Nursing

Information
System
Mark Zeus G. Abalos, MSN
 INTRODUCTION
The information system is composed of the internet applications
that aid to facilitate faster operations of the healthcare setting.
Even though devices as simple as mobile phones can help nurses
and other healthcare professionals communicate with each other
to obtain a goal, and that is to have an effective health system for
clients. This unit focuses on the different applications that is part
of our system today in the practice of nursing in various settings.
It talks about the practical applications that we can use in the
performance of our duties.
 At the end of this unit, students will be able to:

PURPOSE & 1. Ensure a working relationship with individual

and family based on trust, respect, and shared

OBJECTIVES decision-making using appropriate electronic

information system and technology.
2.Communicate effectively in speaking, writing,
and presenting using culturally appropriate
language.
INTERNET
APPLICATIONS
 PERSONAL DIGITAL
ASSISTANT (PDA) &
WIRELESS DEVICES
Pocket-sized computers that can access the internet, sending and receiving data, and storing
textbooks worth of information. These tools have the potential to help nurses increase the
quality of care that they provide in the hospital setting. PDAs have been shown to increase
evidence-based practice and decrease medication errors by making relevant information
available right at the point-of-care. PDAs have also been shown to save nurses’ time by
increasing the efficiency and accuracy of electronic patient charting, and by decreasing the time
that it takes nurses to research medication information. The integration of PDAs into nursing
practice poses individual, technical and financial challenges, as well as patient confidentiality and
infection control concerns. However, as nurses and organizations begin to recognize the
potential for PDAs, and as more nursing-focused software and resources continue to be
developed, PDAs truly have the potential to revolutionize the way that nurses provide and record
care (Predhomme, 2009).
Personal The era of PDAs went for a while
Digital between 1992 to 2007 (Edwards,
Assistant 2018), PDA applications have
been slowly being incorporated
to today’s smart phones and
other mobile devices such as
tablets. Being more compact
and losing the stylus for it to be a
practical touch screen device,
smart phones and tablets have
definitely replaced the PDA.
 EMAILS
Emails or electronic mails are ways to send messages
between one user to another or to multiple users. Most of
the companies today including hospitals provide work-
related email accounts to their employees for an efficient
communication within and outside the institution.
Requests and follow-ups are made faster and documented
as it is time-stamped, clutter-free, and traceable in terms
of message history.
 Just as it is used in books for

BOOKMARKS
easy retrieval of the page you are
reading or for common
reference, it also has the same
function in the context of the
internet browsers and other
reading applications such as
Kindle and iBook to name a few.
In the practice of nursing, nurses
utilize bookmarks with its
intended purpose to quickly
retrieve information on drugs,
medical diagnosis, procedures,
and other necessary
information in planning and
implementing care to patients.
PERSONAL DIGITAL
WIRELESS PHONES
ASSISTANT (PDA) &
(MOBILE DEVICES)
WIRELESS DEVICES
Mobile devices as discussed previously have replaced the function
of PDAs. With its multi-function capabilities as a smart phone,
health care professionals can access information quickly and
communicate.

Nurses communicate with multiple members of the health

member team, often while maintaining heavy patient loads. Optimal
communication procedures can help nurses use their time more
efficiently to improve patient safety and outcomes. (VanDusen, 2017).
WIRELESS PHONES Healthcare personnel are often
in different locations when
(MOBILE DEVICES) collaboration is needed.
Maintaining safe patient care may
require fast, accurate
communication among mobile
staff. Delays in communication
have been identified by The
Joint Commission as significant
contributors to adverse events.
The Joint Commission has made
communication between
healthcare workers a patient
safety goal in an effort reduces
medical errors (VanDusen, 2017).
 Nurses use many different methods of
WIRELESS PHONES electronic communication in the clinical
setting to coordinate patient care. This
(MOBILE DEVICES) includes e-mail, smartphone application,
and two-way or group texting options.
The Joint Commission standards have
been redefined, and they now allow
texting of orders and patient
information, if the clinician is the
compliant with a secure texting platform
and maintains safety measures to ensure
order accuracy. Texting lets members of
the healthcare team communicate and
collaborate effectively and among several
disciplines. These methods reduce
response time in emergencies and
increase the frequency of provider
responses to nurses (VanDusen, 2017).
 When used appropriately, electronic
WIRELESS PHONES devices can improve the organization of
daily activities and administrative tasks.
Applications allow users to set
(MOBILE DEVICES) reminders for upcoming meetings or
deadlines. They can also speed up
patient data management, improve
staff cooperation, and provide
opportunities for more efficiency
(VanDusen, 2017).

