Healthcare Technology and Nursing Leadership

Emerging Technology and Nursing Practice

As technological advancement is booming in all sectors of healthcare, the field of nursing is no exception. Nurses of the 21st century need to have the ability to use technology in a way that facilitates mobility as well as relationships, interactions and operational processes. In addition to these, Nurse Leaders need to be experts at information management, including knowledge acquisition and distribution. Health care needs nurses who can analyze technologies from both the bedside and IT perspectives and that is why Nursing informatics is so important nowadays.Here is a glimpse of how technology is changing the way nurses care for their patients.

Looking back…

 It all started in 2009 when it was determined that the national mandates and guidelines for the development and adoption of health IT were not enough to accelerate technological advancement which was needed in healthcare  and therefore  the American Recovery and Reinvestment Act(ARRA) was enacted to address this issue(Nelson &Staggers,2015). With this act, came the  Health Information Technology for Economic and Clinical Health (HITECH) Act , a critical component which is now responsible for authorizing programs that  improve healthcare quality, safety and efficiency using health IT( Nelson & staggers, 2015; DesRoches, Worzala & Bates, 2013). The provisions of this act were intended to stimulate adoption of electronic health records and development of secure healthcare information exchange.

Today

Healthcare institutions and healthcare providers are  under pressure to implement EHR in order to comply with CMS’s Medicare incentive payments. The implementation of EHR involves disbursement of large amounts of money and other capital purchases that support the system and healthcare institutions and providers are required to comply with meaningful use standards . Therefore the is a remarkable increase in the utilization of CLOUD

The Impact of Mobile Technology in Healthcare

The Challenge for Nurse Leaders

Nurse leaders are challenged to lead the way in this changing landscape in healthcare, they are actively involved in care coordination.They are using databases to extract actionable knowledge and use it in strategic planning, workflow improvement, quality improvement,safety improvement and patient outcomes improvement.In addition to the this Nurses play an important role in patient care, patient education and documentation. Emphasis is currently being placed on effective discharge teaching as a way to prevent penalties from readmissions.Our discharge instructions give a detailed explanation on how patients can access their electronic medical record from home and we are required to explain this to the patients on discharge. Physicians are slowly moving away from the medicine model of care to holistic model in which they ensure that patient is being treated as a whole person and not just for his or her presenting complaint (Gelinas, 2015). 

References

Gelinas, L. (2015). Meaningful use is a workforce issue. American Nurse Today, 10(9), 6-6 1p.
Nelson,R & Staggers,N (2015).Health informatics; An interprofessional approach. Louis,,MO: Elsevier
DesRoches, C. M., Worzala, C., & Bates, S. (2013). Some hospitals are falling behind in meeting 'meaningful use' criteria and could be vulnerable to penalties in 2015. Health Affairs, 32(8), 1355-60. Retrieved from http://search.proquest.com.ezproxy.roberts.edu/docview/1428492276?accountid=13562Westra, B., Subramanian, A., Hart, C., Matney, S., Wilson, P., Huff, S., & ... Delaney, C. (2010). Achieving 'meaningful use' of electronic health records through the integration of the Nursing Management Minimum Data Set. Journal Of Nursing Administration, 40(7/8), 336-343 8p. doi:10.1097/NNA.0b013e3181e93994

Improving Point of Care Testing

With CLINITEK Status Connect System

Point of care testing for urine used to be manual for both pregnancy test and urine dipstick.The manual process took long for women to have a Urine pregnancy test done and be able to receive medications . The risk for error when interpreting both the pregnancy test and the urine dipstick were high. Especially with the dipstick, some providers had a hard time interpreting the results correctly , some did not know the order in which results are read and not all the time were results  input into the computer in a timely manner. Sadly in some cases it took hours.In some cases young women were triage to our urgent care area of the emergency room and only to find out that they are pregnant and therefore would need to be moved to GYN so that they can receive appropriate care.Many times we ended up with a very upset patient or family who spent too much timed waiting to receive care because of the delays in this process.

