FEDERAL UNIVERSITY OF SANTA CATARINA
HEALTH SCIENCES CENTER
NURSING DEPARTMENT
NURSING INFORMATICS AND TELENURSING
NURSING PROCESS FROM ICNP 1.0 FOR ICU
IN HANDHELD DEVICES
Grace T. M. Dal Sasso, RN, MSC, PhD
Nursing Informatics Professor
Member of eHealth Strategic Group at the ICN
Member of IMIA-NI - representative of Brazil
Member of Panamericana Network to patient safety
Brazilian Leader in Telenursing and Nursing
Informatics Network
Agenda
• The Conception of System – History
• Modular Framework
• Structure and Modeling of Computer Data
Platform
• The Entity-Relationship Model (ERM)
• Examples
• Results
The Conception of System - History
• 1999 –Step1
– Study of ICNP version Beta2 Estudo and
development of first prototype to respiratory system
assessment - It was developed in Delphi language
• Characteristics:
– 8 axes to the classification of nursing phenomenon
(diagnosis): focus of nursing practice,judgement,
frequency, duration, topology, body site, likelihood,
carrier
– 8 axes to compose nursing actions:
type of action, target, media,time, topology, location,
route, benefit
– Practical test and usability
The Conception of System - History
• 2000–2001 –
– Step 2: inclusion of the human cardiovascular system
– Practical test and usability
• 2002-2004 –
– Step 3: restructuring of the data for all human systems and
expansion of the diagnoses and interventions
– Practical test and usability
• 2005-2006 –
– Step 4 - Incorporating Web-database in PHP and MySQL of
entire data structure using 1.0 ICNP– database in PHP and
MySQL.
– Incorporation of new protocols for care guidelines from the
Health Ministry
– Practical test and usability
The Conception of System - History
• 2006-2008 – Step 5 - structure for mobile devices.
– Practical test and usability
• 2008 - until now:
– Improved data security and system design
– Java Programming for Mobile Devices with PHP Link
- Data Warehouse
– Practical tests and usability
– Development of warning systems for:
• same nursing diagnosis for more than three days, potential
for pressure ulcer, potential to fall from bed, use of
vasoactive drugs, potential for extubation, potential for
infection and potential for barotrauma.
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Login de Acesso
Cadastro
Módulo I
Entrada de Dados
Avaliação e
registro
Consulta Prontuário
Exames
Módulo 2
Diagnósticos CIPE
Lista de Pacientes da
UTI
Beira do Leito
Módulo 5
Módulo 3
Interv. de Enf.
Protocolos de
Cuidados e Sites
Medicamentos
Módulo 4
Relatórios e
Sistemas de alerta
Processo de
Enfermagem
Drogas e Fluido
Integração ao PEP
Central
PEP
Potencial para queda
Tempo de Cicatrização de
feridas
Potencial para úlcera de
pressão
Exames
Tempo de
Permanência CCU
Erros de Medicação
Infecção Sítio de punção
Taxas de Altas,
Óbitos e
transferências
Complicações
Obstrução TOT
+ de 3 dias do mesmo diagnóstico
Structure and Modeling of Computer Data
Platform
Conceptual Modeling
Physical Modeling
Logic Modeling
DATA
MODELING DATABASE
The EntityRelationship
Model (ERM)
DBDesigner 4
Entity-Relationship Modeling
• Entity-relationship modeling is a database
modeling method, used to produce a type of
conceptual schema or semantic data model of a
system, often a relational database, and its
requirements in a top-downfashion.
• Diagrams created by this process are called
entity-relationship diagrams or ER diagrams.
Entry Screen
Login and Password
Summary of Patient Data
Patient Screen
Patient Screen
Free language
Patient Assessment and Diagose Screen
Diagnose and Intervention Screen
Alert System
Menu: Care Protocols
Reports
General Report Model
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Screen Management System
RESULTS UNTIL NOW
• The system works in multiple Handheld devices
with access to Internet, such as:
TABLET
PDA
iPHONE
iPAD
Smartphone
Blackberry
RESULTS UNTIL NOW
– Ease of use, can be used also as an educational
tool ;
– Has criteria of safety, ergonomics and usability
– Reduces costs with Web-based system in
diverse platforms ;
– The system adapts to proprietary databases, and
therefore can be inserted into existing systems of
EPR (Electronic Patient Records) .
– Encouraging study and research
– Improves patient safety by allowing the record to
the bedside and trigger warning systems ;
Future
– Incorporate strategies for nursing telecare
– Obtain digital certification and electronic
signature
– Implement in other areas of health care
System URL:
http://www.nfrinfor.ufsc.br – to Desktop
http://www.nfrinfor.ufsc.br/movel - To Mobile Devices
Hercilio Luz Bridge – Florianópolis-SC-Brazil
E-mail: grace@ccs.ufsc.br or grace@matrix.com.br