Nursing Informatics in Europe

The main rational for implementing a greater use of information technology in the healthcare sector in Europe is to improve safety and quality, improve patient outcomes, and at also to try to reduce the cost of healthcare. Widespread use of IT is very limited in the area of healthcare services. It has been accepted and fully integrated by manufacturers and production services in the 1980s, next in business services, and only in 1990s, it was introduced to the healthcare service. It is not yet in its optimum functioning because managing people¶s illness is very complex. The usage of nursing informatics started 5 to 10 years after the development of United States in their system and the gap is slowly decreasing for the development of IT. The main mission is to establish a stable infrastructure that improves healthcare quality, facilitates the reduction of errors and the delivery of evidence based and cost-effective care. The building blocks are electronic health records, nursing informatics education at all levels, communication and terminologies, and standards for technology, communication and patient care. y IT IN THE EUROPEAN UNION (EU) European Communication (EC) is a driving force of healthcare informatics development by funding projects that are all cross-cultural involving healthcare professionals as users, educators, and administrators, always with three or more countries participants. An action plan was implemented, ³e-Health Action Plan´, and it aims at delivering better quality healthcare throughout Europe. It covered aspects like electronic prescriptions, computerized patient records and information systems to cut waiting time and reduce errors. Their objective is ³European e-Health Area´ and some steps are needed to fulfill this like a high speed Internet access for health system is needed. One goal is by that 2005, they should develop their own road maps for e-Health, and an EU public health portal should be up and running to provide a one-stop shop to access health information. Work must also be done in order for it to progress and to allow measurement of the impact of e-Health technologies on the quality and efficiency of services as well as productivity. Europe is strong on healthcare and electronic business and this will be used for patient¶s benefit. The goal is that four out of five physicians must have an access to Internet and four out of five European citizens can use the Internet to know about their health and illness.

they have three objectives: confidence in IT. Next is. United Kingdom. Ireland. which is the practice of medicine and nursing over a distance where data and documents are transmitted through telecommunication systems.NATIONAL IT STRATEGY Many countries have contributed to the development. is widely disseminated in parts over Europe. Belgium. One of their goals was to have access to an IT infrastructure with highspeed connections in all households and companies around the country. competence to use IT and information about society services available to all citizens. The first phase of the project is focused on the admitting data that should be possible to share among different healthcare professionals and geographical areas to enhance the security and also adhere to the idea of data once entered are used many times. France. Slovenia. the ability to communicate between systems. One of which is Telemedicine or Telehealth. Denmark. and to meet the healthcare needs of a more mobile population. Countries such as Austria. Germany. The use of electronic signatures will facilitate this. Like in Sweden. PATIENT PARTICIPATION One of the grounds for the e-Health Action Plan in the EU is that the ministers have identified the potential for citizen empowerment through widespread availability of high quality appropriate health information on the Internet. Another problem is most information found in the Internet is in English which is not the first language in European countries. . The government is giving their support to achieve this goal. Portugal. and Italy are practicing telemedicine but other countries practice this rarely. Sweden. These are supported in different projects in different settings. Most staff and other healthcare agencies are not connected to the Internet. Confidence in IT implies that the users must trust the information retrieved in the system and it is secured and invisible to others. Norway. Improved patient participation and the consideration of patient preferences have improved outcomes and treatment adherence as well as increased patient satisfaction with their care. Greece. CONTINUITY OF CARE AND AVAILABILITY OF INFORMATION Key concepts are continuity of care and care providers. Iceland. Finland. the directors of each hospital agreed to develop their hospital systems which will allow them to communicate with each other and confidentiality still remains. Spain.

decisions and evaluation and only a few European countries have a law forcing nurses to record nursing. A study was conducted by the National Board of Health and Welfare was used to illustrate the increasing amount of information in healthcare: in 1971. 81% in hospitals. . Registered nurses have an autonomous responsibility for planning. all nurses are obliged to document nursing care by law. a framework which has continuously provided foundation. implementing. DISSEMINATION OF ELECTRONIC PATIENT RECORDS Norway and Sweden used electronic patient records both in primary healthcare and in hospitals.y ELECTRONIC PATIENT RECORDS Most nurses by their professional behavior make notes about patient care such as assessments. which have raised demands for the cost-effective care and quality improvement. One of the early initiatives that laid the foundation of terminologies in nursing was the concerted action on ³People¶s needs for nursing care´ by the WHO. 4 week hospital stay produce 3 sheets of paper. In Sweden 85-90% is used in primary healthcare and 40% in hospitals while in Norway. and evaluating nursing care and that nursing diagnoses in the patient record is a part of that responsibility. and in 1999 a shorter stay of 10 days generated 34 sheets of record information. It became an important milestone which raised the awareness about the need to make nursing care more visible. The nursing diagnoses are the weakest link in the nursing process and thus it is promising that some projects have shown that educational efforts have positive effects on both quantity and quality of nursing diagnoses. DEVELOPMENT OF COMMON TERMINOLOGY FOR NURSING PRACTICE IN EUROPE There is probably a great variety in reasons for the development of uniform terminologies for nursing in different European countries. Common flaws found in studies are unspecific notes. Swedish nurses prefer the use of problem statements. The assurance and introduction of electronic health record pushed for the standardization and accessibility of nursing information. 1984 generates 18 sheets. systemic assessment and nursing diagnoses are rare and a lack of planned and prioritizes interventions. In Sweden. Some common factors are the increasing cost constraints in the mostly publicly financed healthcare systems. Other influencing factors is that the professionalization of nursing thus making it visible and aspiration for greater accountability. The nursing process was used as a framework for the project.

and feeding assistance and wound care. interventions and outcomes. NMDS contains 23 nursing interventions. In Netherlands. Since 1988. and a fourth level of information aggregated for international sharing. y INTERNATIONAL COUNCIL OF NURSES (ICN) . it is mandatory to collect data four times a year in all hospitals using the Belgian nursing minimum data set (B-NMDS).Belgium has made the nursing care visible and it has been acknowledge by the national level policy makers. second level of interpretations and decisions by the nurse. elimination. It identifies a base level of patient¶s data. nursing information reference model has been developed to accommodate the information needs of nurses at the clinical level and for aggregating data at higher levels. medical diagnoses. patient demographics. third level of aggregated data on nursing diagnoses. mobility. nurse variables and institutional characteristics. The nursing interventions were derived from extensive testing and it covers areas such as hygiene.

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