New Technological Advances and Trends in Nursing- Update
Wednesday 28 October Academic Year 1437
Umm Al- Qura University College of Nursing
Faculty of Medicine
Dr Grace Lindsay Professor of Medical Surgical NursingCollege of NursingUmm Al-Qura University
Information search
Term- Healthcare technologiesGoogle Scholar
Medline
Convenience sample of users
Purpose of session• Overview of trends and
practices using new information technologies (IT)
• Consider IT applications and their impact on practice, safety and effectiveness
• Explore possible areas for development in existing teaching programmes
• Discuss areas for investigation and research
Historical perspective• Late 1940s…’nursing the
equipment trend’..therapy oreintated
• 1950-1960s …new medications (e.g.antibiotics), IV therapy, blood/+products
• 1960s-80s…’machines of all kinds’..dialysis, cardiac monitors, automated recording devices
• 1980s onwards..computers in healthcare; patient safety monitors, wireless charting, robotics, telehealth +++
Benefits of new technology• Efficient storage and retrieval of data• Access to information• Communication• Organise and coordinate routine processes e.g
appointments; action prompts• Summarise and generate activity reports• Being made easier to use through – Portable devices– Friendly user interface– Wireless , satellite, cable media
Functions enhanced by use of new technologies
• Faster data collection• Stores large amounts of
data• Easy access by many• Reduces duplication• Interactive-prompts; Access
to information sources; measurement tool scoring
• Smart Technology: Early warning systems; falls risk +++
• Analysis/interpret data inputs (direct/indirect)
• Subtle trends identified in ‘real-time’
Applications of IT
• Drug information including, action, dosage, interactions etc
• Clinical guidelines• Decision-making• Accessing patient
medical records• Access to most recent
tests/investigations
• Call centresDirecting health
enquires via computer-based algorthims
Decision-making function
Triage and immediate management in Emergency room
Canadian Triage Score• Vital signs, preliminary
clinical assessment made• Code of urgency assigned• Monitoring schedule
selected• Surveillance coded via vital
signs• Alarm and decision-making
output (!!noise issues!!)
Feedback on Emergency Triage System
• Good for inexperienced
• ‘Cumbersome’• Time consuming for
experienced staff
IT systems: Point of Care Devices (POC)• Array of devices, systems,
software• Quicker access to
information at patient level
• Aim to reduce time on task such as– Finding equipment– Collaborating with other
staff– Ordering tests– Updating patient records– Appointment scheduling
Point of Care Devices-Evaluation studyLarge survey in Australia
• 60% reduction in vitals signs documentation (30mins/nurse/shift) saved
• Clinical data latency reduced by • more than 2 hrs
• 83% reduction in data items needed to be transcribed
• Time-consuming computer log-ins reduced by 20%
• 20% increase in automated vital sign acquisition and POC charting
Nursing Informatics and technology: A blog for all level users Jan 2011
Some examples Smartphones use in self-management
Chronic disease management• Support patient self-
monitoring• Diet, exercise, BP,
HR, lifestyle choices• Keeping logs of actions
and results (e-diaries)• Providing guidance on
care management• Can aid consultations with
HCP
•No easy access for back-up advice/interpretation
Benefits (cont.)• Aids decision making
in ‘real time’• Access many sources
of patient and professional information through single portal
• Travels with you• Telephone, computer
and internet access at your fingertips!
Store and access large volume of written materials
Quick access to clinical guidelines at point of use
Specific use in practice: Pharmacy
• Pharmacists advising on therapy administration working at ward level ‘must’ have portable ‘Internet access device’ for complex protocols used in practice
• Bar scanning medications
Technology in a contemporary health care setting
Note:Patient also IT engagedConcern of possible reduction in inter-personal relationships...???could have ‘computers talking to computers’
Implementation of new technology strategy: considerations
• Technical design should be ‘user-friendly’
• Good interfaces with user/task/ patient/other tasks
• Integration with other aspects of healthcare environment
• Cost-effective??• Enhance standards and
quality of care
• Education and Training• Support and
maintenance• Compatibility with other
devices• Long ‘shelf-life’
Engagement of technology in practice
Some concerns (1)...• Personal and professional
technology has outpaced policy and codes of practice and education????
• Reduction in inter-personal interactions
• Wi-fi networks; hard wire systems-limited access
• Mainframe server access; security; maintenance; manager
• Supplier of devices (approval); cost of usage?
• Staff training• Quality control and standards
Complexity and danger
Existing hospital infrastructure not always able to cope with the pace of technology
Some concerns (2) …..• Ever advancing
systems/devices• Compatibility with other IT
systems• Can be distracting from
patient care• Could be construed as being
used for recreational purposes• Security; confidentiality;
backup• Energy maintenance• IT support; calibration• Back up data
• Data integrity failures with health IT systems
• Poor care coordination with next level of care
• Reporting errors of test results
• Drug shortages• Inadequate management
of behavioural issues in acute settings
• Mislabelled specimens• Retained devices /un-
retrieved fragments• Patient falls while toileting• Inadequate monitoring of
respiratory depression in patients taking opiates
• Inadequate re-processing of endoscopes and surgical instruments
Emergency Care Research Institute . http://www.ECRI.org/2014hazards
Don’t loose sight of the patient in electronic cyberspace!!
Educator Role …….application, management and generation of new knowledge
Tele-medicine
Practice
ResearchEducation
New technologies: ? position in current activities
Research: possible areas
• Infection control• Family health care• Quality
• Evaluation of Self-care monitoring with tailored feedback in chronic disease; health promotion
• Acceptability by patients, clinical staff of existing and new systems
• Monitoring CQI’s in relation to impact of new technologies
• Pattern tracking e.g.errors; root cause analysis
Research Strategy taking into account role of existing and emerging technology• Feasibility /Acceptability • Outcome Evaluation– Pre-post test comparisons
• Devices can be research tools in own right
Implications for nurse educationReflect use and application of new technology to
curriculum– Fundamentals of Nursing– Communication– Documentation– Evidence-based practice– Patient care support– Diagnostics– Supporting patients in the use of electronic devices– Interpretation of patient self-care schedules– Critical appraisal
Thank you
DiscussionPoints of discussion this topic or future areas
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