Along with benefits, electronic

communication has some limitations
in the clinical setting. For example, it
can create additional interruptions
that decrease clinician’s presence in
other patient-care situations
(VanDusen, 2017).
WIRELESS PHONES
(MOBILE DEVICES)
Confidentiality is also a concern. Improved efficiency could be offset by
communication difficulties and loss of reliability and confidentiality. Several studies
have raised doubts about information security, inadequate technical skills, and poor
staff interrelations. Nurses may perceive a worsening of interprofessional
relationships due to an overreliance on text messaging and a subsequent lack of
verbal communication (VanDusen, 2017).

Smartphone applications should be carefully chosen for confidentiality as well as

efficiency. Peer-reviewed software allows date encryption of stored patient
information, remote wiping to destroy data in the event of loss or theft, secure
encrypted data transmission over Wi-Fi, and coordination with facility-specific
standardized clinical communication tools. Additional studies to examine the
clinical value of electronic communication systems are currently underway and
should provide further information about the effectiveness of this technology
(VanDusen, 2017).
TWO-WAY or
MULTI-PERSON VIDEO
TELECONFERENCING

Video conferencing is a visual communication session

between two or more users regardless of their
location, featuring audio and video content
transmission in real time. This platform became very
popular in the rise of COVID-19 pandemic because social
and physical distancing was instituted as part of the
health and safety protocols.
TWO-WAY or
MULTI-PERSON VIDEO
TELECONFERENCING
For effective video conferencing, business companies or organizations need to set up a
profiling conferencing software and hardware solutions for rooms, PCs, mobile devices,
and browsers. Video conferencing consists of an endpoint (ranging from a simple PC to
a telepresence system), video conferencing server (to run group videoconferencing),
peripherals (webcam, microphone, speakerphone, headset, etc.) and software
infrastructure (video processing, content transmission, integrations). Video
conferencing is modern high-tech communication tolls for increasing efficiency for
businesses, optimizing and accelerating decision-making processes, and cutting
customer’s and company staff travel costs. There are a lot of video teleconferencing
applications that people in various sectors utilized to continue their operations such as
Zoom, Microsoft Teams (between office 365 Users) Google Meet, and Facebook
Messenger Rooms to name a few. Each platform presented is various features and prices
from free to premium subscriptions. As we draw near the new normal, this video
conferencing platforms will remain to be used in various industries.
 FACE TIME
For a more personal communication especially this time of pandemic,
which resulted to feelings of anxieties between patients and their families,
they found the significance of video calling mobile applications such as
Apple’s facetime, and Facebook Messenger to communicate safely yet
efficiently. Based on the study by Padala et al (2020) interaction with family
members using Face Time improved behavioral problems in a patient with
Alzheimer’s dementia during the COVID-19 pandemic. Use of such
applications need to be studied both for clinical and research care to be
prepared for future pandemics. As nurses caring for these patients, it is very
important that we support and value the use of such applications to aid in
the need for communication of our patients.
TEXT MESSAGING /
SHORT MESSAGING SYSTEM

Text messaging has already been normal to us for

communicating faster and clearer. Text messaging is the act
of sending short, alphanumeric communications between
cellphones, pagers or other hand-held devices, as
implemented by a wireless carrier. As discussed on Mobile
Phones, nurses and other healthcare professionals are
already using text messaging as a form of communication
and providing orders for treatment and care for the patient.
SOCIAL MEDIA
Social Media like Facebook, Twitter, and Instagram have been a
norm to all of us. Mostly this is our personal space in the online
world, where we can express our thoughts, appreciation,
achievements, sorrow, and many more. The way we share our
information depends on how we chose to share it. Either by the
public or anyone who is registered user or visitor of Facebook can
access the content; or by selected audiences such as users who are
on the friends list or more precise list such as those that the user
chose to share it with. In the healthcare setting, we take a look at
how social media can be used to benefit the practice.
Uses of Social Media according
to Ventola (2014):
1.Professional Networking
2.Professional Education
3.Organization Promotion
4.Patient Care
5.Patient Education
6.Public Health
The first three users are very common and
expected use of social media that can benefit
the healthcare professionals. Since the
intended use of social media is to connect
people, it is known that professional
networking can be establish using this
platform. Professional Education, likewise, can
be done using Social Media through hosting a
live event such as FB live or providing links in
the social media website where users or
participants can access the site directly
without typing the website address. Lastly,
Organization Promotion can be done
through social media by posting their
activities, services, awards, and other
relevant materials that can increase or
promote their organization. Many
organizations find the marketing aspect in
social media very cost-efficient as it reaches
out to millions of its users with a small fee per
posting.
PATIENT
Although there has been a
reluctance among HCPs to use
social media for direct patient

CARE
care, this practice is slowly being
accepted by clinicians and
healthcare facilities. For
example, Georgia Health
Sciences University has
provided patients with access to
a platform called Web View,
which allows the patient to
reach their doctors to ask
questions or request
prescription refills (Ventola,
2014).
 Recent studies have found that physicians have

VENTOLA
begun to develop an interest in interacting with
patients online. Some physicians are using social
media, including Twitter and Facebook, to
enhance communication with patients.

