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CREATIVITY IS THINKING UP NEW THINGS
INNOVATION IS DOING NEW THINGS
                    - THEODORE LEVITT




                   J.SANGEETHA
                   M.SC (N)
INTRODUCTION
• The only constant feature in this world is change.
• While all the change may not lead to progress, there
  can be no progress without change.
• This is true for the individual, institution,
  organization or the country.
• Civilization owes its existence to change.
• The success or even survival of an institution or
  organization on depends on making necessary
  changes.
DEFINITION

Innovation is the act of
• constructive thinking
• grouping knowledge
• skills
• attitude into new
• original & rational ideas.
Critical thinking Imagination   Plan
Action Achieve objectives
DEFINITIONS:

• Innovation is defined as the
  generation of new ideas or
  application of existing ideas to a
  new    situation    resulting   in
  improvement in organization
• Innovation is the action of
  introducing a new method,
  idea or product
NEED OF INNOVATION:

1. INOVATION TO CENTRAL TO MAINTAINING AND
     IMPROVING QUALITY OF CARE

2. GROWING DEMANDS IN HEALTH SERVICES

3. GLOBAL WORKFORCE SHORTAGE
CHARACTERISTICS OF
       INNOVATION

• RELATIVE ADVANTAGE:
       It is the degree to which the new
  idea is considered superior to the old
  one
• COMPATIBILITY:
              It refers to the degree of
  congruence between the innovation
  and      existing    values,habits,past
  experience      and    need   of    the
  participant
COMPLEXITY:
          It describes the amount of difficulty that
participants    have    in   understanding      and
subsequently using the innovation

TRIALABILITY:
       it is the degree to which the new idea can be
pretested or tried on a limited basis

OBSERVABILITY:
         It refers to how visible the innovation is to
participants and onlookers
PRICIPLES
• Innovation is to analyze the
  opportunities or sources
• Innovation is both conceptual and
  perceptual
• It should be simple and focused
• Effective innovation start small and
  they aim to do one specific thing
• Successful innovation aim at being
  the best from the very beginning
INNOVATION IN NURSING EDUCATION
HANDHELD COMPUTERS IN
  NURSING EDUCATION

• First personal digital assistant in 1996
• According to ANA (2001) all nurses
  need to use nursing informatics
VIDEOCONFERENCING AND
      WEB BASED
    CONFERENCING

• Connects students and educators
  across distance
• Connects diverse student groups
E-LEARNING

• Adaptation     of   different  distance
  learning technologies
• Self directed, active learning
• Refocusing from educator to the
  subject
SERVICE-LEARNING

• Structured learning experience that
  combines community service with
  preparation and reflection
• Achieves a balance between service
  and learning objective
HIGH FIDELITY PATIENT
       SIMULATOR

• Help student practice decision making
  and problem solving skill and to
  develop human interaction
• Simulation is the third leg in the stool
  of education and science
TELE TEACHING
• Online model of education-learner
  directly interacts with tutor
• Learner oriented learning
• Promotes discovery learning
MICRO TEACHING

• Miniature classroom teaching
• Small duration
• Paying full attention to a particular
  unit and skill
• Content reduced to one unit with a
  single concept
NURSING INFORMATICS
• Integrates nursing science, computer
  science and information science in
  identifying, collecting, processing
  and managing data and information
      to support nursing practice,
  administration, education, research
URSING CERTIFICATION   NURSING CERTICATION
                        NURSING CERTIFICATION


    Certification      •Advanced cardiac life support
    example            •Basic life support
                       •Certified emergency nurse
                       •Critical care registered nurse
                       •Neonatal resuscitation program
                       •Pediatric advanced life support
                       •Cardio thoracic nursing
                       •Emergency and trauma care
                       nursing
                       •Oncology nursing
•Renal nursing
•Fellowship in family nurse
practice
•Fellowship in Hematology
Nursing
•Fellowship in Respiratory
Nursing
•OT       technique      and
management
•Psychiatric nursing
NURSING MOBILE
         LIBRARY
• Access to health care information for
  nurses working in remote area
• To reduce the gap between the
  desperate     need      for      nursing
  information and its availability
STAFF AND STUDENT
        RECRUITMENT

• New methods like OSCE &OSPE
• Objective because examiner use a
  checklist for evaluating the trainee
• Structured, because every trainee
  sees the same problem and performs
  the same task in same time frame
• Clinical, because the task are
  representative of those faced in real
  clinical situation
INNOVATION IN
     CLINICAL
PRACTICE AREA
COMPUTER ASSISTANCE

