Download - TELEHEALTH TECHNOLOGIES
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TELEHEALTH TECHNOLOGIES
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y Clinical telehealth applications enable healthcare professionals to haveface to face meetings with patients. They can see images and hear
patient output as it is occurring or at a later time.y These applications allow professionals to view, send, or store video and
digital images for a patient assessment, diagnosis, treatment, andevaluation over video conferencing technology and computerapplications.
y In the homecare environment, telehomecare technologies assist homecare nurses to monitor a patient's vital signs, including heart and lungsounds.
y These applications also enable a nurse, who is in a remote locationrelative to the patient, to identify changing trends in the patient'sphysiological state.
y This type of technology can also assist with medication compliance anddecrease the need for in-home care or office visits.
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y It can be of great value to patients in remote locations.
yIt can help nurses in their everyday practice and provide themwith an expanded set of career choices.
y It makes it possible to share medical skills, information, andknow how.
y
It can provide nurses -- be they novices, experts, or somewherein-between -- the opportunity to play an important role in thedevelopment, deployment, and utilization of telemedicine andtelehealth applications in patient care.
y It allows clinicians to conduct remote physical assessment and
consults, as well as capture and store patient information (with astore-and-forward software application) for further evaluationand sharing with a consulting physician or nurse practitioner.
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Six areas that are important to
master in clinical telemedicine:
y Learning how to use the telemedicine medical devices as wellas audio, video, and digital software applications over phone,Integrated Services Digital Network (ISDN), or InternetProvider (IP) communication networks
y Becoming techno-savvy in using other software applicationsfor entering patient demographic data, saving, sending, andretrieving information to or from the consulting physician ornurse practitioner
y
Collaborating with information technology staff, biomedicalengineers, and telehealth physicians and nurses in one'shealth care system or hospital as atelemedicine/telehealth/e-health team.
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y Assisting in the development of telehealth guidelines,
policies, and procedures
y Reviewing and understanding the applicable Health Insurance
Portability andA
ccountabilityA
ct (HIPAA
) laws with use oftelehealth applications
y Learning the evolution of telehealth/telemedicine/e-health
technologies and how they are being used in healthcare
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The eLearning
y A Learning Management System (LMS) to automate theprocesses associated with learning management
administration, educational content development and
program delivery provides a centralized, web-based portal
for registration, course and curriculum management, studenttranscripts, testing, as well as activity tracking and reporting.
eLearning Centre to ensure that nurses across have access to
the latest information when and where they need it, nurses
can participate in online learning through the eLearning
Centre.
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TELENURSING
y The branch of telehealth that involves actual nursing and
client interaction through the medium of information
technology.
y
The nurse must strive to envision and experience the client'sthree dimensional body and being in order to accurately
advise, assess, diagnose, and interact fully and dynamically.
This perceiving must occur within the virtual network
environment, where both body-sense and body-awareness are
combined with digital information.
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THE ROLE OF TECHNOLOGY IN THE
MEDICATION USE PROCESSy Computerized provider order entry (CPOE), i s a
process of electronic entry of medical practitioner
instructions for the treatment of patients (particularly
hospitalized patients) under his or her care. These orders are
communicated over a computer network to the medical staff
or to the departments (pharmacy, laboratory, or radiology)
responsible for fulfilling the order. CPOE decreases delay in
order completion, reduces errors related to handwriting or
transcription, allows order entry at point-of-care or off-site,provides error-checking for duplicate or incorrect doses or
tests, and simplifies inventory and posting of charges.
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BAR-CODE ENABLED POINT OF CARE- Barcode scanningand wireless mobility technologies at point-of-care improvepatient safety by greatly reducing the possibility of human error.
y MedicationAdministration
Wireless mobile computers equipped with barcode scannersenable healthcare professionals to scan the patient wristband andthe medication to verify the five rights -- the right medication isgoing to the right patient at the right time at the right dose usingthe right method of administration.
