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1 Nursing Informatics SANGEETHA ANTOE NURSING INFORMATICS SANGEETHA ANTOE M.SC (N)

Nsg informatics

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Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE MSC (N)

INTRODUCTION

bull Health care is delivered in dynamic complex and ever changing environment

bull Changes in medical treatments regulations for federal and state reimbursement and public knowledge create growing demands for information

bull Computer has moved from ldquonice to knowrdquo luxury item to ldquoneed to knowrdquo

bull On average medical surgical nurse spent 34 of their time handling information

2SANGEETHA ANTOE NURSING INFORMATICS

3

Definition of Nursing Informatics

bull Nursing informatics is a combination of computer science information science and nursing science designed to assist in the management and processing of nursing data information and knowledge

-Graves amp Corcoran1989

SANGEETHA ANTOE NURSING INFORMATICS

4

Definition of Nursing Informatics (2)

bull Nursing informatics is using technology research and professional experience to manage nursing data information and knowledge to improve practice and deliver better health care

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics

5SANGEETHA ANTOE NURSING INFORMATICS

Historical development

bull Healthcare began to use computers in the 1950rsquos bull Computers in this era were typically used in the

business office bull In the 1970rsquos nursing began to realize the importance

of computers to the nursing profession and became involved in the design purchase and implementation of information systems

6SANGEETHA ANTOE NURSING INFORMATICS

Historical developmenthellip

bull In the 1980rsquos medical and nursing informatics specialties emerged

bull 1995 saw the first certification exam for NI

bull The post-2000 era saw an unprecedented explosion in the number and sophistication of both computer hardware and software

7SANGEETHA ANTOE NURSING INFORMATICS

Historical develpomenthellip

bull Telemedicine became possible and was recognized as a specialty in the late 1990rsquos

bull NI has experienced rapid growth in the last 40 years which does not appear to be slowing

8SANGEETHA ANTOE NURSING INFORMATICS

All Nurses Must

9

bullPossess computer skills

bullBe able to use applications and

bullKnow how to manage information and knowledge

SANGEETHA ANTOE NURSING INFORMATICS

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

INTRODUCTION

bull Health care is delivered in dynamic complex and ever changing environment

bull Changes in medical treatments regulations for federal and state reimbursement and public knowledge create growing demands for information

bull Computer has moved from ldquonice to knowrdquo luxury item to ldquoneed to knowrdquo

bull On average medical surgical nurse spent 34 of their time handling information

2SANGEETHA ANTOE NURSING INFORMATICS

3

Definition of Nursing Informatics

bull Nursing informatics is a combination of computer science information science and nursing science designed to assist in the management and processing of nursing data information and knowledge

-Graves amp Corcoran1989

SANGEETHA ANTOE NURSING INFORMATICS

4

Definition of Nursing Informatics (2)

bull Nursing informatics is using technology research and professional experience to manage nursing data information and knowledge to improve practice and deliver better health care

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics

5SANGEETHA ANTOE NURSING INFORMATICS

Historical development

bull Healthcare began to use computers in the 1950rsquos bull Computers in this era were typically used in the

business office bull In the 1970rsquos nursing began to realize the importance

of computers to the nursing profession and became involved in the design purchase and implementation of information systems

6SANGEETHA ANTOE NURSING INFORMATICS

Historical developmenthellip

bull In the 1980rsquos medical and nursing informatics specialties emerged

bull 1995 saw the first certification exam for NI

bull The post-2000 era saw an unprecedented explosion in the number and sophistication of both computer hardware and software

7SANGEETHA ANTOE NURSING INFORMATICS

Historical develpomenthellip

bull Telemedicine became possible and was recognized as a specialty in the late 1990rsquos

bull NI has experienced rapid growth in the last 40 years which does not appear to be slowing

8SANGEETHA ANTOE NURSING INFORMATICS

All Nurses Must

9

bullPossess computer skills

bullBe able to use applications and

bullKnow how to manage information and knowledge

SANGEETHA ANTOE NURSING INFORMATICS

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

3

Definition of Nursing Informatics

bull Nursing informatics is a combination of computer science information science and nursing science designed to assist in the management and processing of nursing data information and knowledge

-Graves amp Corcoran1989

SANGEETHA ANTOE NURSING INFORMATICS

4

Definition of Nursing Informatics (2)

bull Nursing informatics is using technology research and professional experience to manage nursing data information and knowledge to improve practice and deliver better health care

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics

5SANGEETHA ANTOE NURSING INFORMATICS

Historical development

bull Healthcare began to use computers in the 1950rsquos bull Computers in this era were typically used in the

business office bull In the 1970rsquos nursing began to realize the importance

of computers to the nursing profession and became involved in the design purchase and implementation of information systems

6SANGEETHA ANTOE NURSING INFORMATICS

Historical developmenthellip

bull In the 1980rsquos medical and nursing informatics specialties emerged

bull 1995 saw the first certification exam for NI

bull The post-2000 era saw an unprecedented explosion in the number and sophistication of both computer hardware and software

7SANGEETHA ANTOE NURSING INFORMATICS

Historical develpomenthellip

bull Telemedicine became possible and was recognized as a specialty in the late 1990rsquos

bull NI has experienced rapid growth in the last 40 years which does not appear to be slowing

