Friday, May 4, 2012 @ 8:12 AM
●
NEW
ZEALAND
Harnessing technology to benefit nursing: as
technology and health informatics become an increasingly significant part of
nursing practice, it is vital nurses are able to articulate their technological
and professional needs for the benefit of patients
Document Type: Article
Full
Text:
All of us
are aware of the increasing place of technology in our lives, including our
personal lives--such as audiovisual appliances and home computers. The common
experiences of using automatic teller machines, internet banking and household
devices such as video and microwave ovens are further examples.
Technology
is also part of our professional lives, whether we work in clinical,
management, administration, education or research. Nursing practice is seen as
information-intensive, with one study estimating nurses spend nearly half their
time documenting patient information. (1) Therefore, technology that reduces
the time and effort in routine aspects of care delivery and documentation could
lead to more quality time caring for our patients.
Technology
can provide further gains beyond computerised documentation, including
co-ordination of care, communication and medication management. There are many
advantages for the profession of increasing the use of technology because of
the storage, processing, retrieval, display, processing, analysis and
communication capabilities of the computer. (2) For nursing to take advantage
of the potential benefits of technology, it is essential nurses articulate what
the profession needs and how technology can support nursing practice.
What is nursing
informatics?
The
International Medical Informatics Association special interest group in nursing
informatics' (IMIA-NI) definition of nursing informatics was ratified by the
2009 general assembly as: "Nursing informatics, science and practice
integrate nursing, its information and knowledge and their management with
information and communication technologies to promote the health of people,
families and communities world wide." (3)
A history
of nursing informatics in New Zealand states: "Nursing and the use of
information to improve patient care have gone hand-in-hand since at least the
time of Florence Nightingale." (4) In fact, Florence Nightingale is often
attributed as being the first nurse informatician, as she used data she
collected during the Crimean War to change the way she cared for her patients.
(5) The challenge for nurses is to consider how we can also use data to inform
and improve our nursing care.
In the
early 1990s, computers were becoming more common, though how the technology
could be used in health care, and more specifically to support nursing
practice, was less understood. In 1991, following a conference entitled Nursing
informatics in New Zealand: An impetus for learning, organising committee chair
Jan Hausman sought a mandate to form a group to continue sharing knowledge and
ideas engendered by the conference.
The first
meeting to set up a national nursing informatics group was held six weeks later.
The objective for the fledgling group was: "to foster throughout New Zealand
the development of knowledge and utilisation of information systems within all
areas of nursing practice", and the name Nursing Informatics New Zealand
(NINZ) was adopted. (4) The new millennium saw NINZ merge with the New Zealand
Health Informatics Foundation (NZHIF) to form a new incorporated society,
Health Informatics New Zealand (HINZ).
Role of
HINZ
HINZ is a
national, not-for-profit organisation. Its focus is to facilitate improvements
in business processes and patient care in the health sector through the
application of appropriate information technologies. (6) HINZ helps improve the
effectiveness of health informatics business and acts as a single portal for
the collection and dissemination of information about the health informatics
industry. Membership is open to anyone with an interest in health and informatics
who wants to be part of an organisation that can provide relevant, up-to-date
information about health informatics, through information sharing, seminars and
annual conferences.
HINZ has
established working groups to mirror some of those within the IMIA-NI. The HINZ
nursing informatics working group is the most active of HINZ groups.
The
Ministry of Health is interested in information collection and hosts 17
national collections and systems. New Zealand is fortunate to have a National
Health Index (NHI) database where each person has a unique health care
identifier which follows the individual through each health care event in
his/her life, allowing easier tracking of information through health care
episodes. All information collection, storage, access and retrieval is governed
by the Privacy Act (1993) and the Health Information Code (1994) and subsequent
amendments.