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y Specimen Collection
True positive specimen identification begins at the point of
collection. Whether its blood, tissue, or fluids, accurate test
results and speedy diagnoses depend on specimens beingclearly and positively identified. Barcode scanners, wireless
data terminals and portable barcode label printers enable
healthcare professionals to positively identify specimens at
the bedside as they are collected.
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y Blood Transfusion Verification
Accurate matching of blood to patients is critically important
to avoiding life-threatening errors. Barcode scanners, mobile
computers and barcode label printers assure accuracy inidentification of blood, from the moment it is drawn to when
it is given to the laboratory.
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y An automated dispensing cabinet (ADC) is a
computerized drug storage device or cabinet designed for
hospitals. ADCs allow medications to be stored and dispensed
near the point of care while controlling and tracking drug
distribution. They also are called unit-based cabinets (UBCs),
automated dispensing devices (ADDs), automated
distribution cabinets or automated dispensing machines(ADMs). ADCs are designed to meet the exact needs of the
nurses and pharmacists that use them. When ADCs are
purchased for a facility, the order is customized for whatever
the cabinet will be specifically used for.
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y Smart pumps are designed to offer extra bedside
protection against mistakes. The pumps' software can hold an
extensive drug library that includes pre-established
maximum and minimum range doses for each medication. A
warning sounds if a staffer tries to exceed these doses. The
pump may give a "soft alert," which asks users to reconsider
whether they want to program that particular dose. A "hardalert" will not allow users to override the machine and
administer a dose outside of the library's limits.
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y A failure modes and effects analysis (FMEA) is a
procedure in product development and operations
management for analysis of potential failure modes within a
system for classification by the severity and likelihood of the
failures.
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y personal digital assistants (PDA), offer great potential
as portable communication tools that can provide
information and decision support. In one study, these devices
were shown to improve the detection and prevention of
adverse events in an ICU setting.
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y Smart cards are electronic devices the size of credit cards that
store and process medical information on a microprocessor
chip. The Department of Defense has been a leader in the use of
this technology. In much the same manner that ATM cards allow
consumers to access banking services from virtually anywhere
in the world, these smart cards would give patients a portable
means of carrying their medical information, which could thenbe accessed electronically by providers or healthcare facilities at
disparate locations. Interactive smart cards could also generate
alerts about potential adverse events resulting from medication
and other types of errors. While promising, this technologyremains in development and has not been utilized or evaluated
to a significant degree in the clinical setting.
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y High-alert medications are drugs that bear a heightened
risk of causing significant patient harm when they are used inerror. Strategies like improving access to information about
these drugs; limiting access to high-alert medications; using
auxiliary labels and automated alerts; standardizing the
ordering, storage, preparation, and administration of these
products; and employing redundancies such as automated or
independent doublechecks when necessary could decrease the
risk.
Ex. ISMPs LIST OF HIGHALERTMEDICATIONS
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y eMAR/Medication Order Entry/Administration
(MOE/MAR)
The MOE/MAR project implemented both electronic
medication order entry and an electronic medication
administration record as part of the Electronic Patient Record.
The redesign of workflow and the elimination of transcription
have improved patient safety.
Electronic Medication Administration Record (eMAR), a fully-
integrated software, eMAR with two technologies: Bluetooth(r)
wireless and hand-held scanners to read bar codes: the same bar
code technology used in supermarkets.
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TheMedication Administration Process Using eMAR
y A Physician writes the order, which is sent to the Pharmacy.
y A Pharmacist enters the order in Meditech (a specialized
healthcare software provider)
y The Pharmacy bar codes the medication and distributes to the
floors.
y The nurse views the eMAR screen and reviews the patient's
medication list and verifies with the physician orders.
y eMAR alerts the nurse about the next dose due, overdue doses,
or cautions about medications
y Nurse takes the cart to the patient, scans the medication and the
patient's wristband.