8SANGEETHA ANTOE NURSING INFORMATICS

All Nurses Must

9

bullPossess computer skills

bullBe able to use applications and

bullKnow how to manage information and knowledge

SANGEETHA ANTOE NURSING INFORMATICS

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

4

Definition of Nursing Informatics (2)

bull Nursing informatics is using technology research and professional experience to manage nursing data information and knowledge to improve practice and deliver better health care

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics

5SANGEETHA ANTOE NURSING INFORMATICS

Historical development

bull Healthcare began to use computers in the 1950rsquos bull Computers in this era were typically used in the

business office bull In the 1970rsquos nursing began to realize the importance

of computers to the nursing profession and became involved in the design purchase and implementation of information systems

6SANGEETHA ANTOE NURSING INFORMATICS

Historical developmenthellip

bull In the 1980rsquos medical and nursing informatics specialties emerged

bull 1995 saw the first certification exam for NI

bull The post-2000 era saw an unprecedented explosion in the number and sophistication of both computer hardware and software

7SANGEETHA ANTOE NURSING INFORMATICS

Historical develpomenthellip

bull Telemedicine became possible and was recognized as a specialty in the late 1990rsquos

bull NI has experienced rapid growth in the last 40 years which does not appear to be slowing

8SANGEETHA ANTOE NURSING INFORMATICS

All Nurses Must

9

bullPossess computer skills

bullBe able to use applications and

bullKnow how to manage information and knowledge

SANGEETHA ANTOE NURSING INFORMATICS

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Nursing Informatics

5SANGEETHA ANTOE NURSING INFORMATICS

Historical development

bull Healthcare began to use computers in the 1950rsquos bull Computers in this era were typically used in the

business office bull In the 1970rsquos nursing began to realize the importance

of computers to the nursing profession and became involved in the design purchase and implementation of information systems

6SANGEETHA ANTOE NURSING INFORMATICS

Historical developmenthellip

bull In the 1980rsquos medical and nursing informatics specialties emerged

bull 1995 saw the first certification exam for NI

bull The post-2000 era saw an unprecedented explosion in the number and sophistication of both computer hardware and software

7SANGEETHA ANTOE NURSING INFORMATICS

Historical develpomenthellip

bull Telemedicine became possible and was recognized as a specialty in the late 1990rsquos

bull NI has experienced rapid growth in the last 40 years which does not appear to be slowing

8SANGEETHA ANTOE NURSING INFORMATICS

All Nurses Must

9

bullPossess computer skills

bullBe able to use applications and

bullKnow how to manage information and knowledge

SANGEETHA ANTOE NURSING INFORMATICS

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Historical development

bull Healthcare began to use computers in the 1950rsquos bull Computers in this era were typically used in the

business office bull In the 1970rsquos nursing began to realize the importance

of computers to the nursing profession and became involved in the design purchase and implementation of information systems

6SANGEETHA ANTOE NURSING INFORMATICS

Historical developmenthellip

bull In the 1980rsquos medical and nursing informatics specialties emerged

bull 1995 saw the first certification exam for NI

bull The post-2000 era saw an unprecedented explosion in the number and sophistication of both computer hardware and software

7SANGEETHA ANTOE NURSING INFORMATICS

Historical develpomenthellip

bull Telemedicine became possible and was recognized as a specialty in the late 1990rsquos

bull NI has experienced rapid growth in the last 40 years which does not appear to be slowing

8SANGEETHA ANTOE NURSING INFORMATICS

All Nurses Must

9

bullPossess computer skills

bullBe able to use applications and

bullKnow how to manage information and knowledge

SANGEETHA ANTOE NURSING INFORMATICS

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Historical developmenthellip

bull In the 1980rsquos medical and nursing informatics specialties emerged

bull 1995 saw the first certification exam for NI

bull The post-2000 era saw an unprecedented explosion in the number and sophistication of both computer hardware and software

7SANGEETHA ANTOE NURSING INFORMATICS

Historical develpomenthellip

bull Telemedicine became possible and was recognized as a specialty in the late 1990rsquos

bull NI has experienced rapid growth in the last 40 years which does not appear to be slowing

8SANGEETHA ANTOE NURSING INFORMATICS

All Nurses Must

9

bullPossess computer skills

bullBe able to use applications and

bullKnow how to manage information and knowledge

SANGEETHA ANTOE NURSING INFORMATICS

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Historical develpomenthellip

bull Telemedicine became possible and was recognized as a specialty in the late 1990rsquos

bull NI has experienced rapid growth in the last 40 years which does not appear to be slowing

8SANGEETHA ANTOE NURSING INFORMATICS

All Nurses Must

9

bullPossess computer skills

bullBe able to use applications and

bullKnow how to manage information and knowledge

SANGEETHA ANTOE NURSING INFORMATICS

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

All Nurses Must

9

bullPossess computer skills

bullBe able to use applications and

bullKnow how to manage information and knowledge

SANGEETHA ANTOE NURSING INFORMATICS

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Why is it importantWhy is it important

10

bullInformatics enables nurses to use information and communications technologies in the

collection of datause of informationgeneration of knowledge to support nursing practice