Health
care is guided by a national health strategy. This acknowledges the importance
of good information management for better health outcomes, to reach the goal of
good health and well-being for all New Zealanders throughout their lives. (7)
The overall vision for information management is set out in this strategy. (8)
Subsequent to a Ministerial review in 2009, changes to the health sector have
been instigated, with the overall objective of "better, sooner, more
convenient health services'; A major change has been the establishment of the
National Health Board (NHB) and the formation of a sub-committee, the
Information Technology Health Board. A number of informatics-related
recommendations have been made, including strengthening health IT and prioritising
new technologies and medical devices. The IT Health Board is seen as a health
sector leadership group to support the delivery of high quality health care by
providing strategic leadership on health information investments and solutions
across the health and disability sector, and ensuring health sector policy is
supported by appropriate health information and IT solutions.
Health
technology plan
In July
this year, the IT Health Board published a national health information
technology plan. This aims to "drive a culture of innovation, partnership
and respect to support health sector leaders to make appropriate health
information technology investments in the context of the whole sector" (9)
and to work towards the eHealth Vision. This vision has a clear aim: "To
achieve high quality health care and improve patient safety, by 2014 New
Zealanders will have a core set of personal health information available
electronically to them and their treatment providers, regardless of the setting
as they access health services". (9)
Pressures
ahead
New Zealand
currently faces a number of pressures, including:
* health
inequalities and the need to address Maori health disparities because of the
over representation of Maori in morbidity and mortality data; (10,11,12,13)
* a
growing older population, and more people with long-term and complex health
conditions. (14)
* a more
informed consumer. With our history of free health services, there is an
expectation that health care will continue to be freely available and that
evidence-based best practice will determine the treatments, with no regard to
cost.
*
workforce issues, including an ageing workforce. The nursing workforce is the
single largest health professional group, and is recognised as having enormous
potential to advance health and disability outcomes. (15)
These
pressures can only be expected to intensify in the next decade. We need to
target and prioritise where health IT investments are made. Judicious use of
technology could be the key to the long-term sustainability of a free health
care service.
Conclusion
Nurses
deserve to have quality information at their fingertips, when and where
required, to ensure they can deliver the best care possible to individuals,
communities and populations. Nurses cannot expect to practise effectively
without reliable information delivered at the right place, in a timely fashion.
Work is underway to achieve this, with the plans focusing on information
exchange to support the continuum of care. Nurses need to be actively involved
in this, so the right information and knowledge required to support care is
targeted. The infrastructure and communications and IT have now matured
sufficiently, so high quality health care can be achieved, and patient safety
and health outcomes improved.
HINZ held
its annual conference in Wellington early this month. For further information
about HINZ, see the website www.hinz.org.nz. To find out more or keep in
contact with other nurses about nursing informatics, contact chair of the nursing
informatics working group at HINZ, Michelle Honey. Phone 09 9237308 or email:
m.honey@auckland.ac.nz.
References
(1)
Bowies, K. H. (1997) The barriers and benefits of nursing information systems.
Computers in Nursing; 15: 4, 191- 196.
(2)
Thede, L. Q. (1999) Computers in nursing: Bridges to the future. Philadelphia:
Lippincott.
(3)
IMIA-NI. (2010) IMIA NI--The Nursing Informatics Special Interest Group.
http://www.imiani.org/. Retrieved 25/10/10.
(4)
Appleton, M., Carr, R. & Hausman, J. (2000) NINZ: the first 10 years.
Auckland, New Zealand: Nursing Informatics New Zealand Inc.
(5)
Kenney, J. A. & Androwich, I. (2009) Nursing informatics roles,
competencies and skills. In D. McGonigle & K. Mastrian (Eds), Nursing informatics
and the foundation of knowledge (pp107-131). Sudbury, MA: Jones and Bartlett
Publishers.
(6)
Health Informatics New Zealand. (2010) About Health Informatics New Zealand.
http://www.hinz.org.nz/page/abouthinz/about-hinz. Retrieved 09/06/10.
(7)
Ministry of Health. (2000) The New Zealand Health Strategy. Wellington, New Zealand:
Ministry of Health.
(8)
Health Information Strategy Steering Committee. (2005) Health Information
Strategy for New Zealand. Wellington: Ministry of Health.
