BY DAY 3 OF WEEK 1
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
BY DAY 6 OF WEEK 1
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.
NURS-6051N Week 1 Discussion
Discussion: The Application of Data to Problem-Solving
In personal nursing practice, collecting patient data on admission is one of the most vital areas of data collection. Working at a facility that deals in adolescent psychiatric and behavioral health, it is essential to collect enough background data on patients before they are fully admitted. It has to be ensured that the patients meet the admission criteria before they are accepted. The knowledge acquisition process begins soon after admission to learn more about patients.
The data collected before admission is mostly patients’ electronic medical record that is typically fed to the computer systems. The collected information would comprise primary and secondary diagnoses, hospitalization history, prior assessments, past treatment history, obtained lab results, and medications. According to Stoots (2015), psychiatric nurses involved in optimizing EHR to support behavioral health population management improvements can be generated cost-effectively. These efforts are regarding preventing and treating mental health disorders and preventing the myriad of co-occurring health conditions. Regarding developing new plans, it is essential to note what has been done in the past. Documenting the plans that failed and those that succeeded is vital in creating a successful strategy and attaining positive patient care.
The computer era has brought significant changes and efficiency. Safety alerts and more information have been provided through such systems as technology continues to expand. Knowledge is inevitably embedded into electronic patient records. New algorithms that assist in decision-making are also taken care of. Despite EHR not being the latest form of healthcare technology, it is constantly updated to ensure that the provided information is valid (Nagle, Sermeus, Junger & Bloomberg, 2017). Besides gathering the necessary information and providing care, educational material can also be provided to patients to improve them.
The hypothetical scenario I chose to discuss involves the awareness of a patient’s adverse psychiatric reaction to a medication prescribed during hospital admission. Extreme distress can result from an undesirable response to psychiatric medication. Even though patients may not achieve the desired reaction from psychiatric drugs, such are not explicitly listed as “allergy” in the patient’s records. In the electronic records, it may be indicated in the patient’s chart that they had the specific medication, but it needs to be apparent where such a drug was discontinued. At times, discussing all prior medications with patients may be imperative. For patients who are not in their right state of mind may not be able to tell particular events in their life. Using patients’ medical records, staff notes, and past providers’ notes can be looked through and determined by the patient’s health state. Upon a nurse reporting findings to the provider, all patient behaviors must be recorded. A better level of care can be utilized and reviewed, given the information collected is helpful.
Understanding how a patient experiences a specific reaction to a medication is vital. This is critical to the psychiatric field. We would ensure that the drug was not used again during care for patients who have had manic, aggressive, or self-injurious behavior in response to previously used medication. We could also flag the medical record to alert others of the reaction if that was not already done. There have been previous dangerous situations; under such circumstances, quick adjustments are necessary. Such adjustments are essential in helping care for patients. It is known that most adolescents are hesitant to discuss sensitive information with adults they are not close to. The experience I have had has helped me obtain information ahead of time. This is vital as it plays a role in understanding what teens indulge in and the situations they usually are in. In addition to the recorded medical record, verbal information and reports are extremely important. Oral information, in addition to medical records, gives a clearer picture of the state of patients. The care team is always set to realize any notable patient changes.
Communication and continued collaboration among team members is critical for overall patient care. I’m grateful that my facility uses computer systems linking local hospitals and providers. In addition to verbal communication among our care team, progress notes can also be read by coworkers and outside providers that care for patients. Critical information gives the team all the necessary advantages to handle various patient issues. With all the information I can acquire from the verbal report, record, and patient, I can then analyze what has been found to develop a plan to move forward. McGonigle and Mastrain (2017) shared the necessary steps to using information and applying knowledge to solve problems, acting with wisdom based on nursing practice science. Knowing where my patient stands and their situation is key to developing a starting point and creating a care plan with which the patient and care team feel most comfortable.
References
McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers.
Nagle, L. M., Sermeus, W., Junger, A., & Bloomberg, L. S. (2017). The evolving role of the nursing informatics specialist. Stud Health Technol Inform, 232, 212-22.
Stoots, M. (2015). Unlocking Electronic Health Record Data Helps Drive Behavioral Health Population Management. Journal of the American Psychiatric Nurses Association, 21(5), 348-350.
