Nursing Informatics in Europe Chapter 38: Nursing Informatics in Europe Chapter 38 PowerPoint Presentation: The main rational for implementing a greater use of information technology(IT) in the healthcare sector is to improve Safety Quality Improve patient outcomes Reduce costs of heath care. The main mission in Europe : The main mission in Europe Is to establish a stable infrastructure that improves healthcare quality, facilitates the reduction of errors, and the delivery of evidence-based and cost-effective care. IT in the Europe Union(EU) : IT in the Europe Union(EU) In May 2004, the EC adopted an action plan , ”e-Health Action Plan” Aiming at delivering better quality healthcare throughout Europe. PowerPoint Presentation: One goal is that by 2005 member states (in EU) should develop their own roadmaps for e-Health, and an EU public health portal should be up and running to provide a one-stop shop to access health information . Nursing IT Strategy: Nursing IT Strategy The government’s IT policy in Sweden has three objectives: Confidence in IT Competence to use IT Information about society service available to all citizens Patient Participation : Patient Participation Studies have found that improved patient participation and the consideration of patient preferences have improved outcomes and treatment adherence, as well as increased patient satisfaction with their care. Continuity of care and availability of information: Continuity of care and availability of information Telemedicine or Telehealth -which is the practice of medicine and nursing over a distance where data and transmitted through telecommunication system, is widely disseminated in parts over Europe. PowerPoint Presentation: Germany, France , United kingdom, Italy Finland, Norway and other counties are practicing telemedicine, but the practice by other allied professions is rare. Electronic Patient Records: Electronic Patient Records Regulations emphasize that RNs have an autonomous responsibility for planning, implementing, and evaluating nursing care and that nursing diagnoses in the patient record is a part of that responsibility(SOSFS 1990). PowerPoint Presentation: A Swedish study by the National Board of Health and Welfare(2000) -can be used illustrate the increasing amount of Information in healthcare. 1971- three sheets of paper 1984- 18 sheets 1999-34 sheets Dissemination of Electronic Patient Records: Dissemination of Electronic Patient Records In Sweden the estimated occurrence of EPR in primary healthcare is 85-90% while the percentage for hospitals is about 40%. In Norway there are EPRs for 81% of the hospital beds. Development of Common Terminology for Nursing Practice in Europe: Development of Common Terminology for Nursing Practice in Europe Belguim -undoubtedly, is the european country that has made nursing care most visible and where early on the contribution of nursing care in healthcare has been acknowledged by national level policy makers. PowerPoint Presentation: 1988 it is mandatory for all hospitals in the country to collect data four times per year, using the Belgian Nursing Minimum Data Set(B-NMDS). The NMDS consists of 23 nursing interventions, medical diagnoses, patient demographics, nurse variables, and institutional characteristics . PowerPoint Presentation: In the Netherlands, A nursing information reference model(NIRM) -has been developed to accommodate both the information needs of nurses at the clinical level and for aggregating data at higher level. PowerPoint Presentation: Nurses in Denmark where early pioneers in the development of common terminology and informatics in Europe . In Sweden it became mandatory for nurses to keep patient record in 1986, which sparked local efforts to apply the nursing process for recording. PowerPoint Presentation: The WIPS (Well-being, Integrity , Prevention, and Safety) model -was developed with the purpose of conceptualizing the essential elements of nursing care, clarifying and facilitating systematic thinking and nursing recording. International Council of Nurses(ICN): International Council of Nurses(ICN) - Is one of the example of organizations working in some areas of nursing informatics . Concept and Process Modeling: Concept and Process Modeling In Sweden, one model care is called the SAMBA model(Structured Architecture for Medical Business Activities). Mission: Was to develop a process model for the workflow of Swedish healthcare when dealing with one individual subject of care. PowerPoint Presentation: The model was divide into 3 parts: Clinical process -core process Management process -which monitors and evaluates the clinical process based on the mandate to provide healthcare. Communication process -dealing with information and interaction with the surrounding world as document or messages. Implementation of IT Healthcare : Implementation of IT Healthcare Healthcare attempts for the first time to implement a major application into its core processes. Implementation– A Tricky Term : Implementation– A Tricky Term 3 steps and phases: Technical installation -(e.g., local net , servers, PCs, and printers) Functional implementation -this phase introduce the users to the application and its functionality(e.g., to order an x-ray and register nursing notes. Organizational implementation -a process where the change of workflow and organizational structure are important factors. Organizational Implementation : Organizational Implementation The objectives are often described as seamless care, supporting clinical and nursing protocols, better service to patients, and increase medical safety. To be able to realize the possibilities embedded in the EPR as a technology, implementation has to induce organizational changes. The Organizational implementation is more about how the application supports planned and wanted changes in workflow and organizational structure. Project Management : Project Management Project team are mostly selected to be representatives of different categories of clinicians and organizational part of healthcare enterprise. Selecting a group of clinicians from a total workforce of perhaps several thousand in a complex organization will most certainly involve some sort of compromise. PowerPoint Presentation: During the project the team will develop a culture of its own with specific skills and knowledge. The alternative option is to select members for project teams from a knowledge perspective, focusing on those who can contributes the most. Clinical and Nursing Implementation: Clinical and Nursing Implementation Variety of views on data - appears to be a very attractive advantage. Structure of data -is important if data are to be reused and presented in several different ways. Decision support -is advantageous if the clinician enters the data. PowerPoint Presentation: Support of other data analysis -may prove an important feature for quality improvement, and resource management. Electronic data exchanges and sharing care support - assumes reuse of data,. Data are entered only once. Future Development: Future Development Most of all we need nurses educated in NI that can take a lead in the development of NI in different countries in Europe. PowerPoint Presentation: The end!