(9)
Ministry of Health. (2010) IT Health Board.
http://www.ithealthboard.health.nz/. Retrieved 10/06/10.
(10)
Cannolly, M., Boyd, M.-A., Kenealy, T., Moffitt, A., Sheridan, N. & Kolbe,
3. (2010) Alleviating the burden of chronic conditions in New Zealand: The ABCC
NZ Study Workbook 2010. Auckland: The University of Auckland and Freemason's
Unit of Geriatric Medicine. http://dhbrf.hrc.govt.nz/media/documents_abcc/
ABCC_Study_Workbook_Final.pdf. Retrieved 19/02/10.
(11)
Ministry of Health. (2007) Diabetes surveillance. Wellington: Ministry of
Health.
(12)
Ministry of Health. (2008) The health and independence report 2008. Wellington:
Ministry of Health.
(13)
Davey, J. A., & Gee, S. (2002) life at 85 plus: A statistical review.
Wellington: New Zealand Institute for Research on Ageing.
(14)
Statistics New Zealand. (2010) QuickStats of 2006 census data.
http://www.stats.govt.nz/Census/ 2006CensusHomePage/QuickStats.aspx. Retrieved
24/02/10.
(15) Nursing
and Midwifery Workforce Strategy Group. (2006) Nursing workforce strategy,
http://www.dhbnz.org.nz/ includes/downioad.aspx?ID=25740. Retrieved 16/06/08,
* For a
report on the recent world congress on medical and health informatics, see p29.
Michelle
Honey, RN, PhD, is a senior lecturer with the University of Auckland's school
of nursing.
Robyn
Cart, RN, specialised in cardio thoracic surgery before becoming customer
services manager of Auckland District Health Board's (DHB) IT division. She was
IMIA-NI world chair from 2006-2009.
Denise
Irvine, RN, BSocSci, MBS, is director of e3Health consultancy. She is on the
HINZ executive and is NZNO's representative on the International Council of
Nurses' telenuring and nursing informatics network.
Lucy
Westbrooke, RN, DipNg, PGDipBus (health informatics), works as an information
management consultant for Auckland DHB's information and technology service.
Honey,
Michelle^Carr, Robyn^Irvine, Denise^Westbrooke, Lucy
Source
Citation
Carr,
Robyn, et al. "Harnessing technology to benefit nursing: as technology and
health informatics become an increasingly significant part of nursing practice,
it is vital nurses are able to articulate their technological and professional
needs for the benefit of patients." Kai Tiaki: Nursing New Zealand
Nov. 2010: 24+. Academic OneFile. Web. 4 May 2012.
Document
URL
http://go.galegroup.com/ps/i.do?id=GALE%7CA243451589&v=2.1&u=phspuqc&it=r&p=AONE&sw=w
Gale
Document Number: GALE|A243451589
INSIGHT
Technology is now an inseparable part of good nursing practice and
nurses themselves have become leaders in the development of health informatics
in New Zealand. Yet the term "nursing informatics" is comparatively new,
having first being used here in the early 1990s.
Initially the use of computer technology in health care was limited.
However, today all nurses would be familiar with a range of digital data
collection devices--from electronic blood pressure machines, tympanic
thermometers and blood sugar level equipment--and information technology (IT),
eg electronic laboratory results, patient records and email communication, in
both their personal and professional lives.
The increase in the use of information and computer technology in health
care has led to health professionals, the government, through the Ministry of
Health and New Zealand technology companies, to work together to consider how
best to harness the opportunities technology-supported health care can provide.
The umbrella group uniting those interested in this area is Health Informatics New
Zealand (HINZ). Nurses are an active group within this organisation.
0 comments>/a>
@ 8:07 AM
●
United Kingdom
Electronic nursing: informatics
is about communication not technology, says Marina Copping, and nurses are
expert communicators
Document
Type: Article
Full
Text:
Nursing
Standard' s Nursing the Future campaign aims to redefine nursing, celebrate its
diversity and challenge misconceptions. New and emerging roles are often
misunderstood, even within the profession itself, and the role of the nurse in
information management and technology (IM&T) is one of them.
