1、,Advanced Technology and Information Systems,Chapter 7,7-2,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Technological Advancements in Acute Care Clinical Practice,Information Technology (the use of computers to gather, organize, process and communicate information) is one
2、of the highest priorities in health care today.,7-3,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Technological Advancements in Acute Care Clinical Practice,Computers will be involved in almost every area of direct client care, making it possible to accomplish work more eff
3、ectively and efficiently.,7-4,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Technological Advancements in Acute Care Clinical Practice,The acute care setting (hospital) uses advanced technology and computerized equipment that is up-to-date and ever-changing.,7-5,Copyright 2
4、004 by Delmar Learning, a division of Thomson Learning, Inc.,Hospital,IV and gastric infusion pumps Patient-controlled analgesia (PCA) Vital signs, oxygen blood saturation levels Computer-assisted ventilators Pulmonary function, blood gas, cardiac and intracranial pressure monitoring,7-6,Copyright 2
5、004 by Delmar Learning, a division of Thomson Learning, Inc.,Technological Advancements in Acute Care Clinical Practice,Computers at the bedside facilitate more efficient recording of assessments and actions.,7-7,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Hospital,Wirele
6、ss Communication Paging systems allow nurses to be contacted regardless of their location. Electronic phone devices (cell phones) allow two-way communication among nurses. Handheld wireless computer devices or personal digital assistants (PDAs),7-8,Copyright 2004 by Delmar Learning, a division of Th
7、omson Learning, Inc.,Hospital,Electronic Health Record (EHR) All information related to the client is recorded electronically. Information is recorded legibly and more completely than in handwritten form. Provides accessibility to all members of health care team from any point of service. Orders are
8、 conveyed to appropriate departments from a computer terminal.,7-9,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Hospital,Electronic Health Record Laboratory results are posted directly into clients record. Appointments are scheduled. Printed discharge summaries, referral o
9、rders, teaching guides can be customized. Home care nurses have access to the hospital information system.,7-10,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Hospital,Decision-Making Support Systems (Expert Systems) Alert the nurse to abnormal diagnostic findings. Warn the
10、nurse regarding factors related to medication administration. Support use of the nursing process. Additional programs provide procedural guidelines.,7-11,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Legal and Ethical Issues: Privacy and Confidentiality,Methods to limit acc
11、ess to client information via computerized systems: A firewall, passwords, codes provide limited access. Backup files should be stored separately. Computers are placed in a secure area. Closed-circuit television surveillance. Automatic recording of any activity.,7-12,Copyright 2004 by Delmar Learnin
12、g, a division of Thomson Learning, Inc.,Legal and Ethical Issues: Privacy and Confidentiality,When documenting with computers, the nurse must still remember the principles for legal documentation. Identify the right client and the right record. Record date and time of each entry. Sign the entry with
13、 correct professional credentials.,7-13,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Technological Advancements in Ambulatory Care Services,Ambulatory care services are client care services that are delivered within 24 hours. Ambulatory care centers are usually satellites
14、within a hospital network.,7-14,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Advanced Technology and Ambulatory Care,Provide many short-term services that require advanced technology: Endoscopic Examinations Elective Surgeries Dialysis Radiation Chemotherapy,7-15,Copyright
15、 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Advanced Technology and Ambulatory Care,Free-standing birthing centers Day care Rehabilitation centers Community-based, nurse-managed centers,7-16,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Advanced Technolog
16、y and Ambulatory Care,This child is having an audiology test performed in a community-based, nurse-managed center.,7-17,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Advanced Technology and Ambulatory Care,Mammogram technology has become a common method for wellness promoti
17、on for women over the age of 40.,7-18,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Advanced Technology and Ambulatory Care,This bone density scan equipment is very expensive and requires adequate resource allocation for smaller health care agencies to afford its purchase.,
18、7-19,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Technological Advancements in Ambulatory Care Services,Care Map A plan of care based on standards that reflect optimal timing of sequential steps in managing health problems.,7-20,Copyright 2004 by Delmar Learning, a divisi
19、on of Thomson Learning, Inc.,Technological Advancements in Ambulatory Care Services,Advanced Technology and Documentation Provide access to a clients hospital/clinic records. Used to order prescriptions, schedule tests and future appointments. Used to record information related to the visit.,7-21,Co
20、pyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Technological Advancements in the Home and the Community,Use of mechanical ventilators, infusion pumps modified for home use Computer access to client records and diagnostic information Communication with others on health care tea
