Tuesday


Conference& Tuesday14 Jun 2006 12:14 am

Peter MurrayAt the end of Tuesday afternoon, a workshop was held titled ‘Developing nursing informatics globally: the Croatian, Cuban and South African experiences and some issues for future IMIA-NI activity’. Unfortunately, several of the planned presenters were unable to be present; Yoadis from Cuba was unable to get the NI2006, as was the case with Nolwazi from South Africa. Patti Abbott, from the USA, was feeling unwell and unable to participate. Nevertheless, with a reasonably sized audience, Robyn Carr, Aleksandar Radenovic and Peter Murray provided an overview of the issues affecting the countries mentioned in the title.

Robyn CarrRobyn Carr, incoming Chair of IMIA-NI, did a superb job of moderating the session, and gave some background to her visits to South Africa to work with Nolwazi and colleagues. Aleksandar Radenovic gave an overview of the status of nursing and nursing informatics in Croatia, and ofr some of the issues that currently influence the development, or lack of development, of nursing informatics in his country. He identified lack of education opportunities at post-graduate level as one major issue, a theme echoed in the presentation about the situation in Cuba.

While Yoadis from Cuba was not able to be present, she did provide some presentation slides; Peter Murray spoke to these slides which summarised some of the history of health informatics and nursing infofrmatics in Cuba, and some of the issues facing the development of nursing informatics. Again, need for education was highlighted as an issue; Peter also commented on some of the issues from the perspective of his visits to Cuba. He also provided a summary of the current work he and colleagues (particularly Graham Wright and Helen Betts) from CHIRAD and University of Winchester in the UK are undertaking with Walter Sisulu University in South Africa in the development of a Masters in Health Informatics.

Peter Murray

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NI2006& Social& Tuesday13 Jun 2006 02:38 pm

National Dress

Ice SculptureThe conference Gala Dinner was held on the Tuesday evening (when Korea were playing their first match in the worldcup). The dinner was soup, salad, steak and a mouse & quite pleasant (although they had problems with deleagtes who were vegetarian or on Gluten free diets etc). The wine (possibly rice wine) didn’t taste too good to some western palates & alternative wine/beer had to be purchased at high prices.

Several foreign delegates and many of the Koreans wore national dress and paraded and danced, including a dance around the entire hall, there was also professional entertainment from drummers and a Korean Jazz Band. In the foyer was a large ice sculpture containing the logo of the conference.

The dinner was quite restrained in comparison with some similar events and many delagtes had left before the finish time of 22.00 (which was also kick off for the football.

Drummers

Dancing

KOrean Jazz

NI2006, Gala

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NI2006& Tuesday& Workshop13 Jun 2006 08:35 am

CarolKathleen Smith and Carol J. Bickfordled this workshop and started by getting everyone to introduce themselves & saying what they wanted to get out of it.

They described there experience and purposes in setting up the Weekend Immersion in Nursing Informatics moving from clinical topics to informatics and education. They tried to use the Who, What, Where, When, Why and How approach and applied these to nursing informatics programmes. They described who attends WINI’s and the identification of learner needs. Issues raised included the context, resources and the content which needs to be included - although it was very, very US centric some of the issues could be transferred to other settings, including the levels on NI competancy.

KathleenThey got delegates into groups to look at case studies which brought out lots of experiences and ideas for the future, and triggered further questions. Kathleen and Carolprovided references and concluded with some questions and discussion.

There was some interesting ideas about running events - but it did come across as a sales pitch for WINI.

NI2006, lifelong learning, WINI

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NI2006& Tuesday& papers13 Jun 2006 06:19 am

Ursula HuebnerUrsula Huebner form Fachochsule Osnabruck, Germany asked the question eHealth in Nursing - is it already routine? She used a definition of e-health (from Gnter Eysenbach) which suggests it is a state of mind and wa of wrking, as well as being about technology. The presentation was based on 2 case studies, 1 at national level for general health and one at regional level for nurses.

