Title : Health Technology and Nursing Practice

 Health Technology and Nursing Practice

 

Around the globe, in every setting, nurses seek to provide care to patients and families to keep them safe, help them heal, and return them to the highest possible level of functioning.

Technology is rapidly changing our world. Technological innovation has yielded truly remarkable advances in health care during the last three decades in such areas as antiviral biotechnology, diagnostic imaging, molecular diagnostics, organ and tissue replacement, surgical techniques, wound care, and computer technology that have helped to improve health care delivery and patient care outcomes.

Factors that reinforce market for health technology:

Advances in science and engineering

Emphasis on Patient safety and protection Care of Aging population

‘Cascade’ effects of unnecessary tests, unexpected results, on patient and physician / nurses’ anxiety

Emerging pathogens and other disease threats Emphasis on Malpractice avoidance

 

Public demand driven by consumer awareness, and mass media reports

Nurses are the cornerstone of hospital care delivery and the hospital’s most valuable assets: their efficiency and commitments are central to any effort to maximise patient’s safety or minimise costs

Definition of health technology: It is defined by the World Health Organisation as the “application of organised knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives”.

Broad categories of health technology

  • Drugs: aspirin, beta-blockers, antibiotics
  • Biologics: vaccines, blood products, cellular and gene therapies 
  • Devices, equipment and supplies: e.g., cardiac pacemakers, CT scanners, surgical gloves, diagnostic test kits
  • Medical and Surgical procedures: e.g., psycho-therapy, nutrition counselling, coronary, angiog-raphy
  • Support systems: e.g., electronic patient record systems, telemedicine systems, drug formularies blood banks, clinical laboratories
  • Organisational and managerial systems: e.g., prospective payment using diagnosis-related groups, (DRG), clinical pathways, total quality management programmes.

Application of technologies in health care

  • Prevention: protect against disease by preventing it from occurring, reducing the risk of its occurrence, (e.g., immunisation, hospital infection control programme, fluoridated water supply)
  • Screening: detect a disease, abnormality, or as-sociated risk factors (e.g., pap smear, tuberculin test, mammography, serum cholesterol testing)
  • Diagnosis: identify the cause and nature or ex-tent of disease in a person with clinical signs or symptoms (e.g., electrocardiogram, serological test for typhoid, X-ray for possible broken bone)
  • Treatment: designed to improve or maintain health status (e.g., antiviral therapy, coronary artery bypass graft surgery, psychotherapy, drugs for cancer pain)
  • Rehabilitation: restore, maintain or improve a physically or mentally disabled person’s function and well-being (e.g., exercise programme).

Some emerging technologies that will change the practice of nursing are: Genetics and genomics, Less invasive and more accurate tools for diagnosis and treatment, 3-D printing, Robotics, Electronic health records, Computerised physician order entry (CPOE)and clinical decision support, and Biometrics.

Genetics and genomics

It gives predictive value for Risk for cancer, cystic fibrosis, sicklecell anemia

Helps in determining carrier status Determines carrier status Prenatal screening

Newborn screening - phenylketonuria [PKU], cystic fibrosis, sickle cell anaemia

Determines prognosis or potential benefits of certain types of treatment specially for cancer

Genetic advances are likely to eliminate the need for organ transplants since new organs can be grown from a patient’s own tissues. Since organs are genetically matched to the patient the chance of rejection should become minimal or non-existent.

Less Invasive and More Accurate Tools for Diagnosis and Treatment

A new 23-gene blood test checks for certain blood proteins linked to heart disease

Tattoos can monitor blood glucose without a finger prick

Magnets are used as a treatment for major depression

Scanning technology 

 

Vaccines for some types of cancer

3-Dimensional (3D) Printing

Also known as additive manufacturing, it is “a method of building objects layer by microscopic layer, fusing each cross section of molecules until a complete object is formed. The bio printer prints the object by adding layer after layer of materials such as plastics, glass, metal, or ceramics. Thus, three dimensional solid objects can be created from a digital model. Human organs can be “bio printed” for transplant by 3D printing. The parts are made from the organ recipient’s own genetic matter, and pre-cisely match the tissue or organ they replace. One study observed that in February 2013, doctors and engineers in Netherlands collaborated on the 3D printing of a prosthetic lower jaw, which was subsequently implanted into an 83-year-old woman who suffered from chronic bone infection. The printer produced the prosthetic jaw from 33 layers of titanium powder that were heated, fused together, and then coated with bio ceramic artificial bone. Artificial limbs can be created by the same technology

Robotics

Nano machines can detect defective metabolic product circulation in blood stream and remove it as a Nano Robotic therapeutic procedure.

Microbots: Repair system in early disease processese and reduce or eliminate the risk of cancer.

