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Course: Oncology Nursing

Topic: Use of Technology

The Nurses International Community

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COPYRIGHT

NI Privacy Policy and Terms of Use.

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Module Goals

Learners will be able to:

Identify of the significance of technology related to patient care.
Describe various types of technology resources.
Explore the elements of systematic inquiry.
Describe the nurse’s role in use of technology resources related to patient care and outcomes.
Explore future trends in information technology in healthcare.

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Why is This Important?

Mary Joy, 2020

Nurses are knowledge workers – need information to do their job – critical thinking!
Technology helps bring information to the point of care to support nurse’s decision-making processes
Goal of informatics is to use technology to:

Increase efficiency
Make healthcare safer and more effective
Improve quality and outcomes

Software is now a major factor in any business
Need to balance human caring with technology

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What is Information?

Delivered in conversation, handwritten notes, stored in a computer.
Regardless of the form, the same basic principles apply to the structure and the use of information.
Words are often used interchangeably to describe information.

Canadian Nurses Association, 2001

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Data and Information

Data: Facts objectively described, without interpretation or context

Example: 110

Information: Data processed into a structured form
Data that are interpreted, organized, structured and given meaning are referred to as information

Example: Combining 110 with other data, becomes information. Systolic blood pressure of 110 mmHg and diastolic blood pressure of 70 mm Hg
This information can be organized in a form, on a graph or in a report

Canadian Nurses Association, 2001

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From Information Comes Knowledge

Canadian Nurses Association, 2001

Knowledge: synthesized information derived from the interpretation of data
It provides a logical basis for making decisions and is essential for new discoveries

Example: When the BP reading is combined with information about anatomy and physiology, pharmacology, and pathophysiology, knowledge is used to decide about care and treatment

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Data and Information Management

May be text-based or numerical/statistical
May be processed and managed using a wide range of systems, including:

Computer-based applications (word processing, spreadsheets, patient information systems)
Communications devices (e.g. mobile phone, videoconference)
Other electronic systems (Personal Digital Assistant, photocopiers)
Paper-based systems (patient records)

Mary Joy, 2020

Contact info: info@nursesinternational.org

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Case Study/Critical Thinking Question/What would the nurse do?

Reflection:

How is data different from knowledge?

How do you use data in your work?

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Evidence-Based Practice

Integrates clinical expertise with research¹
Applies evidence to practice and builds evidence from practice¹
Clinical databases are essential¹ ∴ common vocabulary
The “gold standards”: Randomized controlled trial , Meta-analysis
Data exchange standards – HL7²

Commonly used data interchange standard
Includes messaging specifications for patient administration, orders, results, scheduling, claims management, document management

Canadian Nurses Association, 2001
HealthIT.gov, 2019

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Systematic Inquiry

Ask an answerable question
Find reliable and relevant data
Weigh the evidence for validity and usefulness
Integrate conclusions into practice

Wiederhold & Shortliffe, 2006

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How Computers Help Systematic Inquiry?

Wiederhold & Shortliffe, 2006

Data acquisition and presentation
Record keeping and access
Communication and integration of information
Surveillance
Information storage and retrieval
Data analysis
Decision support
Education

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Where Are the Data? Inside the Organization…...

Wiederhold & Shortliffe, 2006

Enterprise network

Patient

workstation

Clinical

workstations

Clerical

workstation

Research

databases

Administrative systems

(e.g. admissions, discharges and transfers)

Library

resources

Radiology

Billing and

financial systems

Pharmacy

Clinical databases

Electronic medical

records

Personnel

systems

Material

management

Educational

programs

Clinical

laboratory

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Moving Beyond the Organization

Wiederhold & Shortliffe, 2006

Patients

Healthy

individuals

Providers

in offices

or clinics

Information

resources

(Medline)

Government

medical research

agencies

3rd party

payers

The Internet

Government

health insurance

programs

Other hospitals

and physicians

Pharmaceuticals

regulators

Communicable

disease agencies

Health Science

Schools

Vendors

of various types

(e.g. pharmaceuticals

companies

Private

labs

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How To Organize All This Information?

Informatics infrastructure

Standardized terminologies
Digital sources of evidence
Data exchange standards
Informatics processes
Informatics competencies

Bakken, 2001

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The Nurse’s Role

Registered Nurses Association of Ontario (n.d.)

Know how to use information (identify, collect, record, analyze and interpret).
Use computer applications for patient care.
Manage privacy, confidentiality and security of patient information.

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Nurses Work With 3 Types Of Information

Biomedical technology

Diagnosis, monitoring, testing, administering therapies.

Information technology

Recording, processing, delivering care.

Knowledge technology

Expert systems, decision-support systems.

Smith & Hunt, 2013

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How Many Types of Biomedical Technology Can You See Here?

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Case Study/Critical Thinking Question/What would the nurse do?

Provide specific examples for the three types of information:

Biomedical technology

Information technology

Knowledge technology

How are they used by the nurse?

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Barcode Medication Administration

Shah et al., 2016

Ensures provider of right patient, medication, route, time, and dose.
Reduces medication errors.
Most of the US hospital use this technology.

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Biomedical Technology

Nurse’s responsibility

Monitor the data generated
Assess effectiveness of device

Nurse manager’s responsibility

Staff education
Preventive maintenance
Quality assurance
Budgeting and prioritizing

Huston, 2013

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Information Technology

Need to understand database architecture—how data is stored and accessed
Nursing structure of the database

Vocabulary e.g. nursing diagnosis
Taxonomies and Coding Schemes

E.g. demographic or service elements

Nursing Minimum Data Sets

Shah et al., 2016

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Case Study/Critical Thinking Question/What would the nurse do?

