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Technology And Nursing:  Past, Present and Future Perspectives
 

Technology And Nursing: Past, Present and Future Perspectives

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This powerpoint presentation contains key concepts and historical innovations involving technological advancements in nursing care delivery and nursing education

This powerpoint presentation contains key concepts and historical innovations involving technological advancements in nursing care delivery and nursing education

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  • End at 4:50 minutes
  • 1870: coincided with first formally trained nurses 1816: first stethoscope invented. Doctor’s use only 1853: first prototype of blood pressure monitor invented. Doctor’s use only Webster's Revised Unabridged Dictionary (1913): Scarify Scar"i*fy, v. t. [imp. & p. p. Scarified ; p. pr. & vb. n. Scarifying .] [F. scarifier, L. scarificare, scarifare, fr. Gr. ? to scratch up, fr. ? a pointed instrument.] 1. To scratch or cut the skin of; esp. (Med.), to make small incisions in, by means of a lancet or scarificator, so as to draw blood from the smaller vessels without opening a large vein.
  • 1930s: nurses started administering IM injections under MD’s orders U.S. Patent Office does not indicate type of inventor, just gender
  • Have class look at article with examples of nursing inventions. Discuss
  • PDA= Personal Data Assistants
  • ENCOURAGE GROUP DISCUSSION OF ANY OTHER TECHNOLOGICAL ENHANCEMENTS THAT NURSES WANT
  • *ASK GROUP FOR OTHER PROS AND CONS *Have class read vignette about child patient
  • REFER TO MARIA’S POSTER AND TALK BRIEFLY ABOUT HER CLASS I TOOK IN JANUARY OF THIS YEAR
  • Everett M. Rogers ( March 6 , 1931 - October 21 , 2004 ), sociologist , communications scholar, pioneer of diffusion of innovations theory, writer, and teacher
  • This is my technology in my work setting. This practical application of knowledge acquired by completion of this questionnaire can enable me to assess the patient’s depression status and assist the patient through high level psychosocial counseling and coping techniques to get better
  • Discuss how Health Risk Assessment is used to predict utilization of future healthcare needs.
  • Have class read about eMAR then do Learning Activity. Discuss

Technology And Nursing:  Past, Present and Future Perspectives Technology And Nursing: Past, Present and Future Perspectives Presentation Transcript

