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"Technology-Enhanced Nursing: The Foundation of Patient-Centered Care"

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  • Mark intro
  • Overlook walk with glass railing Visible from Atrium – destination point Exam Room – Scales, consultation & exam areas – Shower room for Mock Patients Physical Assessment labs – integrated discussion/demonstration areas Clinical Skills labs – being massaged open up to discussion/demo area Sliding Doors – space saver Home Health – Floor sensors, Video capture = real kitchen, dining, bath, bedroom, living room Living Environments – ”the cave” future build out – WID Patty Brennen space E-nurse/Telahealth Support offices and storage/work spaces
  • Manikins Simulation types - 2 Med Surg. - 1 larger with Family space Intermediate Care Unit Nurse Servers
  • Aacn 10.28 no movies

    1. 1. Technology-Enhanced Nursing: The Foundation of Patient-Centered CarePatricia Flatley Brennan, RN, PhD University of Wisconsin-Madison Madison, WI USA Support provided by UW Madison, RWJF
    2. 2. achieving the audacious goal ofhealth for all lies in increasing the alignment between the practice of nursing & the technologies that support it, record it, and extend nursing’s reach into the every-day lives of patientsacademic nursing can make this happen!
    3. 3. Objectives for the day1. Critically appraise the emerging technologies for their ability to achieve patient centered care.2. Enumerate three policy agenda items related to technology enhanced practice that could benefit from greater input by schools and colleges of nursing.3. Plan a strategy to leverage existing nursing educational efforts to create technology enhanced practice.
    4. 4. Patient centered, person- centered, individualized….Recognizing Patients’ Health Problemsas They See Them …knowing whatproblems are rather than what the diagnosis is(Starfield, 2011).Clinical encounters reflect life-course Focus on health concerns & diseases as interrelated phenomena Coding systems allow for specifications of people’s health concerns
    5. 5. Professionals are experts in clinical care People are experts inevery-day living
    6. 6. Wisdom and guidance for assessing technologies in support of patient-centered careAutomation must be guided by the overall purpose or mission of the nursing professionA “prepared mind” (is necessary) to facilitate more interspecialty communications between various fieldsThe work of nursing and the work of NURSES IS NOT ONE AND THE SAME THING
    7. 7. The changes are such that the past offers no guides for the futureCybernation should be studied from the standpoint of how it fits or doesn’t fit into nursing’s purposeForemost in the nurse (__)’s broad framework when considering automated devices which they will select or help design is a belief in human dignity and man’s continuing personal development
    8. 8. Now is the time for nurses to stop and take a look, to consider the clues to large-scale automation to our society , and to bring to bear theirindividual and collective judgments on the profession’s stands relative to this phenomenonHildagarde Peplau 1962
    9. 9. And in 1996, Hilda said… Nursing has made great progress from being an occupation to becoming a profession in the 20th century. As the 21st Century approaches, further progress will be reported & recorded in Cyberspace – the Internet being one conduit for that. Linking nurses and their information & knowledge across borders – around the world – will surely advance the profession of nursing much more rapidly in the next century. Used with Permission, Cheryl Forchuk UWO
    10. 10. So… Let’s explore a few technologies remembering… Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, andadvocacy in the care of individuals, families, communities, and populations.