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Collapse SubdiscussionMansong Ntekim Hi Sheila,
Thanks for you for your well-written discussion post. Like you stated, gathering a patient’s data is a vital part of the admission process. The data collection process is simplified and made faster by the application of EHR system in most facilities that has adopted the EHR. The availability of health information from prior treatment locations, the frequency and outcomes of past treatments has helped in the evaluation of the efficacy (or lack of) of past treatment and guide in the implementation of revised plan of care for better results for the patient.
You mentioned the use of data in understanding patients experiences and reactions to previous medication regime. The EHR has been a great tool in the safe management of medication, mostly, among patients with mental health who have a higher propensity for “doctor shopping” and medication misuse. It is important for nurses to acquaint themselves with informatics competency. Being competent in the use of informatics will aid the nurse in using information and technology to communicate, manage knowledge, reduce errors, and enhance good decision-making at the point of care (Glassman, 2017).
Reference
Glassman, K. (2017). Using Data in Nursing Practice. American Nurse Today. Retrieved from https://www.myamericannurse.com/using-data-nursing-practice/
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Collapse SubdiscussionBarkisu Fortenberry Hi Sheila,
Hi Sheila, your discussion post is not only insightful, but it is also thought-provoking. Indeed, obtaining patient information is an important part of the administration procedure. The data collection procedure is broken down through the use of the EHR system. In fact, most facilities have incorporated the use of EHR in their operations. The accessibility of health information from the existing treatment setups, and the frequency and results from past treatments have enhanced the assessment of effectiveness or lack thereof in past treatments (Nagle et al., 2017). Therefore, it will basically guide in implementing a revised plan of care to ensure better outcomes for the patient.
Reference:
Nagle, L. M., Sermeus, W., Junger, A., & Bloomberg, L. S. (2017). The evolving role of the nursing informatics specialist. Stud Health Technol Inform, 232, 212-22.
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Collapse SubdiscussionBertina Boma Soh Hello Sheila,
You are right when you say that it is essential to understand how a patient reacts to specific medications. Most medications have side and adverse effects, so distinguishing between a side and a negative impact will determine what actions a nurse can take to help a patient deal with the situation. The nurse usually reports allergic and adverse reactions to the doctor, who then gives an order for the next step.
That being said, communication and continuous collaboration are essential in overall patient care. When managers establish sound systems to facilitate communication, it goes a long way to improve comprehensive patient care and reduce risky incidences.
Huang et al. found that tackling complex team problems requires understanding each member’s skills to devise a task assignment to maximize the team’s performance. Visual people prefer written communication (email or cloud-based software), while auditory people benefit more from a phone calls, video chat, or face-to-face meetings. Realizing that everyone is different allows for better communication. It sends the message to your team members that you value them as individuals and recognize which form of communication works best for them.
Studies were conducted to describe interprofessional collaboration (IPC) in pain management in neonatal intensive care based on healthcare team members’ perceptions of partnership, cooperation, and coordination (Mäki-Asiala et al., 2022). Collaboration in teamwork is based on respect for and trust in oneself and others. Mäki-Asiala et al. highlighted that neonates’ well-being and brain development should be supported by pain assessment, prevention and treatment of painful procedures, and appropriate dosed medications(Mäki-Asiala et al., 2022).References
Huang, E. Y., Paccagnan, D., Mei, W., & Bullo, F. (2022). Assign and appraise: achieving optimal performance in collaborative teams. IEEE Transactions on Automatic Control.
Mäki-Asiala, M., Kaakinen, P., & Pölkki, T. (2022). Interprofessional Collaboration in the Context of Pain Management in Neonatal Intensive Care: A Cross-Sectional Survey. Pain Management Nursing.
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Collapse SubdiscussionRaminder Kaur Hi Sheila, Excellent Post!
