1. Communication and Health Care Technology

2. Learning Outcomes 1. What are the element of communication? 2. What is effective communication? 3. Explore types of technologies used in healthcare. 4. Analyze components of (nursing) informatics: data, information & knowledge. 5. Discuss how technology can improve patient safety. 6. Explore some internet resources for using technology in healthcare.

3. Communication A two-way process. Shared thoughts, attitudes information and feelings. Interpretation plays a major role. Verbal communication – used in clinical situation, affected by gender, age, culture, biases, education, loss of hearing or vision. Nonverbal communication- expressions, attitudes, eye contact or not, posture, space.

4. Effective Communication Verbal Listening – make the speaker feel heard and understood. Avoid interrupting. Avoid seeming judgmental. Show interest. Be aware of your own emotions. Nonverbal Use open body language. Patting a friend on the back (if appropriate).

5. Barriers to Communication Failure to listen Selective listening Misinterpreting the information Making judgments Intimidating others Overusing reassuring statement: “It will be OK”. Defensive body language. Using profanity, criticism. Getting “too close”, important even in a meeting. Being secrecy.

6. Resolving Communication Problems Clarification of values Seek positive and constructive feedback Write goals and action plans Continually make steps towards the goals Communicate progress Communicate the “why” behind the “what” Effective communication takes time (Finkelman, 2012, p. 397)

7. Technologies

8. Technology Technology is increasingly important in healthcare. Used in patient care planning, organization & delivery. Helps healthcare professionals: facilitate decision making improve efficacy & efficiency enhance quality decrease costs Nurses are “knowledge workers” need data & information to provide care

9. Types of Healthcare Technology Biomedical- use of clinical equipment for diagnosing, monitoring, testing, administering therapies. Information- recording, processing, and using data and knowledge to deliver patient care. Knowledge- use of expert & decision-support systems to assist in nurse decision making.

10. Biomedical Technology Physiologic monitoring – arterial lines Diagnostic testing – MRI, CAT scan IV Fluid & Medication Administration – “Smart Pumps” Therapeutic Treatments – PT, OT

11. Information Technology Computer databases often used to collect and store information Patient information Documentation of care – point-of-care Research data collection Structured Terminologies- collection of data for comparisons. Health Information Technology (HIT)

12. Structured Terminologies Uniform Minimum Health Data Set (UMHDS) Nursing minimum data set (NMDS) Nursing Care elements Diagnosis Intervention Outcome Intensity of care Patient demographics Personal identification Service elements

13. Information Systems Allows for storage of large amounts of data Assist in transformation of data into knowledge Data Information Knowledge

14. Transformation of Data into Knowled ge 3, 1, 5, 2 Patient A- 3 ED visits Patient B- 1 ED visit Patient C- 5 ED visits Patient D- 2 ED visits Average use of ED visits = 2.75 visits Patient C has 55% higher use of ED than average patient Data Information Knowledge

15. Information Systems Accreditation The Joint Commission requires healthcare organizations adhere to standards on information management. Quality Healthcare information systems must allow for the analysis of patient outcomes.. CNOs & nurse managers are often involved with choosing hardware & software for IS. 2014 Medicare requires everyone to bill electronic. If not a 2-3% decrease in payment.

16. Informatics “Science that combines a domain science, computer science, information science, and cognitive science.” (Hunter, 2001) Nursing Informatics Recognized nursing specialty (ANCC) American Nursing Informatics Association (ANIA) American Medical Informatics Association (AMIA)

17. Knowledge Technology Computer programs can provide clinical decision support. Clinical Decision Support Systems (CDSS)- clinical pathways Based on research & evidence-based practice Interactive applications Pertinent patient data entered Series of questions, define patient parameters

18. Evidence Based Practice Systematic approach to choosing clinical options Key elements to using EBP 1. Ask a clinical question. 2. Acquire the evidence. 3. Appraise the evidence. 4. Apply the evidence. 5. Assess the outcomes.

19. Technology & Patient Safety Technology can be used to improve patient safety Improvement & ease of clinical assessment Pulse oximetery Portable lab devices (BS machines) Improved documentation Legible Timely (Nurses spend up to 25-50% of their time documenting) Uses accepted abbreviations Accessible More organized

20. Technology & Patient Safety Use of clinical decision support tools. Alert to errors, deviation from protocol. Reduced medication errors.

22. Other Technology Terms Electronic Health Record (EHR) System that allows sharing of information (EMRs) between healthcare providers Electronic Medical Record (EMR) Legal, computer record of clinical data for a patient Electronic Medication Administration Record (e-MAR) Bar codes

23. Computerized Prescriber Order Entry (CPOE)

24. eMAR System

25. Smart Cards

26. Nurse Leaders & Managers Assist in decisions regarding choices of data systems, software, & other technology purchases. Ensure cost effective, quality patient care being delivered with technologies acquired. Monitor staff performance, patient outcomes, error rates related to technologies implemented.

27. Nurse Leaders & Managers Assure staff adequately trained to use available technology Ensure patient confidentiality maintained (HIPAA)

28. Evaluating Internet Sources 10 C’s for Evaluating Internet Sources Stanhope & Lancaster p. 221 1. Content 2. Credibility 3. Critical Thinking 4. Copyright 5. Citation 6. Continuity 7. Censorship 8. Connectivity 9. Comparability 10. Context

29. The Joint Commission “Never Events” 28 Serious, reportable errors in patient care Must be prevented & never happen Examples: Patient death related to a medication error. Patient death or serious disability related to hypoglycemia while in a healthcare facility. Wrong limb surgery.

30. Stage 3 or 4 pressure ulcer acquired after hospital admission. Administering wrong gas through an oxygen line. Patient death or serious disability related to a fall while in a healthcare facility. Death or significant injury to a patient or staff member related to assault at a healthcare facility.