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