Practice Application

Historical
Perspectives
More than 150 years ago, Florence Nightingale
spoke about the critical importance of nursing
informatics in patient care. Decision making must
be based upon the use of accurate data, she said
(Ulrich, 1992)
The nursing pioneer also spoke of frustration from
difficulties of exacting such critical patient- related
data from hospital record.
It was more than a century after Florence
Nightingales era that computer made their
appearance on the hospital landscape. The first
hospital information system arrived in the late
1950s to the mid-1960, although these systems
focused primarily on processing financial and
administrative information

Nursing
Documentation
Nursing
In 1989, the
steering Committee
In 1993,
the ANA house
was establish
of Delegate passed a
resolution to develop
nursing classifications
specifically aimed at
diagnosis, interventions,
and nursing sensitive
patient outcomes, and
support activities
directed toward the
inclusion of nursing data
elements in healthcare
databases.

documentation in
the patient record
has become more
complex as
nursing practice
has expanded to
encompass care to
critically ill and
specialty patients,
and as technologic
advances have
become standards
of care in practice.

Care
planning
The
computer-

based patient
record facilities
the automation of
the nursing care
planning process.
The benefits and
the challenges of
integrating
computerized
systems with the
care planning
have been
extensively
reported in the
literature during
the last decade.
Two

Two
types
typesof
of
Artificial
Artificial
Intelligen
Intelligen
ce

Decision-Making
Broadly defined the
with
Expert
term
clinical
decision support
Systems
system (CDSS)
includes an array of
computer-based
applications that
assist healthcare
clinicians in the dayto-day work of
patient care. These
may include
programs that
involve Artificial
Intelligence (AI);
different types of
knowledge such as
uncertainty,
heuristics and fuzzy
logic; expert
systems; and
decision support
Expert system
systems.

Machine
Learning

Outcomes
A look at
outcomes
Management
A chapter on the
use of computers
in nursing
practice today
would be
incomplete
without a
description of
how informatics
is being used to
organize and
implement
systems for
outcomes
management.

management
provides a
powerful
illustration of
how nurses use
informatics in
daily practice to
evaluate the
relationship
between patient
goal attainment
and nursing
interventions.

Discharge
The
Planning
Discharge care plan
documentation of
systems provide for
patient care
usually begins
with the admission
assessment and
ends with the
discharge care
plan.

continuity of care from

the home to the
hospital and back to
the community,
another care facility,
an outpatient
department, or the
home

Five components or Types of

discharges plan
Summary of the admission
assessment
Summary of learning needs that
the patient had at discharge
Multidisciplinary plan including
problems still unresolved and
outcomes not met during
hospitalization

Medication and procedures

that the patient must
continue

Summary of selected patient

outcomes that a multidisciplinary
team desired as minimal criteria for
the patient to have achieved during
hospitalization. (Romano, McCormick,
and McNeely,1982

Progress in practice
The inevitable integration of
computers into nursing
practice has been
accompanied by speculation,
controversy, and research on
the benefits, barriers, and
real potential of Network
Information Service (NIS) for
improving
clinical
practice
Although
related
research
onand
giving
nurses
a voice in
the
practice
application
ofthe
development
of healthcare
computers
in nursing
will
policy. continue, there is
certainly
general agreement that
organization and use of data
with computers have exerted
a positive influence on the
provision of the patient care.

Critical
Critical
Care
Care Nurse
Nursing
Is responsible
Is an
to ensure that
area of
critically ill
expertise patients are
seriously
within
conditioned
nursing individuals.
Ensure that
that
families of the
medically ill
focus
patients
specifical should receive
optimal care.
ly with
Rely upon a
dedicated
human
response knowledge,
skills and
s to life- experience
and of course
threateni automated
system of
ng
support

Critical
Care
Applicati
ons
Areas where
patients
require
complex
assessment,
highintensity
medication,
continuous
therapy and
intervention
s, and
unrelenting
nursing

Critical
CareInformationSyste
m
Provide real-time resource utilization data
and management of informationand
access critical care areas through the
integration of the medical facilities in the
critical to an intelligentcomputersystem
which is capable
of processing
all data.
Enables
the electronic
collection
of

hospital and patient-specific critical

care data of the entire patient in
the critical care areas which can be
processed to create a patient
profile which generate real time
Automated
collection
and historical
report and

management of

medicalinformation will
become the important task of
the critical careinformation

MedicalInformationBus (MIB)
Provides a
generalized
method of
attaching
patient
monitoring
devices to a
common
This
interface
interface.
converts
the
unique
manufacturer data
communications
protocol into a

It eliminates the
need for custom
connector and
software
presently
needed to
Has the ability
interface
suchto
filter, store and
device.

selectinformation
sent for inclusion
into the clinical
medical record on
the clinical

VENTILATO
RS

PULSE
OXIMETER
S

PATIENT
MONITO
RS

Advantages of Critical
CareInformationSystem
Intelligently integrates and process
physiologic and diagnostic informationand
store it to secured clinical repository.

Creates trends analysis with

graphical representation of results.
Offline stimulation can be
performed to test the condition of
the patients.
Provide clinical decision support
system
Provide access to vital
patientinformation
Providing feedback and quick evaluation
of the patient condition and provides
alert.

REFERENCES
www.clinicalinnovation.com
www.himss.org
www.csulb.edu
www.nursingTHANK YOU FOR YOUR
informatics.com
ATTENTION
Nursingcrib.com