    • Presented by Karen V. Duhamel, RN, MS, CCM
    • THE LEARNER WILL….
    • Gain a historical perspective on noted technological innovations by nurses from 1850 to present
    • Consider how modern technologies have enhanced care delivery
    • Reflect on the pros and cons of technology in nursing, the ethical implications and technological needs voiced by nurses
    • Gain a greater understanding of who’s pushing for technology in nursing and what is Nursing Informatics
    • Consider future technological trends in nursing
  • According to Merriman-Webster’s Dictionary (2009): <medical technology> b : a capability given by the practical application of knowledge -What does technology mean to you in your work setting?
    • Nursing from 1850 to 1900 concerned with providing care to physical needs of patient and maintaining a hygienic environment
    • Some nursing inventions and innovations during this time:
    • bedpans, bandages; surgical splints, nursing bottle; hospital bed prototype; foot cradles; abdominal, uterine and breast supports; invalid chair; portable tub wheeled to bedside; syringe; safety pin; diapers; improvements to stethoscope (invented in 1816 by M.D.); medicine spoon and vial holder, etc.
    • Proliferation of hospitals began around 1870 which coincided with
    • first formally trained nurses
    • Nursing the equipment” according to Sandelowski (1997) became the emphasis of nursing care since WWII
    • In the 1950’s to 1960’s, technological advancements involving new medicines (particularly antibiotics), IV therapy, and administration of blood products became available
    • From 1965 to 1980, machines of all kinds – from dialysis to cardiac monitors to fetal monitors and automatic recording devices;
    • Hospice created (1967)
    • From 1980’s to present, technological advancements include: computers in healthcare, safer medication administration and patient safety monitoring devices; EMRs/EHRs; wireless charting devices; robotic assistants; clinical decision-making tools and telehealth services
  • More inventions and innovations by nurses 1990’s to present: 1990’s: Burns Wean Assessment Protocol/Program (BWAP) to wean patients off ventilators; Perioperative nurse invents Omni-Jug for drainage of arthroscopic fluid, the Puddle Guppy that aspirates fluid from hospital floors and the Aqua-Box that disinfects fluid waste prior to sewage disposal; blood draw protector called Med Search Hand Guard ( or hemoshield); Bath-Bag; Bili-Bonnet 2000’s: eMAR medication bar coding; Cardibra for female post-op cardiac patients;
    • Wireless devices: PDAs, Hand-held Computers, Smart phones
    • Real-time equipment and supplies location systems
    • Delivery robots for interdepartmental services, such as meal delivery, hospital lab deliveries, laundry services
    • Workflow management systems such as automated census boards
    • Wireless patient monitoring systems for prevention of falls
    • Electronic medication administration with bar coding
    • Electronic clinical documentation with clinical decision support capability
    • Interactive patient systems: a digital platform for two-way communication and delivery of multimedia content at the bedside to assist in rendering care and educating patients
    • PC-based simulations; i.e., Healthstream software
    • Virtual Patient Simulation
    • Task Trainers
    • Human Patient Simulation; i.e., Simman, Simbaby
    • Standardized Patients (SP)
    • Integrative systems
    • According to Dr. Carol Bickford of the ANA (2005), nurses want tools that help with patient-centered care including:
      • Stronger collaboration between manufacturers and nurses when designing tools for care delivery
      • Better software integration; i.e., biometric fingerprinting/eye-scanning of nursing personnel, to save time and numerous log-ons/log-offs
      • Charting devices that allow for the telling of each patient’s “story” of care instead of individual system updates; i.e., a “whole person” view
      • Continued emphasis on self-directed learning through Web-based training programs
      • The Best of Information Technology (IT): intuitive interfaces, wireless connectivity, seamless integration of software applications and the ability to access data when and where it is needed
  • PROS CONS
    • Potential breaches in confidentiality via phone, fax and emails
    • -HIPAA violations can be up to 6 digit dollar amounts
    • depending on severity of violation
    • Tele-health nursing: duty to care and patient abandonment
    • -occurs once you start a professional relationship with the
    • patient
    • Patient education materials from credible websites; i.e., MedlinePlus;
    • WebMD; MayoClinic, etc.
    • The nurse must “uphold the overall well-being of the patient and advocate
