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Nursing meets the Millennium: Future of Nursing in the Information Age

Nursing meets the Millennium: Future of Nursing in the Information Age

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Nursing meets the Millennium: Future of Nursing in the Information Age

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  1. Nursing meets the Millennium:Future of Nursing in the Information Age Patricia Flatley Brennan, RN, PhD, FAAN Moehlman Bascom Professor School of Nursing and College of Engineering University of Wisconsin-Madison

  2. Goals • Define nursing’s social role. • Describe the present and future role of information technology in the practice of nursing • Identify modifications in nursing practice to capitalize on information technology

  3. Nursing the diagnosis and treatment of human response

  4. Nursing’s Social Responsibility

  5. Nursing’s Social Responsibility diagnose and treat human responses

  6. Critical Events in YOUR Nursing Life • Think of an incident during the last 4 days in which you fulfilled nursing’s social role • Be as explicit as possible - time of day, who involved, how you felt • Now -- identify three points in this incident at which information or communication was important • Could you get what you wanted? Express what you had to say? Know what you needed to know?

  7. Informatics needed to support Nursing’s Social Role • Identify & describe phenomena indicative of the human response • INFORMATICS NEED: Produce a language • Discover & evaluate therapeutic interventions to treat human responses • INFORMATICS NEED: Create therapeutics Record interventions, Monitor responses • Collaborate with other disciplines to fulfill health care goals • INFORMATICS NEED: Communicate

  8. Information Technology today • Promises almost met • Computer-based patient records • DataRepositories • Formal languages • Telemedicine • Remote access to expertise and consultation • Consumer Health Informatics • The Challenges • Security • Authentication • The digital Divide • Legacy systems

  9. Moving the site of care

  10. On the horizon... Integration of different data types, with particular emphasis on time-variant data Intelligent agents and meta-data that support efficient use of knowledge resources (text, images, sound) Merging of public health and personal health data Re-engineering of clinical practice to capitalize on informatics advances

  11. Promising (ie, not yet here)IT Applications • Distributed records management systems • W3EMRs and CareWeb: Web front-end to legacy information systems • Authentication and Authorization • Healtheon • Consumer Health Informatics • CareLink • CHESS • HeartCare

  12. HeartCare: Meeting the Challenges of CABG Recovery • Monitor, Manage, Mend, Motivate • Demands in the discharge encounter • Patient-centered, tailored information

  13. The HeartCare Intervention • Home-based Unit: • WebTV(C) box & 19” television • Server supplies: • Monitor & Recovery Information • Four periods: Wks 1-2, 3-6, 7-12, & 13-26 • Professional & Peer contact

  14. Tailoring Recovery Resources to Patients • Establishing the tailoring model • Patient Profiles • Access (TM) database • Delivering WWW resources ‘on-the-fly’, across the recovery period • Active server pages sorting nurse-identified or developed WWW pages

  15. Contemporary Health Care rests on a successful partnership between Clinicians, Delivery Systems,and Patients

  16. SMART Patients

  17. SMART Patients • Self-assured • Motivated • Aware • Resourceful • Talented

  18. Remember they may also be: • Scared • Minors! • Anxious • Reluctant • Time consuming

  19. Common behaviors of SMART patients • self triage • values and preference clarification • participative • collaborative • independently engage in health promotion

  20. What they aren’t : • complacent • quiet • unchallenging • similar

  21. Clinician’s responses to the SMART patient: • engaging • tolerant • dismissive • condescending

  22. The Challenges for Clinicians • Use technology to help make patients SMART • Treat them as a resource • Change our practice activities to capitalize on their talents • Reorganize our practice environments

  23. Clinical Practice Issues • Henderson “...what the patient can do...” • Re-examining every action • Find the right balance of workers • Trusting our colleagues • Timing of interventions • What must be done now, what should wait for later?

  24. Nursing Roles • Content Expert • Envision a clinical practice that makes use of the patient as a resource • Re-organize care and care activities to incorporate patients

  25. Constructing a Health Care Delivery System responsive to SMART Patientsrests on effective, appropriate IT!

  26. Critical Event, Take II • Recall the event identified earlier • Review the information intensive and communication sensitive elements • Circle those for which today’s presentation suggested a solution • Star one for action on Monday • List at least one IT-related aspect • List at least one System Level aspect • List at least one clinical aspect

  27. Patient-Centered Systems • Clinical Records • Network Communication • Consumer Health Informatics

  28. Patient-Centered Information Systems Clinic Physician Office Computer-based Patient Record Pharmacy Dentist Furtive Records Consumer Health Information Hospital

  29. Seen any ‘SMART’ patients lately? ...they’re there, everywhere!

  30. Slides and references will be available on Monday November 1 athttp://heartcare.ie.wisc.edu