Healthcare Technology and Nursing Leadership

Progress in technology are affecting the way that most people do their jobs – and nursing is absolutely no different. With innovations in health care devices and software, technological advancements are literally transforming the way that nurses practice, involving everything from how they provide care to patients to how they handle the clinical workflow.

The nursing technology involves an array of systems, devices, and software designed to decrease the amount of time nurses must consume on tasks, for instance, locating and collaborating with other staff members, tracking down equipment, and updating patient charts. Another technology serves to develop efficiency and patient safety by decreasing health care errors and accessing sensitive patient records or preventing unauthorized individuals from entering a facility. In addition to improved efficiency and safety, accuracy, technology also permits nurses to consume more time on direct patient care.

But why should leaders and senior nurse executives promote expertise in IT acquisition, upgrading and evaluation?

Quality measures at the national level depend on health information technologies to provide data gathering, shared information, and analytic capabilities to notify approaches to care that have the potential to achieve better outcomes. As a key member of the quality assurance team, the senior nurse executives and leaders must give the infrastructure to manage and build nursing knowledge and instill accountability for following evidence-based practices.

Some might claim that the acquisition and evaluation of EHI systems are outside the field of a nursing profession and that these decisions are better left to the Information and Communications Technology (ICT) experts employed in healthcare institutions.

Permit the nurses clinicians and to do their clinical work, and allow the healthcare ICT experts to help that work with appropriate and well-designed electronic health record systems.

 User ( nurse leaders, clinicians ) involvement gives several benefits; the improvement of a rich and grounded understanding of the problems, an opportunity to build community capacity, facilitated data collection, the fostering of stakeholder cooperation, the risen likelihood of success, decreased costs to the system.

Some Exmples of The Medical Technologies That Are Changing Health Care .... 

" Google Glass Helps Truma Care "..

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Source : Allegheny Health Network

" The Orderly Robot "

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Source : Wired, Februray 2015

" A Health Check Chair "

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Informatics Nurses Are Bilingual  ..They Can Talk Nursing And Information Technology ..

Nursing Workload

What Is Workflow?

Workflow defined, is the set of responsibilities grouped chronologically into processes and the set of resources or people needed for those responsibilities, which are necessary to accomplish a given goal. An institution's workflow is comprised of the set of processes it requires to achieve, the set of people or other resources available to perform those processes, and the interactions between them.

In health care system, as in other businesses, some workflows are originated, while others arise naturally and evolve. The methods and systems by which institutions achieve specific goals vary dramatically. It is in the interaction between the processes that complexities occur. Some of these interactions hide struggles in the priorities of diverse roles in an institution, such as, what the nursing staff is responsible to versus the physician staff and its schedule. Institutions also adapt workflows to support the developing environment. Over time, reflecting on institutional workflows may show that some processes are no longer necessary, or can be optimized and updated.

Why workflow management necessary to Nurses?

Health care has frequently faced the pressure to design, or redesign, its workflows to be more effective and efficient. In many cases, the trigger for reviewing workflow is in response to alterations in how things are done. Certain day, the require to think about workflow design is numerous pressing due to many factors, containing:

1- The difficulty of coordinating care for the chronically ill.

2- The introduction of new technologies and treatment methodologies into clinical care.

3-Cost and competence pressures to improve patient flow.

4-The participation of a growing array of professionals in a patient’s care team, and new definitions of their roles

5-Implementation of reforms to make the care team more patient-focused.

6-Initiatives to ensure patient safety.

The design of good institutional workflow is not easily about developing efficiency. Workflow processes are maps that guide the health care staff how to achieve a goal. A great workflow will attain those objects promptly, driving to care that is delivered more reliably, safely, and consistently in compliance with standards of practice. A great workflow process can include differences that inevitably arise in health care through communication with another workflow processes, as well as environmental factors such as staff schedules, workload, and patient load.

