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1. Technology-Enhanced Nursing:
The Foundation of
Patient-Centered Care
Patricia Flatley Brennan, RN, PhD
University of Wisconsin-Madison
Madison, WI USA
Support provided by UW Madison, RWJF
2. achieving the audacious goal of
health 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 patients
academic nursing can make this
happen!
3. Objectives for the day
1. 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. Patient centered, person-
centered, individualized….
Recognizing Patients’ Health Problems
as They See Them …knowing what
problems 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. Professionals are
experts in
clinical care
People are
experts in
every-day living
6. Wisdom and guidance for
assessing technologies in
support of patient-centered care
Automation must be guided by the overall purpose or
mission of the nursing profession
A “prepared mind” (is necessary) to facilitate more
interspecialty communications between various fields
The work of nursing and the work of NURSES IS
NOT ONE AND THE SAME THING
7. The changes are such that the past
offers no guides
for the future
Cybernation should be studied from the standpoint
of how it fits or doesn’t fit into nursing’s
purpose
Foremost 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. 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 their
individual and collective judgments on the
profession’s stands relative to this
phenomenon
Hildagarde Peplau
1962
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. 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, and
advocacy in the care of individuals, families,
communities, and populations.
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
13. Which of the wonders of glass
will serve nursing best?
1. Thin, portable, 3-D projection tablets
2. Wall-size, fully-interactive
whiteboards
3. Multi-touch interactive table surfaces
4. Gesture-flick interaction control
5. Volumetric capture and 3D rendering
21. What do Aaron’s nurses need to
know to protect, promote, etc?
1. The data has left the hospital
2. PC’s are sooooo yesterday
3. Kids are users, too!
4. Information must be actionable
5. There’s no NANDA term for
“skateboard”
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.
24. Policy Action – enabling
technology-enhance practice
Enumerate
three policy agenda items
related to
technology enhanced practice
that could benefit from greater
input by academic nursing
25. Policy: the actualization of our
mandate to advocate for all
Issues 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
26. 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)
29. 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.
31. 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
32. 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
33. Creating a learning environment
that supports patient-centered care
Point of Care
Point of Practice
Point of Living
34. Plan a strategy
to leverage
existing nursing educational
efforts to create
technology enhanced
practice.
35. 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
36. 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
37. 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
38. 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!
39. 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
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