•   Maintenance of health records
•   Health security card
•   Use of ROBOTS
•   Reduce error and give certitude to the clinical
    planning process
WIRELESS TECHNOLOGY
• Nurse have immediate telephone contact with
  employees and with patient
• Direct and accurate communication between Nurse
  and Physician
• E.g.. In south Africa nurses uses their mobile phone
  to support people living with HIV/AIDS
EVIDENCE BASED PRACTICE

•    It is combination of professional expertise with
     available evidence to produce practice that lead a
     positive outcome for client
•    Steps:
    1.   Identify a knowledge need and formulate an
         answerable clinical question
    2.   Locate the best available evidence
    3.   Critically evaluate the evidence
    4.   Integrate the evidence with patient’s unique biology,
         preferences and values
    5.   evaluate
PATIENT CLASSIFICATION BY ACTIVITY &
         ACUITY OF ILLNESS



• This will provide more nurses for each
  shift.
• INC says 1 : 9 / shift.
• In areas where they are unable to use
  that ratio, an activity study is done &
  they come to a conclusion about the
  number of needed staff nurses.
INFECTION CONTROL
• To meet the annual JCAH educational
  requirement.
• To identify available resources which in the
  Hospital while maintaining good patient care.
• Infection control has become Paramount
  importance.
• Segregation of waste has become mandatory in all
  the hospitals.
• Every hospital need to have Hospital infection
  control committee & policy.
MANAGEMENT &
              LEADERSHIP
    Nursing leaders and managers are exposed to
    different management principles relevant to nursing
    practice. They are as follows:
       Management theory & leadership principles
       Time management
       Decision making & problem solving
       Teaching & performance strategies
       Identifying and achieving patient goals
       Documentation as an instrument
       Performance evaluation
       Quality assurance
OUTCOME
By exposing them to all the aforesaid concepts
o the nurses have developed personal plans for using time
  more effectively.
o There is an increase in written agendas for staff
  meetings.
o Routine tasks are delegated more effectively.
o A calendar system for planning & setting appointments
  is used.
o Are able to identify and achieve patient goals.
o Documentation on the nursing care has improved in
  measurable terms
JOB DESCRIPTION

• These are written according to specific
  practice area and level of responsibility.
• Nurses are also given format of the
  standards for performance.
PROCEDURE MANUALS

• Procedure manual has become
  mandatory.
EMERGENCY MEDICAL
          SERVICES
• To disseminate information about emergency
  medical services, pre hospital care & emergency
  department care, as well as to share ideas,
  problem solving & develop relationships among
  many emergency departments within the country.
• By doing this kind of networking will enhance pre
  hospital and emergency care in our country.
TRIAGE

• Triage has become mandatory in the
  accident and emergency and thereby
  they are able to prioritize the patients
  those who come to causality and are
  able to treat the sick and vulnerable one
  as early as possible.
ETHICS
• This is to increase more awareness among
  nurses that they will be able to apply ethics
  principles while caring for patients.
• It significantly increase their knowledge about
  ethics and improves patient satisfaction and the
  litigation rates.
• Many hospitals encourages nurses to attend
  such conferences and workshops.
MAGNET HOSPITAL STATUS
• In 1980, the concept of magnet hospital came into being.
• In 1994, the American Nurses Association through the
  American Nurses, credentiality centres (ANCC),
  established a ‘new magnet’ hospital designation process
  that would allow hospitals to self – nominate under the
  “Magnet Nursing Services recognition program” for
  excellence in Nursing Services.
• Becoming a magnet hospital is not easy. First the
  hospital must create and promote a professional practice
  culture in all aspects of nursing care.
MAGNET HOSPITAL STATUS
      CONTD….
• Then, they must apply to ANCC, submit
  comprehensive       documentation      that
  demonstrates its compliance with standards
  in the ANA’s scope & standards for nurse
  administrators and undergo a multi day
  onsite evaluation to verify the information
  in the documentation submitted and to
  assess the presence of the “forces of
  magnetism within the organization (Joint
  commission For the Accreditation of
  Hospitals, 2003)
•Magnet status is awarded for a 4year period after
which the organization must reapply.

•As of October 15, 2003, there were 88 magnet –
designated organization.

