Authors (including presenting author) :
Lo PS (1), Yu MY (1), Wong CW (1), Sin LY (1), Cheung WM (1), Hui GK (1), O SC (1), Yeung YM (1), Lui ML (1)
Affiliation :
(1)Department of Anaesthesia, Pamela Youde Nethersole Eastern Hospital
Introduction :
The application of Perioperative Nursing Information System (PNIS) is evolving in many operating theatres (OT). Preliminary the PNIS is merely opted to digitalize and standardize the nursing documentation during intraoperative care. Recently, PYNEH OT is trying to adopt the information intelligence methodologies in PNIS; by converting the complex data into relevant and actionable intelligence in order to better manage surgical risk, to improve care quality, to streamline nursing initiatives and, to better engage the surgical team.
Objectives :
We sought to communicate our design ideas of PNIS.
Methodology :
An inter-professional team was developed in October 2021 to instill information intelligence to the system throughout the perioperative process in a holistic approach. Theatre nurses use PNIS for multiple purposes regardless of the work place starting from pre-op assessment, initial identification of a case, through surgery, recovery, and ongoing outcome analysis. Our PNIS characterize with the following feasibilities: A. Ability to provide safe clinical decision support: (1)pioneer an automated verification process to help decrease implant-selection errors for total joint surgery. (2)promote data-driven decision-making to activate clinical protocol such as massive transfusion protocol. B. Ability to uphold strong team communication (1)preoperative phase – exchange complex health information during patient assessment between different disciplines to prevent transcription error and repetitive work. (2)intraoperative phase – enable a cohesive dashboard to deliver key patient information by using perioperative handover tools (SWITCH) to improve OR efficiency and patient safety. (3)postoperative phase – use a digital structured format for nursing shift handover to improve communication. C. Ability to develop best nursing practices and support research for evidence-based practice (1)integrate Munro Scale into the system to prevent OT-acquired pressure injury. (2)Consolidate relevant information to facilitate continuous improvement program such as surgical debriefing D. Ability to apply IT infrastructure to the nursing process but not limited to: (1)provide logic behind to trigger alert or warning in OR workflow to enhance staff compliance. (2)auto-transcribe the specimen information to eliminate transcription error and provide safety check-points to prevent specimen missing. (3)provide messenger function to SSD about implant consumption to enhance replenishment efficiency. (4)simplify on-loan equipment procedure by scanning the asset information bar-code and provide a summary of on-loan equipment for follow-up action.
Result & Outcome :
A prototype to show the feasibility of system design was still underway till 1Q 2022 and has been implemented in Feb 2023. PNIS acts as an intersection of patient safety and technology; while not foolproof, hopefully the system can show to improve safety, quality, and patient outcomes in future studies.
