enurse: automaton or thinking professional? paula m procter reader in informatics and telematics in...

eNurse:eNurse:Automaton or Thinking Automaton or Thinking

Professional?Professional?

eNurse:eNurse:Automaton or Thinking Automaton or Thinking

Professional?Professional?

Paula M ProcterPaula M ProcterReader in Informatics and Telematics in NursingReader in Informatics and Telematics in Nursing

Faculty of Health and WellbeingFaculty of Health and Wellbeing

Sheffield Hallam UniversitySheffield Hallam University

UKUK

AUTOMATON

Information is a Information is a resource as long as it resource as long as it has a value to the has a value to the individual, individual, organisation or organisation or profession looking at profession looking at the information.the information.

Information Management Information Management and Nursingand Nursing

Information Management Information Management and Nursingand Nursing

Reaction to technology...Reaction to technology...Reaction to technology...Reaction to technology...

Rarely have we Rarely have we embraced embraced technology except technology except where it has direct where it has direct relevance to patient relevance to patient care, eg monitor, iv care, eg monitor, iv pump.pump.

Reaction to technology...Reaction to technology...Reaction to technology...Reaction to technology...

Rarely have we Rarely have we embraced technology embraced technology except where it has except where it has direct relevance to direct relevance to patient care, eg patient care, eg monitor, iv pump.monitor, iv pump.

The technology is The technology is often seen as often seen as conflicting with conflicting with practice.practice.

Reaction to technology...Reaction to technology...Reaction to technology...Reaction to technology...

Rarely have we Rarely have we embraced technology embraced technology except where it has except where it has direct relevance to direct relevance to patient care, eg patient care, eg monitor, iv pump.monitor, iv pump.

The technology is The technology is often seen as often seen as conflicting with conflicting with practice.practice.

We buried our heads We buried our heads and wished it to go and wished it to go away.away.

Structured Systems DesignStructured Systems DesignStructured Systems DesignStructured Systems Design

ResponseResponse

TransactionTransactionKeyedKeyed

EventEvent

Notice ofNotice ofEventEvent

ResponseResponse TPSTPSProgramProgram

Report(s)Report(s)

TPSTPSDataData

Architecture of a generic Transaction Processing System (TPS)Architecture of a generic Transaction Processing System (TPS)

Architecture of a generic Management Information System (MIS)Architecture of a generic Management Information System (MIS)

Report(s)Report(s)

MISMISDataData

MISMISProgramsPrograms

UserUserReportReport

RequestsRequests

TPSTPSExtractExtractDataData

fromfromTPSTPS

Architecture of a generic Decision Support System (DSS)Architecture of a generic Decision Support System (DSS)

TPSTPSDataData

Report(s)Report(s)GraphsGraphs

MISMISDataData

DSSDSSModelsModels

DSS UserDSS User

DSSDSSProgramsPrograms

ExternalExternalDataData

Data, Requests, Models

Responses

A Question:A Question:A Question:A Question:

What is unique about nursing in a What is unique about nursing in a hospital or community setting ?hospital or community setting ?

The AnswerThe AnswerThe AnswerThe Answer

In an information intensive In an information intensive environment, the uniqueness of environment, the uniqueness of nursing is that we are there, 24 nursing is that we are there, 24 hours a day, seven days a week, hours a day, seven days a week,

52 weeks a year.52 weeks a year.

Nursing’s role in the 21Nursing’s role in the 21stst CenturyCentury

Nursing’s role in the 21Nursing’s role in the 21stst CenturyCentury

To be the information To be the information management advocate for the management advocate for the

patient, their relatives and patient, their relatives and friends.friends.

Nursing - Essential SkillsNursing - Essential SkillsNursing - Essential SkillsNursing - Essential Skills

Care ProviderCare Provider

Decision-makerDecision-maker

CommunicatorCommunicator

Community LeaderCommunity Leader

ManagerManager

Source: A WHO European Strategy for Nursing and Midwifery Education, WHO, December 1999

Nursing - Essential SkillsNursing - Essential SkillsNursing - Essential SkillsNursing - Essential Skills

Care ProviderCare Provider

Decision-makerDecision-maker

CommunicatorCommunicator

Community LeaderCommunity Leader

ManagerManager

Source: A WHO European Strategy for Nursing and Midwifery Education, WHO, December 1999

Event Event recordingrecording

datadata

So, if nurses are not recording the day today activities accurately - often due to a lack of belief in the system, then...

