My last post about this topic was the oral presentation summary which got me as a finalist for the Oral Presentation Competition organized by the International Nurses Day Committee of our hospital.
This morning, all the finalists delivered their presentation on slides during the International Nurses Day Symposium. I was the last to present and I think I did good 🙂
Here’s the transcript of my speech.
TECHNOLOGY, INNOVATIONS AND INFORMATICS: EQUIPPING NURSES FOR EFFICIENCY
The world is changing. I am sure everyone would agree with me on that. It is inevitable. It is a reality. And as the world crawls into the 21st century, we are all witness to the major achievements of advancing technology, modern innovations, and high tech informatics. Modern technology has greatly improved people’s lives through different fields such as engineering, architecture, communication, computers, information systems, education, machineries and transportation.
The major achievements of technology have left man spell- bound and every part of the world today is enjoying the comforts provided by technology. However, we cannot say that technology is all good in itself. It is a two-edged sword and we have to see to what extent it has really to help improve people’s standard of living.
The health care industry is not an exception. As the world evolves into a techno-era, the way patients are treated in health care facilities are also changing. Changing societal demographics, increasing complexity in health care knowledge, and increasing nursing shortages have led health care strategists to call for a redesign of the health care system. Embedded with most redesign recommendations is the increased use of technology to make nursing practice more efficient.
The introduction of high tech equipments in hospitals is revolutionizing the way health care professionals interact with patients, deliver care and interact with colleagues.
Nurses being key members of the health care team play a very important role in driving technology, innovations and informatics to become useful tools in improving patient outcomes. Without the nurses’ hands running these high tech equipments, they will be just useless pieces of hardwares.
This presentation will discuss:
1. The current technological advances useful in nursing
2. Considerations in adopting new clinical technologies
3. How technology helps improve nursing care
4. The nurses’ role as the technology advances
I. TECHNOLOGICAL ADVANCES USEFUL IN NURSING
Technological innovation has swept the globe, and nurses have accepted the challenge this evolution brings. Modern technology has revolutionized the way nurses perform their many functions especially in the inpatient environment.
Equipment such as computer terminals on hospital units, laptops, wireless slates at the bedside are as necessary as stethoscopes for health care providers to do their jobs. Modern technology, innovations and information systems are integrated and essential parts of the heal-care practice.
Examples of technological advances that are useful in nursing practice include:
A. ELECTRONIC HEALTH RECORDS
B. PATIENT MONITORING DEVICES
C. ELECTRONIC MEDICATION ADMINISTRATION RECORDS
D. ELECTRONIC CLINICAL DOCUMENTATIONS
E. POINT-OF-CARE TESTING
F. WIRELESS COMMUNICATIONS
ELECTRONIC HEALTH RECORDS
An Electronic Health Record (EHR) (also called electronic patient record (EPR) or computerized patient record) is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations. It is a record in digital format that is capable of being shared across different health care settings, by being embedded in a network-connected enterprise-wide information systems. Such records may include a whole range of data in comprehensive or summary form, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal stats, like age and weight, and billing information.
How this technology help?
Improves quality of care. The implementation of HER can help lessen patient sufferance due to medical errors and the inability of analysts to assess quality. Information technology is being used today to automate day-to-day processes, thus helping to reduce administration costs which then in turn can free up time and money for patient care.
Computerized Physician Order Entry – one component of HER – increases patient safety by listing instructions for physicians to follow when they prescribe drugs to patients. This applies to nurses as well who reads the medication orders at the unit level. Naturally, this can tremendously decrease medical errors, eliminating scores of adverse drug events and eventually reducing costs of patient hospitalization due to errors.
Promotes evidence-based practice. EHRs provide access to unprecedented amounts of clinical data for research that can accelerate the level of knowledge of effective medical practices.
Realistically, these benefits may only be realized if the HER systems are interoperable and widespread, so that various systems can easily share information. Also, to avoid failures that can cause injury to the patient and violations to privacy, the best practices in software engineering and medical informatics are deployed.
PATIENT MONITORING DEVICES
Patient monitoring devices are electronic medical devices that measure a patient’s vital signs or other important clinical values, and displays the data so obtained, which may or may not be transmitted on a monitoring network. Physiological data are displayed continuously on a screen as the data channels along the time axis. They may be accompanied by numerical readouts of computed parameters on the original data, scuh as maximum, minimum and average values, pulse and respiratory frequencies, and so on.
This allows continuous monitoring of patients, with nurses being informed of the changes in the general condition of the patient. Some monitors can even warn of pending fatal cardiac conditions before visible signs are noticeable to clinical staff, such as atrial fibrillation and premature ventricular contraction (PVC).
ELECTRONIC MEDICATION ADMINISTRATION RECORDS
Whenever a medication is given to a patient in the hospital, it is documented on Medication Administration Record (MAR) that is stored in the patient’s charts. Up until a few years ago, this has been a manual paper process.
Electronic medication administration records (eMAR) is designed to replace the traditional paper MAR and is integrated with different applications such as Physician Order Entry, and Pharmacy Information Systems. Medication orders recorded automatically appear in the eMAR.
eMAR provides nurses and other authorized staff with an efficient online process for charting medication administration.
Benefits of the technology:
-Reduces medication errors and improves safety by minimizing transcription errors and eliminating illegible writing.