There is
a myth that IT nursing is all 'techy' talk and computers, but in reality nurses
involved in informatics are agents for change and communicators who have less
interest in the technology and more in what it can do to support nursing care.
Nurses are becoming involved in informatics in increasing numbers and in
different ways, including:
* Local
IT developments, such as defining midwifery, renal or cardiac care systems.
*
Developing training tools, audit databases or patient information leaflets.
* Acting
as a bridge between clinical teams and IT departments.
* Working
in project management, education or research.
Information
technology department staff are always desperate for more clinicians to get
involved in developing, testing and using products, and they in turn can be
valuable allies for nurses in the wake of new ways of managing information such
as:
* Shared
assessments
*
Integrated records
* Child
protection alerts
* Mobile
technologies
*
National electronic patient records.
At the
same time, nurses can define what they need from IT, and where, why, and when
they need it, and can evaluate and measure results.
Building
partnerships with IT departments reaps benefits for all, and as expert
communicators, nurses can play a pivotal role in improving communication
between the departments.
You do
not have to be an expert in IT to become involved. The informatics nurse's role
is about new ways of working, communicating and managing change
Case
study 1
Kath
Darroch, informatics officer, University of Manchester
'My
practice became a lead site for practice-wide electronic patient records. I was
enthused by having information around that could help plan my work, and it
helped create a team feeling and an understanding about each other's
contribution to health care. The GPs now have a handle on what health visitors,
district and practice nurses do. I find it exciting to see health care evolving
and believe that by having improved access to information about patients we
deliver better care.'
Case
study 2
Val
Baker, director of clinical informatics, NHS Lothian, Edinburgh
'I got
involved in informatics to get rid of numbers and start working towards what
nurses really needed. I did a degree in informatics and social use of
computers, then became a nurse project manager for a new community information
system. Now I have the lead role in defining the clinical priorities in IT for
the region. As a nurse working in an IT department, I speak the language of the
people who need to use the technology. There is a need to change the view that
IT is about computers. It's not. It is about information for patients and those
who care for them--the technology is just the tool.'
Case
study 3
Rosemary
Currell, midwife, Suffolk West Primary Care Trust
'What I
love about working in informatics is the problem solving, the to understand
people's work, how they tick, their role [n the healthcare process, what they
do and why they do it. The technical computer side of it is only a little bit
of informatics. There are people who are skilled at managing wires and boxes,
but what is needed are people who can translate the needs of the clinical world
to the technical world.'
FURTHER
INFORMATION
* The
Scottish information, management and technology (TM&T)
strategy--Health/Information Management and Technology Strategy NHS Scotland--can
be accessed at www.show.scot.nhs.uk/imt
* For
information about the English strategy, visit www.dh.gov.uk and key
'information management and technology' into the search box.
* The
Welsh strategy, Informing Healthcare: Transforming Healthcare in Wales Using
Information and ICT, can be found at www.wales.nhs.uk. Click on 'continuous
improvement' on the left hand side, then click on 'national IM&T
programmes', and finally click on 'informing healthcare'.
* To
access Northern Ireland's Information and Communications Technology Strategy,
go to www.dhsspsni.gov.uk and key 'information and communications technology
strategy' into the search facility.
Marina
Copping is clinical nurse specialist, health informatics, NHS Lothian
Copping,
Marina
Source
Citation
Copping,
Marina. "Electronic nursing: informatics is about communication not
technology, says Marina Copping, and nurses are expert communicators." Nursing
Standard 19.40 (2005): 69+. Academic OneFile. Web. 4 May 2012.
Document
URL
http://go.galegroup.com/ps/i.do?id=GALE%7CA133682784&v=2.1&u=phspuqc&it=r&p=AONE&sw=w
Gale
Document Number: GALE|A133682784
INSIGHT
All four of the UK's health departments have published comprehensive
information management and technology strategies (see further information
overleaf), all of which outline the development of core electronic health
records for patients. Each country is implementing its strategy in different
ways and nurses need to be engaged to ensure the strategies meet their needs,
as well as those of their patients and clients.