Nursing

Technology

SANGEETHA ANTOE NURSING INFORMATICS

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Nursing information system

11

Nursing Information Systems

bull When time and energy are at a premium using a Nursing

Information System (NIS) in acute care settings can assist in

applying nursing knowledge and wisdom to everyday care

bull Documentation can be more timely more complete and more

accurate when captured at the ldquopoint of originrdquo usually the

clientrsquos bedside in acute care settings

SANGEETHA ANTOE NURSING INFORMATICS

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

12

Functional Areas of Nursing Informatics ANA Scope and Standards of Practice

bull Administration leadership and managementbull Analysisbull Compliance amp integrity managementbull Consultationbull Coordination facilitation amp integrationbull Developmentbull Educational amp professional developmentbull Policy development amp advocacybull Research evaluation

SANGEETHA ANTOE NURSING INFORMATICS

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

The goal of nursing informaticshellip

13

bull is to improve the health of populations communities

families and individuals by optimizing information

management and communication This includes the use of

information and technology in the

bulldirect provision of care

bull in establishing effective administrative systems

bull in managing and delivering educational experiences

bull insupporting lifelong learning

bull in supporting nursing researchrdquoSANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

The Value of Nurse Informaticists

14

bull Support nursing work processes usingtechnologyndash Design systems to match clinical workflows Telehealth Home health Ambulatory care Long-term care Acute care ndash all specialties Outpatient settings Software development Redesign work flows

SANGEETHA ANTOE NURSING INFORMATICS

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

The Value of Nurse Informaticists

15

bull Increase the accuracy and completenessof nursing documentationbull Improve the nursersquos workflow ndash Eliminate redundant documentationbull Automate the collection and reuse of nursing databull Facilitate analysis of clinical data

SANGEETHA ANTOE NURSING INFORMATICS

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Using informationUsing information

bull Evidence-based practice leads tondash Determining standards and guidelinesndash Guide for decision-making processndash Determines best practice

bull Nursing informatics can enable dissemination of new knowledge ndash Practitioners update themselves of new developments

through journals conferences continuing education sessions

16SANGEETHA ANTOE NURSING INFORMATICS

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

17

Disaster Nursing Informatics

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

The Benefits of NursingInformatics

18

bull In the practice of professional nursingbull In the delivery of patient care in thehealthcare continuum

SANGEETHA ANTOE NURSING INFORMATICS

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

The Benefits of Nursing Informaticists

19

bullBenefits for nurses and the interdisciplinary team a Support for their mission to deliver high quality evidence-based care b Support for better service by facilitating true interdisciplinary carec Promotes improvement in key relationships with physicians peers interdisciplinary care team members patients and families

SANGEETHA ANTOE NURSING INFORMATICS

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

EDUCATION IN INFORMATICS

Both formal and informal education for nursing informatics are available Needs BSc (N) plus a second degree in computer science or information technology

20SANGEETHA ANTOE NURSING INFORMATICS

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Formal informatics

bull Category I- it is a graduate programs with a specialist nursing informatics focus

bull Category II- in this program students take 6 to 12 months credits of course work in informatics

bull Category III- offer individual courses in nursing informatics at both the graduate and undergraduate level

21SANGEETHA ANTOE NURSING INFORMATICS

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Informal education

bull Networking through professional organizations

bull Keeping abreast of literature byReading journalsProfessional conferences

22SANGEETHA ANTOE NURSING INFORMATICS

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Frist Nursing Informatics Center

SANGEETHA ANTOE NURSING INFORMATICS 23

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Certification

American Nurses Credentialing Center (ANCC) offers certification

bull Possess active registered nursing license

bull BSc (N) or higher Nursing degree

bull Have practiced at least 2 years

bull Have earned 20 contact hours of continuing education credit

24SANGEETHA ANTOE NURSING INFORMATICS

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

NEEDED COMPETENCIES

25SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

TECHNICAL COMPETENCIES

26

Technical competencies are related to the actualpsychomotor use of computers and other technologicalequipment Specific nursing informatics competenciesinclude the ability to use selected applications in acomfortable and knowledgeable way It is importantthat nurses feel confident in their use of computers andsoftware in the practice setting especially at thebedside in order to be able to attend to the client at thesame time

SANGEETHA ANTOE NURSING INFORMATICS

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

TECHNICAL COMPETENCIES

bull E-mail programs

bull Expert data systems

bull Multimedia

bull Telecommunication

devices

bull Nursing information systems

bull Hospital information system

27

bullWord processingbullKeyboardingbullSpreadsheetsbullPresentation GraphicsbullDatabasesbullDesktop PublishingbullPeriphereals (printersCD-ROMS DVD)bullWorld Wide Web

SANGEETHA ANTOE NURSING INFORMATICS

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

UTILITY COMPETENCIES

28

Utility competencies are related to the process of using

computers and other technological equipment within nursing

practice education research and administration Specific

nursing informatics competencies include the process of

applying evidenced based practice critical

thinking and accountability in the use of selected applications

in a comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

LEADERSHIP COMPETENCIES

29

Leadership competencies are related to the ethicaland management issues related to using computersand other technological equipment within nursingpractice education research and administrationSpecific nursing informatics competencies includethe process of applying accountability clientprivacy and confidentiality and quality assurance indocumentation in the use of selected applications ina comfortable and knowledgeable way