•The first ANCC magnet hospital, university of
Washington, was designated in 1994 & international
certification began in 1999.
FORCES OF MAGNETISM FOR
     MAGNET HOSPITAL STATUS
•   Quality of nursing leadership
•   Organizational structure
•   Management style
•   Personnel policies & programs
•   Professional model of care
•   Quality of care
•   Quality improvement
FORCES OF MAGNETISM FOR
      MAGNET HOSPITAL STATUS
             CONTD…
•   Consultation & resources
•   Autonomy
•   Community and the Hospital
•   Nurses as Teachers
•   Image of Nursing
•   Interdisciplinary relationships
•   Professional development
FORENSIC NURSING
        SPECIALIST

• Forensic psychiatric nurse work with
  mentally ill offenders and with victims
  of crime
• It is the management of crime victims
  from trauma to trial
• SANE-Sexual Assault Nurse Examiner
COMMUNITY BASED
       NURSING ROLE

• People in communities in partnership
  with health care professionals will
  define the health needs to be met and
  maintain control of strategies for
  meeting those needs
NURSE RESEARCHER
• Nurse researcher is pivotal to the
  profession and discipline because it
  directs the future path of nursing
NURSE EDUCATOR
• They are the leaders and developers
  of nursing program of the future
• Diabetic nurse educator
• Asthma educator
ASTHMA EDUCATION   COPD EDUCATION
Home Peak Flow   Smoking Cessation
  Monitoring
NURSE ANESTHETIST
Nurse anesthetist is a registered
 nurse who got specialization in
 anesthesia and is responsible for
 monitoring     ,   administering
 anesthesia, to detect equipment
 fault
NURSE MIDWIFE LED ANTENATAL
CLINIC
TELE NURSING

• Tele nursing is nursing practice that
  occurs through the utilization of
  telecommunication and includes the
  use of nursing knowledge, skills and
  abilities; the application of critical
  thinking and nursing judgement;and
  provision of nursing direction or care
  in specific client situation
VARIATIONS IN
     TRADITIONAL ROLE
• HOSPICE NURSE
            The nurse works holistically
  with clients and family.

• INFORMATICS NURSE
  SPECIALIST
                Nursing specialty whose
  activities center or management and
  processing of health care information
• OCCUPATIONAL HEALTH
  OPPORTUNITIES
        Nurse designs and implement a
  program of health promotion and
  disease prevention for employees

• QUALITY MANAGER
          Quality management nurses
  research and describe findings and
  look for opportunities to improve
  care
• CASE MANAGER:
            case manager co-ordinate
  resources to achieve health care
  outcomes based on quality, access
  and cost.

• FLIGHT NURSE:
           military and civilian flight
  nurse
• TELEPHONE TRIAGE NURSE
            The practice nurse interacts
  with clients on telephone to assess
  needs, intervene and evaluate

• TRAVEL NURSE
              Assignment usually for a
  minimum time. Extra allowance will
  be provided
• PARISH NURSE
           The role focuses on health
  promotion within the beliefs, values
  and practices of various faith
  communities
• NURSE PRACTITIONER
             Nurse serves as a primary
  care provider and consultant for
  individuals, families or communities

• CERTIFIED NURSE MIDWIFE
          Independent management of
  women’s health care. should pass
  the national certification examination
  conducted by ACNM
• CLINICAL NURSE SPECIALIST
          Clinical expertise in a defined
  area of nursing practice for a
  selected client population or clinical
  setting

• NURSE ADMINISTRATOR
         Nurse administrator unites the
  leadership      perspective        of
  professional nursing with various
  aspects of business and health
  administration
INNOVATION IN
ADMINISTRATION
AND MANAGEMENT
• USE OF COMPUTER
    Computerized physician order
     entry (CPOE)
    Clinical decision support system
     (CDSS)
ELECTRONIC MEDICAL
         RECORDS
• Affordable & integrated.
• For improving patient care.
• Powerful practice management system for practices of
  any size.
• Fast, flexible, Easy to use schedule for increasing
  productivity.
• Clinical desktop for improving enterprise work flow.
• Integrated, Internet – based solution that securely
  connects clinics and patients.
• Electronic document management system for eliminating
  paper charts.
• LEADERSHIP FOR CHANGE
        It is an action learning programme to develop
 nurses as effective leaders and managers


• OUTSOURCING
     outsourcing is subcontracting a process to a
      third party company
     it helps to provide core job-care giving
     transcription
     electronic medical record
     medical billing and coding services
     entry level recruitment, security, house
      keeping, nursing assistance
Source: HR Magazine (April 1995)
• STAFFING STRUCTURE
  Benchmarking: organization has varying levels of
 support in place at the unit level for the nurse.eg.
 Nursing unit that has dietary aides
  JCAHO: surveys hospitals for the quality of care
 provided. sees for the right number of competent
 staff to meet the need of patient

