Nursing Informatics

(NCM 110)

Rhizel Marie C. Fariñas

2BSN-C
Informatics HEMODYNAMIC MONITORS
 Applications in Evidence-Based  Machines under the human-machine
Nursing Practice. interface used specifically for the
following:
A. Computer Generated Nursing 1. Measure hemodynamic
Care Plans parameters closely to
B. Critical Pathways examine cardiovascular
C. Clinical Guidelines function.
D. E-journals 2. Evaluate cardiac pump
output and volume status.
Hospital and Critical Care Applications: 3. Recognize patterns
 PHYSIOLOGICAL MONITORING (arrhythmia analysis) and
SYSTEMS extract features.
 HEMODYNAMIC MONITORS 4. Assess vascular system
 Thermodilution Technique integrity Evaluate the
 Pulse Oximetry patient's physiologic
 Telemetry response to stimuli.
 ARRHYTHMIA MONITORS 5. Continuously assess
respiratory gases
various applications of information technology in this (capnography)
setting particularly focusing on patient care: 6. Continuously evaluate
glucose levels.
 Process store and integrate
7. Store waveforms
physiological and diagnostic
8. Automatically transmit
information from various sources.
selected data to a
 Present deviations from pre-set
computerized patient
ranges by an alarm or an alert
database.
 Accept and store patient care
documentation in a lifetime's clinical Pulse Oximetry
repository.
 Trend data in a graphical presentation  A critical piece of hemodynamic
 Provide clinical decision support information involves the availability of
through alerts alarms and protocols. oxygen to bodily tissues.
 Provide access to vital patient  Co-oximetry- standard for
information from any location inside measurement of blood oxygen
and outside the critical care setting. saturation.
 Comparatively evaluate patients for  A noninvasive method of measuring
outcomes analysis Present clinical oxygen saturation that also uses
data based on oriented views. spectrophotometry.
 Uses two wavelengths of light, red
Physiologic monitoring systems and infrared, to determine the oxygen
 Monitor vital physiologic parameters saturation level in the blood.
so that clinicians can be informed of  Calculates the oxygen saturation level
changes in a patient's condition. by comparing the ratio of absorbed
 Consist of several distinct components red and infrared light to the total
including: a central station, bedside amount of red and infrared light that
monitors, and ambulatory telemetry was transmitted through then
transmitters and receivers. patient's tissue.
Problems that can affect the accuracy of the database Data can be incorporated
Pulse oximeter readings: into flowsheets with other data
elements such as laboratory results
 Poor signal quality body results body system assessment
 Motion artifacts findings problem lists.
 Abnormal hemoglobin
 Skin pigmentation Clinical Information System (CIS)
 Nail polish  A type of healthcare information
technology system that is used to
Telemetry
manage and store patient health data,
 Allows for the continuous monitoring such as medical history, laboratory
of patients usually outside of the ICU. test results, medication orders, and
 Susceptible to signal loss. clinical notes.
 Include various types of  to facilitate the collection,
measurements, such as temperature, management, and use of patient
pressure, speed, position, vibration, health data to support clinical
and other physical or environmental decision-making and improve patient
parameters care.
 Data is transmitted in real-time or  includes several components, such as:
near-real-time, allowing for quick 1. Electronic Health Record
analysis and response to changes or (EHR)- the core component
anomalies in the system being of the CIS and is used to
monitored. store and manage patient
 They can provide valuable insights health data.
into the functioning and behavior of 2. Clinical Decision Support
complex systems, helping to improve (CDS)- provides clinicians
their performance, efficiency, and with information and alerts
safety. to support clinical decision-
making.
CRITICAL CARE INFORMATION 3. Computerized Physician
SYSTEMS Order Entry (CPOE)- allows
clinicians to enter medication
 A system designed to collect store,
and treatment orders directly
organize, retrieve, and manipulate all
into the EHR, reducing errors
data related to care of the critically ill
and improving patient safety.
patient.