I agree with you that collecting patient data on admission is one of the most vital areas of data collection. The first of the five steps in the nursing process, the initial nursing assessment, requires the systematic and ongoing collection of data; organizing, sorting, and analyzing that data; and the communication and documentation of the collected data. Decisive reasoning abilities applied during the nursing system give a dynamic structure to create and direct an arrangement of care for the patient integrating evidence-based practice ideas. The third leading cause of death in the United States is medical error. An error can occur while planning patient care, when the plan is not followed, or when a healthcare professional does not have all the information necessary to treat the patient. Accurate patient data collection and making the patient a partner in their care are two of the most effective strategies for preventing medical errors. The process of gathering patient data is called patient data collection. The gathered data can be put to use for a variety of purposes, including research into novel treatments and improving care quality. Be that as it may, if it isn’t gathered productively, it can prompt defers in treatment and different issues. The patient’s individual physiological, psychological, sociological, and spiritual requirements are the subject of the nursing assessment. By allowing the formation of a nursing diagnosis, the assessment identifies the patient’s current and future care requirements. The nurse helps to prioritize interventions and care by recognizing both normal and abnormal patient physiology. Experts in patient safety concur that effective communication and teamwork are necessary for providing high-quality healthcare, as you point out. Healthcare teams can improve patient outcomes, reduce medical errors, increase efficiency, and improve patient satisfaction when all clinical and nonclinical staff work together effectively.
Refernces:
Bhatt, J., & Swick, M. (2017, March 15). Focusing on teamwork and communication to improve patient safety: AHA News. American Hospital Association | AHA News. Retrieved December 1, 2022, from https://www.aha.org/news/blog/2017-03-15-focusing-teamwork-and-communication-improve-patient-safetyLinks to an external site.#
Toney-Butler, T. J., & Unison-Pace, W. J. (2022, August 29). Nursing admission assessment and examination. National Center for Biotechnology Information. Retrieved December 1, 2022, from https://pubmed.ncbi.nlm.nih.gov/29630263/Links to an external site.
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Collapse SubdiscussionAdrienne Aasand Response #2:
Sheila,
Thank you for your post about collection of medication reaction data for psychiatric patients. Adverse drug reactions account for about five percent of hospital admissions, 28% of emergency department visits and five percent of hospital deaths (Liu, 2013). Although I do not work with psychiatric patients, I also encounter issues with patients not being able to accurately report their current medications and their medication allergies or reactions. I have also found that in reviewing outside EMRs, often a discontinued medication is not documented.
Your post made me think of medication errors made in outpatient clinics that could be avoided by improving the medication data collection process. One article I read described a pilot study on a program called CancelRx which is an electronic communication of medication discontinuation from prescribers to pharmacies. The article stated that approximately 4.5 million outpatient visits each year result in adverse drug events (Pitts et al., 2022). The result of the pilot study was that CancelRx led to the elimination of the sale of e-prescribed medications after discontinuation in the EMR (Pitts et al., 2022). Not being aware of medications or reactions can be very dangerous when prescribing new medications or cancer treatments due to possible drug interactions. And as you stated, linking records from outside hospitals and facilities is very helpful when collecting data about a patient’s medications.
References
Liu, M., Hinz, E., Matheny, M., Denny, J., Schildcrout, J., Miller, R., Xu, H. (2013). Comparative analysis of
pharmacovigilance methods in the detection of adverse drug reactions using electronic medical records. Journal of the American Medical Informatics Association, 20(3), 420-426. doi.org/10.1136.amiajnl-2012-0011119
Pitts, S., Yang, Y., Woodroof, T., Mollenkopf, N., Wang, N., Thomas, B., Chen, A. (2022). The impact of
electronic communication of medication discontinuation (CancelRx) on medication safety: A
pilot study. Journal of Patient Safety, 18(6), 934-937. Doi.org/10.1097/PTS. 0000000000000998.
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Collapse SubdiscussionColleen Lewis Response 1
Hi Sheila,
Your discussion topic is thought provoking. I’ve experienced in the Emergency Department a similar problem with our adolescent patients presenting for aggression or psychiatric problems. For example, there have been a couple of cases where patients that were administered Haldol to help calm them, but instead experienced an increase in agitation. If there were, as you suggest, a way to document this reaction and have it linked to the MAR to populate a warning when ordering this medication for the patient in the future, it would prevent unnecessary agitation for patients. In the long term, having a reminder pop up for certain medications that have been ordered in the past, but were not therapeutic, could help providers to plan care better. The only downside is providers may begin to rely heavily on these reminders, and not review the chart in as much depth as would be appropriate for effectively planning these patients’ care.
