Modern Information and Communication Technology (ICT) will fade away the boundaries between inpatient and outpatient care enabling a more efficient, patient-centered health care. Everyone would have equal opportunity in being informed using ICT. Maitra (2007), states in her article, ICTs will help in improving connectivity for individuals and communities, they are used to create, nurture and manage human connectedness, equalizing opportunities. Kubias (2011) discussed health IT in his article, In constant evolution, the healthcare environment has multiple challenges to meet: cost containment, increase and ageing of the population, enormous quantities of data and quickly evolving knowledge, complex and multi-disciplinary approaches for healthcare, need for safer care. It is no secret that internet users are self-motivated. Nearly one third of the world's population is connected to the internet. The spread of users of the web is almost equal across the ages of 11 to 55+. (Wikipedia 2011). Master et al (2005) describes in his article that e-Patients report two effects of their online health research: "better health information and services, and different (but not always better) relationships with their doctors.

ICT in Nursing In 2006, the Technology Informatics Guiding Education Reform Tiger (2007) Summit convened a group of national leaders from nursing, technology organizations, government, and other stakeholders to create a vision for nursing future that enables nurses to use informatics in practice and education to support patient safety and quality of care delivery.

While et al (2011) highlight limited evidence relating to nursing contribution in ICT, Additionally, the absence of research relating to the impact of ICT upon nurses and their working lives is identified. Use of information and communication systems improves nurses' ability to make decisions in a timely manner; however, nurses are still reluctant about or avoiding using information systems in their daily work. Abdrbo et al (2011) explored the relationships among age, nursing education, computer experience, user involvement in implementation, nursing management support to use information systems, nurses' information system use, and information system outcomes (benefits and satisfaction). Computer experience, user involvement, and nursing management support were found to significantly related to ICT use.

Involvement of Nursing in implementation:

Without involving nurses in ICT implementation, the use will seem obligatory to nurses, limiting their feelings of autonomy, shared decision making, and satisfaction. They could even consider ICTs to be additional work instead of something that is supposed to assist them and augment their performance. Since using ICTs changes nursing work processes, nurses sharing in ICT development and implementation can also shape these systems in a way that is valuable to their work. They can provide feedback on their expectations of work flow and their professional needs. Involvement can also help nurses achieve a sense of ownership and avoid resistance and thus improve chances of system success.

Abdrbo et al (2011) also suggested, there is a need to incorporate nursing informatics specialists into the clinical workplace so that they can help nurses integrate ICTs into their daily work by offering technical and clinical support, providing essential educational programs and working as a liaison between nurses and the ICT team. Midwives have a lot to learn in order to take a proactive role in how ICT revolution affects their work. The web and its tools are profoundly changing health care, including midwifery. Midwives can choose to help steer this progress in the right direction, to jump on the bandwagon, or to be left behind. Sinclair (2010)

Training:

The importance of training physicians and nurses in the art, skill and science of clinical informatics has never been greater Safran (2009). Yee et all (2008) suggest in their paper to empower Generation Y healthcare workers as change agents, as they may might assist future ICT implementation in healthcare. Irelands National Health Information Strategy (NHIS) recognized and stated in publication, that effective use of health information is largely dependent on the skills and knowledge of health service staff.

Nursing care plan:

Computerized nursing care plans should be generated to standardized nursing documentation. The nursing process and standardized nursing terminologies are essential elements to structure nursing documentation in daily nursing information management. Integrating the nursing process in ICT will also motivate nurses to use the system efficiently. Thoroddsen et al (2011) stated, Content and completeness of documented nursing care improved after implementation of standardized nursing terminologies. Documentation of nursing care, signs and symptoms, related factors, and nursing interventions increased.

Nursing Clinical decision:

According to systematic review by Kawamoto et al (2005) in UK, clinical decision support systems were able to improve clinical practice by 68% of 70 studies by providing support automatically and within the daily routine workflow of physicians by delivering patient-specific recommendations, by providing support at the time and location of clinical decision making, and by using a computer to generate the support. Study addressed to decision support for nurses specifically should be initiated.