 Skill mix: it is the percentage of RN staff to other
 direct care staff, LPNs and unlicensed assistive
 personnel


• PERSONAL MANAGEMENT
                   Use of computer in recording staff
 files,biodata,accounts
INNOVATION IN
  RESEARCH
• TYPES OF RESEARCH

       QUALITATIVE RESEARCH
       QUANTITATIVE RESEARCH


• USING NURSING RESEARCH TO
  PROMOTE EBP
              EBP requires integration of best
 research evidence with clinical expertise
 and patient value and needs in the delivery
 of quality, cost effective care
• INCREASED FOCUS ON OUTCOME
  RESEARCH
           Outcome research is research designed to
 assess and document the effectiveness of health care
 services


• PROMOTION OR RESEARCH
  UTILIZATION
             Translate research findings into practice
 and nurses at all levels are encouraged to evidence
 in evidence based patient care
• EXPANDED DISSEMINATION

     CINAHL (Cumulative Index to Nursing
      and Allied Heath Literature)
     MEDLINE (Medical Literature on line)
     psyc –INFO( Psychology Information)
     AIDSLINE(AIDS information on- line)
     Cancerlit (Cancer literature)
     HEALTH        STAR(Health        services
      Technology,
      Administration and Research)
     CHID (Combined Heath Information
      Database)
• ELECTRONIC PUBLICATION

     Information of all type is disseminated in
      computer and in internet
     Many journals that publish in hard copy
      format now also have online capabilities
     Some researches or research team develop
      their own web page with information about
      their studies
     Electronic research reports are accessible to
      worldwide audience of potential consumers,
      typically without page limitations, thus
      enabling researchers to describe and discuss
      complex studies more fully
PATHOPHYSI
                   PATHOPHYSI      RETROSPECT
                                   RETROSPECT
                     OLOGY
                     OLOGY            IVE OR
                                       IVE OR
   COST
   COST                            CONCURREN
                                    CONCURREN
EFFECTIVE
 EFFECTIVE                           T CHART
                                      T CHART
ANALYSIS
 ANALYSIS                            REVIEW
                                      REVIEW
                                               QUALITY
                                               QUALITY
                                           IMPROVEMEN
                                            IMPROVEMEN
                                             T AND RISK
                                              T AND RISK
 BENCHMARKING                                   DATA
                                                 DATA
   DATA
                         VALID &
                        CURRENT
                        RESEARCH            INRERNATION
                                             INRERNATION
                                             AL,NATIONAL
                                              AL,NATIONAL
                                                &LOCAL
                                                 &LOCAL
   CLINICAL
    CLINICAL                                 STANDARDS
                                              STANDARDS
  EXPERTISE
   EXPERTISE

                  PATIENT
                   PATIENT         INFECTION
                                    INFECTION
                PREFERENCE
                 PREFERENCE         CONTROL
                                     CONTROL
                     SS               DATA
                                       DATA
INNOVATION IN PRIMARY
AND COMMUNITY HEALTH
        CARE
• INNOVATION IN HEALTH PROMOTION AND
  DISEASE PREVENTION
       Nurses are uniquely positioned to identify risk
 factors, provide information about how to manage
 these risks and promote the benefits of healthier
 lifestyles , diet and avoid risky behavior


• APPLICATION OF TELENURSING IN HOME
  CARE
      The programme targets families living in rural
 areas who often find it difficult to repeatedly travel
 to a distance medical center for necessary follow up.
• POPULATION BASED HEALTH CARE
                    Acts on three levels: the community
 system      within the community, and individuals,
 families    and groups. Population based individual
 focused    practice changes the knowledge, attitude,
 beliefs,    practices and behavior of individuals ,
 families   and groups
INNOVATION IMPLEMENTATION
• DISSEMINATION
           Planned, formal communication of
 information about the innovation, through formal
 channels


• DIFFUSION
               ideas become adopted through more
 informal, decentralized means. It occurs through a
 series of communication channels over a period of
 time among the member of similar social system
• STAGES OF DIFFUSION




KNOWLEDGE                    DECISION             CONFIRMATION
                   P
                   P
            PERSUASION                  IMPLEMENTATION




