Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Information and Communication Technology (ICT) Use in Child and Family Nursing: What Do We Know and Where to Now?

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Information and Communication Technology (ICT) Use in Child and Family Nursing: What Do We Know and Where to Now?

Article excerpt


Information and communication technology (ICT) is rapidly becoming an essential aspect of health service delivery as the demand grows for clinicians to have access to health information and for timely transfer of client information between clinicians (Department of Health and Ageing, 2010). ICT implementation into primary health care settings such as child and family health nursing services raises issues that differ from those in acute care services. This study focuses on ICT use in the Maternal and Child Health (MCH) Service in the State of Victoria, Australia.

Child and family health services, available to all Australian families, include health promotion, monitoring, and intervention activities (Department of Education and Early Childhood Development [DEECD], 2009a). Although all States and Territories deliver a universal public health service to families and children, the services vary in structure, funding, title, role and qualification requirements (Productivity Commission [PC], 2011). In the State of Victoria, Australia, the title 'Maternal and Child Health' (MCH) is used to describe the service. The universal service is offered to all families with children up to 6 years of age and an initial home visit occurs for 99.8% of births (DEECD, 2011). An enhanced (home visiting) service is offered to families in need of more targeted support (DEECD, 2009a).

Maternal and child health nurses apply a primary health care philosophy, as they work in and with communities to identify and address individual, family and community needs (DEECD, 2011). Like other primary health care nurses, MCH nurse (MCHN) practice has a strong emphasis on health promotion and community support rather than treatment. In addition, this role has a strong prevention and early detection focus, particularly around child health monitoring (DEECD, 2009a). The role is akin to that of the European or British Health Visitor (Ellefson, 2001; Wilson, 2006), the American or Canadian public health nurse (Bradley & Bray, 2003) or the New Zealand child health nurse (Hansen, Carryer, & Budge, 2007). In Victoria, Australia the MCH service is provided by nurses who are experienced clinicians with nursing and midwifery qualifications in addition to their postgraduate qualifications in child, family and community health nursing (PC, 2011).

Service provision is carried out in a variety of locations such as clients' homes, single or multipurpose centres and community buildings. Despite a number of policy documents promoting linkages between children's services (DEECD, 2009b; Department of Premier and Cabinet [DPC], 2005; Municipal Association of Victoria [MAV], 2004; Premier's Children's Advisory Committee [PCAC], 2004), and the co-location of MCH centres with early childhood education and care services, many MCHN work as the only nurse at that location, often in stand-alone centres; that is, they are working in professional isolation (Keating & Barrow, 2006). This has been noted to impact on resource provision such as ICT services and accessibility, including data collection and electronic health record (EHR) functionality (Department of Human Services [DHS] Office for Children, 2006a).

Although the MCH services in Victoria are jointly funded and managed by State and local governments, the major provider of the service is local government. This dual management provides a level of consistency in MCH service structure across the state, while also allowing the service to be tailored to meet community priorities. Each of Victoria's 79 local government areas (LGAs) provides a MCH service by either employing MCHN directly or by contracting service provision to another agency, such as a community health centre or hospital. A disadvantage of dual management is some discrepancy in service delivery because infrastructure and support for MCH varies between LGAs (DHS, 2006a). This is particularly evident in the multiple, incompatible data collection and EHR programs systems in use across the state (DHS, 2006a). …

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