Client education:

There are many opportunities in midwifery care in the hospital where mother likes to know or revise about aspects of baby care when she is in for child birth during her stay in birthing facilities. Certain topics of client education such as hospital information, breast feeding, cord care, baby bath can be prerecorded.

Electronic Drug guide:

The Davis Electronic Drug Guide for Nurses 2.0 is the electronic version of the 7th edition of the Davis Drug Guide, which provide comprehensive up-to-date information to midwives involved in drug administration. Access to more than 4,900 generic and trade drugs is included. The professional midwife as well as the nursing student will find this software extremely useful.

Discharge advice:

Text4Baby (www.text4baby.org) in the USA sends those pregnant women who register, text messaged information about ‘immunisation, nutrition, prenatal care, emotional well-being, drugs and alcohol, labour and delivery, stopping smoking, breastfeeding, mental health, oral health, car seat safety, exercise and fitness, developmental milestones, safe sleep, family violence, and more.’ This can be utilized as a discharge advice.

High risk mothers:

The Sense4Baby (www.medicineandtechnology.com) is wireless technology which measures fetal heart rate and uterine contractions, and allows women and their health care providers to monitor maternal and fetal well-being at any time and any place. Rodney Itaki (2007, 2011), a medical doctor who promotes maternal and child health in Papua New Guinea, supports the use of telemedicine, including mobile phone picture messaging .

Commercial applications:

‘Hello Baby’ (www.imedicalapps.com) for smart phones which allows parents to see the development of the baby in the uterus, week by week. Another mobile phone download enables nursing mothers to learn how to breastfeed and a third allows a woman to track her breastfeeding sessions.

Professional Development and networking:

Many midwives are already using their laptops and phones for professional development, news and networking. In addition, many midwives belong to virtual communities of people with similar interests and use social networks to promote campaigns and garner public support. Brain storming sessions, debates, case study presentation with ICT for midwives by midwives should be started online.

In Australia, Sarah Stewart (http://sarah-stewart.blogspot.com), is a veteran midwife who specialised in eLearning, social media, networked learning, professional development and mentoring using web resources. Caroline Hastie (http://thinkbirth.blogspot.com) similarly weighs evidence as she questions and assesses birth procedures.

Midwifery practice:

Community Midwives can also make use of electronic communication programs in their practice. The Dutch Ministry of Health initiated an online e Health program to serve as a communication channel of health messages about pregnancy, nutrition and lifestyle between midwives and pregnant women. Van Zutphen et al (2009) state in

his study Pregnant women are often more aware than their midwives of such sources for health information, Many people have access to mobile phones, although they may never have had land lines. Klein (2011)

Promotion of midwifery practice:

Midwives can use social networking tools, to promote their practices and agendas for mothers from Cork community. The International Alliance of Midwives www.midwiferytoday.com/iam, which is committed to honoring and promoting traditional midwifery around the world had more than 6000 fans on its Facebook page at the end of January 2011.

Reflective practice:

Finally, personal social networks, chat forums, and blogs enable midwives to share thoughts and fears, to introspect and assess themselves, to widen their horizons, and to grow and mature in their profession. Midwives share professional experiences, wisdom, and difficulties with colleagues on discussion forums, chat rooms and blogs.

