Beth L. Elias

Smart pump technology: what we have learned.

Intravenous infusion may present the greatest preventable medication administration error risk to hospitalized patients. Smart pumps can provide clinical decision support at the bedside for nurses who are administering intravenously administered medications with the potential to significantly reduce medication errors and subsequent patient harm. However, implementations of smart pumps have yielded mixed results and mixed perceptions of their ability to actually decrease error. To realize the potential of smart pumps, there must exist a clear understanding of how these devices are being integrated into healthcare organizations, specifically nursing practice. The purpose of this article was to describe current smart pump evaluation studies and to suggest areas of future evaluation focus.

Nursing-Centric Technology and Usability A Call to Action.

K Nancy Staggers, PhD, RN, FAAN Department of Biomedical Informatics and College of Nursing, University of Utah, Salt Lake City, Utah Beth L. Elias, PhD, MS School of Nursing, Virginia Commonwealth University, Richmond, Virginia Jane R. Hunt, MS, BSN, RN Ellen Makar, MS, RN-BC, CCM, CPHIMS, CENP Office of the National Coordinator for Health IT, US Department of Health and Human Services, Washington, DC Gregory L. Alexander, PhD, RN, FAAN Sinclair School of Nursing, University of Missouri, Columbia, Missouri.

Implementation of an electronic health records system within an interprofessional model of care

Abstract Implementation of electronic health records (EHR) systems is challenging even in traditional healthcare settings, where administrative and clinical roles and responsibilities are clearly defined. However, even in these traditional settings the conflicting needs of stakeholders can trigger hierarchical decision-making processes that reflect the traditional power structures in healthcare today. These traditional processes are not structured to allow for incorporation of new patient-care models such as patient-centered care and interprofessional teams. New processes for EHR implementation and evaluation will be required as healthcare shifts to a patient-centered model that includes patients, families, multiple agencies, and interprofessional teams in short- and long-term clinical decision-making. This new model will be enabled by healthcare information technology and defined by information flow, workflow, and communication needs. We describe a model in development for the configuration and implementation of an EHR system in an interprofessional, interagency, free-clinic setting. The model uses a formative evaluation process that is rooted in usability to configure the EHR to fully support the needs of the variety of providers working as an interprofessional team. For this model to succeed, it must include informaticists as equal and essential members of the healthcare team.

Development of a simulated smart pump interface.

Medical device user interfaces are increasingly complex, resulting in a need for evaluation in clinicallyaccurate settings. Simulation of these interfaces can allow for evaluation, training, and use for research without the risk of harming patients and with a significant cost reduction over using the actual medical devices. This pilot project was phase 1 of a study to define and evaluate a methodology for development of simulated medical device interface technology to be used for education, device development, and research. Digital video and audio recordings of interface interactions were analyzed to develop a model of a smart intravenous medication infusion pump user interface. This model was used to program a high-fidelity simulated smart intravenous medication infusion pump user interface on an inexpensive netbook platform.

Education in Nursing Informatics

Nurses at all levels of practice and specialization are, at their core, knowledge workers. They collect data from numerous human and electronic sources and organize these data for analysis and dissemination to all members of the healthcare team. Nurses and others use information derived from these data as the basis for optimum clinical decision-making. Increasingly, nurses are using technology to facilitate the collection and use of data and information in their practice and nursing educational programs are preparing them to gain related competencies. This chapter provides an overview of the use of technology in nursing practice and the computer competencies, information literacy, and data management content needed in educational programs to prepare nurses for basic, advanced, and informatics practice.

Local Global Access: Virtual Learning Environment

A few years ago, during the American Informatics Medical Association’s annual conference keynote address, Dr. David Brailer spoke about the importance of integrating information technology (IT) in healthcare. His remarks included the old saying about how a rising tide floats all boats. This adage prompted a discussion between nursing informatics leaders at the conference on the kind of nursing boats that could be launched on this rising tide. Nurses have long embraced the use of technology in practice and have been leaders in the use of technology in education.1 However, there are some gaps in the informatics and information literacy competencies we teach in nursing education that are needed for effective nursing practice (Pravikoff et al 2005 and Jensen 2009). The nurses hearing Dr. Brailer saw the need to organize a concerted effort to integrate the use of IT into practice and education in the future. It is this rising tide of nursing practice incorporating new technologies that will “float the boat” of healthcare information technology (HIT) adoption.