Guest Editorial

MSW, LCSW examine the value of IT in the homecare venue. Their article describes the HOUSE (Home Operations Utilizing Safety Education) Program, which uses patient assessment, education, and other interventions to adjust the home environment to meet patients’ needs. It explains how assessment and education cost-effectively and efficiently link inpatient, ambulatory, and homecare while reducing preventable injuries in a predominantly rural setting—all by using a handheld telephone. This is Diane J. Skiba Roy L. Simpson a perfect example of a simple technological solution to address patient safety issues in the home. Will Technology Change Our Practice? In another example of the value of handheld technology, “The Transforming Effect of Handheld To measure blood pressure in 1847, you Computers on Nursing Practice,”Brent W. inserted catheters directly into the artery. To draw Thompson, DNSc, RN, explains how handheld blood in 1860, you perforated the skin with 12 computers have the power to transform nursing small lancets, placed a hot cupping glass over the care. He points to increasingly decentralized wound, extracted 3 to 5 oz of blood, and then communication, electronic health records, and dressed the wound with lint and plaster. Today, nurses’ greater need for information at the we have automatic noninvasive blood pressure point-of-care as the reasons behind and for this monitors and, in the not so distant future, we will new technology. Access to information at your have a technique that will use sound to painlessly fingertips allows nurses to practice as knowledge extract a number of important molecules through workers. He discusses the effects of handheld the skin and render the familiar needle prick resources, calculators, databases, electronic obsolete. Will technology change nursing health records, and communication devices on practice? It already has and you can bet it will nursing practice and explains why nurse continue to do so. administrators must encourage and promote Technology—broadly defined to include diffusion of this technology. information and communication technologies, Karen L. Courtney, MSN, RN, George Demiris, biotechnologies, and nanotechnologies—will PhD, and Greg L. Alexander, RN, discuss how have a dramatic effect on the way nurses practice information technology (IT) changes not just and learn. Technological advances will have practice and processes but the actual way in positive, negative, and unintended consequences which nurses interact with patients in, on nursing as a profession, as well as on “Information Technology: Changing Nursing healthcare providers, consumers, healthcare Processes at the Point-of-Care.”They explain how delivery systems, and society. Whether one achanging society, an increasingly complex believes technology is the ultimate bane or the healthcare environment, and the everworsening ultimate boon to nursing, it is clearly the ultimate nursing shortage have created a need for a agent for change. This issue will examine issues redesign of the healthcare system. They suggest related to how nursing shapes technology and we view IT as part of that redesign rather than as how technology can and will be used to shape simply the automation of existing processes and nursing. allow it to change nursing processes within In “The Development of a Patient Safety institutions, all the way to the point-of-care. To Program Across the Continuum of Care,”Sydney that end, they go on to say nursing can and Wertenberger, MSN, RN, CNAA and Jessi Wilson, should actually shape the design of IT. They also

301 c 2005 Lippincott Williams & Wilkins, Inc. present a case study of nurses using IT in nursing practice and proactive in the homecare. development of telehealth and telenursing?” IT’s implications for practice transformation Finally, “From Tele-ed to Telehealth: The Need amid the nursing shortage and an aging forITUbiquity in Nursing,”attempts to answer population–two of the biggest challenges facing some of these questions by exploring IT as a core, US healthcare—are the topics of the next two intuitive capability for nursing, while Leah L. articles. Curtin, ScD (H), RN, FAAN, explains the ethical In “Cultivating Informatics Competencies in a implications of it all in, “The Intersection of Community of Practice,”Amy J. Barton, PhD, RN, Nursing, Ethics and Information Technology.” explains why nurses—both new and Business writer Tom Peters said, “Today, loving existing—must become well informed in the use change, tumult, even chaos is a prerequisite for of informatics to provide optimal care to their survival, let alone success.” We may not have to patients, despite the inadequate number of formal love chaos, but we certainly must accept it as nursing informatics programs that exist across the business as usual in today’s world. Technology can country. She advocates for incorporation of help us survive, manage, and be successful in the informatics competencies into nursing curricula midst of it. both at entry-level and via staff development to If nurses are one of the knowledge workers in ensure a ready workforce. She recommends the the healthcare delivery system, they must use of a community or practice model to facilitate embrace information and communication creative faculty development strategies. technologies as an integral component of their In “Aging Well With Smart Technology,” practice. They must stop viewing the use of authors Penny Cheek, RN, BSN; Linda Nikpour, technology as another task to perform and think RN, BSN; and Heather D. Nowlin, RN, BSN discuss about the technology as an enabler to provide safe aging-in-place, an idea whose time has come as patient-centered quality care. In this issue, we nursing homes become increasingly have presented some of the transformative overburdened by too many patients and too few practice that can occur with information and nurses. They introduce and explain smart home communication technologies. technology, which will make aging-in-place possible. Amy Peck, RN, discusses what telehealth and Diane J. Skiba, PhD, FAAN, FACMI telenursing can make possible in “Changing the Professor and Project Director, The Face of Standard Nursing Practice Through I-Collaboratory, Partnership in Learning, Telehealth and Telenursing.”She delineates University of Colorado at Denver and benefits and barriers to telehealth ubiquity. She Health Sciences Center raises such questions as, “How do nurses Colorado assimilate important nursing skills and common Roy L. Simpson, RN,C, CCMA, FNAP, FAAN nursing practices and telehealth and Vice President, Nursing Informatics, telemedicine?”and “How can nurses Cerner Corporation simultaneously be relevant in the development of Kansas City, Mo

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