4. Clinical Documentation-
 Provides a rich repository of patient
component allows clinicians
information that can be integrated for
to document patient
use in or outcomes management.
encounters and care in a
 includes: Patient management
structured and standardized
service, length of stay, mortality, and
way.
readmission rates.
5. Patient Portals- web-based
 Can use the healthcare organization's
applications that allow
system to schedule patient care
patients to access their
activities, treatment, and diagnostic
health data, communicate
testing.
with their healthcare
Vital Sign Monitoring providers, and participate in
their own care.
 Acquired from bedside instruments 6. Analytics and Reporting-
and incorporated into the clinical allow healthcare
 organizations to analyze and 6. Effective integration of information to
report on patient data to other disciplines to concretize
identify trends, improve knowledge
clinical outcomes, and 7. and creates better understanding.
manage population health. 8. Creation of computerized patient
records, medical information system
Community Health Applications 9. Central repositions of all data such as
 Focuses on the health information data warehouse.
system of the community, it is 10. Simple Graphical User Interface (GUI)
centered on the majority part of the for nurses and other healthcare
public. providers, patient, and consumer.
 Emphasizes the prevention of the Health Statistical Surveys
disease, medical intervention and
public awareness.  Are used to collect quantitative
 Fulfills a unique role in the information about items in a
community, promoting and protecting population to establish information
the health of the community at the from the obtained data.
same time maintaining sustainability  Focused on opinions or factual
and integrity of health data and information depending on its purpose
information. and many surveys involving
administering questions to
Goal of Community Health Informatics:
individuals.
 Effective and timely assessment that
Philippine Integrated Disease Surveillance
involves monitoring and tracking the
health status of populations including and Response (PIDSR)
identifying and controlling disease Goal:
outbreaks and epidemics.
 strengthen the surveillance and
Community Health Application System response capabilities at each level of
 Encourages optimal application of the health system by building local
computer systems, computer capacities and leveraging strengths
programs, and communication and areas of expertise through
systems for the benefit of the majority partnership and coordination.
of individuals, families, and Vision:
communities.
 To improve the availability and use of
Primary Focus of Community Health surveillance and laboratory data so
Information System: that public health managers and
1. Preventing, identifying, investigating, decision-makers can plan for and
and eliminating communicable health carry out more timely detection and
2. problems. Accessibility of data and response to the leading causes of
information, through communication illness, death, and disability.
3. Educating and empowering Function:
individuals to adopt healthy lifestyle.
4. Facilitate the retrieval of data. 1. Facilitate collecting, managing,
5. Effective transformation of data into analyzing, interpreting, and
information. disseminating health-related data
2. for diseases designated as
nationally notifiable.
 3. Develop and maintain national Emergency Preparedness and Response
standards, such as consistent case
definitions for nationally  Focuses on the mitigation and control
4. notifiable diseases applicable of emergencies.
across all provinces and cities.  The use of informatics here is much
5. Maintain the official national wider and more critical. The need for
notifiable disease statistics. information in real-time is very crucial
6. Provide detailed data to control in saving the lives of many.
programs to facilitate the  Bio surveillance- key capability of
identification of specific disease obtaining and maintaining situational
trends. awareness before and during a health
7. Work with cities and provinces emergency.
and partners to implement and
Telehealth
assess prevention control
programs.  the use of digital information and
communication technologies, such as
Ambulatory Care Systems computers and mobile devices, to
 A healthcare delivery system that access health care services remotely
provides medical care to patients who and manage your health care. These
are not admitted to a hospital, but may be technologies you use from
rather receive care on an outpatient home or that your doctors use to
basis. improve or support health care
 Refers to a wide range of medical services.
services, including diagnosis, Goals:
treatment, and follow-up care,
provided in settings such as clinics, 1. Make health care accessible to people
physician offices, urgent care centers, who live in rural or isolated
and mobile medical units. communities.