                    ACCEPT              REJECT
READINESS TO CHANGE
• Some individuals and organizations are more ready to affect
  changes than others.
• This depends often on the degree of felt security.
• In turn, it depends on the knowledge
• skill
• attitude
• self confidence
• tolerance to stress
• motivation of the individuals
  It also depends on the security to change. If there is optimal
  feeling of security , then the acceptance of change will be
  possible.
  Change is crucial. Change is a must for progress.
ADOPTABILITY
                  Qualities of
                   innovation




                 INNOVATION



                                 SUSTAINABILITY
  PROCESS OF
                                   Involvement
IMPLEMENTATION
                                   commitment
CAUSES FOR NOT ATTEMPTING
        INNOVATION

• Afraid of failures; of opposition; of the
  unknown.
• Lacking adequate and correct information.
• Reluctant to experiment.
• Bound by custom & tradition.
• Unaware of our strengths for achievement.
Nursing innovation are key to
improvement and progress in
  health systems worldwide

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Innovation in Nursing

  • 1. CREATIVITY IS THINKING UP NEW THINGS INNOVATION IS DOING NEW THINGS - THEODORE LEVITT J.SANGEETHA M.SC (N)
  • 2. INTRODUCTION • The only constant feature in this world is change. • While all the change may not lead to progress, there can be no progress without change. • This is true for the individual, institution, organization or the country. • Civilization owes its existence to change. • The success or even survival of an institution or organization on depends on making necessary changes.
  • 3. DEFINITION Innovation is the act of • constructive thinking • grouping knowledge • skills • attitude into new • original & rational ideas. Critical thinking Imagination Plan Action Achieve objectives
  • 4. DEFINITIONS: • Innovation is defined as the generation of new ideas or application of existing ideas to a new situation resulting in improvement in organization
  • 5. • Innovation is the action of introducing a new method, idea or product
  • 6. NEED OF INNOVATION: 1. INOVATION TO CENTRAL TO MAINTAINING AND IMPROVING QUALITY OF CARE 2. GROWING DEMANDS IN HEALTH SERVICES 3. GLOBAL WORKFORCE SHORTAGE
  • 7. CHARACTERISTICS OF INNOVATION • RELATIVE ADVANTAGE: It is the degree to which the new idea is considered superior to the old one • COMPATIBILITY: It refers to the degree of congruence between the innovation and existing values,habits,past experience and need of the participant
  • 8. COMPLEXITY: It describes the amount of difficulty that participants have in understanding and subsequently using the innovation TRIALABILITY: it is the degree to which the new idea can be pretested or tried on a limited basis OBSERVABILITY: It refers to how visible the innovation is to participants and onlookers
  • 9. PRICIPLES • Innovation is to analyze the opportunities or sources • Innovation is both conceptual and perceptual • It should be simple and focused • Effective innovation start small and they aim to do one specific thing • Successful innovation aim at being the best from the very beginning
  • 10.
  • 12. HANDHELD COMPUTERS IN NURSING EDUCATION • First personal digital assistant in 1996 • According to ANA (2001) all nurses need to use nursing informatics
  • 13. VIDEOCONFERENCING AND WEB BASED CONFERENCING • Connects students and educators across distance • Connects diverse student groups
  • 14. E-LEARNING • Adaptation of different distance learning technologies • Self directed, active learning • Refocusing from educator to the subject
  • 15. SERVICE-LEARNING • Structured learning experience that combines community service with preparation and reflection • Achieves a balance between service and learning objective
  • 16. HIGH FIDELITY PATIENT SIMULATOR • Help student practice decision making and problem solving skill and to develop human interaction • Simulation is the third leg in the stool of education and science
  • 17. TELE TEACHING • Online model of education-learner directly interacts with tutor • Learner oriented learning • Promotes discovery learning
  • 18. MICRO TEACHING • Miniature classroom teaching • Small duration • Paying full attention to a particular unit and skill • Content reduced to one unit with a single concept
  • 19. NURSING INFORMATICS • Integrates nursing science, computer science and information science in identifying, collecting, processing and managing data and information to support nursing practice, administration, education, research
  • 20. URSING CERTIFICATION NURSING CERTICATION NURSING CERTIFICATION Certification •Advanced cardiac life support example •Basic life support •Certified emergency nurse •Critical care registered nurse •Neonatal resuscitation program •Pediatric advanced life support •Cardio thoracic nursing •Emergency and trauma care nursing •Oncology nursing