SUMMARY:

ICT is no longer add on to traditional methods of health care, but rather integrated, integral part of practice. Midwives need specific training and knowledge for different specialty settings but all of them will use ICT. Though advancement is seen and felt ICT development has multiple challenges to meet. There is limited evidence relating to nursing contribution in ICT. Studies are needed in this area. Computer experience, user involvement, and nursing management support were found to be directly related to ICT use in healthcare. Nurses share in ICT development and implementation can also shape these systems. There is need to incorporate nursing informatics specialists in clinical setting. Need of Training of art, skill and science of clinical informatics is greater. To structure nursing documentations computerized nursing care plans should be generated. Development of system to support clinical decision for nurses specifically should be initiated. Topics of client education can be prepared. Use of Drug Guide would provide comprehensive up-to-date information to midwives. Use of ICT in discharge advice and monitoring high risk mothers, community support will be effective. Brain storming sessions, debates, case study presentation with ICT would support professional development. Promotion of midwifery practice would be wider with ICT. ICT can be effective tool for Reflective practice.

REFERENCES:

· Abdrbo, Amany A, Hudak, Christine A, Anthony, Mary K. Douglas, Sara L (2011) Information Systems Use, Benefits, and Satisfaction among Ohio RNs, Computers, Informatics, Nursing, 29(1), 60;

· Itaki R (2007) Telemedicine in developing countries, Pacific family health journal http://pacificfamilyhealth.wordpress. com/2007/03/20/telemedicine-in-developing-countries-some-examples/. [Accessed 18th March 2011]

· Itaki R (2011), Telehealth in rural Papua New Guinea: mobile phone picture messaging tool has potential, http://pacificfamilyhealth.wordpress.com/2011/03/01/telehealth-in-rural-papua-new-guinea-mobile-phone-picture-messaging-tool-has-potential/. [Accessed 18March 2011]

· Kawamoto K, Houlihan CA, Balas EA, Lobach DF(2005) Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success, British Medical Journal, 330(7494):765

· Klein. M(2011) mHealth, MIDIRS Midwifery Digest, vol 21, no 2, 172

· Kubias (2011) Health and Clinical Management – From the Pen and Paper to the Digital Era. Adapting the Healthcare Environment to Take Full Advantage of Information and Communication Technology, International Medical Informatics Association Yearbook

· Maitra (2007)United Nations Public Administration Network (UNPAN), available from http://unpan1.un.org/intradoc/groups/public/documents/unpan/unpan037289.pdf

· Masters K, Ng'ambi D, Todd, G (2010) I Found it on the Internet:" Preparing for the e-patient in Oman". SQU Med J 10 (2): 169–179, http://en.wikipedia.org/wiki/E-Patient

· Safran. C( 2009) Informatics Training for Clinicians Is More Important than Hardware and Software, International Medical Informatics Association Yearbook

· Sinclair M (2010) Moving midwifery research forward in the revolutionary information and high-tech era, Evidence Based Midwifery 8(4):111.

· Thoroddsen, Asta, Ehnfors Margareta, Facmi Ehrenberg, Anna (2011) Content and ompleteness of Care Plans After Implementation of Standardized Nursing Terminologies and Computerized Records, CIN: Computers, Informatics, Nursing, 29(10, pp 599-607

· VanZutphen M, Milder IE, Bemelmans WJ (2009) Integrating an eHealth program for pregnant women in midwifery care: a feasibility study among midwives and program users, Journal of Medical Internet Research 11(1):e7

· While, Alison ; Dewsbury, Guy (2011) International Journal of Nursing Studies, 48(10), 1302-10

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· TIGER (2007)Technology Informatics Guiding Education Reform. The TIGER Initiative-Evidence and Informatics Transforming Nursing: 3-Year Action Steps Toward a 10-Year Vision. http://www.tigersummit.com. Accessed April 22, 2007.

· Wikipedia (2011) YouTube. en.wikipedia.org/wiki/YouTube. [Accessed 5 April 2011]. [Context Link])

· http://en.wikipedia.org/wiki/File:2005ICT.PNG, 4th July 2007

· http://www.imedicalapps.com/2010/07/pregnancy -calendar-app-pampers-ob-gyn-patients/

Received on 10.11.2013 Modified on 18.11.2013

Int. J. Nur. Edu. and Research 1(1): Oct.- Dec., 2013; Page 09-11