In the past nurses have had to cope with inappropriate IT systems that
were introduced without their input. Although communication plans for the new
strategies exist, a recent RCN online survey found that more than 90 per cent
of respondents felt that consultation on NHS information technology
developments was inadequate.
Despite nurses' expertise in communication and technology--a major part
of nursing care is, after all, about information sharing, and we use
sophisticated technology every day in the form of pumps or monitors--we do not
see ourselves as having a central role in IM&T.
0 comments>/a>
@ 8:03 AM
●
FINLAND
Teaching with and about technology: providing
resources for nurse educators worldwide
Document
Type: Article
Full
Text:
AS A
PARTICIPANT AT THE 10TH INTERNATIONAL CONGRESS ON NURSING INFORMATICS, held in
Helsinki, Finland, in late June, I learned that the challenges we face are
universal. These challenges focus on teaching with technology and teaching
about technology. Educators worldwide are struggling with how to use emerging
technologies, particularly Web 2.0 tools, in their nursing courses. As in the
United States, faculty and students are represented on a continuum as digital
refugees, digital voyeurs, digital immigrants, and digital natives.
Elsewhere,
faculty are still struggling to teach nurses basic computer skills, or, as they
say, information and communication technologies (ICT) skills. With more and
more countries implementing information technologies into their health care
systems, there were numerous discussions on how to help faculty integrate informatics
competencies into the nursing curriculum.
I chaired
the education component of the postconference where we talked about the need to
prepare nurses to interact with engaged citizens. We also discussed emerging
models of care, where citizens and their families are collaborative partners in
their health care and partnerships differ according to individual preferences
over the course of the health care continuum. But two topics kept coming up,
time and time again: How should nursing education programs prepare nurses for
new care models? How do we prepare nurses with the necessary ICT and informatics
knowledge and skills?
During
the postconference, I presented the NLN position statement on the informatics
agenda and spoke about the numerous faculty development opportunities we offer
for learning about informatics, e-health, and the use of educational
technologies. For context, I hope that you will read the position statement
(online at www.nln.org/aboutnln/PositionStatements/ index.htm). Then I hope you
will investigate the numerous opportunities available in this country for
teaching with technology and teaching about technology. Many attendees in
Helsinki were envious of the wealth of resources we have available, including
conferences, audio/web seminars, and online courses offered by the NLN and
other professional organizations.
Among the
conferences are the NLN Education Summit 2009 (www.nln.org/ summit/index.htm)
and the 2009 NLN Technology Conference and Pre-Conference, scheduled for
October 29 to November 1 at Johns Hopkins University, Baltimore, Maryland (www.nln.org/
facuhydevelopment/workshopsandconf.htm). There is also WINI, the Weekend
Immersion in Nursing Informatics, offered in various locations throughout the
year (www.winiconference.net/).
The
Alliance for Nursing Informatics (www.allianceni.org/default.asp) brings
together more than 25 groups that function separately at local, regional,
national, and international levels and host workshops and meetings on informatics.
The American Medical Informatics Association (AMIA) offers the AMIA 10x10
Program (www.amia.org/10x10), and a website (www2.amia.org/mbrcenter/wg/ni/
education/catl.asp) listing numerous courses and programs, including an
Educators Certificate for HeahhCare Informatics (www.nursing.ucdenver.edu/
grad/off_prof_dev2.htm).
Faculty
in the United States also have the good fortune to take advantage of
opportunities offered by the Health Resources and Services Administration
(HRSA). Several contracts have been funded under HRSA's Faculty Development:
Integrated Technology into Nursing Education & Practice Initiative. Our own
HITS Collaborative, which includes the University of Kansas, Indiana
University, the University of Colorado, Denver, and the NLN
(http://www.hits-colab.org), is a five-year program originally funded in 2007.
