Let's talk telemetry

As telemetry becomes more prevalent, the lines between medical device and clinical information system begins to blur. The author explains why telemetry is growing and merging with traditional information systems and the issues this creates.

Changing world, changing systems: why managed health care demands information technology

In an industry in which the only constant is change, information technology is increasingly becoming the means by which health care organizations manage the constant volatility they face. This article discusses the emerging managed care trends that are driving the move to open systems and increased technological flexibility. In addition, it explains how changing models of care are fueling the evolution of a new breed of clinical information systems that are interdisciplinary, interoperable, and outcomes focused.

Tech talk on multistate licensure

Professional nursing associations, unions, state regulatory boards, and even Congress are hotly debating the topic of multistate licensure. This article discusses several hurdles to implementing a multistate licensure model and explains how technology can help to overcome them.

Reengineering for a new millennium: the year 2000 problem in health care

Reengineering and restructuring of systems--indeed, entire organizations--has become commonplace in today's volatile health care environment. Of all the reengineering to come, the most immediate is year 2000 compliance. This article will discuss the problem in general and its urgency, and why it's particularly critical that health care achieve compliance. In addition, it will discuss key issues to address in a conversion project, such as the importance of including clinicians on the project team.

Long-distance nursing kindles multistate licensure debate

Telehealth enables nurses to practice across state lines, but it also raises the critical issue of multistate licensure. This article explores nurses involvement in telehealth and the multistate licensure discussion--key issues, developments, players, and models currently being considered by states.

A few points about point-of-care technology

Managed care's focus on patient-centered care has made the need for point-of-care (POC) clinical systems more critical than ever. This article examines some of the more common POC options available, explains what nurses need to know to choose among them, and suggests ways to ensure that nursing's needs are addressed in the selection process.

The technologic imperative: a new agenda for nursing education and practice, Part 2

The National Advisory Council on Nurse Education and Practice (NACNEP), which advises the Secretary of the Department of Health and Human Services, recently published a report on the state of nursing informatics. Part 2 of this two-part series offers a definition of nursing informatics and nursing's role in furthering it, details the current state of nursing informatics education/training, and delineates key goals.

Information technology: soul of a new organization

If the total quality organization is the structure of the 1990s, then the structure of the new millennium is the world class organization--and information technology (IT) is the foundation upon which it will be built. This article explores how clinical information systems and IT are evolving to support several unique characteristics of the world class organization, including (1) how patient-centered care and the advent of the interdisciplinary care team has led to the development of a new breed of clinical information systems; (2) how accountability has empowered nursing and led, in turn, to a need for systems and languages to measure and document nursing care and its outcomes; and (3) how care across the continuum and rapid, constant change demands open systems that are scalable and interoperable.

The technologic imperative: a new agenda for nursing education and practice, Part 1

Here's an explanation of what the National Advisory Council on Nurse Education and Practice is and a description of the environment and issues that compelled its recent effort, a report on the state of nursing informatics. The report set forth specific goals for expanding the use of informatics in nursing education and practice.

Information technology: foundation of the world-class organization

The total quality organization of the nineties is rapidly giving way to the structure for the new millennium--the world-class organization (WCO)--and information technology (IT) is the foundation. This article explores how clinical information systems and IT are evolving to support several unique characteristics of the WCO.

Why managed care demands information technology

In health care, the only constant is change. Increasingly, information technology (IT) is becoming the primary means by which health care organizations manage the constant volatility they face. This article delineates several managed care trends driving the move to open systems and increased technologic flexibility. Changing models of care are creating a new breed of interdisciplinary, interoperable, and outcomes-focused clinical information systems.

Bridging the nursing-physician gap: technology's role in interdisciplinary practice

Nurses and physicians are different--in the ways they practice, think, and in the information systems they use. But managed care and such concomitant features as care teams, cost control, outcomes management, and the move from a "Medical Model" to a "Wellness Model," are closing the gap between the two. This article will explore some of the traditional differences between the two disciplines and the problems they present. It will also discuss some of their shared expertise, how managed care is contributing to this overlap and how information systems are evolving and must continue to do so to support the new synergies.

In search of the CPR

In 1991, the National Academy of Sciences' Institute of Medicine defined, endorsed, and called for the implementation of the computerized patient record (CPR) by 2001. Seven years later, in 1998, health care is still arguing about what a CPR is, how it's to be implemented, and when. This article discusses the origins of the CPR and its initial development efforts. It explores the roadblocks that stalled its development and how managed care may have jump-started the process. Finally, it explains current CPR development efforts and what's on the horizon.

