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Transcript of Nsg informatics
1
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
-