International journal of medical informatics
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Recent data suggest that medical injuries, or adverse events, represent an important international problem, and that many are caused by errors. Spontaneous reporting is the main tool used to detect errors and adverse events in most countries, and reporting systems are believed to be important for improving patient safety. Increasingly, such reporting can be done using information systems, and information systems are widely used in Korea. However, few data are available regarding the use of electronic medical error reporting systems in Korea. ⋯ While HIT is increasingly widely used in Korea in many areas, it is not being used for error reporting. Increasing the use of electronic reporting systems, and systemically evaluating the medical errors and adverse events reported, represent essential steps for reducing systemic errors and improving patient safety.
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Many health informatics organizations seem to be slow to take up the advantages of dynamic, web-based technologies for providing services to, and interaction with, their members; these are often the very technologies they promote for use within healthcare environments. This paper aims to introduce some of the many free/libre/open source (FLOSS) applications that are now available to develop interactive websites and dynamic online communities as part of the structure of health informatics organizations, and to show how the Open Source Nursing Informatics Working Group (OSNI) of the special interest group in nursing informatics of the International Medical Informatics Association (IMIA-NI) is using some of these tools to develop an online community of nurse informaticians through their website, at. Some background introduction to FLOSS applications is used for the benefit of those less familiar with such tools, and examples of some of the FLOSS content management systems (CMS) being used by OSNI are described. The experiences of the OSNI will facilitate a knowledgeable nursing contribution to the wider discussions on the applications of FLOSS within health and healthcare, and provides a model that many other groups could adopt.
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The purpose of this study was to describe the information management used by hospital and home care nurses for patients in need of continuing care after an episode of hospitalization. ⋯ Discrepancies between the policies expressed by the health care organizations and the authorities in formal documents and the information management used by the nurses were identified. Differences were also found between nurses in hospital and home care with regard to how they assessed the information management during patient admission, throughout the patient's hospital stay and at the patient's discharge. The perceived differences decreased, however, after the hospital introduced electronic nursing documentation. The study shows a need to contextualize and customize the information that nurses exchange. In addition technological problems with the lack of integrated EPR systems between the hospital and the home health care as well as different practice models in the two organizations entail complex information handling during a patient's trajectory through the health system.
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Various forms of electronic health records (EHRs) are currently being introduced in several countries. Nurses are primary stakeholders and need to ensure that their information and knowledge needs are being met by such systems information sharing between health care providers to enable them to improve the quality and efficiency of health care service delivery for all subjects of care. The latest international EHR standards have adopted the openEHR approach of two-level modelling. ⋯ As the openEHR archetype approach does not rely heavily on big standardised terminologies, it offers more flexibility during standardisation of clinical concepts and it ensures open, future-proof electronic health records. We conclude that it is highly desirable for the nursing profession to adopt this openEHR approach as a means of documenting and governing the nursing profession's domain knowledge. It is essential for the nursing profession to develop its domain knowledge constraint models (archetypes) collaboratively in an international context.
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As the demands on the emergency medicine (EM) system continue to increase, improvements in the organization of work and the access to timely clinical and system information will be required for providers to manage their workload in a safe and efficient manner. Information technology (IT) solutions are beginning to find their place in the emergency department (ED) and it is time to begin understanding how these systems are effecting physician behavior, communication and workload. ⋯ The results indicate that the electronic whiteboard improves the efficiency of work and communication in the ED. IT solutions may have great utility in improving provider situational awareness and distributing workload among ED providers. The results also demonstrate that IT solutions alone will not solve all problems in the ED. IT solutions will probably be most effective in improving efficiency and safety outcomes when paired with human-based interventions, such as crew resource management. Future studies must investigate team interaction, workload and situational awareness, and the association of these factors to patient and provider outcomes.