens Crit Care Nurs, 29(3), 125-128.Lefebvre, R. C. (2007, Fall). The new technology: the consumer as participant rather than target audience. SMQ, 8(3), 30-42.Linden Research, Inc.. (2009). Economic statistics. Retrieved from http://secondlife.com/whatis/ economy_stats.phpLinderg, D., & Humphrey, B. (1998). Medicine and health on the Internet: The good, the bad, and the ugly. JAMA, 280, 1303-1304. doi: Retrieved fromMiller, L. C., Cook, J. T., Brooks, C. W., Heine, A. G., & Curtis, T. K. (2007, August/September). Breastfeeding education: Empowering future health care providers. Nursing for Women’s Health, 375-380.O’Reily, T. (2005). What is Web 2.0. Retrieved from http://oreilly.com/web2/archive/what-is- web-20.htmlPersonal Conversation. (2010, November 1). InJoy education stock video and customized broadcast [InJoy Video Productions comment]. Retrieved from http://www.injoyvideos.com/index.php? id=55&page_name=InJoy+Education+Stock+Video+Footage
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