So after taking in to consideration all the complaints from patients and their families, my institution decided to invest in the CLINITEK Status Connect System. With this technology urine samples are tested for urinalysis/dipstick and pregnancy test within five minutes and the results are transferred direct into patient's chart because clinitek is Epic friendly. All youneed is your patient's ID and the testing kit.The bar code scanner scans dipstick bar code and the pregnancy test cassette. 

Here is how all you need to know about this Clinitek

CLINITEK Status Connect System is wireless  and has wired connectivity and testing oversight in point-of care urinalysis for improved risk management. It;

• Offers flexible connectivity solutions by integrating data directly to the LIS, EMR or via point-of-care data management software solutions
• Provides improved POC testing workflow efficiencies when interfaced to leading data management solutions
• Improved barcode response time allows quick entry of lot and expiration data with a single scan.
• Improves risk management through advanced operator control functions, prevents unauthorized use
• Drives compliance across testing sites with programmable QC protocols and QC lockout
• Has auto-checks which help to ensure the quality and accuracy of data while facilitating an enhanced interpretation of results

Nursing Leadership And Technology

Implementation of technology to improve patient safety and patient outcomes has not always been as smooth sailing as the leadership may want it to be. Literature shows that success has been seen in organizational leaders who create a shared vision with their staff, ensure an environment of collaboration and trust where the voice of staff is valued, and establish an ongoing process for problem solving that includes the input of staff. Such leadership is consistent with transformation leadership style where leaders and staff work interdependently to achieve improvement.

With the emergence of meaningful use and accountable care in healthcare, nursing roles, responsibilities and career trajectories are being transformed and key to these changes is nursing informatics (Troseth, 2012). Nursing informatics supports the nursing process by helping to integrate the data, information, and knowledge required for clinical decision making (ANA). Therefore in an attempt to leverage technology to improve patient outcomes, a new role of chief nursing information officer (CNIO) has emerged. A CNIO leads strategy, development and implementation of information technology to support nursing, nursing practice and clinical applications, but also collaborates with CNOs on the clinical and administrative decision-making process and develops clinical systems strategy with a regional CMIO (Troseth, 2012).

Driving Adoption of Technology for Nurses

You need to have true leadership and cooperation from staff.

Building a New Future

With all these advances in technology, demand is on the rise for nurses at the executive level to lead this process and possess the competencies needed to lead the development of informatics and assist in advancing the science. The CNIO role provides nursing leaders with that expertise, and an important partner in the advancement of the overall strategy for nursing within systems and organizations. A vision of the coalition for the future for nursing includes the CNE/CNO and CNIO partnerships which provides an important blend of competencies and talents that will advance nursing well.

The following are some of the initiatives for technology advancement in nursing;

• Develop and champion leaders with the ability to develop, deploy, re-engineer and integrate clinical information systems. They will also function as members of strategic management teams and will collaborate on goals and implementation of clinical information systems.
• Leverage programs such as The Alliance for NursingInformatics (ANI) Emerging Leader Program
• Advance nursing informatics education through partnerships with colleges of nursing
• Promote TIGER initiative.

     References
     

Troseth, M. (2012).Informatics & the Future of Nursing Practice: Technology is being integrated into every area of healthcare. What does that portend for nursing?Advance healthcare network for nurses. Retrieved from http://nursing.advanceweb.com/features/articles/informatics-the-future-of-nursing-practice.aspx

      Manos, D. (2012) CNIO role on the rise. Healthcare IT news. Retrieved from http://www.healthcareitnews.com/news/cnio-role-rise

Nelson, R. & Staggers, N. (2014). Health Informatics: An Interprofessional Approach. Elsevier Mosby: St. Louis, Missouri.