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Collapse SubdiscussionMenard Tchatchou-Tchoubia Transforming Nursing and Healthcare through Technology
Menard Tchatchou
Walden University
NURS 6051 N
11/29/2022
Transforming Nursing and Healthcare through Technology
Nursing informatics is a term that has evolved over the past five decades. Its main aim has been to address the needs of healthcare organizations with the help of developing technology. It incorporates nursing, information science, and computer science (McGonigle et al., 2022). It ensures that the medical department is well-managed and developed. The data systems are designed to improve the outcomes of the patients and ensure that the overall performance of the healthcare organization is boosted.
Nevertheless, nurses, the most significant healthcare professionals, have the mandate of ensuring the safety of their patients. Therefore, to facilitate this, nurses need to make informed practice decisions, such as accessing data about their patients, the impact of their care, and interpretation of the data collected. It is, therefore, crucial for all nursing students to comprehend and understand the requirements of informatics. These include understanding the electronic health record (EHR), demonstrating how to navigate EHR, valuing the ability of technology to support clinical decisions, which helps reduce errors, and lastly, the ability to use evaluating technology systems to support patient healthcare. Informaticians, therefore, help translate the information from different data languages, such as capturing disease codes, thus ensuring efficient communication between the nurse and the patient (Sweeney, 2017).
On the other hand, it allows patients to have direct access to their records from the clinicians; the system enables the addition or editing of the patient’s information. The Health Information Technology for Economic and Clinical Health (HITECH) promotes freedom of share of information with the patient. Therefore, the article focuses on the applications and importance of informatics in the nursing discipline to help solve various patient problems.
Numerous healthcare organizations have decided to adopt the use of technology to ensure the efficient delivery of services. The applications of informatics knowledge in nursing have been depicted in different scenarios. I would focus on how the technology, based on the data that is analyzed and collected in conjunction with knowledge and skills, to solves patients’ problems. An example is that nurses regularly review an individual’s patient data; hence because they are essential communicators, providers have the mandate to subtle changes in the patient’s conditions. Information about the individual patient is extracted and compiled into flow sheet rows containing the patient’s story explaining why he or she sought medical assistance and the cause of the problem. Through technology, a patient with localized prostate cancer would seek treatment options online, which would help the patient with the help of a medical practitioner to develop and initiate a treatment remedy (Nagle et al., 2017). Another scenario is in ambulatory care, whereby the nurse documents the data collected, including screening tests, vaccines, and health teaching.
Other aspects of technology, such as middleware, a software monitoring device that links the patient and nurse, are vital to maintaining effective communication. Nursing is a practice that ought to be carried along. It takes a long time for health practitioners to complete their education. It is, therefore, vital for the advancement of technology to help close the gaps, in that their knowledge is likely to be outdated as they complete their education. To solve the problem, electronic patient records ought to be introduced. Conclusively, nursing informatics, a new form of technology introduced in the health sector, has helped solve different patient problems through data analysis. Over time the technology is likely to advance and transform more healthcare lives.
References
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist Links to an external site.
Public Health Informatics Institute. (2017). Public Health Informatics: “translating” knowledge for health Links to an external site.Links to an external site.
[Video file]. Retrieved from https://www.youtube.com/watch?v=fLUygA8HpfoSweeney, J. (2017). Healthcare informatics Links to an external site.Links to an external site.. Online Journal of Nursing Informatics, 21(1).
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Collapse SubdiscussionMaxine A Lewis Maynard thank you for an interesting post have was not familiar with “middle-ware” which is referred to as the “missing link” in EHRS. Health information exchanges (HIEs) are more analogous to old-school mainframe systems, requiring data duplication in a centralized, non-distributed manner. Middleware (Voltz,2015). Furthermore cites Voltz, Middle-ware solves the interoperability problem by creating a platform that connects current EHR systems while allowing for a single way to integrate more upcoming healthcare technology. The need for digital transformation has showcased that middleware is here to stay cites Gazis and Katsiri (2022). Middleware allows you to achieve communication between different devices, applications, and software layers. There is a need to educate new developers about middleware and highlight its importance through education techniques and learning systems Gazis and Katsiri (2022).
GAZIS, A., & KATSIRI, E. (2022). Middleware 101. Communications of the ACM, 65(9), 38–42. https://doi.org/10.1145/3546958
Voltz, D.M. “Connecting the Disparate: Middleware’s Role in Solving Healthcare’s EHR Interoperability Problems” Journal of AHIMA 86, no.5 (May 2015): 28-33.
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Collapse SubdiscussionRaminder Kaur Hi Menard, Very Informative Post!