Reflection:

How can technologies can contribute to safe patient care?

How might technology contribute to unsafe patient care?

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Information Technology: Computerized Order Entry

Agency for Healthcare Research and Quality, 2019

Helps prevent medication errors due to illegible handwriting.
Orders are ready immediately for all providers to help improve communication.
Increases amount of time a provider can spend with patients.

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Administrative Systems Assist Hospital Managers With

Tracking patients within the hospital.
Managing materials and inventory.
Supporting personnel functions.
Managing the payroll.

Caroll, 2021

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How Nurse Managers Might Use Information Systems

Performing quality assurance (e.g. error rates).
Match patient acuity to staffing patterns.
Reminders for licensing and mandatory education.
Documentation for accreditation.

Caroll, 2021

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Knowledge Technology

Expert systems can guide decision-making

E.g. selecting the right antibiotic to treat infection.

And improve patient safety

E.g. alert provider of drug allergies or interactions.
Allow the provider to retrieve & analyze lab results.

Mitchell & Kan, 2019

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Professional Issues

Data privacy

Passwords
Firewalls and organizational policy

Ethics and biotechnology

Technological intervention has changed our concepts of living and dying
Patient advocacy role of the nurse
Ethics committees

Mary Joy, 2020

Contact info: info@nursesinternational.org

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Future Trends

Computerized patient records

Smart-cards

Internet

Provider information
Provider communication
Patient information

Telecommunications

Videoconferencing
Remote diagnostics

Mitchell & Kan, 2019

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Future Trends

Genetics and Genomics
Less Invasive and More Accurate Tools for Diagnostics and Treatment
3-D Printing
Robotics
Biometrics
Electronic Healthcare Records (EHR)
Computerized Physician/Provider Order; Entry (CPOE) and Clinical Decision Support

Huston, 2013

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Case Study/Critical Thinking Question/What would the nurse do?

Reflection:

Describe the benefits of telecommunications for patients and health care providers.

How might telecommunications affect the role of the nurse to provide safe patient care?

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Reference:

Agency for Healthcare Research and Quality. (2019). Computerized Provider Order Entry. Accessed from: https://psnet.ahrq.gov/primer/computerized-provider-order-entry

Bakken S. (2001). An informatics infrastructure is essential for evidence-based practice. Journal of the American Medical Informatics Association : JAMIA, 8(3), 199–201. https://doi.org/10.1136/jamia.2001.0080199.

Canadian Nurses Association (2001). What is nursing informatics and why is it so important?. Nursing NOW: Issues and trends in Canadian nursing. Accessed from: https://www.nursing-informatics.com/kwantlen/NursingInformaticsSept_2001_e.pdf

Contact info: info@nursesinternational.org

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Reference:

Caroll, W.M., (2021). Healthcare Information and Management System Society (HIMSS). 2020: Emerging Technology in Global Nursing Care. Retrieved from https://www.himss.org/resources/2020-emerging-technology-global-nursing-care

HealthIT.gov (2019). Health IT Standards. The Office of the National Coordinator for Health Information Technology. Accessed from: https://www.healthit.gov/topic/standards-technology/health-it-standards

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Reference:

Huston, C., (May 31, 2013). "The Impact of Emerging Technology on Nursing Care: Warp Speed Ahead". OJIN: The Online Journal of Issues in Nursing, 18 (2). Manuscript 1. Accessed from: http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Emerging-Technology.html

Mary Joy, G.D. (2020). Balancing care with technology. Nursing Management, 51(4):56. Accessed from: https://journals.lww.com/nursingmanagement/fulltext/2020/04000/balancing_care_with_technology.10.aspx

Contact info: info@nursesinternational.org

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Reference:

Mitchell, M., & Kan, L. (2019). Digital technology and the future of health systems. Health Systems & Reforms, 5 (2): 113-120. Accessed from: https://www.tandfonline.com/doi/full/10.1080/23288604.2019.1583040

Registered Nurses Association of Ontario (n.d.). Health Education Fact Sheet : From nurses for you (PDF). Accessed from: https://rnao.ca/sites/rnao-ca/files/Nurses_and_the_Use_of_Computer_Technology.pdf

Shah, K., Lo, C., Babich, M., Tsao, N. W., & Bansback, N. J. (2016). Bar Code Medication Administration Technology: A Systematic Review of Impact on Patient Safety When Used with Computerized Prescriber Order Entry and Automated Dispensing Devices. The Canadian journal of hospital pharmacy, 69(5), 394–402. https://doi.org/10.4212/cjhp.v69i5.1594

Contact info: info@nursesinternational.org

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Reference:

Shortliffe, E.H., & Cimino, J.J. (2014). Biomedical Informatics: Computers application in healthcare and biomedicine (4th ed.). London: Springer

Smith, J.B., & Hunt, C. (2013). Caring, Communicating, and Managing with Technology. In Yoder-wise, P.S. (Ed.). Leading and Managing in Nursing (5th ed., 199-299). Elsevier Mosby.

Wiederhold G., Shortliffe E.H. (2006) System Design and Engineering in Health Care. In: Shortliffe E.H., Cimino J.J. (eds) Biomedical Informatics. Health Informatics. Springer, New York, NY. https://doi.org/10.1007/0-387-36278-9_6

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