SANGEETHA ANTOE NURSING INFORMATICS

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

30

NI Leadership Role

bull Evidence-Based Practice

bull Computer literacy skills

bull Information literacy skills

bull Project Management skills

bull Change Management skills

bull Process Management skills

bull Information management and communication

ndash Data analysis

ndash Trending amp forecasting

bull Resource Planning Utilization amp Evaluation

ndash Technology Assessment

bull Administration

bull Safety amp quality

bull Make judgments based on data trends amp patterns

bull Consultant

bull Innovator

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Nursing Informatics ndash Future

31

bull Ubiquitous computing is becoming a reality and the continued innovation and miniaturization of technology is evident Consequently partnering between nurses in all specialties and new technologies is becoming imperative

bull The speed of information transfer and the increasing availability of communication technologies will impact nurses and informatics nurse specialists in the future making nursing practice and NI in particular more international in practices with world-wide standards competencies and curricula

SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Future of Nursing Informatics

bull Acute care outpatient care

Home carebull Need knowledgeable practitioners to investigate implement

and use automation

bull Practitioners will be hired not so much for their knowledge of skill as for their ability to handle information to make decision that produce cost effective results

32SANGEETHA ANTOE NURSING INFORMATICS

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Future of Nursing Informatics

bull Emerging rolesndash Entrepreneurs Product Developers Web design

Independent Consultants

bull Challengesndash Integration of datamdashduplication oftenndash Inability to access data for decision making

33SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTER

34SANGEETHA ANTOE NURSING INFORMATICS

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Development of modern computing

bull Phase I- Main frame era

many people share one computer

bull Phase II- PC era

one person to one computer

bull Phase III-

1 Ubiquitous computing

many computers to each person

Matsushita of Japan developed a prototype toilet that includes online health monitoring system

2 Internet

35SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

OFFICE AUTOMATION

bull Nursing office automation is the integrated electronic technology distributed throughout the Nursing administrative office

bull Affects the filing and retrieval of documents text processing telephone communication and informal meetings

36SANGEETHA ANTOE NURSING INFORMATICS

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

bull Word processing

Typed material is entered onto some form of magnetic media The equipment has the capability of easily moving sentences paragraphs or entire page to different part of the document The document can be processed against automatic spelling and grammar checker program Data can be stored and retrieved for further revision

37

OFFICE AUTOMATIONhellip

SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

OFFICE AUTOMATIONhellip

bull Electronic filing

With electronic filing system it is possible to search for documents by keywords titles originators name or date of preparation

38SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

OFFICE AUTOMATIONhellip

bull Electronic document distribution(EDD)

Used for transmitting cash reports draft of contracts questionnaires routine correspondence and other administrative documents

39SANGEETHA ANTOE NURSING INFORMATICS

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

OFFICE AUTOMATIONhellip

bull Electronic mail

It is unofficial electronic communication among individuals or office It replaces several telephone calls that would be required to impart the same message

40SANGEETHA ANTOE NURSING INFORMATICS

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Electronic Health Record (EHR)hellip

41

bull a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting Included in this information are patient demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports

SANGEETHA ANTOE NURSING INFORMATICS

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

EHRshellip

42

bull The EHR has the ability to generate a complete record of a clinical patient encounter as well as supporting other care-related activities directly or indirectly via interface ndash including evidence-based decision support quality management and outcomes reporting

SANGEETHA ANTOE NURSING INFORMATICS

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

E-health

43

bull E-health is a client-centered World WideWeb-based network where clients andhealth care providers collaboratethrough ICT mediums to research seekmanage deliver refer arrange andconsult with others about health relatedinformation and concerns

SANGEETHA ANTOE NURSING INFORMATICS

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Nursing Roles in E-health

44

bull health advisorsbull Internet guides to help clients select reliable information resourcesbull support group liaisonsbull web information providersbull Nurses need to be involved in the design and implementation of E-health portals and programs that provide the best possible experience for health care clients

SANGEETHA ANTOE NURSING INFORMATICS

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Tele-nursing

45

bull Telenursing is the branch oftelehealth thatinvolves actualnursing and clientinteraction throughthe medium ofinformationtechnology

SANGEETHA ANTOE NURSING INFORMATICS

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Benefits of Tele-nursing

46

bull Nurses can actually view healing wounds canaccess physiological monitoring equipment tomeasure physical indicators such as vital signsand provide routine assessment and follow-upcare without the client having to travel to thehealth care agency for an appointmentbull New technologies have added a visualcomponent to the interactions that augmentsthe historic audio exchange

SANGEETHA ANTOE NURSING INFORMATICS

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Interaction with other health care professionals

47SANGEETHA ANTOE NURSING INFORMATICS

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Computerized documentation system

48SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED DOCUMENTATION SYSTEM

1 Auditing

Computers are making it possible to audit records on an ongoing basis and provide feedback to care providers on the completeness of their documentation

49SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

2 Billing systems

Entering both patient information and a provider password into a computer inorder to access supplies or medications

This means no items can be taken without proper authorization and expenses can be attributed to the appropriate patient

50SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

3 Patient information retrieval

Results of lab and diagnostic tests have been posted to computer records made rapidly available to those who need it

51SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

4 Order entry

aEntry of physicians order lab tests diagnostic tests and therapies is recorded

b eliminate source of error such as illegible handwriting mistakes regarding abbrevation and confusion over spelling of similar drug names

52SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

5 Nursing data entry

Many long term care facilities have nurses complete assessment forms such as minimum data set (MDS) and they have a data entry person in medical records enter the data in order to facilitate the computerized billing process

53SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

6 Computerized medication administration system

computerization of all medication records along with bar coding of the medications and patient identification bands

54SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Drug reference

bull References regarding diagnostic tests

bull Policy and procedure manual

bull Medical center library reference

bull Copies of journals

bull bed management

55SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Nursing service information

bull To bleep

bull Staff information

bull Patient search

bull Bill checking

bull ECT list posting

bull Admission recording56SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED DOCUMENTATION SYSTEM contrsquod

Other computer resources

bull Entering transfer discharge

bull Salary

bull Weekly institution news

bull Staff meetings

bull E-mail to the authorities

57SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED PATIENT RECORDS

bull Computerized patient record (CPR) or electronic patient record include all information about an individualrsquos life time health status and health care

bull Include information on Allergies History of illness and injury Functional status Diagnostic studies Assessments Orders Consultant reports Treatment records

58SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED PATIENT RECORDS- contrsquod

bull Also includes wellness information Immunization history Behavioral data Environmental information Demographics Health insurance Administrative data for care delivery processes Legal data such as consents

59SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED PATIENT RECORDS-contrsquod

1 Data capture

bull Refers to the collection and entry of data into a computer system

2 storage

bull Health data are distributed across multiple systems at different sites

bull Needs common access protocols retention schedule and universal identification

60SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED PATIENT RECORDS- contrsquod

3 Information Processing

bull Computer processing functions provide for effective retrieval and processing of data into useful information

bull These include decision support tool such as alerts and alarms for drug interactions allergies and abnormal lab results

bull Reminders can be provided for administration medication administration

61SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED PATIENT RECORDS-contrsquod

4 Information communication

it refers to the interoperability of systems and linkages for exchange of data across disparate systems

5 Security

ensures security as only authorized users with legitimate uses have access to health information

62SANGEETHA ANTOE NURSING INFORMATICS

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTERIZED PATIENT RECORDS-contrsquod

6 Information presentation

authorized care givers should have the information they need in their preferred presentation form

Eg nurses needs data in detail

blood donation centers need not need much

63SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Information resources through Internet

1 E-mail access

E- mail allows to send and receive messages rapidly around the world

Specific names

gov- governmental agencies

edu- educational institutions

com- commercial companies

org- non profit organizations64SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Information resources through Internet contrsquod

bull Uses of E-mail

1Contact experts in the field

2Ask specific questions of manufactures regarding the use of their products

3Seek answers to questions from Governmental agencies

4Share information with other health care professionals

65SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Information resources through Internet-contrsquod

bull Group discussion online

1It is a means for many individuals to send and receive messages from a large number of people with a similar interest

2Types

bull Listserv

bull newsgroup

66SANGEETHA ANTOE NURSING INFORMATICS

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Information resources through Internet-contrsquod

bull World wide web

it is a use of the Internet for the connection of computers that all use a common protocol for information exchange

67SANGEETHA ANTOE NURSING INFORMATICS

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

COMPUTER ASSISTANCE

bull Maintenance of health records

bull Health security card

bull Use of ROBOTS

bull Reduce error and give certitude to the clinical planning process

SANGEETHA ANTOE 68NURSING INFORMATICS

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

VIDEOCONFERENCING AND WEB BASED CONFERENCING

bull Helps to discuss the health problems of community people who cant get access to tertiary hospitals

SANGEETHA ANTOE 69NURSING INFORMATICS

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Uses of Computer in Hospital and Community

70SANGEETHA ANTOE NURSING INFORMATICS

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

71

Physician writes order Secretary completes paper work

Nurse validatesNurse corrects Nurse contactPhysician

Secretary sends to pharmacy

PHARMACY ORDER MANUAL PROCESS

SANGEETHA ANTOE NURSING INFORMATICS

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

PHARMACY ORDER AUTOMATED PROCESS

Physician enters order in computer

pharmacy receives order

72SANGEETHA ANTOE NURSING INFORMATICS

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

73

bull Workload statistics

bull Performance monitoring

bull Performance Improvement projectsndash Identification of problem areas ndash Before amp After data

bull Regulatory compliance

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

74

bull How many new orders written on Ward X in a daybull How many medications given on Ward X in a week bull Show me all restraint orders for the past monthbull List patients in the hospital for gt24 hours without a

VANOD skin assessment

Data Management

SANGEETHA ANTOE NURSING INFORMATICS

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

75

Education

Clean up those te

xt orders

Unsigned notes

Q72h orders

Hold Orders

Splitting tablets

Antibiotic

Stop D

ates

SANGEETHA ANTOE NURSING INFORMATICS

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

76

How are Presence amp Caring Conveyed

SANGEETHA ANTOE NURSING INFORMATICS

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Clinical Reasoning Software

77SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Clinicianrsquos Access to Paper Record

