A Bonus Blog

Ran across these ladies doing my internet searches. This is the nurse I want to be! Excited, interactive, and funny as heck.

Nurses and Technology

Nurses and Technology

Medicine has always been in the forefront of technology. New inventions had to be created to continue to better patient outcomes. One of those early discoveries was made by Dr. Martin A. Couney. He felt that there was a way in which to save and nurture the premature babies of the day. His colleagues disagreed, so he needed a way to show off his invention. A Coney Island sideshow offered him the opportunity to display his babies in incubators, thereby showing how well this new technology was working. The first incubators were crude, but effective. They were the precursors of today's incubators. And as the picture shows, nurses were the ones who were running these boxes that held and nurtured tiny lives.

Another important piece of technology that was created by doctors and scientists, but administered by nurses was the iron lung or negative pressure ventilator. The technology first arose in 1670, but became prominent in the late 20's. The first clinical use of the Drinker respirator on a human was on October 12, 1928, at the Boston Children's Hospital. The subject was an eight year old girl who was near death as a result of respiratory failure due to polio. She made a dramatic recovery, within, less than a minute of being placed in the chamber, thereby popularizing the new device in the treatment of polio. 

Today's nurses have to be in the forefront of the electronic medical record revolution. As nurse leaders, we must be the example for which our staffs and colleagues measure their own performance against. This video is leadership done right -- if you are excited about the use of the new technologies your staff will be also.

Another important example to be set is that of how we use that electronic medical record. Data mining is becoming an amazing resource for medical and nursing knowledge. However, for data to mined accurately and usefully, it must be good data. When a nurse leader charts sloppily, using abbreviations, nicknames, and colloquialisms, then her staff will do the same. If a nurse manager doesn't chart in a timely manner, neither will her staff. 

There are many resources available for Nurse Leaders of today to use to help their staff. One is Nurse Leader, a web site full of helpful articles and resources. Another site provides the nine principles of nursing leadership, which are a short, very useful list that gives new or existing nurse leaders a great starting point for nursing leadership excellence.

As this cartoon shows, you get what you put in.

To be a leader of any group you must be willing to be the first to do something, the one to show how it is done, and the one who continues to improve and use the new system with willingness and enthusiasm, and those who follow you will do the same.

References

Babies in incubators were once an attraction at Coney Island (n.d.) Retrieved from http://io9.com/5885939/babies-in-incubators-were-once-an-attraction-at-coney-island

Jensen, P.B., Jensen, L.J., and Brunak,S. (2012) Mining electronic health records: towards better research applications and clinical care. Nature Reviews Genetics. 13. 395-405.

Schwirian, P.M. (2013) Informatics and the future of nursing: harnessing the power of standardized nursing terminology. Bulletin of the American Society for Information Sciences and Technology. 39(5). 20-24.

Workflow Changes

Adding Bedside Charting

In her article Rebecca Hendren noted ten ways to increase nurses' time at the bedside. One of the ways she suggests is bedside documentation. She notes, that charting at the bedside improves patient safety, but it's also been shown to save time. She also notes that bedside reporting and hourly rounding can also increase this bedside time. Adding to the time you spend with your patient and their families not only increases the safety of the patient and saves time, but it also can lead to more accurate, real-time charting, reduces errors in medication administration, and can lead to better and more frequent observations of your patient's condition, thereby, perhaps allowing for better and faster responses to changes in that condition.

Having real-time bedside charting also allows other providers to be viewing the data in the instant that it is recorded, giving these providers the chance to act more quickly to solve issues as they arise. In her article, Laura Stokowski notes that probably the single most significant effect on workflow prompted by the emergence of electronic medical records (EMRs) is the real time charting that occurs. If the EMR is not used in this manner, it negates the effectiveness of the immediacy of the data being used by the rest of team.

Another issue that often arose with paper charting was the need for nurses to stay after their shifts to finish all the handwritten notes and flowsheets. The usage of real time bedside charting has reduced this need, thereby saving money in overtime costs.

Nursing Management conducted a survey of 1000 nurses to learn about the technology they use. They found that 49.9% of them stated that 81 to 100% of their charting was at the bedside, while 56.1% stated that the charting was done at computers at the nurses' station. This leaves much room for improvement. Increasing bedside chart will lead to improved patient outcomes, more accurate real time charting, and more satisfied, less stressed nurses.

References

Evans, O. (2014) Hospitals to replace bedside charts with iPads. Oxford Mail. Retrieved from http://www.oxfordmail.co.uk/news/10914011

 

Hader, R. (2013) How connected are you? Nursing Managementt. February. 19-23.

Hendren, R. (2010) Ten ways to increase nurses' time at the bedside. HealthLeaders Media. Retrieved from www.healthleadersmedia.com

Stokowski, L.A. (2013). Electronic nursing documentation: charting new territory. Retrieved from www.medscape.com.

 

We Love Data!

We Love Data!

Knowing how data surrounds us, affects us, and is effected by us, it is important to know as much as we can about it. This video will help introduce you to the wonderful world of data.

Nurse Leaders and Nursing Informatics

How do you lead your staff into the technological frontier?

The best way is by example. As a nurse leader, the changes that have come about just in the last few years with the emergence and gaining dominance of the electronic medical record (EMR) could be very overwhelming. Embracing this change for yourself and then being able to pass that enthusiasm onto your nurses is key to developing a department that is in the forefront of your institution's informatics revolution.