    • for the patient, not the technology” (Drought & Liaschenko, 1995)
    • The American Association of Colleges of Nursing (2002) recommended incorporation of technology into nursing education
    • The Institute of Medicine (2003) named five core competencies needed by health professionals, one of which is Informatics competency
    • The Australian Nursing Federation (2005) recommended Information Technology and Information Management Systems be incorporated into all lifelong learning opportunities for nurses
  • “ It’s using data to translate into information to make decisions when providing patient care” -Professor Maria Pietrantuono University of Hartford (2009)
    • Innovators : venturesome, eager to try new things
    • Early Adopters : role models in their departments;
    • usually the first to “buy-in” to new technology; become the
    • “ Subject Matter Experts” on their units
    • Early Majority : adopt new ideas just before the masses
    • Late Majority : skeptics; require intense communication
    • to learn new technologies
    • Laggards : very last to change; distrust change
  • HOW I USE INFORMATICS IN MY JOB: HIGH MEMBERSHIP PROVIDER LIST Provider ID PPO HMO TOTAL Provider Region Specialty State Zip code 77623XXXX 112 0 112 Jabe, MD SW FP TX 12345 22930XXXX 339 64 403 Dan, MD SW FP TX 12345 22924XXXX 159 19 178 Maureen, MD SW FP TX 12345 43663XXXX 106 0 106 Mark, MD SW IM TX 12345 31786XXXX 33 3 36 Fort, MD SW FP TX 12345 33245XXXX 69 1 70 Fran, MD SW FP TX 12345 72500XXXX 39 0 39 Kyle, MD SW IM TX 12345 21720XXXX 252 93 345 Joe, MD SW FP TX 12345
  • PATIENT HEALTH QUESTIONNAIRE-9 (PHQ-9) - Medical questionnaire consisting of 9 questions that address various symptoms related to Depression per the DSM-IV-TR -Patient’s response to each question is scored from 0 (absence of symptom) to 3 (prevalence of symptom). Total scores for each rating are tallied for Total PHQ9 score -Scoring grid on form indicating absence to severity of Depression -Medical provider has option of referring patient into telephonic case management for medication/treatment plan compliance -Status reports faxed to provider after each contact with patient
  • ALCOHOL/DRUG ABUSE SCREENING PROGRAM
  • FORECASTED SEVERITY 8.542 October 2009 8.130 September 2009 8.175 August 2009
    • HEALTH PROFILE CONDITIONS
    • Depression 45% Benefit Usage
    • Migraines 43% Benefit Usage
    • Gastritis 12% Benefit Usage
    PHARMACY PROFILE Celexa 20mgs qd Last filled October 20, 2009 Replax 40mgs qd Last filled October 20, 2009 Nexium 1 tab qd Last filled October 20, 2009 LAB PROFILE Service Start Date: October 20, 2009 Laboratory Test: Hgb/Hct Laboratory Results: 14.8/38.6 Laboratory Abnormal Results: N/A HEALTH RISK ASSESSMENT
  • TRANSLATES INTO….
  • Sources: NIDA and NIAAA (1998); Journal of Clinical Psychology 1993;54(11) pp. 405-426
    • Nursing inventions and innovations in context to time period
    • Technology in nursing today focused on improving patient safety
    • and care delivery outcomes
    • Nurses want the best technology that makes sense for them and is
    • geared towards their specific care needs
    • Technology in nursing has pros/cons and ethical implications
    • Nursing Informatics = gathering and translating data into improving
    • patient care
    • Future technology in nursing will become more computer-based and
    • automated
  • Barnard, A.& Locsin, R. (2007). Technology and nursing: Practice, concepts and issues . In A. Barnard and R. Locsin(Eds.). Houndmills, Basingstocke, Hampshire, United Kingdom: Palgrave Macmillan. Drought, T.S. & Liaschenko, J. (1995). Ethical practice in a technological age. Critical Care Nursing Clinics of North America, 7 (2), 297-304. Hiestand, W. (2000). Think different: Inventions and innovations by nurses, 1850-1950. The American Journal of Nursing, Vol. 100, No. 10,100 th Anniversary Issue(Oct 2000), pp.72-77. Medical technology (2009). In P. B. Gove & H.B. Woolf (Eds.), Merriam-Webster's Collegiate® Dictionary, Eleventh Edition. Springfield, MA. Retrieved from Internet November 12, 2009. Sandelowski, M. (1997). Making the best of things: Technology in American nursing, 1870-1940. Nursing History Review 5 (1997), pp. 3-22. YouTube video (2008, June 5). Did you know? [Video file]. Retrieved from http://www.youtube.com/watch?v=KRFRrJlicgE. YouTube video (2008, March 10). Microsoft’s future vision: Healthcare. [Video file]. Retrieved from http://www.youtube.com/watch?v=V35Kv6-ZNGA&feature=PlayList&p=13AD60E168A30822&playnext=1&playnext_from=PL&index=7. U.S. Dept of Commerce Patent and Trademark office (1999). Buttons to biotech: 1996 update report with supplemental data from 1998, U.S. patenting by women, 1976 to 1996. (Feb 1999).