(2014)
Approximately 60% of physicians were found to
favor interacting with patients through social
media for the purpose of providing patient
education and health monitoring, and for
encouraging behavioral changes and drug
adherence, with the hope that these efforts will
lead to “better education, increased
compliance, and better outcomes.” However,
other studies have shown that considerable
resistance still exists to using social media to
interact with patients. In a survey of
approximately 480 practicing and student
physicians, 68% felt it was ethically problematic
to interact with patients on social networks for
either personal or professional reasons.
PUBLIC According to Ventola (2014)
social media have created vast
global networks that can

HEALTH quickly spread information and

mobilize large numbers of
people to facilitate greater
progress toward public health
goals. Social media can
therefore be a powerful tool for
public education and advocacy
regarding public health issues.
Some states ‘public health
departments are using Twitter
and other social media for these
purposes.
Other public health organizations
use keyword content from Twitter
and other social networks, in
combination with location-tracking
technologies, to respond rapidly to
disasters and to monitor the health
and welfare of populations. The
CDC maintains an active presence
on Twitter and Facebook to track
tweets that might indicate a flu
outbreak and to share updates
about such incidents. The CDC has
also used social media to locate
and monitor sources and
suspected cases of Legionnaire’s
disease.
Organizations such as the Red Cross track
Twitter post during natural disasters, such as
hurricanes and earthquakes to gather
information about where the greatest needs
are. Citizen report blogs have also been
monitored by hospitals for information about
potential mass casualty events. When used in
this way, real-time social media sites provide
greater agility and enhanced preparedness
for responses to disasters and public health
emergencies. Social media sites also provide
disaster and emergency response personnel
with a means to rapidly share, and access
important information provided by agencies
such as the CDC and the U.S Preventive
Services Task Force.
The widespread use of social
media can also influence public
health behaviors and goals
through social reinforcement. 8
because human beings are a
highly social species, they are
often influenced by their friends,
as well as by friends of friends.
One example of the powerful
effect of social media was seen
after Facebook decided to allow
users to post their organ-donor
status in their profile. According
to Donate Life America, the week
after this feature was introduced,
online state organ-donor
registries experienced a 23-fold
surge in donor pledges that was
presumably due to this social
networking effect (Ventola, 2014).
Dangers of Social Media in the
Health Care Practice according to
Ventola (2014):
1.Poor Quality of Information
2.Damage to Professional
Image
3.Breaches of Patient Privacy
4.Violation of Professional-
Patient Boundary
5.Licensing Issues and other
Legal Issues
Professional Guidelines for the use of
Social Media based on the study by
Ventola (2014):
Context Concept
Share only information from credible
sources.
Content credibility
Refute any inaccurate information you
encounter.
Remember that the content you author
may be discoverable.
Legal concerns
Comply with federal and state privacy laws.
Respect copyright laws.
Licensing Know professional licensure requirements
concerns for your state.
Professional Guidelines for the use of
Social Media based on the study by
Ventola (2014):
Context Concept
Do not contact patients with requests to join your network.
Networking policies Direct patients who want to join your personal network to a more
secure means of communication or to your professional sites.
Avoid providing specific medical advice to nonpatients.
Patient care Make appropriate disclosures and disclaimers regarding the
accuracy, timelines, and privacy of electronic communication.
Avoid writing about specific patients.
Make sure you are in compliance with state and federal privacy
laws.
Patient privacy
Obtain patient consent when required.
Protect patient information through “de-identification.”
Use a respectful tone when discussing patients.
Professional Guidelines for the use of
Social Media based on the study by
Ventola (2014):
Context Concept
Use the most secure privacy settings available.
Personal privacy Keep professional and personal profiles separate.

