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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