21、m Electronic mail to transmit progress reports,7-22,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Technological Advancements in the Home and the Community,Home Care Monitoring Devices Identify changes in a clients condition. Assist client and non-professional care provider
22、to follow prescribed plan of care. Maintaining medication routines Monitoring blood sugar levels Recording vital signs,7-23,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Home Care Monitoring Devices,Cardiovascular Monitoring Devices Holter cardiac monitor and diagnostic too
23、l Cardiac pacemaker monitoring and regulating,7-24,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Home Care Monitoring Devices,Home Monitoring of High Risk Pregnancy Evaluation of uterine activity and fetal heart rate via television and telephone hookup,7-25,Copyright 2004 b
24、y Delmar Learning, a division of Thomson Learning, Inc.,Home Care Monitoring Devices,Automated Telephone Monitoring System “Home Talk” Clients with chronic health problems Menu of “problem specific” questions Scores tallied and rated according to a predetermined standard Phone contact made for any n
25、egative changes or clients failure to answer a call,7-26,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Emergency Response Monitoring Systems,Particularly helpful to elderly persons living at home in the event of a: Fall, heart attack, stroke Linked directly to a monitoring
26、agency.,7-27,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Telehealth, Telemedicine, and Telenursing,Home-based technology providing telecommunication services in health care delivery. These services are conducted through video, audio, and computer systems.,7-28,Copyright 2
27、004 by Delmar Learning, a division of Thomson Learning, Inc.,Telehealth, Telemedicine, and Telenursing,Allows “virtual office visits” via audio-video monitors. Clients test their blood pressure, oxygen levels, and blood sugar levels. Health care providers respond with instructions. Access to on-line
28、 courses for clients. Additional communication by e-mail.,7-29,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Telehealth, Telemedicine, and Telenursing,The Governments Role Support for emergency care for combat casualties, diagnostic studies, computerized client records, and
29、 links for aeromedical evacuation,7-30,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Telehealth, Telemedicine, and Telenursing,Telehealth Distribution Worldwide connections between health professionals and clients Transmission of client information from inside ambulances du
30、ring transport,7-31,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Telehealth, Telemedicine, and Telenursing,Finances and Telehealth Issues High costs of equipment and installation too costly for many agencies. Reluctance of some physicians, other health care providers, and
31、clients. Reimbursement and interstate licensure restrictions have limited widespread acceptance.,7-32,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Advances in Biotechnology,Magnetic Resonance Imaging (MRI) Computed Tomography (CT) Electromyography Fiber Optics Computerized
32、 Microscope Digital Cameras,7-33,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Cost of Biotechnology,Research and development costs overshadow need for funds for illness/disease prevention and health promotion measures. Cost control strategy: Managed care is major reimburse
33、ment system at present.,7-34,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Nursing Roles and the Use of Advanced Technology,Nurse Administrators/Managers Some nurses become certified in Nursing Informatics. Nurse Educators,7-35,Copyright 2004 by Delmar Learning, a division
34、of Thomson Learning, Inc.,Advanced Technology Use by Nurse Administrators/Managers,Computer Information Systems Community Health Information Networks (CHINs) Smart Card (computer disk for carrying information),7-36,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Advanced Tech
35、nology Use by Nurse Educators,Computer-Assisted Instructional (CAI) Programs Audio-Visual Presentations Distance Learning “Virtual Learning Labs”,7-37,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Nursing Research and Advanced Technology,National and international computer
36、databases enhance literature searches. Theses and dissertations to be submitted electronically to their universities and made available through digital libraries. The Washington, DC Area Nursing Research Resources (WANRR) website.,7-38,Copyright 2004 by Delmar Learning, a division of Thomson Learnin
37、g, Inc.,Classification Systems for Nursing Language,Computers have contributed greatly to the development of a standardized language for documenting nurse-sensitive outcomes and client outcomes.,7-39,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Classification Systems for N
38、ursing Language,The Unified Nursing Language System (UNLS) Developed by the American Nurses Association (ANA) in 1991. Encompasses common nursing terms from a variety of vocabularies that can be used interchangeably.,7-40,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,Classi
39、fication Systems for Nursing Language,Advanced technology has allowed for an easier use of four classifications systems recognized by the ANA: The North American Nursing Diagnosis Association (NANDA) The Omaha Classification System (OCS) The Home Healthcare Classification (HHC) The Nursing Intervent
40、ions Classification (NIC),7-41,Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.,High-Tech, High-Touch Nursing,It is imperative that the nurse balance “high-tech” (advanced technology) care with the caring aspect of nursing. Personal contact is still a very important part of nursing that technology cannot replace.,