The national programme involves electronic cards for patients and professionslas - but nursing can not access the EHR. The second study is built around the nursing record in nursing homes and hospitals. She attempted to compare the two particluarly in relation to purposes and user involvement.
NI2006, eHealth, Germany

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NI2006& Tuesday& papers13 Jun 2006 05:58 am

Stephen TimmonsAfter my own presentation on the use of ICT to support students in practice - which I will let someone else comment on - I attended a presentation by Stephen Timmons a sociologist for Nottingham, Uk who reported a study looking at a teledermatology project. He reported the view that the technology was not important but that the introduction of the new service was about working practices. One finding was that nurses didn’t need to refer very often as they had the necessary knowledge & that fact that a telehealth route for support was made available enabled them to use theirexisting knowledgemore fully. Patients which would traditionally have been under consultant care in hospital were cared for at home by nurses who were able to refer if needed but were making their own “diagnoses”. This let patients avoid the travelling (and parking) at the hospital. The pateints and nurses both valued the expertise of the nurses. Controversy surrounded this “advanced” nursing and the development of new roles. Stephen then moved on to look at the policy context and related it to Actor Network Theory and sociological constructs.
NI2006, teledermatology, healthcare roles

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Tuesday& papers13 Jun 2006 02:45 am

Charlotte WeaverDuring the cnfernce I had asked various key people from Cerner about the possibility of having access to a version of their Millennium Software which is to be used in the UK’s southern cluster (and pobably London as we hear today) to be available for educationalinstitutions - therefore I was very grateful for the opportunty to attend a session on how ths had been achieved andused in the USA.

Charlotte Weaver (from Cerner) presented on behalf of Judith Warren from the Faculty at Kansas. One of the drivers was the US report on erroros in the health care system & therefore trying to get students at the point of graduatio not necessarily to know everything - but to be able to find it.


The SEEDS (Simulated e-Health Delivery System)
was described enabling interactive system for education with simulated pateints. The system, which is an adapted version of the clinical software, has been used to enable students to explore patient assessment and planning and make links to the evidence base - hopefully reducing the divide between education and practice.

Following the presentation I am even more interested in exploring the possibility of implementing a version of this system in the UK and will be contacting Charlotte when I get back to the UK to explore these options further.

NI2006, education, simulated patients

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NI2006& Tuesday& papers13 Jun 2006 01:57 am

After coffee by jumping between rooms I was able to listen to a variety of presentations.

The first was by Jill Phillips of Unitec in New Zealand who described work they had underaken in partnership with the local health board to develop asimulation learning lab. She described the context and issues aboutthe working between the two differnt organisations and the staged aproach adopted. She talked about moves towards advanced simulation in addition to the KIWIN project with students using PDAs which is described elesewhere in the conference.

Next was a paper from Norway which described a study comparing the information needs and satisfaction between hospital and community nurses. They found that both the format and content of information needed between the two groups was different. This was analysed in the context of Proctes information filtering model.

A further paper from Taiwan looked at attitude towards end user development amongst nurses. They concluded that computer compeancy was vital to include in nursing problems, and focused on standards and quality issues.

NI2006, education, attitudes, interface design

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Keynotes& NI2006& Tuesday13 Jun 2006 12:15 am

Vilma PatelTuesday morning started with a keynote presentation by Vilma L. Patel from Columbia University, USA. She started by looking at CPOE and error and their links to human cognition foucsing on how technology links to safety. She gave an overview of cognitive cience and some of the methods used and theunderpinning theories and conceptual frameworks.

She used 3 case studies from nursing practice to illustrate how the concepts can be related to practice. The first related to Decision-making strategies for telephone triage in emergency medical services written with Leprohon, J. In this study physicians were better wen physical symptoms were clear, but nurses were better at taking the context into account.

The second study, with coleagues Laxmisan, A., Hakimzada, F., Sayan, O.R., Green, R.A., looked at decision making in the emergecy room and the cognitive demands with complex workflow and constant interuptions and multitasking. The study examined the variety of decisions made during a patients visit.

The third study looked at te nurses role as a coordinator, mapping activities and interactions amongst a clinical team, exploring collaborative and distributed cognition, including the role of technology and shared intellectual property.

Biomedical InformaticsShe concluded by considering clinical cognition and the implications for informatis and plugged a chapter in a  recent book on Biomedical Informatics: Computer Applications in Health Care and Biomedicine

Questions inclded a discussion of the useof technicans supported by algorithms rather than qualified nurses in services such as the UK’s NHS Direct and the balance between quality and cost.
NI2006, cognition

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