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
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
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!
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.
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
Professionals are experts in clinical care People are experts inevery-day living
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
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
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
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
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.
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
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
A wearable breast pump (collection chamber not attached)
envisioning technology-enhanced nursing to support episodes of care AND the Care between the CAREJanuary June December
ProjectHealthDesig n Reaching people inevery day life
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”
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
Policy Action – enabling technology-enhance practice Enumerate three policy agenda items related totechnology enhanced practicethat could benefit from greater input by academic nursing
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
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)
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.
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
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
Creating a learning environment that supports patient-centered carePoint of CarePoint of PracticePoint of Living
Plan a strategy to leverageexisting nursing educational efforts to create technology enhanced practice.
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
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
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
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!
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