Making the move from nurse to nursing informatics consultant

Health care is unique among industries because of the human component involved. That fact, coupled with the unique nursing qualities--critical thinking, caring, attention to detail, accountability and the ability to direct others--makes nurses highly suited o be information system consultants. This article will discuss the health care trends driving the demand for nurse consultants, where and when their skills can be applied, the pros and cons of the entrepreneurial life and What's required to entry consulting.

Incidence of premenstrual syndrome and remedy usage: a national probability sample study

CONTEXT

Premenstrual syndrome is believed to affect 30% to 80% of women. Studies in various cultures have used a variety of methodologies to determine prevalence, symptom profile, and effectiveness of available treatments. This study was designed to provide information on incidence of PMS and therapies used based on a national probability sample of US women.

METHOD

In 1996 a national probability sample (N = 1052) of women aged 21 to 64 years was surveyed by telephone using random digit dial methods. The survey included demographic information, questions concerning respondent knowledge of premenstrual syndrome, incidence rates of common premenstrual syndrome symptoms, and any remedies that were used to control the symptoms.

RESULTS

Forty-one percent of the women responded "yes" to the question, "Do you suffer from premenstrual syndrome?" An additional 17% indicated that they experienced symptoms prior to their menstrual cycle that are commonly associated with premenstrual syndrome (e.g., pain, bloating, feeling more emotional, weight gain, food cravings), though without associating these symptoms with premenstrual syndrome explicity. The most frequently noted severe symptom was that of "[feeling] more emotional." Of those reporting premenstrual syndrome symptoms, approximately 42% took either prescription or over-the-counter medications to relieve them. Eighty percent of the women taking any type of medication relied on over-the-counter medications. Prescription drug use for premenstrual syndrome symptoms focused on medications to control pain; hormone supplements were the second most frequently prescribed rugs. Fewer than 3% of the respondents used prescription medications. Respondents were asked to indicate whether they had used a complementary medical therapy to control symptoms. Exercise was used most frequently (18%), and acupuncture was the least frequently used. Although only a small percentage of women used complementary therapies, for most of these therapies a near-perfect concordance was found between usage and belief in efficacy.

CONCLUSIONS

Women were aware of symptoms related to premenstrual syndrome more frequently than they recognized a formalized medical syndrome. Less than half of the women reporting symptoms had taken either over-the-counter or prescription drugs. Those who tried complementary therapies generally found them to be effective.

The role of technology in interdisciplinary practice

Nurses and physicians practice and think differently and, as a result, the information systems they use are different. But managed care and the things it brings with it--care teams, cost control, outcomes management and the move from a "Medical Model" to a "Wellness Model"--is closing the gap between the two. This article examines some of the traditional differences between the two disciplines and the problems these differences present, as well as shared expertise, how managed care is contributing to this overlap and how information systems are evolving to support the new synergies.

A new millennium for health care IT: the year 2000 conversion

The new millennium. It means many things for many people, from astrologers to information technology (IT) professionals. But the latter, especially those in health care, have good reason to be concerned. Because for the majority of computer systems, January 1,2000, marks both the beginning of a new decade and total system chaos.

A NIDSEC primer: Part 2--Setting the standards

The Nursing Information and Data Set Evaluation Center (NIDSEC), established by the American Nurses Association (ANA), recently published the criteria by which it evaluates information systems that support nursing practice documentation. These criteria include nomenclature, clinical content, clinical data repository and general system characteristics. This article focuses on two of the four dimensions of nursing data sets and the systems that contain them: clinical data repository and general system characteristics.

A NIDSEC primer: Part 1--Setting the standards

The Nursing Information and Data Set Evalution Center, established by the American Nurses Association, recently published the criteria by which it evaluates information systems that support nursing practice documentation. This article focuses on two of the four dimensions of nursing data sets and the systems that contain them: nomenclature and clinical content.

Complete digital duplication: a case report and review of ulnar polydactyly

An unusual case is presented of bilateral, complete digital duplication on the hand of a 9-month-old boy. Radiographic evaluation showed duplication of intact phalanges and metacarpals. Although ulnar polydactyly has been described as one of the most common congenital anomalies of the extremities, it usually manifests itself as a rudimentary skin tag. Ulnar polydactyly can be classified on the basis of genetic, morphologic, and clinical implications. Although polydactyly is reported to occur among approximately 1 in 1000 live births, most of these malformations are rudimentary skin tags. Complete ulnar polydactyly is uncommon; it occurs among approximately 0.014% of all live births. The main goal of surgical treatment of patients with complete-duplication ulnar polydactyly is to establish adequate function. This case report describes the preoperative evaluation and management of complete bilateral duplication of the ulnar digits of the hand.

Internet security concerns

Despite all the media hype, critical security issues do surround the Internet. Nurses need to ask two key questions: How is the Internet used in my organization and What kind of Internet connection do we have?