  • 21. •Renal nursing •Fellowship in family nurse practice •Fellowship in Hematology Nursing •Fellowship in Respiratory Nursing •OT technique and management •Psychiatric nursing
  • 22. NURSING MOBILE LIBRARY • Access to health care information for nurses working in remote area • To reduce the gap between the desperate need for nursing information and its availability
  • 23. STAFF AND STUDENT RECRUITMENT • New methods like OSCE &OSPE • Objective because examiner use a checklist for evaluating the trainee • Structured, because every trainee sees the same problem and performs the same task in same time frame • Clinical, because the task are representative of those faced in real clinical situation
  • 24. INNOVATION IN CLINICAL PRACTICE AREA
  • 25. COMPUTER ASSISTANCE • Maintenance of health records • Health security card • Use of ROBOTS • Reduce error and give certitude to the clinical planning process
  • 26. WIRELESS TECHNOLOGY • Nurse have immediate telephone contact with employees and with patient • Direct and accurate communication between Nurse and Physician • E.g.. In south Africa nurses uses their mobile phone to support people living with HIV/AIDS
  • 27. EVIDENCE BASED PRACTICE • It is combination of professional expertise with available evidence to produce practice that lead a positive outcome for client • Steps: 1. Identify a knowledge need and formulate an answerable clinical question 2. Locate the best available evidence 3. Critically evaluate the evidence 4. Integrate the evidence with patient’s unique biology, preferences and values 5. evaluate
  • 28. PATIENT CLASSIFICATION BY ACTIVITY & ACUITY OF ILLNESS • This will provide more nurses for each shift. • INC says 1 : 9 / shift. • In areas where they are unable to use that ratio, an activity study is done & they come to a conclusion about the number of needed staff nurses.
  • 29. INFECTION CONTROL • To meet the annual JCAH educational requirement. • To identify available resources which in the Hospital while maintaining good patient care. • Infection control has become Paramount importance. • Segregation of waste has become mandatory in all the hospitals. • Every hospital need to have Hospital infection control committee & policy.
  • 30. MANAGEMENT & LEADERSHIP Nursing leaders and managers are exposed to different management principles relevant to nursing practice. They are as follows:  Management theory & leadership principles  Time management  Decision making & problem solving  Teaching & performance strategies  Identifying and achieving patient goals  Documentation as an instrument  Performance evaluation  Quality assurance
  • 31. OUTCOME By exposing them to all the aforesaid concepts o the nurses have developed personal plans for using time more effectively. o There is an increase in written agendas for staff meetings. o Routine tasks are delegated more effectively. o A calendar system for planning & setting appointments is used. o Are able to identify and achieve patient goals. o Documentation on the nursing care has improved in measurable terms
  • 32. JOB DESCRIPTION • These are written according to specific practice area and level of responsibility. • Nurses are also given format of the standards for performance.
  • 33. PROCEDURE MANUALS • Procedure manual has become mandatory.
  • 34. EMERGENCY MEDICAL SERVICES • To disseminate information about emergency medical services, pre hospital care & emergency department care, as well as to share ideas, problem solving & develop relationships among many emergency departments within the country. • By doing this kind of networking will enhance pre hospital and emergency care in our country.
  • 35. TRIAGE • Triage has become mandatory in the accident and emergency and thereby they are able to prioritize the patients those who come to causality and are able to treat the sick and vulnerable one as early as possible.
  • 36. ETHICS • This is to increase more awareness among nurses that they will be able to apply ethics principles while caring for patients. • It significantly increase their knowledge about ethics and improves patient satisfaction and the litigation rates. • Many hospitals encourages nurses to attend such conferences and workshops.
  • 37. MAGNET HOSPITAL STATUS • In 1980, the concept of magnet hospital came into being. • In 1994, the American Nurses Association through the American Nurses, credentiality centres (ANCC), established a ‘new magnet’ hospital designation process that would allow hospitals to self – nominate under the “Magnet Nursing Services recognition program” for excellence in Nursing Services. • Becoming a magnet hospital is not easy. First the hospital must create and promote a professional practice culture in all aspects of nursing care.