    11. 11. So… Let’s explore a few technologies remembering… The guidance lies within the definition… Will the technology help nurses protect, promote, optimize health & abilities, prevent illness & injury,and alleviate suffering by aiding in the diagnosis and treatment of human
    12. 12. A future http://youtu.be/jZkHpNnXLB0?hd=1
    13. 13. Which of the wonders of glass will serve nursing best?1. Thin, portable, 3-D projection tablets2. Wall-size, fully-interactive whiteboards3. Multi-touch interactive table surfaces4. Gesture-flick interaction control5. Volumetric capture and 3D rendering
    14. 14. A cover for an insulin pump
    15. 15. A jacket that illuminates based on physiological state
    16. 16. Pajamas implanted with cardiac sensors
    17. 17. A wearable breast pump (collection chamber not attached)
    18. 18. envisioning technology-enhanced nursing to support episodes of care AND the Care between the CAREJanuary June December
    19. 19. ProjectHealthDesig n Reaching people inevery day life
    20. 20. A Presentwww.projecthealthdesign.orghttp://bit.ly/TRIur2
    21. 21. What do Aaron’s nurses need to know to protect, promote, etc?1. The data has left the hospital2. PC’s are sooooo yesterday3. Kids are users, too!4. Information must be actionable5. There’s no NANDA term for “skateboard”
    22. 22. What is the role of academic nursing? Accelerate knowledge development and transmission Attend to BOTH the work of nursing and the work of nurses! Use our power and status to ensure that public policies promote patient centered care through technology-enhanced nursing Create a learning environment that fosters innovation and imagination
    23. 23. Policy Action – enabling technology-enhance practice Enumerate three policy agenda items related totechnology enhanced practicethat could benefit from greater input by academic nursing
    24. 24. Policy: the actualization of our mandate to advocate for allIssues on the table: • Personal health records and a patient’s abilities to access and control their health information • Technical infrastructure to support patient centered care, everywhere • Quality indicators, reported by patients, that help establish the cost and accountability for care
    25. 25. Making nursing’s voice heard in public policy: public comment Personal health records:  Federal Register (http://www.ofr.gov) Technical infrastructure:  Regulations.gov Quality Indicators: Patient-reported outcomes  National Quality Forum (www.qualityforum.org)
    26. 26. Personal Health Records
    27. 27. Technical Infrastructure
    28. 28. 4.9 GHz Band The Fifth FNPRM seeks comment on various issues relating to the 4.9 GHz band, including the relationship between the 4.9 GHz band and the 700 MHz public safety broadband network, which will be administered by the First Responder Network Authority (FirstNet) , a newly formed independent authority within the National Telecommunications and Information Administration.
    29. 29. Quality Indicators
    30. 30. This is NOT just a technology/informatics concern…The policies that matter … matter to the patients of all nurses For example, Meaningful Use  Medicaid: All clinicians who meet the criteria can receive incentive payments  Medicare: Nurse Practitioners and Midwives are excluded from participation Thus, what appears to be a policy issue related to Electronic Health Records can affect the care of ALL patients! Up next week … EHR performance quality and test bed
    31. 31. The opportunities for public commentary will continue to arise The collective voice of academic nursing, applied to the challenge of patient centered care, holds enormous power Must be a priority for leadership, but an accountability for the entire program  Gov’t affairs, communications, faculty, associations Set aside ONE HOUR A WEEK for policy – local, state, national – read, discuss, establish
    32. 32. Creating a learning environment that supports patient-centered carePoint of CarePoint of PracticePoint of Living
    33. 33. Plan a strategy to leverageexisting nursing educational efforts to create technology enhanced practice.
    34. 34. Planning a strategy Integrate, don’t assign Leverage partnerships Ensure that every initiative contributes towards the future of patient centered care through technology enhanced practice Create a learning environment that drives and rewards innovation
    35. 35. Integrate, don’t assign Technology-enhanced practice is a clinical nursing challenge, not an informatics problem Help faculty groups review syllabi for points of leverage:  critical care – PHRs to support transitions  Leadership – investigate job descriptions for informatics expectations
    36. 36. Leverage Partnerships There’s really too much work to do. Ok. Patient centered care provides a rallying point for interprofessional education  Not just health sciences, but engineering, business, architecture, law Figuring out strategic partners for mutual impact acceleration  Student, school, institution, profession Within organizations, across practice, between institutions
    37. 37. Ensure that every initiative contributes towards the future of patient centered care through technology enhanced practice Establish a shared understanding of patient centered care Mindfully explore the division, school or college’s willingness to forego old models for new approaches Critically appraise recruitment, development and curriculum efforts for consistency Recognize we are building practice models, not computer systems!
    38. 38. Create a learning environment that drives and rewards innovation Balance assessment skills with innovation ability  It’s the difference between precision and exploration  A culture of success-failure cycles is needed Guide faculty and staff in the transition from knowing that and performing how towards envisioning what Create learning environments that foster
    39. 39. Signe Skott Cooper Hall
    40. 40. Center forTechnology- Enhanced Nursing•6 Exam Rooms•2 Physical Assessment Labs•4 Clinical Skills Labs•Home Health Lab•Living Environments Lab “The Cave”•E-Nurse Space•Storage & Break out spaces
    41. 41. Hospital Suite• 4 Simulation Rooms • Patient Lift • Patient Toilet Room• Nurses station• Medication Room• Moulage Room• Debriefing rooms• Guest Reception Area
    42. 42. Innovations For the Future
    43. 43. Creating thefoundation for patient- centered care Begin right NOW! you What are going to do?
    44. 44. … a patient-centeredREAL homebecome atools forhealth notsimply aplace forcare
    45. 45. discovery.wisc.edu/lelhealthsystems.engr.wisc.eduwww.projecthealthdesign.org