Developing an information systems strategy for nursing.

With the rapidly changing health care environment and information technology advances, organizations need to engage in strategic, planned change in order to allocate limited resources, achieve the organization's goals, and fulfill its mission [1]. One of the most important aspects of the organization's planned strategies for change concerns the information systems. The involvement of the nursing department in this process is critical. This poster presentation will communicate how nurses can develop an information systems strategic plan that will enable them to play an active role as contributors and vital participants in the strategic and business planning processes for information systems. This information systems strategy for nursing will: a) provide direction and purpose, b) guide nursing in identifying the kinds of information technology needed, c) assist in timely implementation of a system that supports nursing, and d) identify desired outcomes and benefits of an information system. The nursing information systems plan must be built on, and support, the organization's mission and business plan and integrate into the over-all information systems plans [2]. Components of the nursing strategic plan include the nursing mission statement and vision, an assessment of the current environment to identify supporting technology needed to achieve the nursing vision, expectations/anticipated outcomes, environmental considerations, and special staffing/expertise considerations. The nursing vision and mission statement is an articulation of the overall direction and purpose of the nursing organization. An assessment of the nursing organization, problem areas, opportunities for growth, the physical environment, existing systems, communications requirements, and resources is carried out to help identify areas where new technologies and automated methods of managing information could be applied. Special staffing and expertise not currently available in the organization, but necessary to the successful implementation of the plan, should be identified, and plans for filling those needs should be included in the planning and prioritization process. Based on the mission and assessment findings, goals or anticipated outcomes are developed. These goals must be realistic, financially feasible, and logistically achievable; they should also provide direction for action and decision-making [3]. Measurable objectives and detailed action plans can then be developed from these goals when implementation of this aspect of the strategic plan is begun. It is especially important, even at a strategic planning level, to consider change management techniques, including specific steps to involve individuals who will be affected by the change and to ensure open communication throughout the process. Efforts to collaborate with all affected departments and to offer input and educational opportunities to the various members of the health care team should be included in the strategic plan. A business plan describing the mission, goals, and objectives for a specific system implementation is the final step in the strategic planning process. The business plan includes expected outcomes and cost justification and may be done in cooperation with other departments (in the organization) that will be involved with this system. The business plan is used to communicate the information system's needs to the administration and governing board of the organization. With a good information systems strategy, nursing will be prepared to make more timely and better informed decisions related to applying information technology within the nursing department. The end results of this planning should be evident in the improved utilization of information technology to support the nursing vision and mission.

Differential effects of D600, nifedipine and dantrolene sodium on excitation-secretion coupling and presynaptic beta-adrenoceptor responses in rat atria.

The stimulation-evoked release of tritium was measured from rat atria labelled with [3H]-noradrenaline. The calcium dependence of evoked release and the facilitation of this release via activation of presynaptic beta-adrenoceptors were examined using D600 (methoxyverapamil), nifedipine and dantrolene sodium. Both D600 and nifedipine at dose levels of 20 and 100 microM inhibited evoked release. Dantrolene (20, 100 microM) reduced release by 25%, the effect being maximal at 20 microM. In the presence of 20 nM isoprenaline, a facilitation of evoked release occurred, which was blocked by 0.1 microM (-)-propranolol. The facilitatory action of isoprenaline was abolished by omission of calcium from the buffer, or by D600 or nifedipine, (100 microM). In contrast, the response to isoprenaline was not modified by dantrolene (20, 100 microM). It is concluded that the evoked release of noradrenaline (NA) utilizes Ca from both intra- and extracellular sources and that isoprenaline increases NA secretion by promoting the depolarization-induced influx of Ca.