Management of Management of InformationInformation

Event Event recordingrecording

datadata

So, if nurses are not recording the day today activities accurately - often due to a lack of belief in the system, then…The essential start point for informationmanagement is null and void, and if thisis null and void, then...

Management of Management of InformationInformation

MISMISProgramsPrograms

Management of Management of InformationInformation

MISMISProgramsPrograms

Used in...

Decision Support

Management of Management of InformationInformation

‘‘Power is control, influence or the Power is control, influence or the ability to do or act. Power is the ability to do or act. Power is the ability to make decisions and power is ability to make decisions and power is determining what those decisions will determining what those decisions will be in the first place. Power is having be in the first place. Power is having control of information.’control of information.’

Gaston, (1991)Gaston, (1991)

What is coming next?What is coming next?

Is nursing ready?Is nursing ready?

What is coming next?What is coming next?

Is nursing ready?Is nursing ready?

BiotechnologyBiotechnologyBiotechnologyBiotechnology

Biotechnology advances are increasing Biotechnology advances are increasing life expectancy to new heights. It is life expectancy to new heights. It is estimated that by the year 2050 people estimated that by the year 2050 people born in that year will expect to reach born in that year will expect to reach the age in excess of 150 years. By 2300 the age in excess of 150 years. By 2300 people born in that century are likely to people born in that century are likely to see the next millennium. What age see the next millennium. What age does schooling stop? When will does schooling stop? When will retirement be? Will life-long learning be retirement be? Will life-long learning be possible? How will healthcare be possible? How will healthcare be prioritised?prioritised?

ChallengeChallengeChallengeChallenge

The challenge in healthcare will be to The challenge in healthcare will be to continue under the pressure of continue under the pressure of expectations of care by the public. The expectations of care by the public. The more information individuals can get the more information individuals can get the more information they are likely to use to more information they are likely to use to support their demand for treatment. In support their demand for treatment. In both public health services and those both public health services and those provided within a framework of private provided within a framework of private care there are serious concerns that the care there are serious concerns that the provision cannot cope with the expected provision cannot cope with the expected onslaught.onslaught.

PandemicPandemicPandemicPandemic

The greatest pandemic facing the world The greatest pandemic facing the world is the widespread demographic changes, is the widespread demographic changes, it is estimated that in 50 years time the it is estimated that in 50 years time the percentage of those in retirement will be percentage of those in retirement will be over 50% of the population in most over 50% of the population in most western countries. It is also estimated western countries. It is also estimated that by 2050 there will be some 15% of that by 2050 there will be some 15% of population as minors, leaving only 35% population as minors, leaving only 35% of working age. Healthcare will have to of working age. Healthcare will have to cope with these changes especially with cope with these changes especially with the increase of older people receiving the increase of older people receiving acute and active care.acute and active care.

Hunger for InformationHunger for InformationHunger for InformationHunger for Information

The hunger requires of us to The hunger requires of us to prepare the next generation of prepare the next generation of clinicians with the ability to clinicians with the ability to manage information in order that manage information in order that we do not become greedy or we do not become greedy or overly choosy, but rather we overly choosy, but rather we remain balanced and in control remain balanced and in control of information for the benefit of of information for the benefit of patient care. patient care.

The MessageThe MessageThe MessageThe Message

Nursing Nursing mustmust see itself within a see itself within a changing society and prepare changing society and prepare nurses for work within the nurses for work within the information intensive environment.information intensive environment.

The MessageThe MessageThe MessageThe Message

Nursing Nursing mustmust see itself within a see itself within a changing society and prepare changing society and prepare nurses for work within the nurses for work within the information intensive environment.information intensive environment.

Nursing must have a voice in the development of clinical and community information systems, if nursing does not take on this role, nursing will cease to exist – automatons are all that will be needed.

Paula M Procter

Email: p.procter@shu.ac.uk