Common Issue

Workflow problems usually appear in studies of technology. One great -studied domain field is bar code medication administration (BCMA).10 BCMA is a technology that has been proved to enhance care quality by increasing access to information, decreasing trust on memory, and improving compliance with best practice. 

More challenging interactions have also been observed. Due to many BCMA systems need that the doctor insert an order before the nurse can have access to the medicine, some nurses have, in critical conditions, “borrowed” medication from one patient on the ward to provide to another until the medicine for the second patient shows in the system. Consequently, the nurse cannot quickly document the administration of the order until the order has been inserted by the doctor. In some conditions, a shadow system of informal paper documentation supplements, duplicates, or confuses the documentation captured in an electronic system.

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Informatics & the Future of Nursing Practice

Technology implementation in the medical setting is not a project but rather a transformation of the delivery system. As healthcare provider recognize how to support high-quality professional practice improvement and what situations enables the profession to alter rapidly. If nurse leaders are encouraged to annex new forms of opportunities and knowledge, it can quickly enhance appropriate practice to self-adapt. That is the path to successful, innovation, and sustainable. Nurse need address the leadership challenge of how to accelerate adoption and to respond to of technologies as promising solutions, not issues, and can integrate technology into their mission and vision for meeting practice needs.    

With the assistance of nursing informatics experts, nursing leaders must continue to discuss the problems that will assist us leverage technologies to enhance care and efficiency and achieve the promise that health technology can transform care. 

Evolving Healthcare and Technology Environment

The use of simulation is quickly emerging as a preferred technique to train healthcare professional in controlled and safe manner with no hazard to patients. One of the reasons for its emergence is that simulation better than current traditional clinical practices. There is a deficiency of clinical sites; patients can have a complicated condition that novice learner is unprepared to manage and practice sites might have limited experiences for EHRs, administrating medications to pediatric patients, and other situations. These factors combined with the nurse educator and nursing deficiency and the aging population will further raise the need to educate health care provider in a simulation environment.

Newer methods that reflect the progress in technology are virtual reality computer based gaming and simulation. Standards of best practice: simulation will stay to serve as a foundation for all kinds of simulation based educating methodologies. A potential future step is the combination of the electronic health record into simulation experiences. Simulation experiences that involve EHRs are less popular. 

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" Innovative Information Technology Tools Aid Ensure Patients Get The Right are at the Right Time " 

Human Technology Interface in Nursing

When humans use technology, the software, and hardware that supports and enables the interaction is called “interface. “ At present, advanced and new technologies are emerging in nursing daily practice as defibrillators, electronic health records, and robotic surgery devices. The human-technology interfaces is relevant to patient care, nursing practice, and nursing leadership. Technology can also eliminate waste, assist in tracking staff, physicians, and patients, alleviate some staffing and workload issues, improve the efficiency of the physical environment, and facilitate the medication cycle. Additionally, technology can reduce some of the stressors that result in an emotional reaction to inefficient workflows or poor work environments.

Information systems are a critical technology but only one type of technology that can make clinical transformation. Another kind of technology is biomedical monitoring systems containing wireless telemetry monitors or noninvasive blood pressure devices used in home care and even in acute health care settings. Biomedical systems can raise patient confidentiality and privacy by doing physiological scans such as fingerprinting or retinal images to allow health care providers to have access to patient information. This technology eliminates the necessity for memorizing passwords and should discontinue the practice of recording passwords to keyboards in case they are forgotten.

An extra class of technologies are instrumental is developing patient safety. These technologies imbed computer chips that collect data and reply within a range of preset parameters. Identified as smart technology, because it performs a task we think an intelligent person can do, it involves smart beds, and smart IV pumps. Smart beds can observe patients’ vital signs and movement without using electrodes. Smart beds are able to interface with information systems to transfer information collected and notified healthcare providers when a patient is getting out of bed unattended.

