This presentation provides a short historical overview of the evolving use of technology in nursing practice by means of an introduction to the topic. A review is then presented on the latest classes of devices in use in healthcare delivery (with examples), their supporting communication systems and considerations of their strengths and limitations. A key meesage to the healthcare sector is that this technological advancement is speeding ahead of policy, procedural and infrastuctural considerations. The personal use of devices has become embedded in practice leading to random and unregulated use and limited attention to codes of safe practice and recommended standards of care.

1. New Technological Advances and Trends in Nursing-
Update
Wednesday 28 October Academic Year 1437
Umm Al- Qura University
College of Nursing
Faculty of Medicine
Dr Grace Lindsay
Professor of Medical Surgical Nursing
College of Nursing
Umm Al-Qura University

2. Information search
Term- Healthcare technologies
Google Scholar
Medline
Convenience sample of users

3. Purpose of session
• Overview of trends and
practices using new
information technologies
(IT)
• Consider IT applications
and their impact on
practice, safety and
effectiveness
• Explore possible areas for
development in existing
teaching programmes
• Discuss areas for
investigation and research

4. Historical perspective
• Late 1940s…’nursing the
equipment trend’..therapy
oreintated
• 1950-1960s …new medications
(e.g.antibiotics), IV therapy,
blood/+products
• 1960s-80s…’machines of all
kinds’..dialysis, cardiac
monitors, automated recording
devices
• 1980s onwards..computers in
healthcare; patient safety
monitors, wireless charting,
robotics, telehealth +++

7. Benefits of new technology
• Efficient storage and retrieval of data
• Access to information
• Communication
• Organise and coordinate routine processes e.g
appointments; action prompts
• Summarise and generate activity reports
• Being made easier to use through
– Portable devices
– Friendly user interface
– Wireless , satellite, cable media

8. Functions enhanced by use of new
technologies
• Faster data collection
• Stores large amounts of
data
• Easy access by many
• Reduces duplication
• Interactive-prompts;
Access to information
sources; measurement
tool scoring
• Smart Technology: Early
warning systems; falls risk
+++
• Analysis/interpret
data inputs
(direct/indirect)
• Subtle trends
identified in ‘real-
time’

9. Applications of IT
• Drug information
including, action,
dosage, interactions etc
• Clinical guidelines
• Decision-making
• Accessing patient
medical records
• Access to most recent
tests/investigations

10. • Call centres
Directing health
enquires via
computer-based
algorthims
Decision-making
function

12. Triage and immediate management in
Emergency room
Canadian Triage Score
• Vital signs, preliminary
clinical assessment made
• Code of urgency assigned
• Monitoring schedule
selected
• Surveillance coded via vital
signs
• Alarm and decision-making
output (!!noise issues!!)

13. Feedback on Emergency Triage System
• Good for
inexperienced
• ‘Cumbersome’
• Time consuming for
experienced staff

15. IT systems: Point of Care Devices (POC)
• Array of devices,
systems, software
• Quicker access to
information at patient
level
• Aim to reduce time on
task such as
– Finding equipment
– Collaborating with other
staff
– Ordering tests
– Updating patient records
– Appointment scheduling

16. Point of Care Devices-Evaluation studyLarge survey in Australia
• 60% reduction in vitals signs
documentation (30mins/nurse/shift)
saved
• Clinical data latency reduced by
• more than 2 hrs
• 83% reduction in data items needed
to be transcribed
• Time-consuming computer log-ins
reduced by 20%
• 20% increase in automated vital sign
acquisition and POC charting Nursing Informatics and technology:
A blog for all level users Jan 2011

17. Some examples
Smartphones use in self-management
Chronic disease
management
• Support patient self-
monitoring
• Diet, exercise, BP,
HR, lifestyle choices
• Keeping logs of actions
and results (e-diaries)
• Providing guidance on
care management
• Can aid consultations
with HCP
•No easy access
for
back-up advice/
interpretation

18. Benefits (cont.)
• Aids decision making
in ‘real time’
• Access many sources
of patient and
professional
information through
single portal
• Travels with you
• Telephone, computer
and internet access at
your fingertips!
Store and access large volume of written materials
Quick access to clinical guidelines at point of use

20. Specific use in practice: Pharmacy
• Pharmacists advising on
therapy administration
working at ward level
‘must’ have portable
‘Internet access device’
for complex protocols
used in practice
• Bar scanning
medications

21. Technology in a contemporary health care
setting
Note:
Patient also IT engaged
Concern of possible reduction in inter-personal relationships...???
could have ‘computers talking to computers’

22. Implementation of new technology
strategy: considerations
• Technical design should
be ‘user-friendly’
• Good interfaces with
user/task/ patient/other
tasks
• Integration with other
aspects of healthcare
environment
• Cost-effective??
• Enhance standards and
quality of care
• Education and Training
• Support and
maintenance
• Compatibility with other
devices
• Long ‘shelf-life’

23. Engagement of technology in practice

24. Some concerns (1)...
• Personal and professional
technology has outpaced policy
and codes of practice and
education????
• Reduction in inter-personal
interactions
• Wi-fi networks; hard wire
systems-limited access
• Mainframe server access;
security; maintenance; manager
• Supplier of devices (approval);
cost of usage?
• Staff training
• Quality control and standards

25. Complexity and danger
Existing hospital
infrastructure not
always able to cope
with the pace of
technology

26. Some concerns (2) …..
• Ever advancing
systems/devices
• Compatibility with other IT
systems
• Can be distracting from
patient care
• Could be construed as being
used for recreational
purposes
• Security; confidentiality;
backup
• Energy maintenance
• IT support; calibration
• Back up data

29. US Top 10 Patient Safety Concerns for 2014
(0.3m reports)
• Data integrity failures
with health IT systems
• Poor care coordination
with next level of care
• Reporting errors of test
results
• Drug shortages
• Inadequate management
of behavioural issues in
acute settings
• Mislabelled specimens
• Retained devices /un-
retrieved fragments
• Patient falls while toileting
• Inadequate monitoring of
respiratory depression in
patients taking opiates
• Inadequate re-processing of
endoscopes and surgical
instruments
Emergency Care Research Institute .
http://www.ECRI.org/2014hazards

30. Don’t loose sight of the patient in
electronic cyberspace!!

31. Educator Role …….application,
management and generation of new
knowledge
Tele-medicine

32. Practice
ResearchEducation
New
technologies: ?
position in current
activities

33. Research: possible areas
• Infection control
• Family health care
• Quality
• Evaluation of Self-care
monitoring with tailored
feedback in chronic disease;
health promotion
• Acceptability by patients,
clinical staff of existing and new
systems
• Monitoring CQI’s in relation to
impact of new technologies
• Pattern tracking e.g.errors; root
cause analysis

34. Research Strategy taking into account
role of existing and emerging technology
• Feasibility /Acceptability
• Outcome Evaluation
– Pre-post test comparisons
• Devices can be research tools in own right

35. Implications for nurse education
Reflect use and application of new technology to
curriculum
– Fundamentals of Nursing
– Communication
– Documentation
– Evidence-based practice
– Patient care support
– Diagnostics
– Supporting patients in the use of electronic devices
– Interpretation of patient self-care schedules
– Critical appraisal

37. Thank you

38. Discussion
Points of discussion this topic or
future areas
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