HUMAN TECHNOLOGY INTERFACE

Human Technology Interface allows human interaction with an electronic information system either by inputting data or providing output. Nowadays technology has advanced to the extent that we are going more towards voice activated devices. All devices providing an interface between the user and computer machines are considered HIDs. The Human Technology Interface focus also examines the balance between the technology impact on patients, providers, health care systems and society with the social, legal, ethical and public policy issues on the humanistic side. Some of the interesting technological interfaces available include integrated solutions like teleICU, patient portals ,clinician EHR, barcode medication scanners, smart infusion pumps, video sign language interpreter,telehealth,video conferencing and  defibrillators.

Impact on Nursing Care

Human technology interface is transforming the way nursing care is conceptualized and delivered. Before extensive application of technology, nurses relied heavily on their senses of sight, touch, smell, and hearing to monitor patient status and to detect changes. Nowadays the nurses’ unaided senses were replaced with technology designed to detect physical changes in patient conditions.With electronic charting, nurses have the capability of accessing information quickly and efficiently and are able to use information to improve the quality of nursing workflow I am particularly impressed by Infusion pumpswith Drug Libraries at the point of care. They enable nurses to carry out safer drug delivery. Implementation of new technologies also offers nurses an avenue for ensuring safe and efficient use of technology .In many institutions use of clinical champions, local opinion leaders or super users of any new equipment may greatly facilitate smooth implementation of new equipment. By virtue of their knowledge, clinical competence and accessibility, clinical leaders can offer on-the-spot training, encouragement, advice, and troubleshooting expertise to other staff as workers are learning to use new equipment.

Impact on patient care and patient experience.

With technology interface, patients are able to access their medical records from home via the patient portals.Technology such as telehealth is helping improve quality of care and patient experiences.Patients can have a video conference with their doctor in the comfort of their homes. Many people do not like going to hospitals and this interface meets all their expectations.

References

Powell-Cope G, Nelson AL, Patterson ES. Patient Care Technology and Safety. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 50. Available from: http://www.ncbi.nlm.nih.gov/books/NBK2686/

Longo, B., & Reese, C. (2014). Human-Technology Interface: Computers & Vision Health. Nevada Rnformation, 23(1), 8-19 12p.

http://www.himss.org/ResourceLibrary/GenResourceDetail.aspx?ItemNumber=33541

International Classification for Nursing Practice (ICNP), The Omaha System and ABC Codes

ICNP (International Classification for Nursing Practice) 

The ICNP provides a structured and defined vocabulary as well as a classification for nursing and a framework into which existing vocabularies and classifications can be cross-mapped to enable comparison of nursing data. Its primary elements are nursing phenomena, nursing interventions and nursing outcomes. The INCP strives to establish a common language for describing nursing practice and improve communication. It also helps describe nursing care of people (individuals, families, and communities) in a variety of settings, both institutional and non-institutional, enables comparison of nursing data across clinical populations, settings, geographic areas, and time. Furthermore it demonstrate or project trends in the provision of nursing treatments and care and the allocation of resources to patients according to their needs based on nursing diagnoses. Lastly it stimulate nursing research through links to data available in nursing information systems and health information systems and also provides data about nursing practice in order to influence health policy making (Warren & Coenen,1998).

 The Omaha System and ABC Codes

The Omaha system is a research-based, standardized clinical documentation language (taxonomy) designed to meet the needs of community health nurses and other community-based health providers. It includes all three critical components of care (diagnoses, interventions and outcomes) and was specifically designed to facilitate the statistical analysis of data.

ABC codes are five-digit Health Insurance Portability and Accountability Act (HIPAA) compliant alpha codes that are used by licensed or non-licensed healthcare practitioners on standard healthcare claim forms.

References

Warren, J. J., & Coenen, A. (1998). International Classification for Nursing Practice (ICNP): Most-frequently Asked Questions. Journal of the American Medical Informatics Association : JAMIA, 5(4), 335–336.

The Omaha system.Retrieved from http://omahasystemmn.org/Omaha%20System%20Top%20Ten%20with%20links.pdf