Historia clínica informatizada de enfermería en el Departamento de Torrevieja Salud como instrumento de gestión de calidad

Abstract

In the information society of the 21st century, it is a fact that the Electronic Clinical History (ECH) is not developed in every country. In Torrevieja Salud Health Department, Alicante (Spain), they work with a unique ECH that includes all divisions, including the nursing ones and an advanced operability level in regards to data management. Objectives: 1. - To develop all the information sources to facilitate the communication at all levels of care, so any professional in the community or at the hospital can retrieve information about the patient. 2. - To gather the nursing staff and computer technicians knowledge by working together. Methodology: In order to improve the nursing records, they have used a computer program named "FLORENCE", which is a model of a unique clinical history for the Health Department of Torrevieja. Florence is divided in two environments: Florence Gestión (accountant,-financial, and HH RR scopes) and FLORENCE (clinical assitance scope). This program comes as the result of the teamwork from IT and nursing staff who are knowledgeable of the concerns of the professionals. A product with double value because it combines the nursing methodology and state-of-art technological advances. Conclusions: Nursing records are valued as an effective instrument to empower the continuation of nursing care and coordinate that care at the best quality, as they are registered in a unique and single program. On the other hand, it ensures constant availability of all the information of the health-disease episodes of a patient, and most importantly, the information is kept confidential.