  • 38. MAGNET HOSPITAL STATUS CONTD…. • Then, they must apply to ANCC, submit comprehensive documentation that demonstrates its compliance with standards in the ANA’s scope & standards for nurse administrators and undergo a multi day onsite evaluation to verify the information in the documentation submitted and to assess the presence of the “forces of magnetism within the organization (Joint commission For the Accreditation of Hospitals, 2003)
  • 39. •Magnet status is awarded for a 4year period after which the organization must reapply. •As of October 15, 2003, there were 88 magnet – designated organization. •The first ANCC magnet hospital, university of Washington, was designated in 1994 & international certification began in 1999.
  • 40. FORCES OF MAGNETISM FOR MAGNET HOSPITAL STATUS • Quality of nursing leadership • Organizational structure • Management style • Personnel policies & programs • Professional model of care • Quality of care • Quality improvement
  • 41. FORCES OF MAGNETISM FOR MAGNET HOSPITAL STATUS CONTD… • Consultation & resources • Autonomy • Community and the Hospital • Nurses as Teachers • Image of Nursing • Interdisciplinary relationships • Professional development
  • 42. FORENSIC NURSING SPECIALIST • Forensic psychiatric nurse work with mentally ill offenders and with victims of crime • It is the management of crime victims from trauma to trial • SANE-Sexual Assault Nurse Examiner
  • 43. COMMUNITY BASED NURSING ROLE • People in communities in partnership with health care professionals will define the health needs to be met and maintain control of strategies for meeting those needs
  • 44. NURSE RESEARCHER • Nurse researcher is pivotal to the profession and discipline because it directs the future path of nursing
  • 45. NURSE EDUCATOR • They are the leaders and developers of nursing program of the future • Diabetic nurse educator • Asthma educator
  • 46. ASTHMA EDUCATION COPD EDUCATION
  • 47. Home Peak Flow Smoking Cessation Monitoring
  • 48. NURSE ANESTHETIST Nurse anesthetist is a registered nurse who got specialization in anesthesia and is responsible for monitoring , administering anesthesia, to detect equipment fault
  • 49. NURSE MIDWIFE LED ANTENATAL CLINIC
  • 50. TELE NURSING • Tele nursing is nursing practice that occurs through the utilization of telecommunication and includes the use of nursing knowledge, skills and abilities; the application of critical thinking and nursing judgement;and provision of nursing direction or care in specific client situation
  • 51. VARIATIONS IN TRADITIONAL ROLE • HOSPICE NURSE The nurse works holistically with clients and family. • INFORMATICS NURSE SPECIALIST Nursing specialty whose activities center or management and processing of health care information
  • 52. • OCCUPATIONAL HEALTH OPPORTUNITIES Nurse designs and implement a program of health promotion and disease prevention for employees • QUALITY MANAGER Quality management nurses research and describe findings and look for opportunities to improve care
  • 53. • CASE MANAGER: case manager co-ordinate resources to achieve health care outcomes based on quality, access and cost. • FLIGHT NURSE: military and civilian flight nurse
  • 54. • TELEPHONE TRIAGE NURSE The practice nurse interacts with clients on telephone to assess needs, intervene and evaluate • TRAVEL NURSE Assignment usually for a minimum time. Extra allowance will be provided
  • 55. • PARISH NURSE The role focuses on health promotion within the beliefs, values and practices of various faith communities
  • 56. • NURSE PRACTITIONER Nurse serves as a primary care provider and consultant for individuals, families or communities • CERTIFIED NURSE MIDWIFE Independent management of women’s health care. should pass the national certification examination conducted by ACNM
  • 57. • CLINICAL NURSE SPECIALIST Clinical expertise in a defined area of nursing practice for a selected client population or clinical setting • NURSE ADMINISTRATOR Nurse administrator unites the leadership perspective of professional nursing with various aspects of business and health administration
  • 59. • USE OF COMPUTER Computerized physician order entry (CPOE) Clinical decision support system (CDSS)
  • 60. ELECTRONIC MEDICAL RECORDS • Affordable & integrated. • For improving patient care. • Powerful practice management system for practices of any size. • Fast, flexible, Easy to use schedule for increasing productivity. • Clinical desktop for improving enterprise work flow. • Integrated, Internet – based solution that securely connects clinics and patients. • Electronic document management system for eliminating paper charts.