Two cohorts of scholars have already benefited from a one-year faculty
development opportunity, completing a series of web-based modules on informatics,
telehealth, simulations, and e-learning, and participating in workshops with
faculty mentors. Online discussion groups and a social network keep scholars in
touch with their mentors and each other.
Following
is a sampling of projects completed in 2008 under the HITS Collaborative. (See
Sidebar.) In 2009, 53 scholars representing 27 schools were selected to
participate. These scholars attended a 2.5-day workshop at Indiana University
and will complete their projects by the end of this year.
Grand
Valley State University A website was developed to connect first-semester
students in obstetrics and final-semester students in community health nursing
clinical courses to four neighborhoods where clients, clinical information,
resources, and learning activities are available. For the obstetrical
experience, students are assigned to care for one of eight clients representing
a variety of ages and backgrounds and different stages of pregnancy.
Hunter
Bellevue School of Nursing The maternal-child practica was transformed, with
simulation now providing hands-on experience with complex delivery scenarios.
Simulation scenarios are also used as a quality improvement tool for assessing
learner competency in a select set of knowledge and skills.
Saint
Francis Medical Center College of Nursing Simulation based on select NLN
scenarios and the electronic medical record (EMR) is integrated throughout the
baccalaureate curriculum in both first-semester junior and second-semester
senior courses. Students complete both the Simulation Design Scale and the
Student Satisfaction and Self-Confidence in Learning Instruments (Jeffries,
2007).
Simmons College
PROJECT 1
A website was created that includes a compendium of resources to be used for
the integration of informatics into the entire nursing curriculum. Faculty were
introduced to the website during a faculty development workshop.
PROJECT 2
A fully online course in informatics was developed for the doctor of nursing
practice program. A new module was created in the capstone Leadership and
Management course for undergraduates.
Texas
Woman's University An online resource of key informatics concepts was created
to serve to increase faculty awareness of informatics and assist in the
integration of concepts in the curriculum.
Maricopa
Community College at Mesa Community College A web-based electronic
documentation system was created that allows associate degree students to
enhance their electronic documentation skills in simulation and clinical. Beta
testing included a pilot group of 30 people, six faculty and 24 students from
all four semesters of the ADN and foreign-educated nurses programs. Ninety-seven
percent of participants felt that this tool would be beneficial to use in
clinical in place of the current documentation system. (Learn about this
project during the NLN Education Summit 2009, Session 3D.)
Villanova
University Oversight for the selection, development, and placement of the EHR
was used as part of a high-fidelity patient care simulation with junior-level
students. Electronic charts are now being adopted in several other courses.
(Learn about this project during the NLN Education Summit 2009, Session 3D.)
Some
comments from 2008 scholars follow: "We are very grateful to all of you
for putting the HITS project together. It has helped us feel much more grounded
in the use of technology in the curriculum, and, hopefully, has improved our program."
"We are so thrilled to be able to be part of this wonderful project and
are invested in successful outcome measures!" "Thanks again for the
stellar job you all did with this project. It is an excellent resource for us.
I feel very blessed to be a part of this great adventure."
And my
parting comment: Take advantage of the wealth of learning opportunities that we
are fortunate to have in the United States. As always, you can contact me at
Diane.Skiba@ucdenver.edu.
Sidebar.
HITS Collaborative 2010
A call
for scholars for 2010 will be issued in September 2009. Two sessions at the NLN
Education Summit 2009 will help you prepare a winning application for the HITS
Program: Workshop Session 3A and the HITS Luncheon Roundtable, both on
Thursday, September 24.
For more
information about the HITS Collaborative, including descriptions of all 2008
projects, visit www.hits-colab.org/.
Reference
Jeffries,
P. R. (Ed.). (2007). Simulation in nursing education: From conceptualization to
evaluation. New York: National League for Nursing.
Skiba,
Diane J.
Source
Citation
Skiba,
Diane J. "Teaching with and about technology: providing resources for
nurse educators worldwide." Nursing Education Perspectives 30.4
(2009): 255+. Academic OneFile. Web. 4 May 2012.
