Kathryn J. Hannah

Nursing Informatics: Where Caring and Technology Meet

From the Publisher: Since publication of the first edition in 1988, Nursing Informatics: Where Caring and Technology Meet has established itself as the premier reference text for nurses, nursing administrators, nursing students, and other health care professionals who seek a state-of-the-art review of the role of information technology in the nursing profession. The third edition of this seminal work will keep readers at the forefront of the rapidly evolving field of nursing informatics, examining new trends and thoroughly updating and revising all content. New chapters include: Selecting a Nursing Informatics Consultant; Project Management; Consumer Informatics; Data Mining; Education (CME, Patient); Electronic Medical Imaging; Nursing Informatics Competencies; Telehealth and Implications; Business Process Reengineering; Nursing?s Role in Telehealth.

Using Computers in Nursing

No wonder you activities are, reading will be always needed. It is not only to fulfil the duties that you need to finish in deadline time. Reading will encourage your mind and thoughts. Of course, reading will greatly develop your experiences about everything. Reading using computers in nursing is also a way as one of the collective books that gives many advantages. The advantages are not only for you, but for the other peoples with those meaningful benefits.

The process of change related to health policy shift: reforming a health care system

Efforts of governments to adjust the responsiveness and efficiency of their health care systems are evident across the globe. In the seemingly constant search for solutions providing both better health outcomes and manageable costs, the directions and designs for change are neither consistent nor well studied. Opportunities for shared learning concerning what strategies for transforming health care systems lead to effective and sustainable change are being missed. There is an urgent need to study and understand the processes of change initiated by health policy shifts aimed at controlling health care costs, altering health service delivery and influencing outcomes of health care. In partial response to this need, research was initiated to study health policy transition within the Western Canadian province of Alberta. The primary objective of this research was: to identify, describe, compare and contrast the processes of change adopted and implemented in a variety of health authorities as a result of health policy shift. Change processes initiated by a specific health policy shift (the restructuring of Alberta’s health care system) were explored from the perspective of the change agents (individuals managing the health system reforms) in order to discover indicators of effective change and to identify questions for further consideration and testing in relation to change process related to health policy shift. This qualitative exploratory study coincided with real time alteration to the health system via legislated health policy shift. Findings relate changes in the structure, process and outcome of the health policy transition. Additionally, a number of questions linked to the reported findings are highlighted to encourage additional and continuing efforts to improve understanding of change process related to health policy shift.

Managing Change in the Context of Health Reform: Lessons from Alberta

A qualitative field study of health system reform in Alberta was undertaken to identify, describe, compare and contrast the processes of change management adopted and implemented as a result of legislated health policy shift. Chairs and chief executives of the new regional health authorities and provincial leaders managing the change processes within Albertas health care system were interviewed. Components of change strategies important to the structure, process and impact of the health policy shift to a regionalized system of care were identified and analyzed. Stakeholders involved in managing change inside Albertas health care system were able to consistently identify a range of issues important to beginning and sustaining health policy shift. These issues and insights did not come from the literature, but rather from experience. To test and share this experience further, it will be important to study more consciously the management of change in relation to expected outcomes. With so many natural experiments altering health care systems across Canada and beyond, a window of opportunity exists for researching both the quality and quantity of such change, comparing and sharing findings over time and, eventually, linking process to outcome.

Hyperoxia: Effects on the vascularization of the developing central nervous system

SummaryLitters of experimental and control hamsters were killed on postnatal days 3, 4, 7, 14, 21, and 28 following 7 days of exposure to 85% oxygen at normabaric pressure. Using analysis of variance (ANOVA), light microscopy quantitation of the number of blood vessel profiles per unit area in the region of the frontal cerebral cortex demonstrated that the combined effect of treatment and age on the animals produced a highly statistically significant difference (P<0.001) in the numbers of blood vessel profiles. The statistically separated treatment effect was also found to be significant (P<0.05). The data are summarized in Table 1. Ultrastructural analysis of animals exposed to oxygen only, i.e., killed without being returned to the normal air environment, demonstrated severe signs of vaso-obliteration. Animals which were returned to a normal atmosphere following 7 days in oxygen showed a progressive decrease in the signs of vaso-obliteration. This present study demonstrated the marked similarity between the effects of hyperoxia on the CNS and on the neuro-retina.

Transforming Information: Data Management Support of Health Care Reorganization

Health care delivery systems and organizations around the world are undergoing reorganization and reengineering. Rational decision making about such activities must be based on information. Much of the presently available data is inadequate for this task, and therefore needs to be transformed. One such experience in the province of Alberta, Canada, is discussed. The development of a comprehensive information strategy, the need to apply information management principles, the organizational implications of information management, and a conceptual model for achieving added value from health data are described.

Clinical Practice Applications: Community-based

Community health agencies in general, and nursing in particular, have been slow to take advantage of computer technology beyond the mere collection of financial and statistical information. Saba and Levine (1981) report that an evaluation, done in 1976, of approximately 4500 community health agencies in the United States revealed that only 60 agencies had operational, computerized management information systems. Almost all of the 60 systems were designed to collect “financial or statistical information that focused on the home nursing visit.” The data being collected by these systems could not measure how the client was affected by the nursing care he received nor could it “describe the patient or the care rendered.” In this survey of community health care agencies, systems that were patient oriented were not found, even though patient records contained data on needs, progress, care, and outcomes.

The Future for Nurses in Health Informatics

As a new millennium approaches the emphasis in health informatics is increasingly changing. The initial focus was on hardware and moved to an emphasis on software. As understanding of health informatics evolves, increasingly that hardware and software are recognized as merely means of capturing, transporting, and transforming data into information that enables caregivers to provide people with the best possible health services. There is an information rich environment with new and powerful tools to assist caregivers and care recipients alike to seek and use information to make health-affecting decisions and to generate new health knowledge. Expanded understanding of how people seek and use information by drawing on cognitive science and organizational development (Tang and Patel, 1992; Lorenzi et al., 1995) is essential.

What Is Informatics and What Does It Mean for Nursing

Today, nurses around the world are rapidly increasing the extent to which they use computers and information sciences to assist them in the performance of their increasingly sophisticated and complex duties. Consequently, the field of nursing informatics is developing quickly. Because of the evolution of nursing informatics, new roles for nursing are developing in industry, research, systems development, nursing education, nursing administration, and indeed at the bedside. One need not sacrifice an avocation for direct patient care to participate in the information revolution in nursing. In fact, the reason that many nurses have ventured into the field of nursing informatics is a common vision of information systems being used to enhance the practice of nursing and to benefit the patient by extending and improving the health care received.

Nursing Aspects of Health Information Systems

Motivation for the development and implementation of computerized hospital information systems has been financial and administrative, i.e., driven by the need to capture charges and document patient care for legal reasons The majority of systems marketed today have been motivated by those two factors. Historically, such systems have required a major investment in hardware (typically a mainframe), and, even though they have demonstrated significant improvement in hospital communications (with a corresponding reduction in paper flow), they have been characteristically weak in supporting professional nursing practice. These factors have prevented the level of acceptance by nurses that was originally foreseen. Only recently have developers and vendors begun to consider the nature of modern nursing practice and its information processing requirements (see Figure 6.1).