I agree that nurses are essential medical workers since they ensure their patients are safe. More than 20 years ago, the modern patient safety movement was established. Although there has been a tremendous improvement in patient safety since that time, there is still a severe risk that patients could suffer injury due to mistakes or other unfavorable events while receiving medical treatment. Approximately 10% of patients globally experience an injury while receiving care due to such occurrences. According to estimates from the World Health Organization (WHO), approximately half of those incidents are deemed preventable. More than any other healthcare provider, nurses spend much time with patients. They also have a variety of responsibilities that, when properly carried out, contribute to maintaining patient safety. The ability of a nurse to prevent adverse events and protect patients from harm can be compromised by various circumstances, including staffing levels and shift duration. In order to foster a productive workplace and provide their personnel with the best chance of success, nurse leaders may control these variables, which ultimately helps patients. Nursing staff and their particular role in delivering bedside care require a customized strategy for enhancing patient safety measures. Breaking down patient safety into a collection of practical strategies to reduce medical errors and enhance patient outcomes is helpful to many nurses. Leaders in the hospital’s nursing department are responsible for cultivating deliberate communication and teamwork, which is necessary to promote patient safety. Effective nurse administrators will commend individuals who diligently endeavor to reduce medical errors and inform others when errors have happened, establishing the tone for a dedicated, open medical team.
References:
The importance of a nurse’s role in patient safety: HPU online. Hawaiʻi Pacific University Online. (2022, February 3). Retrieved December 1, 2022, from https://online.hpu.edu/blog/nurses-role-in-patient-safety/Links to an external site.
Vaughn, N. (2020, September 24). Patient safety in nursing. Relias. Retrieved December 3, 2022, from https://www.relias.com/blog/how-nurses-can-help-improve-patient-safety#Links to an external site.
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Collapse SubdiscussionOdion Iseki THE APPLICATION OF DATA TO PROBLEM-SOLVING
Healthcare providers can only provide optimal treatment with access to patient medical records. The topic of vaccines interests the writer. She was a primary healthcare nurse in a sizable African neighborhood. The challenge of that work comes from the fact that families often need to take their immunization records with them when they move across state lines, so it is unclear what, if any, vaccines their children have or have yet to receive. For this information, parents may need to contact their child’s former doctor, the state immunization registry, or their child’s school. Having a single repository for all vaccine data will greatly facilitate this process.
DESCRIBE THE DATA TO BE USED AND HOW THE DATA MIGHT BE COLLECTED AND ACCESSED.
The current system for archiving vaccination histories is called the Immunization Information System (IIS). This program keeps track of immunization records and lets doctors know when it is time for booster shots (“Immunization Information Systems,” 2019). After that, the writer wants to set up a database that collects vaccine information from all offices. Having a centralized repository for vaccine records would make it easier for doctors to retrieve immunization histories for new patients. As a result, doctors might review their patients’ vaccination records and make more informed decisions about immunizations.
WHAT KNOWLEDGE MIGHT BE DERIVED FROM THAT DATA?
Analyzing this information could yield numerous insights. Healthcare providers may be able to see coverage rates and possible disease hotspots. They could also test the efficacy of herd immunity (a form of communal immunity). When enough people are immunized to stop the disease from spreading, a community is said to be disease-free.
HOW WOULD A NURSE LEADER USE CLINICAL REASONING AND JUDGEMENT TO THIS EXPERIENCE?
With this information, nurse managers can use clinical reasoning and judgment to make sure that their patients only get the number of vaccines they need and no more. Also, doctors who care for people with diseases they already have would be able to add vaccine-specific warnings and contraindications to the system. If the patient ever changed care facilities or were admitted to the hospital, the new staff would already be aware of this, which is a huge plus. Both healthcare providers and patients would greatly benefit from having easy access to a centrally stored immunization record.