Document
URL
http://go.galegroup.com/ps/i.do?id=GALE%7CA206851976&v=2.1&u=phspuqc&it=r&p=AONE&sw=w
Gale
Document Number: GALE|A206851976
INSIGHT
In
countries where most students are digital natives, it was that the demand is
for more communication and greater interaction via mobile technology. One
example is Finland, where the penetration of mobile technology is staggering
and finding a pay phone is next to impossible. Only 41 percent of Finnish
households had a landline telephone in 2007, while 97 percent had at least one
mobile phone.
The discussions continued in the postconference, where Diana J. Skiba
was one of 32 informatics leaders who participated in discussions on the impact
of personal health information management tools and strategies for the
engagement of citizens. (No one outside the US likes the term health care
consumer.) We discussed how such tools as personal health records, smart
phones, social networks, and ambient computing (sensors in the home or wearable
computers) hold great promise to engage individuals in their health care. As I
mentioned in two previous columns this year (see Nursing Education
Perspectives, January/February and May/June 2009), we need to rethink the
meaning of consumer-centric or patient-centered care in the wired world. The
postconference represented emerging countries (those in the beginning phase,
such as Slovenia) and implementing countries (like the US).
0 comments>/a>
Wednesday, May 2, 2012 @ 3:45 AM
● IV INSERTION
IV Insertion
Performing venipuncture and starting intraveneous (I.V.) infusions
are among the most challenging clinical skills that a healthcare
professional has to master. In fact, accessing veins in patients with
difficult venous access (DVA) can take up to 10 minutes. The IV
insertion allows liquid substances to be distributed directly into the
vein, providing immediate effect for patients. The most common IV
insertion method is a peripheral IV line, where a hypodermic needle
inserts a short catheter into a peripheral vein. The AccuVein AV300
helps to facilitate IV insertion by projecting a map of the peripheral
veins directly on the skin. Although there is no substitute for a
trained practitioner’s experience, the AV300 can help simplify the IV
catheter insertion process by helping to locate the point of needle
placement. Soon to become an indispensable part of the IV insertion
procedure, the AV300 is effective and simple to use.
IV Insertion Procedure
The AccuVein AV300 can be easily incorporated into the IV insertion
procedure. After applying a tourniquet above the intended puncture site,
simply press the blue button on the side of the AV300. As hemoglobin
absorbs infrared light, the AccuVein AV300 detects the difference in the
hemoglobin concentration between the veins and surrounding tissue,
projecting a map of the veins on the skin above. You can then hand the
AV300 to an assistant or use the optional hands-free stand and continue
the IV insertion smoothly and confidently. Once the IV is in place and
the tourniquet released, the AV300′s work is done!
For more information about making IV insertion procedures easier with
the AV300, contact us at 816-997-9400 or fill out the Call Me Now box
at the right and you will receive a call back from an AccuVein
representative.
Note: The AV300 should only be used by qualified medical
professionals and only in conjunction with appropriate visual and
tactile vein assessment techniques. AccuVein does not recommend that the
AV300 be held by a practitioner when performing an IV insertion.
See the AV300 in Action
16 comments>/a>
@ 3:42 AM
● IV PRIMING
Priming an IV line
The first equipment needed is a signed order for the Intravenous fluid. This is found on the Fluid Treatment Chart.
Intravenous fluid treatment chart
As you can see from the chart above, the order is for 500
mL of 5% Dextrose (often written as D5W) over 8 hours, commencing at
1400 hours. Normally the date is recorded, this chart says Today in the
date column, otherwise this web site would be constantly outdated. The
order is not signed by Nurse as it has not been given yet.
Usually you prepare this in the clean room. Prior to priming the line you must check with an RN the following:
- patient name
- IV fluid against the ordered fluid
- expiry date and clarity of fluid
You will require:
- IV pole
- IV fluid as ordered
- IV giving set
- fluid treatment chart
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@ 2:58 AM
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BLOOD TRANSFUSION
What is a blood transfusion?