Biomechatronics means creating machines which replicate or mimic how the body works. Pancreas pacemakers for diabetics, Mentally controlled electronic muscle stimulators for stroke and accident survivors, Miniature cameras and microphones that can be wired into the brain allowing blind people to see and deaf people to hear and brain-controlled ambulation to the paralysed are some of the examples.

Direct care providers: Robots are used in manning a pharmacy, elderly care in transporting materials. Robot couriers find and deliver medications, supplies, equipment, and other goods so that valuable human resources do not have to leave the patient care area. New health technology in Japan has re-sulted in a kind of robot intelligence known as (“kansei,”), means “emotion or feeling.” Kansei robots monitor human expressions, gestures, and body language and listen to people. They also sense human emotion through sensors that monitor pulse rate and perspiration.

Electronic Health Records (EHR) and nursing practice

 

  • EHRs contain a range of data, including demographics, medical history, medication and allergies, immunisation status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information
  • It assures patient health information confidentiality and security also ensures that data is accurate, appropriate and legible
  • It reduces the chances of data replication and helps to eliminate the issue of lost forms or paperwork.
  • It allows for an entire patient history to be viewed without the need to track down the patient’s previous medical record EHR can be used for the examination of possible trends and long term changes in the patient.
  • Prevents alteration/deletion of records, provides long term stability
  • Suitable for administrative & medical audit Prohibits illegal access to the record
  • Reduce the storage area and health care costs.

Computerised physician order entry (CPOE) and clinical decision support

It is a process of electronic entry of medical practitioner instructions for the treatment of patients under his care. These orders are communicated to other health care personnel / departments. It decreases the delay in order completion and produces clearly typed orders and, reduces dangerous medication errors. CPOE also helps in error checking for duplicate or incorrect doses/tests.

CPOE also provides vital clinical decision support (CDS) via access to information tools that support a health care provider in decisions related to diagnosis, therapy, and care planning of individual patients.

Biometrics

It is the science of identifying people through physical characteristics such as fingerprints, handprints, retinal scans, palm vein prints, voice recognition, facial structure, and dynamic signatures.

Other technologies like Accuvein and Veinlite are devised to locate veins to give intravenous injections. Telehealth and telenursing facilitate health care access to isolated areas, reduced the cost of care, facilitate client provider communication & remove the barriers of time and distance.

Nursing Leadership Challenges and Health Technology

Nursing leaders need to balance the human element with technology, balance cost and benefits, train a technology-enabled nursing workforce and assure that technology use is ethical.

Make sure that nurses use technology to facilitate mobility, communication, and relationships, ensure that nurses have expertise in knowledge information, acquisition, and distribution and understand the application of genomics in nursing.

Nurses should know the positive impact on Health Technology on nursing practice such as It improves patient care and Information Management

Empowering patients: Due to new technologies, patients may now have more information, more control over scheduling appointments and more responsibility for monitoring their symptoms and outcomes.

Changes in work place: New technologies may enable healthcare staff to work offsite, including in the community and even at their own residences.

It is time saving and improves nurses and patients’ satisfaction 

Nurses should know the negative impact of Health Technology on nursing practice such as:

Professionals do not automatically use them as intended by the developers. This means that a substantial proportion of patients/clients will not receive the intended care in such a way that they benefit from these innovations.

Studies show that elements of technological environment contributed to nurse stress and fatigue.

Many times, information technology systems are not designed to match the workflow of nurses.

 

Telenursing lies in its inability to see or incorporate non-verbal behaviour of patients that challenges assessment skills of nurses.

Conclusion

Medical advances and health technology affect nursing practice. Health technologies have potential to create a better work environment for nurses by improving safety, efficiency and quality of care. It must be nurses who are at the forefront in planning for and preparing for technological challenges. Nursing as a profession and leadership as a force for change must accept and adapt emerging health technology.

Nurses must embrace technology and integrate them into nursing practice. Technology will not go away. It will continue to transform the health care delivery system. Nursing must continue to take a leadership role in the incorporation of technology into nursing care. Adapt the technology to patient care, not patient care to technology.

Nurse leaders should learn that emerging health technologies will change the practice of nursing, and proactively create leadership development programmes necessary to assure that nurses will have the competencies they need to address these emerging technological challenges.

Involving nurses in the planning process is imperative to facilitate the proposed change.

Since it has been established that change due to advancements in health technology will continue in healthcare, nurses should be assisted with health technological transition preparedness.

Let us empower ourselves and others with the knowledge and competence of Health Technology (Theme presented during TNAI Biennial conference at Jaipur).

Author: Dr (Mrs) AV Raman
Director of Nursing Education and Research, Westfort College of Nursing, WAHE, Thrissur
Source: TNAI Journal