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Intrapartum Computer Monitoring. Presented by Yvette M. Kreitz, RN. Objectives. Definitions. Describe the purpose of intrapartum computer monitoring. Describe the hardware and software utilized with this technology. Assess the role and function of the nurse involved with this technology.

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Intrapartum computer monitoring l.jpg

Intrapartum Computer Monitoring

Presented by

Yvette M. Kreitz, RN


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Objectives

  • Definitions.

  • Describe the purpose of intrapartum computer monitoring.

  • Describe the hardware and software utilized with this technology.

  • Assess the role and function of the nurse involved with this technology.

  • Examine related legal and/or ethical issues.

  • Discuss the advantages and disadvantages from a nursing perspective.


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Definitions

  • Electronic fetal monitoring (EFM)

  • Fetal heart tracing

  • Fetal monitor

  • Intrapartum computer monitoring

  • Intrauterine pressure catheter (IUPC)

  • Tocodynamometer (“Toco”)

    (Taber’s, 2005)



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Purpose of intrapartum computer monitoring

  • Comprehensive, computerized network consisting of:

    • Centralized server/network

    • Bedside stations

    • Remote access points

    • Printers


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Purpose of intrapartum computer monitoring

  • Diverse access points allow for:

    • Remote patient surveillance

    • Increased participation from support staff

    • Continuous monitoring

    • Improved continuity of care

      (Sandelowski, 2000)


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Purpose of intrapartum computer monitoring

  • Software advancements enable:

    • Comprehensive data over a nine-month period

    • Point-of-care and real-time charting

    • Immediate alarm features and critical value notifications

    • Software integrated with evidence-based practices

      (www.lmsmedical.com, 2009)


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System hardware

  • Centralized server/network

  • Network printers

  • Main station computers

  • Bedside stations

  • Remote access points


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System hardware

  • Fetal monitor & belts

  • Toco or IUPC

  • Ultrasound transducer or fetal scalp electrode

  • Blood pressure cuff

  • Pulse oximeter

    (Ladewig, London & Davidson, 2006)



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System software

  • Top 5 Windows-based intrapartum software monitoring programs:

    • Clinical Computer Systems: OBiXPerinatal Systems

    • GE Healthcare: Centricity Perinatal

    • Hill-Rom: NaviCareWatchChild Solutions

    • LMS Medical: CALM Suite

    • Philips: IntelliVue OB Care

      (www.klasresearch.com, 2009)


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System software

  • Modular design for flexibility and efficiency

  • Patient-focused surveillance and continuous monitoring

  • On-line documentation

  • Alerts and reminders

    (www.gehealthcare.com, 2009)


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System software

  • Archival of data

  • Functions and communicates with other hospital programs and departments

  • Maintains patient confidentiality and data security.

  • Decision support

    (www.gehealthcare.com, 2009)


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Software usability evaluation

  • Users must be an early and continuous focus during interface design.

  • The design process should be iterative, allowing for evaluation and correction of identified problems.

  • Formal evaluation should take place using rigorous experimental and/or qualitative methods.

    (Staggers, 2003), (Effken, 2009)


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Information System Review

  • What is an information system?

  • Information system used for intrapartum computer monitoring, and its function.

    • Part clinical/part special-purpose

    • A communication system

    • A patient care system

      (McGonigle & Mastrian, 2009)


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Information System Review

  • Who uses the information system?

  • How is the information system configured?

  • What data standards are used in this system?

  • What Disease and Procedure Classification System is used?


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Information System Review

  • Nursing practice standards

    • NIC

    • NOC

    • AWHONN

    • NICHD

  • Recommendation regarding this system


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Advantages of Intrapartum Computer Monitoring

  • Nurse-patient interaction

  • Reporting

  • Storage

  • Time Management

  • Flexibility

  • Safety

    (www.obix.net/overview/advantages.asp, 2009)


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Disadvantages of Intrapartum Computer Monitoring

  • Critical thinking

  • System down-time

  • Responsibility

  • Cost


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Ethical and Legal Issues

  • Privacy, confidentiality

  • Responsibility

  • Documentation

  • System over-reliance


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Informatics Competencies

  • Operates Windows applications

  • Uses instant messaging and e-mail

  • Knowledge of applicable intrapartum monitoring system – hardware and software

  • Knows hospital-specific nursing policies for charting, storage & medication administration.


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Functions and Responsibilities of the Informatics Nurse

  • Perspective

  • Theories, principles, concepts

  • Ergonomics

  • HCI principles

  • Social, legal and ethical impacts

  • Role

    (McGonigle & Mastrian, 2009)


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Summary

  • Purpose

  • Hardware/software

  • Role and function of the nurse

  • Information system review

  • Advantages/disadvantages

  • Nursing informatics


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References

  • Clinical Computer Systems, Inc. (2009). OBiX Overview. Retrieved from

    • http://www.obix.net/overview/advantages.asp.

  • Effken, J. A. (2009). Improving the Human-Technology Interface. Nursing

    • Informatics. Sudbury, MA: Jones and Bartlett, (p. 65-71).

  • GE Healthcare, Inc. (2009). Centricity Perinatal Product Technology. Retrieved

    • from https://www.gehealthcare.com/portal/site/usen/1006e73922.asp.

  • KLAS Reseach, LLC. (2009). Rating Healthcare Technology. Retrieved from

    • http://www.klasresearch.com/1106/ob_soft.asp.


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References

  • Laedwig, P. A., London, M. L, & Davidson, M. R. (2006). Contemporary

    • Maternal-Newborn Nursing Care. (6th ed.). Upper Saddle River, NJ: Pearson-Prentice Hall, (p. 432-438).

  • LMS Medical, Inc. (2009). High reliability in obstetrics. Retrieved from

    • http://www.lmsmedical.com/4105/print.asp?url=/4105/03_04_02_calm_curve.asp.

  • McGonigle, D. & Mastrian, K. (2009). Nursing informatics and the foundation

    • of knowledge. Sudbury, MA: Jones and Bartlett Publishers, (p. 206 - 217).


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References

  • Sandelowski, M. (2000, May). Retrofitting technology to nursing: the case of

    • electronic fetal monitoring. JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing, 29(3), 316-325. Retrieved September 8, 2009, from CINAHL database.

  • Staggers, N. (2003). Human factors: Imperative concepts for critical care, 14(3),

    • 310-319. Retrieved October 1, 2009, from CINAHL database.

  • Taber’s cyclopedic medical dictionary (20th ed.). (2005). Philadelphia, PA: F. A

    • Davis, 749.


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