A blood transfusion is the transfer of blood or blood products from
one person (donor) into another person's bloodstream (recipient). This
is usually done as a life saving maneuver to replace blood cells or
blood products lost through severe bleeding, during surgery when blood
loss occurs or to increase the blood count in an anemic patient. The
following material is provided to all patients and/or their family
members regarding blood transfusions and the use of blood products.
Although in most situations the likelihood of a blood transfusion
associated with surgery is uncommon, at times patients may require blood
products. You are encouraged to discuss your particular
need for transfusion as well as the risks of transfusion with your
doctor.
Your options may be limited by time and health factors, so it is
important to begin carrying out your decision as soon as possible. For
example, if friends or family members are donating blood for a patient
(directed donors), their blood should be drawn
several days prior to the anticipated need to allow adequate time for
testing
and labeling. The exact protocols are hospital and donor site specific.
The safest blood product is your own, so if a transfusion is
likely, this is your lowest risk choice. Unfortunately this option is
usually only practical when preparing for elective surgery. In most
other instances the patient can not donate their own blood due to the
acute nature of the need for blood. Although you have the right to
refuse a blood transfusion, this decision may hold life-threatening
consequences. If you are a parent deciding for your child, you as the
parent or guardian must understand that in a life-threatening situation
your doctors will act in your child's best interest to insure your
child's health and well being in accordance with standards of medical
care regardless of religious beliefs. Please carefully review this
material and decide with your doctor which option(s) you prefer.
To assure a safe transfusion make sure your healthcare provider who
starts the transfusion verifies your name and matches it to the blood
that is going to be transfused.
Besides your name, a second personal identifier usually is used as your
birthday. This assures the blood is given to the correct patient.
If during the transfusion you have symptoms of
shortness of breath,
itching,
fever or chills or just not feeling well, alert the person transfusing the blood immediately.
Blood can be provided from two sources:
autologous blood
(using your own blood) or
donor blood (using someone else's blood).
Autologous blood (using your own blood)
Pre-operative donation: donating your own blood before
surgery. The blood bank draws your blood and stores it until you need it
during or after surgery. This option is only for non-emergency (elective)
surgery. It has the advantage of eliminating or minimizing the need for
someone else's blood during and after surgery. The disadvantage is that
it requires advanced planning which may delay surgery. Some medical
conditions may prevent the pre-operative donation of blood
products.
Intra-operative autologous transfusion: recycling your blood
during surgery. Blood lost during surgery is filtered, and put
back into your body during surgery. This can be done in emergency and
elective surgeries. It has the advantage of eliminating or minimizing
the need for someone else's blood during surgery. Large amounts of blood can
be recycled. This process cannot be used if
cancer or infection is
present.
Post-operative autologous transfusion: recycling your blood
after surgery. Blood lost after surgery is collected, filtered
and returned to your body. This can be done in emergency and
elective surgeries. It has the advantage of eliminating or minimizing
the need for someone else's blood during surgery. This process can't be used
in patients where cancer or infection is present.
Hemodilution: donating your own blood during surgery.
Immediately before surgery, some of your blood is taken and
replaced with IV fluids. After surgery, your blood is filtered and returned
to you. This is done only for elective surgeries. This process dilutes your
own blood so you lose less concentrated blood during surgery. It has the
advantage of eliminating or minimizing the need for someone else's blood
during surgery. The disadvantage of this process is that only a
limited amount of blood can be removed, and certain medical conditions may prevent
hemodilution.
Apheresis: donating you own platelets and plasma. Before
surgery, your platelets and plasma, which help stop bleeding,
are withdrawn, filtered and returned to you when you need it later.
This can be done only for elective surgeries. This process may eliminate
the need for donor platelets and plasma, especially in high blood-loss
procedures. The disadvantage of this process is that some medical
conditions may prevent apheresis, and in actual practice it has limited
applications.
http://www.youtube.com/watch?v=6cqctzosEys&noredirect=1
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