A team from the U-M School of Nursing developed a program called Hands-on Automated Nursing Data System (HANDS) and after a series of beta tests of a CD-ROM version, they hope to begin operating a secured, Web-based update of HANDS for use by nurses. Several facilities have begun preparations to use HANDS at one or more of their locations, pending funding to move the software from prototype into operational status. The program's developers hope to get word this fall about funding.
University of Michigan Hospital and Health Centers has contributed to the project and plans to use the application in one Health System unit later this year. The Veterans Health Administration also is a potential partner for collaboration.
Using a series of pull-down menus with dozens of terms approved by nursing professional groups, nurses enter diagnoses, treatments and outcomes for each patient.
These are not transcriptions of doctors' information but the nurses' own observations of their patients' health conditions and records of what they did by doctors' requests as well as the ways in which they used their experience to enhance treatment. For example, a nurse entering notes on a patient with severe arthritis might record what medications or movement therapy he or she provided to help the physical ailments and might also note an educational plan to teach the patient how to function better at home.
One goal of HANDS is to give health care professionals a more holistic sense of what's ailing a patient, what's been done, what's worked and what hasn't, said Gail Keenan, assistant professor at U-M School of Nursing and leader of the HANDS project. Taken collectively, the data---collected in a way that protects patient confidentiality---also can help show which nursing activities lead to the best patient outcomes.
Keenan is not yet sure whether HANDS will become a self-sustaining project, perhaps through selling benchmarking studies or spinning it off to a private company, or whether grants might pay for its use at additional sites. Keenan had hoped a commercial software company would develop a program to provide these functions, but when the private sector didn't show interest, she and nursing colleagues decided not to wait and to do it themselves.
Keenan began work on HANDS four years ago with help on the project from Marcy Treder, project manager; Crystal Heath, systems analyst; Sharie Falan, research associate, and Julia Stocker, nursing doctoral student.
During its four years, the HANDS project has received funding of about $1 million, including indirect support from the National Institutes of Health, as well as support from the U-M Hospital and Health Centers and private foundations.
The University of Michigan
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