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DataBook is a computer application developed to assist the nurse manager in collecting, assessing and monitoring unit data on a day-to-day and summary basis. Once captured, this information can then be presented to create "information snapshots" of unit characteristics. Utilizing a PC-based spreadsheet program, the application is designed to be used by individuals with a modest degree of computer literacy.
From bedside to boardroom, physicians are coming on-line to use automated information systems. Physicians are increasingly able to scroll through computer screens to scan images and lab summaries. But they will obtain their most critical data by listening to, observing, and examining patients. Practitioners will be driven in two diagnostic realms by informatics: acute care and chronic care. Training of both internists and surgeons will be enhanced. Nurses will be able to take on more of doctors' work. Telemedicine may eventually reduce patient visits to the office and doctors' trips to the emergency department. Health care system management is strengthened and network message traffic smoothed by informatics, but lack of trust will slow acceptance.
This is a descriptive study which subject concerns the interfaces of technological production with nursing. Its objectives is to analyse the interface of technological production with nursing and to discuss that production on the following dimensions: instructional, instrumental and informatic. To develop this the summaries of the papers presented during the last three editions of the Congresso Brasileiro de Enfermagem--1998, 1999 and 2000 were used as a source of information. The inherent subjectivity of a study of summaries was considered a limitation, since it is possible that a miscomprehension between our understanding and the real idea of the author occur. This study showed that Nursing, even in an incipient manner, has been producing constitutive components of the technological production, on its daily work.
This paper illustrates the implementation of a computerized guideline for pressure ulcer prevention. In particular, it describes the aspects related to the site-specification of a guideline delivered by the Agency for Health Care Policy Research (AHCPR), to its integration with the electronic patient record, and to its implementation within the clinical routine. The primary goal of the system is both to facilitate nurses assessing the risk of ulcer development, and to manage patients at risk by producing daily prevention work-plans. Concerning this functionality, particular attention has been paid to manage nurse's non-compliance with the guideline suggestions and to collect data for evaluating the guideline impact. Moreover, since it is well known that nurses are often over-loaded, the human computer interaction has been studied in such a way to optimise the time spent for data input. An additional functionality of the system is the novice nurses' education - they can browse a graphical representation of the guideline, asking details about the different tasks, and they can simulate patients to obtain real-time advice. The educational tool is written in Java and it is based on a representation of the guideline as a relational database. A preliminary evaluation of the system has been performed and the results are presented on the management of about 40 patients.
Health care outcomes are clearly impacted by the ability of clients to participate in their health care. Nurses have always used education to empower their patients. With the advent of the Internet the concept of patient education has been transformed to the much broader concept of consumer informatics. For increasing numbers of clients the Internet has become a primary source of health information and a major factor influencing their knowledge and decisions related to their health. Successful use of the Internet depends on several different levels and types of literacies. This paper explores the interrelations between the concepts of basic literacy, computer literacy, information literacy, health information literacy and health literacy. It demonstrates the need for client assessment tools that are sensitive to each of these literacies and their interrelations. In concludes by challenging consumer informatics specialists to develop these assessment tools as well as teaching tools for empowering consumers using the Internet.
Congress enacted Health Insurance Portability and Accountability Act (HIPAA) in 1996 to limit the ability of an employer to deny health insurance coverage to employees with preexisting medical conditions. The law also directed the U.S. Department of Health and Human Services to develop privacy rules, including, but not limited to, the use of electronic medical records. This law has increased patient privacy, but in doing so has added to the financial burden, including personnel costs in health care. Nurses stand at the forefront in the resolution of the dilemma of patient privacy versus health care expediency. The purpose of this article is to assist nurses and other health care professionals to better understand their responsibilities regarding HIPAA regulations. First, responses to HIPAA regulations by covered entities to date, along with responses which are still needed, will be described. It will be noted that HIPAA is a work in progress and not a specific act. Next, future initiatives having HIPAA implications will be presented. In conclusion, the need for all covered entities and their personnel to look broadly at HIPAA as initiating a new way of work in health care will be emphasized.
Computer-generated information is becoming increasingly important in nursing. Nursing schools are faced with the need to ensure that students have basic informatics skills and rudimentary computer literacy. This article describes the introduction of an assignment using electronic communication skills within a teaching-learning course in a baccalaureate program. The assignment was designed to introduce the students to several tasks that would be useful to them in their studies as well as in their care of clients. Students learned to send electronic mail, post to a class list, use search engines, access libraries, and critique web pages. They developed increased confidence and skill, advancing from informed user to proficient user status as identified by Ronald & Skiba. The students' appraisal of the assignment in terms of value to their nursing education and their nursing careers indicated that they recognized the value of these skills for their professional nursing lives. Activities were monitored for content and technical glitches. Lessons learned are highlighted, and "Inbox overload" is identified. The authors found that nursing curricula can be designed to meet the challenge of fostering computer literacy. The assignment could be easily adapted for continuing education or other professional education endeavors.
