Intrapartum Computer Monitoring Presented by Yvette M Kreitz

Intrapartum Computer Monitoring Presented by Yvette M. Kreitz, RN

Objectives Definitions. Describe the purpose of intrapartum computer monitoring. Describe the hardware and software utilized with this technology. Assess the role and function of the nurse involved with this technology. Examine related legal and/or ethical issues. Discuss the advantages and disadvantages from a nursing perspective.

Definitions Electronic fetal monitoring (EFM) Fetal heart tracing Fetal monitor Intrapartum computer monitoring Intrauterine pressure catheter (IUPC) Tocodynamometer (“Toco”) (Taber’s, 2005)

Examples

Purpose of intrapartum computer monitoring Comprehensive, computerized network consisting of: Centralized server/network Bedside stations Remote access points Printers

Purpose of intrapartum computer monitoring Diverse access points allow for: Remote patient surveillance Increased participation from support staff Continuous monitoring Improved continuity of care (Sandelowski, 2000)

Purpose of intrapartum computer monitoring Software advancements enable: Comprehensive data over a nine-month period Point-of-care and real-time charting Immediate alarm features and critical value notifications Software integrated with evidence-based practices (www. lmsmedical. com, 2009)

System hardware Centralized server/network Network printers Main station computers Bedside stations Remote access points

System hardware Fetal monitor & belts Toco or IUPC Ultrasound transducer or scalp electrode Blood pressure cuff Pulse oximeter (Ladewig, London & Davidson, 2006) fetal

System hardware

System software Top 5 Windows-based intrapartum software monitoring programs: Clinical Computer Systems: OBi. X Perinatal Systems GE Healthcare: Centricity Perinatal Hill-Rom: Navi. Care Watch. Child Solutions LMS Medical: CALM Suite Philips: Intelli. Vue OB Care (www. klasresearch. com, 2009)

System software Modular design for flexibility and efficiency Patient-focused surveillance and continuous monitoring On-line documentation Alerts and reminders (www. gehealthcare. com, 2009)

System software Archival of data Functions and communicates with other hospital programs and departments Maintains patient confidentiality and data security. Decision support (www. gehealthcare. com, 2009)

Software usability evaluation Users must be an early and continuous focus during interface design. The design process should be iterative, allowing for evaluation and correction of identified problems. Formal evaluation should take place using rigorous experimental and/or qualitative methods. (Staggers, 2003), (Effken, 2009)

Information System Review What is an information system? Information system used for intrapartum computer monitoring, and its function. Part clinical/part special-purpose A communication system A patient care system (Mc. Gonigle & Mastrian, 2009)

Information System Review Who uses the information system? How is the information system configured? What data standards are used in this system? What Disease and Procedure Classification System is used?

Information System Review Nursing practice standards NIC NOC AWHONN NICHD Recommendation regarding this system

Advantages of Intrapartum Computer Monitoring Nurse-patient interaction Reporting Storage Time Management Flexibility Safety (www. obix. net/overview/advantages. asp, 2009)

Disadvantages of Intrapartum Computer Monitoring Critical thinking System down-time Responsibility Cost

Ethical and Legal Issues Privacy, confidentiality Responsibility Documentation System over-reliance

Informatics Competencies Operates Windows applications Uses instant messaging and e-mail Knowledge of applicable intrapartum monitoring system – hardware and software Knows hospital-specific nursing policies for charting, storage & medication administration.

Functions and Responsibilities of the Informatics Nurse Perspective Theories, principles, concepts Ergonomics HCI principles Social, legal and ethical impacts Role (Mc. Gonigle & Mastrian, 2009)

Summary Purpose Hardware/software Role and function of the nurse Information system review Advantages/disadvantages Nursing informatics

References Clinical Computer Systems, Inc. (2009). OBi. X Overview. Retrieved from http: //www. obix. net/overview/advantages. asp. Effken, J. A. (2009). Improving the Human-Technology Interface. Nursing Informatics. Sudbury, MA: Jones and Bartlett, (p. 65 -71). GE Healthcare, Inc. (2009). Centricity Perinatal Product Technology. Retrieved from https: //www. gehealthcare. com/portal/site/usen/1006 e 73922. asp. KLAS Reseach, LLC. (2009). Rating Healthcare Technology. Retrieved from http: //www. klasresearch. com/1106/ob_soft. asp.

References Laedwig, P. A. , London, M. L, & Davidson, M. R. (2006). Contemporary Maternal-Newborn Nursing Care. (6 th ed. ). Upper Saddle River, NJ: Pearson -Prentice Hall, (p. 432 -438). LMS Medical, Inc. (2009). High reliability in obstetrics. Retrieved from http: //www. lmsmedical. com/4105/print. asp? url=/4105/03_04_02_calm_cur ve. asp. Mc. Gonigle, D. & Mastrian, K. (2009). Nursing informatics and the foundation of knowledge. Sudbury, MA: Jones and Bartlett Publishers, (p. 206 - 217).

References Sandelowski, M. (2000, May). Retrofitting technology to nursing: the case of electronic fetal monitoring. JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing, 29(3), 316 -325. Retrieved September 8, 2009, from CINAHL database. Staggers, N. (2003). Human factors: Imperative concepts for critical care, 14(3), 310 -319. Retrieved October 1, 2009, from CINAHL database. Taber’s cyclopedic medical dictionary (20 th ed. ). (2005). Philadelphia, PA: F. A Davis, 749.