References
Immunization Information Systems. (2019, April). Retrieved from https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunizations/Practice-Management/Pages/immunization-information-systems.aspx
Finding and Updating Vaccine Records. (2020, February 25). Retrieved from https://www.cdc.gov/vaccines/parents/records/find-records.html?CDC_AA_refVal=https://www.cdc.gov/vaccines/parents/records-requirements.html#finding-records
Vaccines Protect Your Community. (2017, December). Retrieved from https://www.vaccines.gov/basics/work/protection
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Collapse SubdiscussionAndrea M Allen Response
Hi Odion,
Thanks for the read. Just to add to your posting, using a centralized repository enables us to also receive other health records as well. We can now access our health history, pharmacies can obtain our drug history and physicians can monitor trends in our health. Not to mention if you are unable to communicate your health history due to some unforeseen event, measures taken from a information systems database can restore your health. The data not only help to solve problems but adds to the practitioner’s and the discipline’s body of knowledge and used not just for consistent care to patients but to conduct medical research to improve healthcare facilities.
Best,
McGonigle, D., & Martian, K. G. (2022). Nursing Informatics and the foundation of knowledge (5th ed.). ones & Bartlett Learning
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Collapse SubdiscussionColleen Lewis Response 2
Hello Odion,
It is an excellent idea to have a centralized repository for this information. I used to work in a Pediatric primary care office that attends many children who recently immigrated to the United States. Some of these families brought a paper pamphlet that had hand markings and scribbled dates next to vaccines in different languages that were often hard to decipher and interpret. Other families had no records of their child’s vaccinations. In those cases, we had to administer (over time) all vaccines that had not been accounted for previously. This is a waste of resources for sure, and unfortunate for the child who has to experience this all over again. Though we know its safe for the child to “receive a vaccine, even if he or she may have already received it”, there must be a better system in place (CDC 2022). As you mentioned, with a centralized repository providers could make better informed decisions. If there were some way to have a global database of any vaccination administered, of course this would be ideal!
Thanks for your post.
Colleen
Reference:
Centers for Disease Control and Prevention. (2022, October 15). Keep track of your child’s immunization records. Centers for Disease Control and Prevention. Retrieved December 7, 2022, from https://www.cdc.gov/vaccines/parents/records/keeping-track.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fparents%2Frecords%2Ffind-records.html
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Collapse SubdiscussionChristiana Nuworsoo Initial Post – The Application of Data to Problem-Solving
In a time such as these, where technology is so prevalent in our lives, it is quite baffling to find an environment that appears technologically advanced to still utilize paper charting for a procedure that could be detrimental if something goes wrong. I have seen at several hospitals that paper charting for blood transfusions is still being used. Although I am not completely against paper charting, steps can be easily skipped in the process allowing errors to occur. A consent form is incomplete if there is no RN witness to a provider’s education to the patient. However, I have seen several times when a patient needs a blood transfusion, but the consent form does not have an RN witness.
Several data could be used to determine if this practice is the best option. However, the data to concentrate on should be RN-to-RN verification because it involves several steps. According to Najafpour et al., the product’s safety is of utmost importance before a blood transfusion because it is where about 70% of the errors occur (2017). The RN verification process includes checking the physician’s order with the blood bank documentation; checking the patient’s name, DOB, and medical record number; checking the patient’s blood type with the donor’s blood type and Rh-factor compatibility; and verifying the blood has not passed its expiration date (Brookline College, 2022).
The collection of this data will be tedious and time-consuming. The Blood Bank can assist by providing a list of all patients in the hospital that have and are receiving blood products. Each patient chart will need to be retrieved with that list, and the RN verification form will be taken out. The forms will then need to be checked for accuracy, and those with errors will be set aside. The knowledge that might be derived from the data will be how often errors occur and whether they cause any harm to the patients, whether minor or severe.
Clinical judgment requires clinical reasoning. Clinical reasoning is practice-based reasoning requiring a background of scientific and technological research-based knowledge about general cases; it occurs within social relationships or situations involving patients, family, community, and the team of health care providers (Benner et al., 2008). A nurse leader can use clinical reasoning and judgment to form knowledge from this experience by analyzing the information collected and bringing it to the attention of other nurse leaders, where careful solutions could be brainstormed and applied. Then evaluate as time goes on if the solutions are beneficial. In my opinion, a computer-based application where each step must be completed before moving on to the next step is a good way to ensure that all information is verified before proceeding to transfuse. I understand that there are times when computers pose a technical issue, but I’ll rather have a technical issue to stop me from an error as opposed to human error that omits a step that could cause harm to the patient.
References
Benner, P., Hughes, RG., & Sutphen, M. (2008). Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US), 6. Retrieved 11/30/2022 from: https://www.ncbi.nlm.nih.gov/books/NBK2643/Links to an external site.