  • 61. • LEADERSHIP FOR CHANGE It is an action learning programme to develop nurses as effective leaders and managers • OUTSOURCING  outsourcing is subcontracting a process to a third party company  it helps to provide core job-care giving  transcription  electronic medical record  medical billing and coding services  entry level recruitment, security, house keeping, nursing assistance
  • 62. Source: HR Magazine (April 1995)
  • 63. • STAFFING STRUCTURE Benchmarking: organization has varying levels of support in place at the unit level for the nurse.eg. Nursing unit that has dietary aides JCAHO: surveys hospitals for the quality of care provided. sees for the right number of competent staff to meet the need of patient Skill mix: it is the percentage of RN staff to other direct care staff, LPNs and unlicensed assistive personnel • PERSONAL MANAGEMENT Use of computer in recording staff files,biodata,accounts
  • 64. INNOVATION IN RESEARCH
  • 65. • TYPES OF RESEARCH QUALITATIVE RESEARCH QUANTITATIVE RESEARCH • USING NURSING RESEARCH TO PROMOTE EBP EBP requires integration of best research evidence with clinical expertise and patient value and needs in the delivery of quality, cost effective care
  • 66. • INCREASED FOCUS ON OUTCOME RESEARCH Outcome research is research designed to assess and document the effectiveness of health care services • PROMOTION OR RESEARCH UTILIZATION Translate research findings into practice and nurses at all levels are encouraged to evidence in evidence based patient care
  • 67. • EXPANDED DISSEMINATION CINAHL (Cumulative Index to Nursing and Allied Heath Literature) MEDLINE (Medical Literature on line) psyc –INFO( Psychology Information) AIDSLINE(AIDS information on- line) Cancerlit (Cancer literature) HEALTH STAR(Health services Technology, Administration and Research) CHID (Combined Heath Information Database)
  • 68. • ELECTRONIC PUBLICATION Information of all type is disseminated in computer and in internet Many journals that publish in hard copy format now also have online capabilities Some researches or research team develop their own web page with information about their studies Electronic research reports are accessible to worldwide audience of potential consumers, typically without page limitations, thus enabling researchers to describe and discuss complex studies more fully
  • 69. PATHOPHYSI PATHOPHYSI RETROSPECT RETROSPECT OLOGY OLOGY IVE OR IVE OR COST COST CONCURREN CONCURREN EFFECTIVE EFFECTIVE T CHART T CHART ANALYSIS ANALYSIS REVIEW REVIEW QUALITY QUALITY IMPROVEMEN IMPROVEMEN T AND RISK T AND RISK BENCHMARKING DATA DATA DATA VALID & CURRENT RESEARCH INRERNATION INRERNATION AL,NATIONAL AL,NATIONAL &LOCAL &LOCAL CLINICAL CLINICAL STANDARDS STANDARDS EXPERTISE EXPERTISE PATIENT PATIENT INFECTION INFECTION PREFERENCE PREFERENCE CONTROL CONTROL SS DATA DATA
  • 70. INNOVATION IN PRIMARY AND COMMUNITY HEALTH CARE
  • 71. • INNOVATION IN HEALTH PROMOTION AND DISEASE PREVENTION Nurses are uniquely positioned to identify risk factors, provide information about how to manage these risks and promote the benefits of healthier lifestyles , diet and avoid risky behavior • APPLICATION OF TELENURSING IN HOME CARE The programme targets families living in rural areas who often find it difficult to repeatedly travel to a distance medical center for necessary follow up.
  • 72. • POPULATION BASED HEALTH CARE Acts on three levels: the community system within the community, and individuals, families and groups. Population based individual focused practice changes the knowledge, attitude, beliefs, practices and behavior of individuals , families and groups
  • 73. INNOVATION IMPLEMENTATION • DISSEMINATION Planned, formal communication of information about the innovation, through formal channels • DIFFUSION ideas become adopted through more informal, decentralized means. It occurs through a series of communication channels over a period of time among the member of similar social system
  • 74. • STAGES OF DIFFUSION KNOWLEDGE DECISION CONFIRMATION P P PERSUASION IMPLEMENTATION ACCEPT REJECT
  • 75. READINESS TO CHANGE • Some individuals and organizations are more ready to affect changes than others. • This depends often on the degree of felt security. • In turn, it depends on the knowledge • skill • attitude • self confidence • tolerance to stress • motivation of the individuals It also depends on the security to change. If there is optimal feeling of security , then the acceptance of change will be possible. Change is crucial. Change is a must for progress.
  • 76. ADOPTABILITY Qualities of innovation INNOVATION SUSTAINABILITY PROCESS OF Involvement IMPLEMENTATION commitment
  • 77. CAUSES FOR NOT ATTEMPTING INNOVATION • Afraid of failures; of opposition; of the unknown. • Lacking adequate and correct information. • Reluctant to experiment. • Bound by custom & tradition. • Unaware of our strengths for achievement.
  • 78. Nursing innovation are key to improvement and progress in health systems worldwide