In a brief by the Academy of Canadian Executive Nurses (ACEN) their was a suggestion of the need to develop innovative leadership competencies that enable nurse leaders to lead and advance transformative health system change. Specifically, this competency is articulated as "state of the art communication and technology savvy," and it implies linkages between nursing informatics competencies and transformational leadership roles for nurse executive (Remus & Kennedy, 2012). In this way, their nurse leaders could be trained and become comfortable with all the changes that are facing their departments and, with this comfort comes confidence, thus being able to lead their nurses.

Another important factor is to realize that no one person can achieve change alone. The change can start with one, but must include others to help with the surge. Therefore, it is not only important for the nurse manager to look towards her management for assistance, but to also surround herself with the staff that can assist her. In looking to management, there is an emerging type of nursing management, the Chief Nursing Informatics Officer (CNIO). This position is a nurse who leads the region in the strategy, development and implementation of information technology to support nursing, nursing practice, and clinical applications, collaborating with the Chief Nursing Officer (CNO) on the clinical and administrative decision making process (Retrieved from http://www.himss.org). Also, getting the rest of the staff involved in the changes, allowing them ownership of such change, and, then, having them help to disseminate the change to the rest of the staff not only builds morale but also creates a team atmosphere.

This nurse manager and her team seem to have a great selection of YouTube videos called "Nurses PRN" discussing topics that are important to their nursing teams. I found the approach refreshing and innovative. What a great way to use technology to tout technology.

In conclusion, the nurse manager first has to learn to be an informatics leader herself and then she can ask her staff to join her in the exciting world of Nursing Informatics.

References

Chief Nursing Informatics Officer Job Description. HIMSS Nursing Informatics. Retrieved from http://www.himss.org/files/FileDownloads/CNIO%20Job%20Descriptions_1392155663869_5.pdf

Garde, S, Harrison, D., and Hovenga,E. (2004). Skill needs for nurses in their role as health informatics professionals: a survey in the context of global health informatics education. International Journal of Medical Informatics.74(11-12) 899-907.

Nursing Leadership Management and Leadership Styles(2014) AANAC Extras. Retrieved from http://www.aanac.org/docs/white-papers/2013-nursing-leadership---management-leadership-styles.pdf?sfvrsn=4

Remus, S.and Kennedy, M.A. (2012) Innovation in transformative nursing leadership: nursing informatics competencies and roles. Nursing Leadership. 25(4) 14-26.

Human Interface Technology and Virtual Reality

Human Interface Technology

 

Human interface technology is a discipline concerned with the design, evaluation, and implementation of interactive computing systems for human use. Computers make it possible for a technology to do many different tasks and react to commands from the user in efficient, effective, and appealing ways (IT Exponent, School of Information Studies). On a daily basis, humans interact with many myriad forms of technology, our coffee makers, our cars, our smart phones, computers, even doors that open automatically. We do this easily and without thinking of the wonder of that interaction. Medical applications of this interface are also myriad, from smart phone apps to track your diet and exercise progress, to telemedicine opportunities, and further to robotic surgeries and the uses of virtual reality.

There are many uses to virtual reality in the medical community. The one that I found most interesting, having a background in caring for patients with extensive burns to their bodies was the use of the application for the reduction of pain during the burn care process. Normal burn care is an extensive and painful process, generally requiring large amounts of medication to be tolerated. It has always been known that the introduction of some sort of distraction, music or television generally, could help reduce the pain associated with this daily care. Now researchers have not only achieved anecdotal pain relief as reported by patients, but have studied MRI results of patients that have shown that individuals who were engaged in virtual reality during the testing have displayed reduction of pain-related brain activity. The United States Army is utilizing this type of therapy for its wounded veterans. The veteran is shown to be receiving wound care for his burns while engaged in playing in the virtual reality SnowWorld. No only does this provide distraction, but as the developer of the game notes, snow is the opposite of fire.

Another way to utilize virtual reality in the medical community is through the treatment of phobias. A similar application to SnowWorld, SpiderWorld was created to help ease the phobia of spiders among its participants with great success. In this video, the doctor explains that overcoming social phobias is difficult, but with the use of virtual reality, the process can be made easier and more convenient.

Both of these are useful, adaptable, and forward thinking ways for the human technology interface we use everyday to aid the medical community. Imagine what is left to discover on the implementations for this fantastic science.

References

Hoffman, H.G. (2014) Virtual reality therapy. Scientific American. August. 58-65.

How do doctors use virtual reality to treat phobias? How Stuff Works. Retrieved from

http://science.howstuffworks.com/life/virtual-medicine.htm

Human interface technology. IT Exponent. Retrieved from

http://itexponent.ischool.syr.edu/index.php?option=com_content&view=article&id=65:hit&catid=39:aet&Itemid=62

Virtual reality pain reduction. University of Washington Seattle and U.W. Harborview Burn Center. Retrieved from

http://www.hitl.washington.edu/projects/vrpain/index_files/SCIAMFin.pdf

Virtual reality video game to help burn patients play their way to pain relief. (2008). Science Daily. Retrieved from

http://www.sciencedaily.com/releases/2008/03/080319152744.htm