Scenario 

Optimally, technology is created to decrease errors and buffer the results of errors1 by (1) eliminating errors and adverse events; (2) mitigating the effects of errors after they occur to minimize injury and; (3) detecting errors early, before harm occurs. In the ideal scenario, patient care technology would permit positive nurse, patient, and institutional outcomes. Consider all of the warning and alarms systems worked in the delivery of nursing care to recognize errors before harm. A partial list comprises warnings on IV pumps that signal occlusions, patient-initiated call bells, bed exit alarms, wandering and elopement alarms, staff-initiated code alarms, ventilator alarms, and cardiac monitor alarms.All of these alarming systems depend on the ability of the nurse to notify the alarm, process the alarming and understand what is happening, and finally, take the proper action to reduce risk to the patient.

 Human Technology Interface and The Future   

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Technology Solutions Can Make Nursing 

More Efficient & Safer

References : 

Bolton, L., Gassert, C., & Cipriano, P. ( 2008). Smart technology enduring solution. HIMSS, 22(4),24-30, available at http://www.aannet.org/assets/docs/fall_jhim.pdf

LOINC (Logical Observation Identifiers Names and Codes)

Introduction

The current health information technology environment is quickly altering worldwide. There is growing evidence that adoption of health information technology will ensure the use best practice and develop the quality of health care in a cost-efficient manner. Applying health standardized terminologies is a fundamental component of health IT adoption. These codes and terminologies facilitate clear communication a well as the aggregation and collection of medical information across setting. So Terminologies are essential to communicate and document patient care data in alignment with the care process. One of the important multidisciplinary terminologies is Logical Observation Identifies Names and Codes (LOINC).

Overview of the  (LOINC)

Logical Observation Identifiers Names and Codes (LOINC) terminology is available to public, nonprofit database that gives a group of codes and names determining clinical test and laboratory results which can be used in transmitted in electronic messages or databases. Primary evolved in 1994, it was generated and is upheld by the Regenstrief Institute, a united state nonprofit medical research institutes. The reasoning for the evolving of LOINC was to generate global codes and names for measurements used in a laboratory setting. The aim of the LOINC committee was to create codes that can be globally used by all health system and can as a therefore easily participate in clinical and laboratory information exchange (LOINC, 2016).

How (LOINC) Work 

Each LOINC measurement, observation, or test is generated using the following six axes:

1-      Component: what is evaluated and measured (for instance, hemoglobin, and glucose).

2-      Kind of property: characteristics of the component that is measured (such as, length, mass, volume, concentration).

3-      Timing of the measurement.

4-      System: the type of system or specimen ( such as, urine, blood).

5-      Scale: the measurement scale ( for instance, nominal, ordinal, qualitative, and quantitative)

6-      The method used to make the observation (optional).

Logical Observation Identifiers Names and Codes (LOINC) and Nursing  

On 18, 2002 December, the American Nurses Association (ANA) Committee for Nursing Practice Information Infrastructure recognized the (LOINC) as the 13 terminologies for use by nursing. LOINC contains different of names and codes of relevance to nursing assessments. Including codes related to vital sign, clinical assessment scales, intake and output, obstetric measurements, research instruments, and evaluation from standardized nursing terminologies. Moreover, LOINC assessment codes can assist the retrieval of related assessment data for connection with nursing diagnoses and nursing intervention to detect the effectiveness of a specific intervention. Such as, in the instance of pain, LOINC codes are for features of pain assessment (duration, severity, and quality) that are essential in detecting the efficiency of particular pain intervention (Matney, Bakken, & Huff, 2003). 

Why LOINC Important to Nursing

Recently, according to LOINC.Org states that there is a new standardized data set of more than one hundred measurable terms and coded that allows health care systems to compare accurately and assess the efficiency of their nursing care, staffing, and facilities, shit-by shift, and unit by- unit. For instance, any two hospitals can compare the staffing complement with the occurrence of catheter-associated urinary tract infections. They use the variety of EHRs, scheduling, and human resource systems. On the other hand, those systems contain the universal LOINC codes standard for reporting the following for their staff; staff turnover, staff mix, education, years of experience, and certifications. Because they apply the same codes and standard, they are now able to compare outcomes and care.

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