Transcript Informatics & Technology in Nursing Practice

How Technology and
Informatics Has Influenced
Nursing Practice
Madeline Gervase RN,MSN,CCRN,FNP
Advanced Practice Nurse
Objectives:
• Identify the role of informatics in nursing.
• Identify the current uses of technology and how
technology will affect clinical practice.
• Understand the advantages and disadvantages
of using technology.
• Demonstrate an understanding to the
techniques and tools used to protect client
confidentiality in practice.
Informatics
• The science of
information
Skills nurses need related to
informatics & technology
• Use information & communication technology
to document & evaluate patient care, advance
patient education, & enhance the accessibility
of care
• Use appropriate technology to assess & monitor
patients
• Work on an interdisciplinary team to make
ethical decisions regarding the application of
technologies & the acquisition of data
Nursing Skills:
• Adapt the use of technologies to meet patient
needs
• Teach patients about health care technologies
• Protect the safety & privacy of patients in
relation to the use of health care & information
technologies
• Use information technologies to enhance one’s
own knowledge base
International Medical Informatics
Association
• Forty-one
recommendations for using
informatics in health care
delivery
• Identified 313
competencies for nurses
with various levels of
education & practice
responsibilities
IMIA
www.imia.org
• Two specialized areas for development:
• Informatics and healthcare delivery
• Specialists design software & create
integrated information systems for health
care delivery
IMIA Nursing Evaluation
Novice Nurse Competency:
• Novice nurse: use of administrative
application, telecommunication devices,
e-mail, database management program,
client care devices, & the Internet while
being able to find resources to address
ethical decision making related to
computing
Seasoned Nurse Competency:
• Experienced nurse: same as the beginner
with the addition of ability to use
diagnostic coding application, evaluate
computerized assisted instruction
programs, integrate selected resources
into client record, & evaluate accuracy of
health care information found on the
Internet
IMIA Competencies for the
Nursing Informatics Specialist
• Graduate education
• Able to integrate established technologies
into clinical practice
IMIA Competencies for the
Nursing Informatics Innovator
• Doctorate Degree
• Designs and develops new technological
systems, techniques, & conceptual models
for databases
• Evaluates safety, effectiveness, cost, &
social impacts of technological systems
• Researches & develops theoretical
foundations for the specialty
Components of an Integrated
Delivery System (IMIA, 1999)
• Hyperlinks to the latest information for client
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care
Nursing care planning programs
Specific client teaching materials
On-line clinical practice manuals with evidencebased nursing care protocols
Data collection for best health care practices
Client billing systems
Health care insurance reimbursement programs
Informatics & Technology in
Client Care
• Handheld monitors
• (e.g., pulse oximetry & peripheral blood
glucose monitors)
• Wireless technology with automatic nurse
paging capability when client
measurements fall outside of normal
parameters
Technology & Informatics in
Client Care :
• Computerized clinical decision-making
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programs
Nurse personal digital assistants
Care-planning software programs
Handheld clinical resource information
devices
Intravenous pumps for medication
delivery
Informatics & Technology in
Record Keeping
• Financial reimbursement applications for
services rendered
• Nursing documentation systems:
CERNER
• Integrated health record systems to
denote past medical history & allergies
• Electronic health records
Informatics & Technology in
Communication
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Wireless telephone systems
Wireless paging systems
Alphanumeric paging systems
Handheld computers to record & receive
client information
• E-mail
Components of a Health
Information System Currently
Used by Health Care Institutions
Current uses of Informatics
Applications in Healthcare:
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Admission, discharge, & transfer
Patient Access Record
Financial parameters
Physician order entry
Ancillary department
Documentation
Informatics Applications in
Healthcare:
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Scheduling
Pharmacy preparation
Acuity criteria
Specialty practice
Decision support
Communication
Critical pathways
The Nursing Informatics
Specialist Responsibilities
• Create systems to maximize the efficiency
of information use & computer
technology for clinical practice
• Develop software programs to support
nurses as they deliver client care
• Keep software management updated &
educate staff on its use & changes
Education for the Nursing
Informatics Specialist
• Thorough understanding of clinical
practice
• Detailed computer expertise
• ANA certification in nursing informatics
• Graduate nursing education programs in
nursing informatics are available
Role of the Nursing Informatics
Specialist in Technological & Health
Care Development
• Contribute specialized nursing knowledge to
systems
• Develop software programs & computer
systems that facilitate nursing care delivery
• Field test software programs
• Verify that systems (hardware & software)
address critical nursing considerations
Technological Influences to
Health Care
• In the late 1950s & early 1960s,
businesses used computers for financial
record management
• Medicare & Medicaid require data for
governmental reimbursement for
rendered services
Technology Influences:
• In 1968, Lawrence Weed developed the
Weed Problem Oriented Medical Record
Information System, the first
computerized system for client care at the
University of Vermont Medical Center
Technological Changes to
Nursing & Health Care
• LifeView Care Station for virtual house
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calls
Telehealth
Genetic advances in health promotion,
disease prevention, & illness treatment
Stem cell research
On-line educational options
Challenges of Managing HealthRelated Informatics & Technology
• Confidentiality of client health
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information
Ethics related to new therapies
Evaluating the quality of information
Information security
Potential health & personal problems
from too much technology
Our Future:
• Technological advances are advantageous
only if nurses find them useful & learn
how to use them
• Nurses may tend to focus on machinery
rather than persons in the future
• Information overload
The Future of Healthcare:
• Keeping institutional & personal systems
updated
• Impact of being dependent on electrical
or other sources of power to run
equipment
• Optical technology or other invasive
methods to confirm identity
Computer Networks
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Local area network (LAN)
Wide area network (WAN)
Internet Service Provider (ISP)
Group e-mail or list servers (Listserv)
Electronic publishing (e-books & on-line
journals)
Access Information
Requirements:
• Accurate typing skills & knowledge of an
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exact website or e-mail address
Internet server provider
A website is a series of pages posted on
the Internet
Website addresses denote the type of
server
Professional chat rooms
Thank you!