110 NCP

• Computer-generated NCP


  Digital aides for nurses, originating from advanced nursing informatics systems
• How a computer information system is connected to a nursing information system

  1. CIS can function independently or as part of a larger system within a healthcare facility

  2. NIS can increase efficiency and accuracy in all phases of the nursing process

  3. CIS provides the infrastructure and framework for managing and organizing healthcare information

  4. NIS is a specialized component that caters to the unique needs of nursing practice

  5. They are interconnected to support the delivery of high-quality, patient-centered care across the healthcare continuum
• Ways computers are used in the nursing process (ADPIE)

  1. Assessment: Record admission information, enter further information as prompted by the computer's software program

  2. Diagnosis: Offer extensive lists of standard diagnoses alongside associated signs and symptoms, nurses must integrate various factors to arrive at an appropriate nursing diagnosis

  3. Planning: Display recommended expected outcomes for selected diagnoses, enable tracking of outcomes for large patient populations

  4. Implementation: Record actual interventions and patient-processing information, facilitate communication between departments

  5. Evaluation: Record observations, patient responses, and evaluation statements, enable collaboration among healthcare team, document new interventions
• Advantages of computer-generated nursing care plans

  • Consistency: Ensures uniformity in nursing diagnoses, enhances communication and coordination
  • Accessibility: Provides easy access for evaluation, updates, and adjustments
  • Time and space saving: Reduces documentation time and physical storage requirements
  • Efficient decision-making: Comprehensive selection of nursing interventions tailored to specific diagnoses
  • Seamless integration: Automated importation of patient data optimizes the nursing assessment process
• Disadvantages of computer-based nursing care plans

  • Limited database: Nursing diagnoses may be restricted to the current EHR database version
  • Adaptation challenges: Some users may struggle to adapt to the computerized system, increasing errors and inefficiencies
  • Dependency: Effectiveness relies heavily on the accuracy and thoroughness of nurse assessments
  • Data loss vulnerability: Risk of total data loss in the event of system crashes
  • Confidentiality concerns: Low security measures can compromise patient confidentiality
  • Cost implications: Requires significant financial investment in infrastructure, training, and software updates
• Electronic journals


  Edited package of articles distributed to most subscribers in electronic form (Kling & Covi, 1995)
• Types or variants of e-journals

  • Classic electronic journals: Available through internet applications
  • Parallel electronic journals or electronic version of print: Available both in print and electronically
  • Database model and software model: Require subscription
  • CD-ROM journals: Versions of academic journals distributed through compact discs
  • Full text: These are e-journals where complete articles are available rather than just summaries of abstracts. Complete articles available online
  • Electronic only journals: Only available electronically, no print or CD-ROM counterpart
• Advantages of e-journals

  • Accessible: Some are freely accessible on the web, hypertext links aid citation and access
  • Faster: Faster speed of publication compared to print journals
  • Environmentally friendly: Smaller carbon footprint than print journals
• Journals often contain an unidentified mix of those that are and are not peer-reviewed
• 1. Journals


  • Have a faster speed of publication compared to print journals
  • The entire publication process is digital, with no need to print and distribute physical copies
  • Researchers can get their findings published more quickly, and readers can access the latest research without having to wait months or years
• 1. Journals


  • Are more environmentally friendly than print journals
  • Do not require physical resources like paper, ink, and energy for production and distribution
• Disadvantages of e-journals


  • Not always referred to
  • Increased potential for plagiarism
  • Reliance on equipment (electricity, telephone, computers, internet, software, hardware) which can be a problem in developing countries
• Electronic journals and websites for acquiring e-journals

  • Australian Electronic Journal of Nursing Education
  • Imprint
  • Internet Journal of Advanced Nursing Practice
  • Journal of Undergraduate Nursing Scholarship
  • NEN - Nurses Empowering Nurses
  • BioMed Central
  • Google Scholar
  • JSTOR
  • PubMed
  • ScienceDirect
• Critical pathways


  • Also known as critical paths, clinical pathways, or care paths
  • Management plans that display goals for patients and provide the sequence and timing of actions necessary to achieve these goals with optimal efficiency
  • Detailed set of multidisciplinary and structured plans of care which are constructed to increase and support the implementation of clinical guidelines and/or protocols
• Importance of Critical Pathways:

  • Improve outcomes - Critical pathways improve patient outcomes while reducing hospital expenses, mortality, and length of stay.
  • Enhanced collaboration - By including the patient and family on the same page for planning and discussions, critical pathways improve collaboration between providers.
  • Cost-effectiveness - it has been proven that critical pathways reduce disparities in the care given, support expected results, shorten hospital stays, cut down on delays, and increase cost-effectiveness.
• Critical pathways

  • Borrowed from the theories of Continuous Quality Improvement (CQI)
  • First developed for use in industry to identify and manage rate limiting steps in production processes
  • First developed and applied in healthcare in the 1980s to improve hospital efficiency
• Advantages of using critical pathways

  • Enhanced project management
  • Clear identification of critical tasks
  • Clear communication of project plans
  • Accurate determination of project length
  • Improved accuracy and flexibility in scheduling
• Possible disadvantages of using critical pathways

  • Complexity
  • Dependency on accurate estimates
  • Lack of flexibility
• Main components of clinical pathways(Hill, 1994, Hill 1998)

  • Timeline
  • Categories of care or activities and their interventions
  • Intermediate and long-term outcome criteria
  • Variance record
• Professionals involved in developing critical pathways

  • Physician
  • Nurse manager
  • Staff nurse
  • Social worker
  • Dietician
  • Occupational therapist
  • Pharmacist
• How to develop a critical pathway

  1. Retrospective or concurrent chart review

  2. Identify costs associated with the treatment

  3. Organize pathway development teams

  4. Identify patient care expectations and critical events

  5. Refine elements of the path in small groups

  6. Test newly developed tools on previously admitted patients

  7. Implement with collaboration from other professionals
• Key steps in critical path method

  1. Activity specification: Select a topic, usually high-volume and high-cost diagnoses/procedures

  2. Activity sequence establishment: Select a multidisciplinary team

  3. Network diagram: Evaluate the current process of care

  4. Estimates for each activity: Evaluate medical evidence and external practices

  5. Identification of the critical path: Determine the critical pathway format

  6. Critical path diagram to show project progress: Document and analyze variance