 Covers a wide range of services that 2. Make services more readily available
can be offered to patients that need or convenient for people with limited
medical attention. mobility, time or
3. Provide access to medical specialists.
Advantages: 4. Improve communication and
1. Access of medical records of patients coordination of care among members
to health care providers. of a health care team and a patient.
2. Nurses will be able to give quality care 5. Provide support for self-management
and improve workflow, reduce of health care.
medical errors.
Evidence-Based Practice
3. Management and monitoring the
billing, doctors' fees, prescriptions and  An approach to healthcare that
many more. involves using the best available
 Are particularly important for patients evidence, along with clinical expertise
with chronic conditions who require and patient preferences, to make
ongoing medical care, as well as for decisions about patient care.
those who require preventive care,  A systematic and structured approach
such as vaccinations and screenings. to clinical decision-making that
 Provide a cost-effective and integrates the best available research
convenient way to deliver high-quality evidence with the clinician's expertise
medical care to patients. and the patient's preferences and
values.
Steps: 3. Customization
4. Integration
1. Formulating a clinical question-
5. Consistency
involves identifying a problem or issue
in patient care that needs to be Critical Pathways
addressed and formulating a focused
and answerable clinical question.  considered to be one of the best tools
2. Searching for and appraising hospitals can use to manage the
evidence- involves systematically quality in healthcare concerning the
searching for and critically appraising standardization of care processes,
the best available evidence to answer since they promote organized and
the clinical question. efficient patient care based on
3. Integrating evidence with clinical evidence.
expertise and patient preferences-  proven that their implementation
involves considering the patient's reduces the variability in clinical
individual circumstances, clinical practice and improves outcomes.
expertise, and values, as well as the  also known as Clinical or Critical
available evidence, to make a clinical pathways.
decision.  Care pathway- multidisciplinary
4. Evaluating the outcome- involves healthcare management tool based
monitoring the outcomes of the on healthcare plans for a specific
clinical decision and adjusting it if group of patients with a predictable
necessary. clinical course, in which the different
 Used in healthcare to ensure that tasks or interventions by the
clinical decisions are based on the professionals involved in the patient
best available evidence, and to care (physicians, nurses, pharmacists,
improve patient outcomes. physical therapists social workers etc.)
 Used in a wide range of healthcare are defined, optimized and sequenced
settings, including hospitals, clinics, either by hour (ED) or day (acute
and community health centers. care).
 Shown to improve patient outcomes,  Appeared for the first time in 1985
reduce healthcare costs, and increase inspired by Karen Zander and
patient satisfaction. Kathleen Bower at the New England
 Important tool for ensuring that Medical Center in Boston.
healthcare practices are consistent  a powerful tool for care process
with current scientific evidence and management since they permit
for advancing medical knowledge. checking the compliance of all the
interventions included in the
Computer-generated Nursing Care Plans healthcare plan, fix care standards,
and introducing clinical audits as a
 Type of digital software that allows
part of the process.
healthcare professionals to create
personalized care plans for their Clinical Guidelines
patients.
 Generated using algorithms and  are statements that include
patient data to create an recommendations intended to
individualized plan of care. optimize patient care.
 informed by a systematic review of
Benefits: the evidence, and an assessment of
1. Efficiency the benefits and harms of alternative
2. Accuracy care options.
Guidelines: 4. Impact on patient population
morbidity and mortality. Research
1. Clinical practice guidelines should
should be conducted on how to
be feasible, measurable, and
effectively implement clinical
achievable.
practice guidelines and the
2. Clinical performance measures
impact of their use as quality
may be developed from clinical
measures.
practice guidelines and used in
quality improvement initiatives. E – Journals
3. In the clinical setting,
implementation of clinical  electronic journals are scholarly
practice guidelines should be publications in digital forms, which
prioritized to those that have the are accessible on the web.
strongest supporting evidence,  often used as an acceptable review of
and the most related literature for research projects
and evidence-based nursing practice.