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

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Technology And Nursing: Past, Present and Future Perspectives

  1. 1. <ul><li>Presented by Karen V. Duhamel, RN, MS, CCM </li></ul>
  2. 2. <ul><li>THE LEARNER WILL…. </li></ul><ul><li>Gain a historical perspective on noted technological innovations by nurses from 1850 to present </li></ul><ul><li>Consider how modern technologies have enhanced care delivery </li></ul><ul><li>Reflect on the pros and cons of technology in nursing, the ethical implications and technological needs voiced by nurses </li></ul><ul><li>Gain a greater understanding of who’s pushing for technology in nursing and what is Nursing Informatics </li></ul><ul><li>Consider future technological trends in nursing </li></ul>
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  4. 4. 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?
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  6. 6. <ul><li>Nursing from 1850 to 1900 concerned with providing care to physical needs of patient and maintaining a hygienic environment </li></ul><ul><li>Some nursing inventions and innovations during this time: </li></ul><ul><li>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. </li></ul><ul><li>Proliferation of hospitals began around 1870 which coincided with </li></ul><ul><li>first formally trained nurses </li></ul>
  7. 7. <ul><li>Nursing the equipment” according to Sandelowski (1997) became the emphasis of nursing care since WWII </li></ul><ul><li>In the 1950’s to 1960’s, technological advancements involving new medicines (particularly antibiotics), IV therapy, and administration of blood products became available </li></ul><ul><li>From 1965 to 1980, machines of all kinds – from dialysis to cardiac monitors to fetal monitors and automatic recording devices; </li></ul><ul><li>Hospice created (1967) </li></ul><ul><li>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 </li></ul>
  8. 8. 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;
  9. 9. <ul><li>Wireless devices: PDAs, Hand-held Computers, Smart phones </li></ul><ul><li>Real-time equipment and supplies location systems </li></ul><ul><li>Delivery robots for interdepartmental services, such as meal delivery, hospital lab deliveries, laundry services </li></ul><ul><li>Workflow management systems such as automated census boards </li></ul>
  10. 10. <ul><li>Wireless patient monitoring systems for prevention of falls </li></ul><ul><li>Electronic medication administration with bar coding </li></ul><ul><li>Electronic clinical documentation with clinical decision support capability </li></ul><ul><li>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 </li></ul>
  11. 11. <ul><li>PC-based simulations; i.e., Healthstream software </li></ul><ul><li>Virtual Patient Simulation </li></ul><ul><li>Task Trainers </li></ul><ul><li>Human Patient Simulation; i.e., Simman, Simbaby </li></ul><ul><li>Standardized Patients (SP) </li></ul><ul><li>Integrative systems </li></ul>
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  13. 13. <ul><li>According to Dr. Carol Bickford of the ANA (2005), nurses want tools that help with patient-centered care including: </li></ul><ul><ul><li>Stronger collaboration between manufacturers and nurses when designing tools for care delivery </li></ul></ul><ul><ul><li>Better software integration; i.e., biometric fingerprinting/eye-scanning of nursing personnel, to save time and numerous log-ons/log-offs </li></ul></ul><ul><ul><li>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 </li></ul></ul><ul><ul><li>Continued emphasis on self-directed learning through Web-based training programs </li></ul></ul><ul><ul><li>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 </li></ul></ul>
  14. 14. PROS CONS
  15. 15. <ul><li>Potential breaches in confidentiality via phone, fax and emails </li></ul><ul><li>-HIPAA violations can be up to 6 digit dollar amounts </li></ul><ul><li> depending on severity of violation </li></ul><ul><li>Tele-health nursing: duty to care and patient abandonment </li></ul><ul><li>-occurs once you start a professional relationship with the </li></ul><ul><li>patient </li></ul><ul><li>Patient education materials from credible websites; i.e., MedlinePlus; </li></ul><ul><li>WebMD; MayoClinic, etc. </li></ul><ul><li>The nurse must “uphold the overall well-being of the patient and advocate </li></ul><ul><li>for the patient, not the technology” (Drought & Liaschenko, 1995) </li></ul>
  16. 16. <ul><li>The American Association of Colleges of Nursing (2002) recommended incorporation of technology into nursing education </li></ul><ul><li>The Institute of Medicine (2003) named five core competencies needed by health professionals, one of which is Informatics competency </li></ul><ul><li>The Australian Nursing Federation (2005) recommended Information Technology and Information Management Systems be incorporated into all lifelong learning opportunities for nurses </li></ul>
  17. 17. “ It’s using data to translate into information to make decisions when providing patient care” -Professor Maria Pietrantuono University of Hartford (2009)
  18. 18. <ul><li>Innovators : venturesome, eager to try new things </li></ul><ul><li>Early Adopters : role models in their departments; </li></ul><ul><li>usually the first to “buy-in” to new technology; become the </li></ul><ul><li>“ Subject Matter Experts” on their units </li></ul><ul><li>Early Majority : adopt new ideas just before the masses </li></ul><ul><li>Late Majority : skeptics; require intense communication </li></ul><ul><li>to learn new technologies </li></ul><ul><li>Laggards : very last to change; distrust change </li></ul>
  19. 19. 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
  20. 20. 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
  21. 21. ALCOHOL/DRUG ABUSE SCREENING PROGRAM
  22. 22. FORECASTED SEVERITY 8.542 October 2009 8.130 September 2009 8.175 August 2009 <ul><li>HEALTH PROFILE CONDITIONS </li></ul><ul><li>Depression 45% Benefit Usage </li></ul><ul><li>Migraines 43% Benefit Usage </li></ul><ul><li>Gastritis 12% Benefit Usage </li></ul>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
  23. 23. TRANSLATES INTO….
  24. 24. Sources: NIDA and NIAAA (1998); Journal of Clinical Psychology 1993;54(11) pp. 405-426
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  26. 26. <ul><li>Nursing inventions and innovations in context to time period </li></ul><ul><li>Technology in nursing today focused on improving patient safety </li></ul><ul><li>and care delivery outcomes </li></ul><ul><li>Nurses want the best technology that makes sense for them and is </li></ul><ul><li>geared towards their specific care needs </li></ul><ul><li>Technology in nursing has pros/cons and ethical implications </li></ul><ul><li>Nursing Informatics = gathering and translating data into improving </li></ul><ul><li>patient care </li></ul><ul><li>Future technology in nursing will become more computer-based and </li></ul><ul><li>automated </li></ul>
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  28. 28. 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).

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