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Controlling and using the power of the information explosion
EDITORIAL
Controlling and using the power of the information explosion W i t h the explosion o f information and new knowledge and the rapid advances in technology which facilitate the collection and &ssemination o f it this can legitimately be called the infomaation age. It has long been said that knowledge is power, and information as one form o f knowledge, can certainly be used powerfully in health care. There are two important developments in information which can be useful in management o f critical care resources. One is the new National Intensive Care Bed-state Register for England, which would make life much easier for those trying to find such a bed for a patient; as well as avoiding for patients the delay in appropriate care and consequent deterioration in condition which have sometimes occurred in the past. The second is the Intensive Care Activity Dataset, 12 items o f information to be collected daily on each patient in all intensive care, coronary care, high dependency and recovery units and mixed units. This will make it possible to identify, to a considerable extent, whether acutely ill patients are being cared for in the most appropriate location for their needs to be met, and the units' resources are being used to the best effect. (Though patients receiving such care in appropriate areas such as general wards will still not be identified.) This information may or may not be collected by nurses, but it reinforces the need for nurses to know that such information is available and to consider any implications and nursing purposes for which it may be useful. Nurses have traditionally collected a lot o f data, usually at other people's request, but have used comparatively little o f it for nursing purposes. There has been some progress over the years, and in some units nurses are making increasingly effective use o f information and information management technology; though the availability and level o f development o f the latter for nursing still leave r o o m for improvement. Both 'hard' quantitative and 'soft' qualitative data can be useful and even essential for clinical, management, research and teaching nursing purposes in critical care areas. Intensive and Critical Care Nursing (I 997) 13, 63-64
© 1997 Pearson Professional Ltd
Collection, analysis and interpretation and use o f data and information are not just add-on extras, but essential components o f professional nursing. 'Nurses are engaged in collecting, managing, processing, transforming and c o m municating information as part o f their everyday practice' (Hovenga 1996). Yet as Hovenga indicates, lnformatics is neglected in nurse education, and information technology is still relatively little used for nursing purposes. If information is to fulfil ItS potential as a powerful tool for nurses then nurses must identify clearly in their practice (m whatever function or area) what information is needed, for what purpose and why; and identify and implement ways o f collecting and recording it in an effective, unambiguous and (usually) retrievable form so that it can be used for various purposes, and shared (with confidentlahty safeguards) when appropriate. In the Umted Kingdom, the Strategic Advisory Group for Information Systems in Nursing (SAGNIS), chaired by the Chief Nursing Officer at the Department o f Health, can and does provide a useful lead on strategy. But major progress can only occur if many nurses catch a vision o f the importance of nursing information and participate in change. This, like much else, is particularly important in critical care nursing, where many patients are so acutely ill that any delay or anything less than the best care may have severe or even fatal consequences. All nurses can and should make a start by reviewing current data collection (of any kind) and use o f information in relation to their own practice for efficacy, efficiency (no redundant or unnecessary data collection), completeness and timeliness (what is needed is available when it is needed). But to achieve the full potential o f information nurses need to make use of m o d e m technology, and that means 'for at least some clinical nurses' finding, consulting and learning from, and working with materials and people with specialist expertise in this area. It often means acquinng information on the topic through reading, networking, attending a conference or even a course, and putting in soundly-reasoned proposals to managers for resources such as expert advice, education, and possibly equipment and support for innovation as what has been gained is shared with others and there is a will to improve information systems. Many critical care nurses are overworked, and emotionally overloaded by circumstances o f demanding work in a situation which makes nursing to their desired standard impossible, and ever-increasing demands without increasing resources. Anything to do with 'paperwork' is the last thing they are interested in, whatever anyone says about its benefits. ' W h e n you are up to your neck in crocodiles it is difficult to
64
Intensive and Critical Care Nursing
r e m e m b e r y o u r original objective was to drain the swamp.' (Original source u n k n o w n ) . But the information b a n d w a g o n is rolling, and if nurses do n o t get o n and help to drive it nursing may be damaged and even crushed by it. W e l l - d r i v e n it may help to solve some o f the problems. Information and information m a n agement is a multidisciplinary issue in health care. Each o f the health-care disciplines makes its o w n contribution to the kind o f data and information needed to provide good treatment and care for critically ill people (and k n o w i n g about the person can be as important as k n o w ing about the pathophysiological processes). For the development and even survival o f professional critical care nursing and, even more important, for the benefit of" patients and their farmlies, it is necessary that nursing should make
its full contribution, which in turn requires the vision and c o m m i t m e n t o f m a n y nurses - and n o t just 'computer compulsives'.