-Makes patient care information readily available to nursing staff during medication administration like critical values and comprehensive allergy and drug interaction information
-Provides physicians with a comprehensive list of patient medication use
-Provides a portable medication profile
– Maintains MAR documentation while doses are administered
-Improves the timeliness of patient order information
-Features secure and auditable record keeping
ELECTRONIC CLINICAL DOCUMENTATIONS
Electronic clinical documentations can be considered as a component of the electronic health record (EHR), but having emphasis on documentations such as admissions, nursing assessments, progress notes, care plans, vital signs and discharges. In addition to being the record of care delivery, clinical documentation is the source of much of the information needed to monitor and improve patient care, as well as improve performance overall.
Saves time for nurses. Although the results vary depending on the factors such as the portion of documentation that involves nursing, system design and configuration, and the implementation approach.
Provides standard templates for assessments, plans and notes to ensure complete data collection. Information already captured is displayed for review and update.
Allows users to perform documentation of an exception, pull data from prior stays, and select from menus rather than having to enter text, which minimizes typing and increases standardization.
Coordinates tasks and reminders to manage work and ensure compliance with regulatory and patient-safety documentation requirements.
POINT-OF CARE TESTING
Point-of-care testing (POCT) is defined as medical testing at or near the site of patient care. The driving notion behind POCT is to bring the test conveniently and immediately to the patient. This increases the likelihood that the patient, physician, and care team will receive the results in a time. POCT includes: blood glucose testing, blood gas and electrolytes analysis, rapid coagulation testing, rapid cardiac markers diagnostics, drugs of abuse screening, urine strips testing, pregnancy testing, fecal occult blood analysis, food pathogens screening, hemoglobin diagnostics, infectious disease testing and cholesterol screening.
POCT is accomplished through the use of transportable, portable and handheld instruments and test kits. Cheaper, smaller, faster and smarter POCT devices have increased the use of POCT approaches by making it cost-effective for many diseases. Examples include blood glucose meter, nerve conduction study device and the urisys urine analyzer.
Major benefits are obtained when the output of a POCT device is made available immediately within an electronic medical record. Results can be shared instantaneously with all members of the medical team through the software interface enhancing communication by decreasing turn around time.
Potential operational benefits of POCT: More rapid decision-making and triage, reduce operating times, reduce high-dependency and post operative care, reduce emergency room time, reduce number of outpatient clinic visits, reduce number of hospital beds required, ensure optimal use of professional time.
Wireless communications are playing an increasingly important role in our everyday lives, influencing all sectors of modern lifestyle in an ever more digital world, not at least in health care where accuracy and urgency not only saves money – it saves lives.
Increasingly, health care professionals will need to retrieve, store, share, and send data using several types of wireless devices. These devices include personal digital assistants, laptops, web tablets, cell phones and clothing that monitor heart rate and blood pressure.
Wireless communications are done by installing wireless access points throughout the hospital, allowing the staff to begin using the mentioned devices to communicate with each other and gain instant access to patient information. Appropriate security measures are implemented to protect patient data.
This technology helps facilitate quicker patient care decisions and a greater degree of staff collaboration, benefitting both patients and staff members. Health care providers are provided with the most up-to-date patient information, and the ability to update this information.
II. CONSIDERATIONS IN ADOPTING NEW CLINICAL TECHNOLOGIES
A thorough assessment of the impact of the new technology should be done on the nursing workflow.
The new technology program should involve the people who are going to use it.
Administrators should be involved in the selection and implementation process early on.
Adopting clinical technology requires a new skill set for nurses and nurse leaders.
The organization needs to provide training to nurse to ensure they have the appropriate knowledge base.
Nurse leaders should show competency and acceptance of the systems.
III. HOW TECHNOLOGY HELPS IMPROVE NURSING CARE
1. Increases efficiency by removing nurses from the communication chain regarding tasks that do not require their attention, such as walking to the central supply to restock bandages.
2. Improves patient safety and quality of care. Technology helps organize work and incorporate clinical knowledge and clinical decision support to provide guidance and feedback on medication administration, vital signs monitoring, and other patient care activities.
3. Helps deliver care by empowering patients and others to assume new delivery roles, thereby making nurses more efficient and effective. For example, patients at some hospitals use an interactive system to receive education about their medical condition or care received.
4. Improves collaboration and communication by routing and prioritizing messages and requests, as well as enabling immediate response to patients, caregivers and staff. One example is wireless technology integrated with patient monitors that enable nurses to respond quickly to alarms.
IV. THE NURSES’ ROLE AS THE TECHNOLOGY ADVANCES
1. Nurses should have a prominent voice with technology selection.
2. Nurses keep themselves updated with trainings and ensure they have the appropriate knowledge before using a new technology.
3. Nurses should enable safe and efficient care ensuring the benefits of technology do not become a detriment to patient care.
4. Nurses should maintain the humane part of nursing beside all these high tech equipments around the patient.
As health care organizations adopt modern technology to improve quality and patient safety, reduce errors, increase efficiency, decrease time-consuming and redundant paperwork, and enhance communication, they’re finding that modern technology can significantly impact nursing workflow.
Technological innovation has swept the globe, and nurses have accepted the challenge this evolution brings. Today, nurses work in a variety of services where they are able to make use of modern technology to provide quality and better care for their patients. These same technological advances require nurses to demonstrate knowledge and understanding that ensure the benefits of technology do not become a detriment to patient care.
These modern times are exciting times for nursing. Now nurses can provide computerized care at bedside, at the point-of-care.
It should be remembered though, that although technology is taking over many nursing functions, the presence of a nurse can never be replaced. Whatever the shape of things to come in the future, the nurses will always be there at the bedside providing the therapeutic touch that only humans can give.
Thank you and have a good day.