78

bullAttending PhysicianbullNursingbullConsulting Physician(s)bullRespiratory CarebullCase ManagementbullNutritional ServicesbullRisk ManagementbullIV TeambullPatient Financial ServicesbullInfection ControlbullWound ManagementbullPastoral CarebullClinical Process ImprovementbullCardiologybullPTOTSpeechbullOthers

BARRIERSbull Record must be on unitbull All clinicians and supportpersonnel must walk tolocation of chartbull One person can access thechart at a timebull Legibility of chart inputbull Timely filing of data resultsinto chartbull Finding clipboard for mostcurrent information

PATIENT CHART

SANGEETHA ANTOE NURSING INFORMATICS

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Clinicianrsquos Access to Online Record

79

1048707Attending Physician1048707Nursing1048707Consulting Physician(s)1048707Respiratory Care1048707Case Management1048707Nutritional Services1048707Risk Management1048707IV Team1048707Patient Financial Services1048707Infection Control1048707Wound Management1048707Pastoral Care1048707Clinical Process Improvement1048707Cardiology1048707PTOTSpeech1048707Others

BARRIERSbull Systems Availabilitybull User Acceptance

ELECTRONICPATIENTDATA

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

BENEFITS

80

bull Integrated Hemodynamic Monitors (Vital Signs) with EMRbullVital signs are automatically updated to the patientbull Eliminates paper documentation and accuratelycaptures patient information at the point of carebull Devices are fixed in the patient room or mobile on COWs (Computers on Wheels)

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

BENEFITShellip

81

bull Hand-held Devices for Data Collection amp Inputbull Assist with obtaining verifying and communicatingdatabullCardiology Transplant and other clinically significantdata can be entered directly onlinebull Eliminates the need for bulky data collection sheetsbull Enhances the ability for version control of data entrydocuments

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

BENEFITShellip

82

bull Online Fully Integrated MedicationbullAdministration RecordbullSignificant time reduction associated to documenting medicationsbull Significant time reduction associated with transcription of medications to paper MARbullDecreased transcription errorsbullIncreased patient safety

SANGEETHA ANTOE NURSING INFORMATICS

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Medication Administration Record

83

before

after

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

BENEFITShellip

84

bull Online and Integrated Rules and Alerts (Workflow)bull Drug-allergy alerts based on order entry functionalitybull Drug-drug interaction alertsbull Alerts for abnormal lab values and vital signsbullAlerts for new ordersbull Alerts for order renewalsbull Alerts for scheduled patient events

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

BENEFITShellip

85

bullCPOE ndash Computerized Provider Order Entrybull Nurses no longer struggle to read physician handwritingbullReduces verbal ordersbull All providers can enter orders directly onlinebull Integrated rules and alertsbullIntegrated allergy checkbull Decreases chances for transcription errorbull Reduces delays in patient care

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

BENEFITShellip

86

bullBar Code TechnologybullBarcodes on patient bands and medication packaging helps to double check that the right medication is being given to the right patient at the right timebullSystem alerts the nurse immediately if any inconsistencies or potential problems exist

SANGEETHA ANTOE NURSING INFORMATICS

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

BENEFITShellip

bull Health information technologies help patient to know more about their health status

bull Patient can inform their health condition to therapist through mail

87SANGEETHA ANTOE NURSING INFORMATICS

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Monitoring of programmes in community

Health Information System (HIS) facilitates effective monitoring of programmes

Eg In Brazil the National AIDS control programme of the federal Government is linked with the AIDS control programmes of Brazilrsquos 27 states and 150 municipalities through computer based information system(SICLOM)

88SANGEETHA ANTOE NURSING INFORMATICS

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

National Rural Health Mission( NRHM)

The Accredited Social Health Activist (ASHA)- in each of the 6 lakh villages of the country so that the medical needs of the people living in remote areas could be taken care of ASHA would be connected with a telephone as well as a computer with the rest of the facilities in the public health care chain

89SANGEETHA ANTOE NURSING INFORMATICS

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Primary health center

bull Designed to lessen the paperwork responsibility get better data accuracy and facilitate village health worker to provide timely care and information to the rural and semiurban population

bull 2 projects were disigned for this

1Health Management Research Institute

2Emergency Management Research Institute

SANGEETHA ANTOE NURSING INFORMATICS 90

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Health management Research Institute(HMRI)

bull HMRI in association with Govermnent of India (GOI) and satyam foundation hyderabad provides health care services on call over a toll free no lsquo104rsquo which is available round the clock

bull Services include medical advice counselling information tele medicine tele monitoring and hospital management

91SANGEETHA ANTOE NURSING INFORMATICS

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

HMRIhellip

bull People can have access to the details of dispensaries diagnostic centres medical shops and hospital in the locality medical colleges rehabilitation canters

bull Field workers engaged in monitoring of epidemics outbreaks and analyzing the morbidity trend of their village contact this response center(104) and give information to the Integrated disease surveillance programme (IDSP)

92SANGEETHA ANTOE NURSING INFORMATICS

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Emergency Management research institute(EMRI)

bull Satyam computers with the collaboration of Government is providing emergency response services which enables distress calls

bull It reaches out to rescue people involved in critical accidents and emergencies

93SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Other uses in community

bull Community information

bull Monthly report (no of birth immunization communicable disease deaths delivery)

bull Planning for programme

bull Planning for mobile clinic with regard to the information

bull Vital statistics

bull Hospital statistics94SANGEETHA ANTOE NURSING INFORMATICS

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Other uses in community

bull Community mapping

bull Research

bull Epidemic outbreak

bull Demographic characteristics of population

bull Mass education

95SANGEETHA ANTOE NURSING INFORMATICS

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Ethics

96SANGEETHA ANTOE NURSING INFORMATICS

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Privacy Security Confidentiality

97

bull Protected by Policies amp Proceduresbull Security refers to technological organizational or administrative processes designed to protect data systems from unwarranted access disclosures modification or destruction

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

ETHICAL IMPLICATIONS

1 CONFIDENTIALITY Develop policies and procedures to ensure confidentiality Limit the time that information is left on the screen Placement of computer terminals A mechanism to determine which individuals are requesting

sensitive information Creating passwords- change routinely Create level of access

98SANGEETHA ANTOE NURSING INFORMATICS

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

2 EMPLOYEE ACCESS Policies and procedures regarding

a How employee can obtain accessibility

b For what reason they wish to access accessibility

c What information can be accessed

d What information is confidential and has limited access The access code should not be in alphabetical or numerical

order

99

ETHICAL IMPLICATIONS contd

SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

ETHICAL IMPLICATIONS contd

3 PATIENT PRIVACYPrivacy of information obtained from the

patient and family members must be protected from those may ldquo abuserdquo such information

100SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

ETHICAL IMPLICATIONS contd

4 ACCURACY OF DATA INPUT

bull Policies and procedures regarding entry of information into computerized records accurately and in timely manner

bull Orientation and training programme must be developed

101SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

ETHICAL IMPLICATIONS contd

5 PATIENTrsquoS RIGHT TO A COPY OF THE MEDICAL RECORD

bull Policies and procedures regarding when a patient or patientrsquos attorney can actively obtain a copy of computerized chart

102SANGEETHA ANTOE NURSING INFORMATICS

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

ETHICAL CONCEPTS

bull Know the importance of confidentiality

bull Know about the laws regarding computer information

bull Be concerned about what data is collected and how the data is used

bull Be concerned about the dehumanisation of patient care

bull Know about ethical legal issues

103SANGEETHA ANTOE NURSING INFORMATICS

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

ROLE OF NURSE MANAGER

104SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Evaluation of information found on the Net

1 PURPOSE What is the authors purpose in developing the

site Are the authors objective clear Many people will develop website as a hobby There should be congruence between author

purpose and ours

105SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Evaluation of information found on the Nethelliphellip

2 LINKSEvaluate the links at the site Are they workingDo they link to reliable sitesCheck for dead links

106SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Evaluation of information found on the Nethellip

3 EDITORIALIs the information in the site accurate

comprehensive and currentWho is the consumer of the siteIs the information presented in an appropriate

format for the intended audience

107SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Evaluation of information found on the Nethellip

4 AUTHORWho is the author of the siteDoes he has appropriate credentialsIs the author clearly identified by name and is

contact information providedCheck for webmaster and author

108SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Evaluation of information found on the Nethellip

5 SITEIs the site easy to navigateDoes it download quickly

6 ETHICALIs there contact information for site developer

and authorIs there full disclosure of who the author is

and the purpose of the site109SANGEETHA ANTOE NURSING INFORMATICS

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Evaluation of information found on the Nethellip

6 DATEWhen was the site last updatedDoes the information need to be updated

regularlyBe concerned with sites that have not been

updated within 12 to 18 months

110SANGEETHA ANTOE NURSING INFORMATICS

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Examine and Describe

111

bull Target environment

bull Current Situation

bull Projected Situation

bull New amp Emerging

Technologies and Resources

bull Key Information Sources

bull Emerging Issues

SANGEETHA ANTOE NURSING INFORMATICS

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Implementation tips

1 Be prepared to implement change within change

bull Personnel change

bull Organizational change

bull Technological change

1 Requires economic justification

2 All groups will demand something immediately

3 Be prepared to violate some classical principles now and then

4 Develop and implement in phases

112SANGEETHA ANTOE NURSING INFORMATICS

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Implementation tipshellip

6 Anticipate that software will be a problem area

bull Buy donot build office automation software

bull Do not be a testing ground for new software

7 Be aware of automation paradox

bull Demand will exceed supply

bull Full automation capabilities will not be used

8 Biggest challenge is people challenge

9 There will be always something you didnrsquot think of

10 Establish standard software and communication protocol

113SANGEETHA ANTOE NURSING INFORMATICS

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Ergonomicshellip

114

bull comes from the Latin ergos (to work) and nomos (knowledge)bull the science of using knowledge of work activities and the human bodyrsquos limitations to structuring work environments orfitting the work to theworker

SANGEETHA ANTOE NURSING INFORMATICS

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Ergonomic Assessment

115

bull Is your computer workstation safe andergonomically situatedbull If not what do you need to change towork in an ergonomically supportedenvironmentbull What about using PDAsbull Or Laptopsbull Or Cell Phones

