Nurses working in eHealth!
So what do they actually do?
What do they contribute to the development of Health and Social Care Services in Scotland?
And how will they be able to Revalidate as part of the new NMC process?
All questions I have either been asked or have thought to myself over the past few years.
As a Registered Mental Health Nurse I have now worked in the eHealth field for almost 15 years in NHS Ayrshire and Arran, and for the last two years as the Nurse Adviser to the Scottish Government eHealth Department.
Being able to revalidate
In a few months time I have the important job of completing revalidation, to retain my nursing registration with the Nursing and Midwifery Council.
Part of this process is the preparation of five written reflective accounts which will refer to:
- my Continued Professional Development, and/or
- practice-related feedback I have received, and/or
- an event or experience in my own professional practiceI also have to relate these accounts to an aspect of the Nursing and Midwifery Council Code.
Evidencing my eHealth work related to the Code
The code has four themed areas:–
Prioritise people by actively seeking and reflecting on any direct feedback received from patients, service users and others to ensure that you are able to fulfil their needs- Practise effectively by reflecting on your professional development with your colleagues, identifying areas for improvement in your practice and undertaking professional development activities
- Preserve safety by practising within your competency for the minimum number of practice hours, reflecting on feedback, and addressing any gaps in your practice through CPD
- Promote professionalism and trust by providing feedback and helping other NMC colleagues reflect on their professional development, and being accountable to others for your professional development and revalidation.
So my challenge to allow me to meet my revalidation requirements was to evidence some of the eHealth work I have been involved in over the last year in line with reflective practice and the NMC Code. 
Over the last 18 months or so I have been leading on the system development, safe migration of data and the implementation of our new web based FACE CarePartner electronic patient record within Ayrshire’s Mental Health and Child Health Services.
Although I am not involved in the provision of care on a daily basis I needed to ensure that the clinical eHealth systems support clinicians in the provision of person centred safe and effective care.
The Development Process
This process included engaging with our supplier and over 100 clinicians and admin staff to go through a process of design, evaluation and testing, this is where my nursing knowledge and skills are key factors. There is clear evidence that involving clinicians throughout the eHealth development journey aids their ongoing engagement and use of the system.
We have a very positive development relationship with our supplier that supports us in building on what we currently have to improve systems functionality.
Safe Data Migration
The new system implementation involved the safe migration of data associated with about 172,000 patients. 
This included about 36 million assessment and contact records for patients going back almost 14 years.
It was important for the governance of our services that all of the data migrated safely and was associated with the correct patients and the correct clinicians.
In order to facilitate this I had to ensure a robust process of project planning and a testing regime were put in place. Governance arrangement were set up to ensure that when safe to do so we could collectively sign off the migration project and move to the final live migration of the data.
On reflection I learnt that when involved in such a big project be very wary of setting potential dates for going live before final testing has been completed. In the later part of the project we learnt from this and tended not to set a date until we were 100% sure that we could progress to the next phase.
System Function and Content
In developing the new systems function and content I had to ensure that we could follow the clinicians workflow of the person centred care process from assessment, to personal goal setting, care planning and of course the measurement of attainment against the patients goals being set.
I also had to ensure that when we worked closely with the clinical teams to develop the clinical content of the assessments and care pathways within the system, that they were evidence based, and reflected the ability to collect a robust physical, social and psychological assessment of the patients needs.
The person centred care planning components also had to reflect the opportunity to promote independence and engage the patient in the development and evaluation of their goals.
Relationship to the NMC Code
This piece of work related to the code on several fronts, examples include:
Prioritise People
- I ensured that the content of the assessments allowed for the ability to record a robust assessment
- Assessments contained aspects of measuring the capacity to consent to care and treatment
- The system was structured to ensure the secure storage of the data and supported a robust audit of the recording and access to the information that was stored.
- The system supported the safe sharing of information between health professionals to support care provision
Practising Effectively
- All assessments and structures of care pathways were developed with respect to the latest clinical evidence available
- In our collaboration work I had to ensure that i communicated effectively with my colleagues to ensure they understood our work programme and how they could contribute to it.
- I had to ensure I communicated effectively to utilised the skills and expertise of my colleagues to support us in the safe development of the product.
- The system had to be developed to support the clinicians in recording care in a secure, timely, accurate and clear manner.
Preserve Safety
- The system was developed to facilitate quick access to information to support alert management and patient safety.
- Risk and child protection alerts were identified to support effective information sharing and promote safety.
Promoting Professionalism
- I was aware of my leadership role within this piece of work and had to maintain a positive and professional outlook at all times, supporting our registered staff and students throughout the process.
The Sciences:
Five months into using the new CarePartner system and things are going well. We have an opportunity to continue to engage with our supplier and clinicians to further develop the functionality of the system.
The skills and competencies of eHealth nurses support us in facilitating the relationship between Nursing Science, Computer Science and Informatics.
Effective leadership and communication skills supported me in working with our clinicians to turn this into reality.
And of course I’m several steps closer to fulfilling all my revalidation requirements.
This week’s blog was by @markfleming1 (Mark Fleming) Programme Manager, Mental health/eHealth NHS Ayrshire and Arran/North Ayrshire Health & Social Care Partnership and Scottish Government eHealth adviser for Nurses, Midwives and Allied Health Professionals.
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