Bosnia and Herzegovina (BiH), as developing country in transition, has to shift from traditional ways of learning to the transformation of the university education in accordance with Bologna process and educational standards in European Union. In the light of these changes authors conducted research at bio-medical faculties in Sarajevo in order to address issues of the education of future physicians and especially role of medical informatics in their under and post graduate studies and continuous medical education. As per given results in this study, current quality of medical education at biomedical faculties, University of Sarajevo, is unsatisfactory due to several reasons and some among others are those traditionally seen as "computer literacy". Problems are determined and recommendations are given for decision makers to support transformation of BiH medical educational system to have physicians, dentists, pharmacists and nurses who possess the knowledge, skills and attitudes required to be competent in medical informatics if they wish to incorporate into their practices systematic approaches for promoting and maintaining the health of defined populations.
This paper concerns one of the main problems facing continuing nurse education, that of matching the learning needs of the individual nurse with the needs of the care setting. This endeavour is inescapable because of the necessity for giving high quality care within financial restraint. Modern information technology, it is suggested, can be helpful in fulfilling the task more easily. A theoretical framework is introduced as a possible solution for developing a computer program which, it is the hope of the author, will be available in the not so far future.
Nurses are quintessential learners. Nested between the fields of science and technology, the professional mandate for life-long learning has never been greater. The expanding demands for performance and quality coupled with the reality of diminishing time and resources increasingly frustrate and challenge providers in the field. By blending the best of current training and education with the emerging potential of virtual learning, new models for enhancing clinical reasoning and performance will simplify the challenges of complexity, moving it to higher order. In this transition lies the key to restoring the joy and commitment of professional practice while enhancing the capacity to care with competence.
Highlights of an electronic healthcare record include clinical reminders, progress note templates, and a clinical reference system.
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Abstract As the home becomes an increasingly important site for health care, an increasing number of technology applications or devices are being introduced to support health at home. However, introducing new technology into a household raises a number of issues that must be considered prior to, during, and after the technology is implemented. This paper reviews the experiences of the UW-Madison Advanced Technologies for Health@Home Project, summarizing our assessment of household requirements that should be analyzed prior to introducing new technology. The overall goal of the Health@Home project is to improve the functionality and content of information technology innovations for the home. Using Venkatesh and Mazumdar's framework this article will summarize the relevant social, behavioral, technological, and physical dimensions of households that must be carefully assessed and understood to help ensure that the technology fits the needs of home residents.
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An increasing number of health-care institutions are in the process of implementing clinical computing systems. The need for an accurate assessment of the clinical, administrative, social, and financial effects of such systems has been recognized. Techniques have been developed to evaluate these effects on the work patterns of health-care workers including: time-motion analysis, subjective evaluations, review of departmental statistics, personal activity records, and work-sampling. This study reviews these techniques, discusses both positive and negative aspects, and presents a step-by-step description of work-sampling.
This paper describes the results of a two year project to design a model curriculum of health care informatics for Dutch higher professional education. The core of the curriculum are sixteen modules which cover the broad range of medical informatics and which are closely related to the profiles of the professions involved (nursing, physiotherapy, speech therapy, occupational therapy and dietetics). The curriculum emphasizes the need of using structured data and information to perform tasks in health care delivery and management, for which modern information technology is indispensable. The model curriculum will enable faculty to redesign existing undergraduate programs and to select the contents they see appropriate. In this way we hope that the model curriculum will contribute to an innovative attitude of future graduating health care professionals. A new three year project just has started to develop learning materials using professional health care software based on the sixteen modules of the curriculum.
There is a growing concern in New Zealand about the need to better prepare clinicians for the real world of nursing practice. The increased use of human patient simulations is one approach to addressing this concern by offering a well-organized and standardised way to provide content and encourage critical thinking in a safe practice environment. Unitec New Zealand has embraced the use of simulations in their undergraduate nursing curriculum and has partnered with Waitemata District Health Board (WDHB) to develop a state of the art interdisciplinary simulation lab. The simulation lab has been designed using wired and wireless technologies to accommodate various clinical and informatics practice scenarios. Supervision of students uses mounted cameras, and video-conference technology. The Unitec/Waitemata Simulation Learning Lab has the potential to enhance the education of nursing students by offering them a safe place to gain valuable experience with patient car delivery and informatics tools. This paper is designed to summarize the planning process used to develop this partnership, describe the vision of the centre and note the progress to date.