SANGEETHA ANTOE NURSING INFORMATICS

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

PPE for Computers

116

bullPersonal Protective Equipment

ndashAntiviralsndashFirewallsndashOperating System Updates

SANGEETHA ANTOE NURSING INFORMATICS

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

117

Implications

Evaluation of the organizationrsquos current Informatics infrastructure should be conducted

ndash Annually

ndash Anytime upgrades are made

ndash As patient populations served change

ndash As care delivery programs change

Nursing leadership must be sensitive to the importance of planning for adequate budgetary resources (personnel hardware and software)

SANGEETHA ANTOE NURSING INFORMATICS

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

Barriers

bull Expensive

bull Training to staff

bull Initial resistance from staff

bull Adoption is time consuming process

bull Aged and outdated equipment calls for replacement due to technological changes which adds to the cost

118SANGEETHA ANTOE NURSING INFORMATICS

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

119

ldquoInnovation distinguishes between a leader and a followerrdquo

- Steve Jobs

conclusionconclusion

SANGEETHA ANTOE NURSING INFORMATICS

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

SANGEETHA ANTOE 120NURSING INFORMATICS

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121

121

THANK YOUSANGEETHA ANTOE NURSING INFORMATICS

  • Nursing Informatics
  • INTRODUCTION
  • Definition of Nursing Informatics
  • Definition of Nursing Informatics (2)
  • Nursing Informatics
  • Historical development
  • Historical developmenthellip
  • Historical develpomenthellip
  • All Nurses Must
  • Why is it important
  • Nursing information system
  • Functional Areas of Nursing Informatics ANA Scope and Standards of Practice
  • The goal of nursing informaticshellip
  • The Value of Nurse Informaticists
  • Slide 15
  • Using information
  • Disaster Nursing Informatics
  • The Benefits of Nursing Informatics
  • The Benefits of Nursing Informaticists
  • EDUCATION IN INFORMATICS
  • Formal informatics
  • Informal education
  • Frist Nursing Informatics Center
  • Certification
  • NEEDED COMPETENCIES
  • TECHNICAL COMPETENCIES
  • TECHNICAL COMPETENCIES
  • UTILITY COMPETENCIES
  • LEADERSHIP COMPETENCIES
  • NI Leadership Role
  • Nursing Informatics ndash Future
  • Future of Nursing Informatics
  • Slide 33
  • COMPUTER
  • Development of modern computing
  • OFFICE AUTOMATION
  • OFFICE AUTOMATIONhellip
  • Slide 38
  • Slide 39
  • Slide 40
  • Electronic Health Record (EHR)hellip
  • EHRshellip
  • E-health
  • Nursing Roles in E-health
  • Tele-nursing
  • Benefits of Tele-nursing
  • Interaction with other health care professionals
  • Computerized documentation system
  • COMPUTERIZED DOCUMENTATION SYSTEM
  • COMPUTERIZED DOCUMENTATION SYSTEM contrsquod
  • Slide 51
  • Slide 52
  • Slide 53
  • Slide 54
  • Slide 55
  • Slide 56
  • Slide 57
  • COMPUTERIZED PATIENT RECORDS
  • COMPUTERIZED PATIENT RECORDS- contrsquod
  • COMPUTERIZED PATIENT RECORDS-contrsquod
  • Slide 61
  • Slide 62
  • Slide 63
  • Information resources through Internet
  • Information resources through Internet contrsquod
  • Information resources through Internet-contrsquod
  • Slide 67
  • COMPUTER ASSISTANCE
  • VIDEOCONFERENCING AND WEB BASED CONFERENCING
  • Uses of Computer in Hospital and Community
  • Slide 71
  • PHARMACY ORDER AUTOMATED PROCESS
  • Slide 73
  • Slide 74
  • Slide 75
  • Slide 76
  • Clinical Reasoning Software
  • Clinicianrsquos Access to Paper Record
  • Clinicianrsquos Access to Online Record
  • BENEFITS
  • BENEFITShellip
  • Slide 82
  • Medication Administration Record
  • Slide 84
  • Slide 85
  • Slide 86
  • Slide 87
  • Monitoring of programmes in community
  • National Rural Health Mission( NRHM)
  • Primary health center
  • Health management Research Institute(HMRI)
  • HMRIhellip
  • Emergency Management research institute(EMRI)
  • Other uses in community
  • Slide 95
  • Ethics
  • Privacy Security Confidentiality
  • ETHICAL IMPLICATIONS
  • ETHICAL IMPLICATIONS contd
  • Slide 100
  • Slide 101
  • Slide 102
  • ETHICAL CONCEPTS
  • ROLE OF NURSE MANAGER
  • Evaluation of information found on the Net
  • Evaluation of information found on the Nethelliphellip
  • Evaluation of information found on the Nethellip
  • Evaluation of information found on the Nethellip
  • Slide 109
  • Slide 110
  • Examine and Describe
  • Implementation tips
  • Implementation tipshellip
  • Ergonomicshellip
  • Ergonomic Assessment
  • PPE for Computers
  • Implications
  • Barriers
  • Slide 119
  • Slide 120
  • Slide 121