NR 361 Trends in Informatics

NR 361 Trends in Informatics

NR 361 Trends in Informatics

Welcome to the Week 5 discussion. This week, we are going to discuss the trends seen in informatics and technology. I look forward to a lively discussion!

This week’s graded discussion topic relates to the following Course Outcomes (COs).

  • CO1: Describe patient-care technologies as appropriate to address the needs of a diverse patient population. (PO 1)
  • CO6: Discuss the principles of data integrity, professional ethics, and legal requirements related to data security, regulatory requirements, confidentiality, and client’s right to privacy. (PO 6)
  • CO7: Examine the use of information systems to document interventions related to achieving nurse-sensitive outcomes. (PO 7)

Select one trend from the list below and discuss:

  • Your understanding of this trend in healthcare
  • Its potential impact on your practice as a nurse.
  • What are the legal, privacy, and ethical considerations of this trend?

TRENDS:

  • Nanotechnology
  • Consumer health informatics (CHI)
  • Social media healthcare applications
  • Health-focused wearable technology
  • eHealth
  • Artificial Intelligence
  • Simulation
  • Computerized provider order entry (CPOE)
  • Bar Code Medication Administration (BCMA)
  • Creative measures in healthcare for use with 3D printers
  • Smart Pumps
  • Smart Rooms
  • Robotics in healthcare
  • Mobile technology in outpatient care
  • Web-based tools and software technology
  • Risk Management tools
  • Chatbots or Bots in healthcare
  • Telenursing
  • Telemedicine
  • Telepharmacy
  • Telerehabilitation
  • Teleconsultation
  • Telehospice
  • Technology advancement from your clinical practice

I’m looking forward to your responses.

Professor PJ

I’m going to choose telenursing for a discussion topic this week. I don’t know why I didn’t realize this before now but I manage a whole telenursing program. We have 3-5 dedicated nurses to phones each day. I never made the connection that this is a form of telehealth always assuming that was strictly video chats with providers. Hebda tell us that telenursing uses similar processes as traditional nursing; it just does them through electronic means. These means could involve the internet, telephones or other digital assessment tools (Hebda, 2019). Pretty much all of my experience with telenursing has been done over the phone but given COVID-19 we are looking at using other forms of technology to perform telenursing. I want to explore what that might look like. Telehealth is one trend the whole world is jumping on right now.

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I often tell training nurses that assessment via the phone is a new ball game because your assessment is limited to

NR 361 Trends in Informatics
NR 361 Trends in Informatics

what the patient tells you. You are relying entirely on their perceptions of sight and feel. An example I often use is that you cannot see that the whites of a patients eyes are yellow when discussing total body itching over the phone, you must ask the patient or even better yet have the patient ask someone who is with them if the whites of their eyes are yellowing and trust their response. But what if we didn’t have to just trust what the patient says. What if, through advancing technologies we could also see the patient while they are describing their rash? Imagine how much better our assessments would be!

 

The need for such telenursing practices has long been established, Elizabeth Moore and Brooke Trainum state “nearly 20%  of Americans living in rural areas suffer from a shortage of providers and healthcare facilities. This scarcity of services is detrimental to the nation’s health.” (2019, p.7). This is very true for my service area. We often must force patients to travel from 200 miles away for them to receive proper oncology care and then when they need even more specialized care, we ask them to travel even further. As nurses we need to help accelerate telehealth practices so that we can provide a high quality of care. The implications for nursing practice are vast. As it stands in my current practice we speak to patients on the phone and ultimately comes down to three outcomes: patient can be managed entirely over the phone by the nurse, nurse decides that patient needs in person assessment by nurse or provider, or nurse recognizes emergent care is needed and patient is directed to ED. I don’t imagine that incorporating video into our telenursing program will prevent ER trips but it certainly could prevent patients from having to come into the office. If I could actually see the rash, I could likely rule out the possibility of it being shingles without bringing the patient in for a visit. This would intern save the patient time and money. Often, we come across the scenario where we feel a patient needs to be assessed but the patient cannot get to us so they end up in urgent care. Video telehealth certainly has the potential to reduce those visits.

There are some obstacles to consider when looking at a virtual telenursing program. One that comes immediately to mind is privacy. If you are performing a video interview anyone walking by could potentially view what is happening on the screen both on the patient side and the nurse’s side. Before my particular office could put something like this into place, we would have to look at getting the nurses private offices (which we do not currently have). Another consideration is the “hackability” of all of these wonderful devices that help us assess patients. If our e-mails are hackable then are our video chats as well? (Hoglund, 2017). The uneasiness regarding security may make patients less like to give us all of the information over a video chat. There are definitely some hurdles to consider and rushing into a telenursing system, as many practices are right now, could have some negative effects down the line, particularly in regard to protected health information and privacy.

 

Reference:

 

Hebda, T., Hunter, K. & Czar, P. (2019). Handbook of Informatics for Nurses & Healthcare Professionals 6th edition. Pearson. New York, NY.

Hoglund, D. (2017). Secure and Reliable Wireless Medical Device and Mobile Connectivity. Biomedical Instrumentation & Technology. Vol. 51(2). P. 130-134. http://dx.doi.org.chamberlainuniversity.idm.oclc.org/10.2345/0899-8205-51.2.130Links to an external site.

Moore, E. & Trainum, B. (2019). Connected Health. American Nurse Today. Vol. 14(12). P. 7. https://web-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/ehost/detail/detail?vid=6&sid=a910cdbd-0f15-49d8-b011-3adfbb48d14f%40sessionmgr4007&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=140299006&db=ccmLinks to an external site.

I to provide telenursing already through work.  In Case Management, 80% of our position is work from home and so we do communicate with patients through telephone and video chat. (This has been a blessing during a time of pandemic as many hospitals in my area are laying nurses off and offering severance packages).  I find it to be successful.  I don’t feel that it will decrease ER visits either, but I do see a continuity of care.  Many questions I receive are medications, signs and symptoms of simple things like a cold, and many patients want direction on how to manage their health at home and information on providers.  I also do phone visits for home health.  The agency I work for has implemented phone visits to save money with recent Medicare reimbursement changes.  Phone visits are less expensive and therefore this is how they are filling the gap with their reimbursement loss.  Patients are very receptive to the phone visit.  Without being able to physically see them (as in a video conference) does make me nervous as I am relying on them to tell me the truth!  I also would like to share that last year, I used telehealth and video conferenced a NP through my insurance.  I was suffering with poison ivy.  Within 5 minutes, she diagnosed me, gave me education, and sent a script to the pharmacy for prednisone.  (Before contacting her, I had contacted my regular PCP and they would not prescribe without a visit and their next available visit was a week out.)

Many nurses in the home health agency worry that telenursing is going to replace our jobs.  They feel if patients can be treated telephonically, there will be less demand for hands on positions.  An article by  Balenton & Chiappelli (2017),  explores telenursing and concludes that nursing is being enhanced with today’s technology and the continuous generation of bioinformational developments and advancements; trends establish that telenursing is an evolving bioinformation-based tool that improves the nursing practice by bringing the nurses’ skills and knowledge to patients who are out of physical reach.

 

Reference:

Balenton, N., & Chiappelli, F. (2017). Telenursing: Bioinformation Cornerstone in Healthcare for the 21st Century. Bioinformation13(12), 412–414. https://doi.org/10.6026/97320630013412