FURTHER R E A D I N G
Dataset change notzce 29/96/P24 1996 Department of Health, UK Gmdehnes on Admission to and Discharge from Intensive Care and High dependency Units 1996 Department of Health, UK Hovenga EJ S 1996 How will nurses make the transmon to the mformanon era? Contemporary Nurse 5(2) 42-44 Informanon Management Group NHSME (SAGNIS) 1994 Informanon systemsfor nurses, lmdwives and health visitors. A strategic statement. IGME (A) Quarry House, Leeds Pat A s h w o r t h
Editor
Controlling and using the power of the information explosion W i t h the explosion o f information and new knowledge and the rapid advances in technology which facilitate the collection and &ssemination o f it this can legitimately be called the infomaation age. It has long been said that knowledge is power, and information as one form o f knowledge, can certainly be used powerfully in health care. There are two important developments in information which can be useful in management o f critical care resources. One is the new National Intensive Care Bed-state Register for England, which would make life much easier for those trying to find such a bed for a patient; as well as avoiding for patients the delay in appropriate care and consequent deterioration in condition which have sometimes occurred in the past. The second is the Intensive Care Activity Dataset, 12 items o f information to be collected daily on each patient in all intensive care, coronary care, high dependency and recovery units and mixed units. This will make it possible to identify, to a considerable extent, whether acutely ill patients are being cared for in the most appropriate location for their needs to be met, and the units' resources are being used to the best effect. (Though patients receiving such care in appropriate areas such as general wards will still not be identified.) This information may or may not be collected by nurses, but it reinforces the need for nurses to know that such information is available and to consider any implications and nursing purposes for which it may be useful. Nurses have traditionally collected a lot o f data, usually at other people's request, but have used comparatively little o f it for nursing purposes. There has been some progress over the years, and in some units nurses are making increasingly effective use o f information and information management technology; though the availability and level o f development o f the latter for nursing still leave r o o m for improvement. Both 'hard' quantitative and 'soft' qualitative data can be useful and even essential for clinical, management, research and teaching nursing purposes in critical care areas. Intensive and Critical Care Nursing (I 997) 13, 63-64
© 1997 Pearson Professional Ltd
Collection, analysis and interpretation and use o f data and information are not just add-on extras, but essential components o f professional nursing. 'Nurses are engaged in collecting, managing, processing, transforming and c o m municating information as part o f their everyday practice' (Hovenga 1996). Yet as Hovenga indicates, lnformatics is neglected in nurse education, and information technology is still relatively little used for nursing purposes. If information is to fulfil ItS potential as a powerful tool for nurses then nurses must identify clearly in their practice (m whatever function or area) what information is needed, for what purpose and why; and identify and implement ways o f collecting and recording it in an effective, unambiguous and (usually) retrievable form so that it can be used for various purposes, and shared (with confidentlahty safeguards) when appropriate. In the Umted Kingdom, the Strategic Advisory Group for Information Systems in Nursing (SAGNIS), chaired by the Chief Nursing Officer at the Department o f Health, can and does provide a useful lead on strategy. But major progress can only occur if many nurses catch a vision o f the importance of nursing information and participate in change. This, like much else, is particularly important in critical care nursing, where many patients are so acutely ill that any delay or anything less than the best care may have severe or even fatal consequences. All nurses can and should make a start by reviewing current data collection (of any kind) and use o f information in relation to their own practice for efficacy, efficiency (no redundant or unnecessary data collection), completeness and timeliness (what is needed is available when it is needed). But to achieve the full potential o f information nurses need to make use of m o d e m technology, and that means 'for at least some clinical nurses' finding, consulting and learning from, and working with materials and people with specialist expertise in this area. It often means acquinng information on the topic through reading, networking, attending a conference or even a course, and putting in soundly-reasoned proposals to managers for resources such as expert advice, education, and possibly equipment and support for innovation as what has been gained is shared with others and there is a will to improve information systems. Many critical care nurses are overworked, and emotionally overloaded by circumstances o f demanding work in a situation which makes nursing to their desired standard impossible, and ever-increasing demands without increasing resources. Anything to do with 'paperwork' is the last thing they are interested in, whatever anyone says about its benefits. ' W h e n you are up to your neck in crocodiles it is difficult to
64
Intensive and Critical Care Nursing
r e m e m b e r y o u r original objective was to drain the swamp.' (Original source u n k n o w n ) . But the information b a n d w a g o n is rolling, and if nurses do n o t get o n and help to drive it nursing may be damaged and even crushed by it. W e l l - d r i v e n it may help to solve some o f the problems. Information and information m a n agement is a multidisciplinary issue in health care. Each o f the health-care disciplines makes its o w n contribution to the kind o f data and information needed to provide good treatment and care for critically ill people (and k n o w i n g about the person can be as important as k n o w ing about the pathophysiological processes). For the development and even survival o f professional critical care nursing and, even more important, for the benefit of" patients and their farmlies, it is necessary that nursing should make
its full contribution, which in turn requires the vision and c o m m i t m e n t o f m a n y nurses - and n o t just 'computer compulsives'.
FURTHER R E A D I N G
Dataset change notzce 29/96/P24 1996 Department of Health, UK Gmdehnes on Admission to and Discharge from Intensive Care and High dependency Units 1996 Department of Health, UK Hovenga EJ S 1996 How will nurses make the transmon to the mformanon era? Contemporary Nurse 5(2) 42-44 Informanon Management Group NHSME (SAGNIS) 1994 Informanon systemsfor nurses, lmdwives and health visitors. A strategic statement. IGME (A) Quarry House, Leeds Pat A s h w o r t h
Editor