Disclose any in-kind or financial compensation

Professional ethics received.
Do not make false or misleading claims.
Identify yourself in professional sites.
Make sure that your credentials are correctly stated.
Self-identification
Specify whether or not you are representing
employer.
WEB 2.0
BLOGS
WIKIS
WEB 2.0
Term devised to differentiate the post-dotcom bubble Word
Wide Web with its emphasis on social networking, content
generated by users, and cloud computing from that in which
came before. The 2.0 appellation is used in analogy with common
computer software naming conventions to indicate a new,
improved version. The term had its origin in the name given to a
series of Web conferences, first organized by publisher Tim O’Reilly
in 2004. The term’s popularity warned in the 2010s as the features
of Web 2.0 became ubiquitous and lost their novelty (Hosch, 2017).
WEB 2.0 In simple terms, Web 1.0
involves websites that are
not interactive or is not
based on contents being
posted or delivered by
user, whereas Web 2.0
are websites that are
interactive such as social
media website. Blogs
and wikis are also
samples of Web 2.0.
WEB 2.0
The use of Web 2.0 for the benefit of the healthcare
practice has wide variations from patient care
schedules e-consultation such as in private hospitals
where you can consult with a physician virtually,
patient information on diagnostic tests, its
preparation, what to expect, and other pertinent
details can be the variation of use.
RELEVANCE OF
INFORMATICS
SYSTEM TO
COMMUNICATION
IN NURSING
In the healthcare setting, patient safety is of
utmost priority among the healthcare
team. It is therefore imperative that we
practice effective communication
techniques to reach this goal. These
communication techniques can be found on
TeamSTEPPS by the Agency for Healthcare
Research and Quality (AHRQ). According to
AHRQ (2013) individuals can learn four
primary trainable teamwork skills. These
are:

▪ Leadership
▪ Communication
▪ Situation monitoring
▪ Mutual support
If a team has tools and
strategies it can leverage to
build a fundamental level of
competency in each of those
skills, research has shown that
the team can enhance three
types of teamwork outcomes:

▪Performance
▪Knowledge
▪Attitudes
Effective teamwork
is important not only
for an organization
to succeed but also
for its people's
wellbeing.
For example, if every member of
the team has basic competency
in situation monitoring and
communication, it is incumbent
upon them to build shared
mental models more effectively.
Improved outcomes beget
greater proficiency (improved
teamwork skills) and a desire to
be a part of the team (attitudes).
Such is the reciprocal
relationship between skills and
outcomes. Certainly, the
informatics system has a key role
in ensuring that communication
between the healthcare team will
be made possible whether from a
simple mobile device functions
to mobile applications.
Essential
Communication
Techniques
under
TeamSTEPPS
according to
AHRQ (2013)
SBAR
(Situation, Background,
Assessment, Recommendation)
A technique for communicating critical information that requires
immediate attention and action concerning a patient’s condition.
Situation - What is going on with the patient?
“I am calling about Mrs. Joseph in room 251. Chief complaint is shortness of breath of new onset.”

Background - What is the clinical background or context?

“Patient is a 62-year-old female post-op day one from abdominal surgery. No prior history of cardiac or lung
disease.”

Assessment - What do I think the problem is?

“Breath sounds are decreased on the right side with acknowledgement of pain. Would like to rule-out
pneumothorax.”

Recommendation and Request - What would I do to correct it?

“I feel strongly the patient should be assessed now. Can you come to room 251 now?”
 CALL-OUT
Strategy used to communicate important or critical information.
• Informs all team members simultaneously during emergent situations.
• Helps team members anticipate next steps.
• Important to direct responsibility to a specific individual responsible for carrying out the task.

Example during an incoming trauma:

Leader: “Airway status?”

Resident: “Airway clear”
Leader: “Breath sounds?”
Resident: “Breath sounds decreased on right”
Leader: “Blood pressure?”
Nurse: “BP is 96/62”
 CHECK-BACK
Using closed-loop communication to ensure that information
conveyed by the sender is understood by the receiver as intended.
The steps include the following:
1. Sender initiates the message.
2.Receiver accepts the message and provides feedback.
3.Sender double-checks to ensure that message was received.
Example:
Doctor: “give 25 mg Benadryl IV push”
Nurse: “25 mg Benadryl IV push”
Doctor: “That’s correct”
 HANDOFF
The transfer of information (along with authority and responsibility)
during transitions in care across the continuum. It includes an
opportunity to asks question, clarify, and confirm.

Examples of transitions in care include shift changes; transfer of

responsibility between and among nursing assistants, nurses nurse
practitioners, physician assistants, and physician; and patient transfers.

Strategy designed to enhance information exchange during transitions

in care.
“I PASS THE BATON”
Introduce yourself and your role/job (include
I Introduction
patient).
P Patient Name, identifiers, age, sex, location.
Present chief complaint, vital signs, symptoms,
A Assessment
and diagnosis.
Current status/circumstances including code
S Situation status, level of (un) certainty, recent changes,
and response to treatment.
Critical lab values/repots, socioeconomic
S Safety
factors, allergies, and alerts, (falls, isolation, etc.)
THE
Comorbidities, previous episodes, current
B Background
medications, and family history.
Explain what actions were taken or are
A Actions
required. Provide rationale.
Level of urgency and explicit timing and
T Timing
prioritization of actions.
Identify who is responsible (person/team)
O Ownership
including patient/family members.
What will happen next?
Anticipated changes?
N Next
What is the plan?
Are there contingency plans?
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