Brookline College. (2022). Step-by-step master’s guide to blood transfusions. Retrieved 11/30/2022 from https://www.brooklinecollege.edu/blog/a-step-by-step-guide-to-blood-transfusions/Links to an external site.
Najafpour, Z., Hasoumi, M., Behzadi, F., Mohamadi, E., Jafary, M., & Saeedi, M. (2017). Preventing blood transfusion failures: FMEA, an effective assessment method. BMC health services research, 17(1), 453. https://doi.org/10.1186/s12913-017-2380-3Links to an external site.
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Collapse SubdiscussionAdrienne Aasand Response #1:
Christiana,
Thank you for your post about collecting data on the RN-to-RN verification process for blood transfusions. Working in oncology, I order blood transfusions for our patients every day. As we are clinic based, we are not able to offer blood transfusions to our patients on site and must place the orders for transfusions to be given at partner hospitals. This makes things more complex as our providers are not at the hospitals to consent patients at time of transfusion. And our EMRs are different, so we need to use paper orders.
As you stated, blood transfusion errors occur frequently and can be detrimental to a patient’s health. The risk of a patient death occurring due to a preventable medical accident while receiving health care is about 1 in 300 (McGonigle & Mastrian, 2022). “Nursing professionals have an ethical duty to ensure patient safety” (McGonigle & Mastrian, 2022, p. 323). As you stated, using a computer system to verify each step would be ideal to minimize errors. I read one study comparing two different systems for recording bedside observations during transfusions at Oxford University. Overall, the study found that electronic bedside systems resulted in improved monitoring of transfusion-related observations compared to manual processes and provided improved early warning of adverse events (Staples et al., 2017). I think most nurses would agree, that an electronic tracking system for administering and monitoring blood transfusions would be very beneficial for our patients.
References
McGonigle, D. & Mastrian, K. (2022). Nursing informatics and the foundation of
knowledge (5th ed.). Jones & Bartlett Learning.
Staples, S., Noel, S., Watkinson, P., & Murphy, M. (2017). Electronic recording of transfusion-related
patient observations: A comparison of two bedside systems. Vox Sanguinis, 112(8), 780-787.
doi.org.10.1111/vox.12569
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Collapse SubdiscussionDawn Lorde Christiana,
Thank you for your post. The use of health information systems can be beneficial in monitoring patient care, improving patient care outcomes, and helping reduce medical errors (Popescu et al., 2022). Unfortunately, healthcare professionals make errors with blood transfusion administration. In the hospital where I work, electronic scanning is used when administering blood products. When the blood is picked up from the lab, the blood bank technician will request a copy of the consent, the patient’s labels, and the order. Additionally, the blood bank technician will scan the blood and verbally confirm the patient’s medical record number, blood type, unit number, and expiration date of the blood. When administering the blood to the patient, the nurse will verify the same data by scanning the patient and the blood product, and a second nurse will confirm the data.
I understand that there may be times when the system is down and computer scanning is impossible. However, a computer-based application is a key to helping minimize human error.
Reference
Popescu, C., EL-Chaarani, H., EL-Abiad, Z., & Gigauri, I. (2022). Implementation of Health Information Systems to Improve Patient Identification. International Journal of Environmental Research and Public Health, 19(22), 15236. MDPI AG. Retrieved from http://dx.doi.org/10.3390/ijerph192215236
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Collapse SubdiscussionErica Schulte Response 1
Hi all,
I enjoyed reading each of your posts! Ultimately, the general conclusion in the posts and also in research is that the most accurate and beneficial direction is to go with an EHR or some type of electronic charting. In addition, and most importantly, it is the safest alternative to these processes. In reading (McCarthy et al., 2022), it emphasizes the benefits not only from a safety aspect but efficiency and timing aspect as well.
To take this a step further, I think that your posts highlight the opportunities in a lot of hospital systems. Whether it be a paper versus electronic documentation or another process opportunity, creating the safest environment possible for the patients is of utmost important. The data that can be collected in this scenario, in addition to what is noted, could be the number of errors or mistakes that are created in each model. This should quickly begin to establish data and trends for nurse informaticists and leadership roles to make the best decision for a process moving forward.
The opportunity for gathering and understanding this data is best supported electronically as well. Look no further than the definition of a computer in the text. “An electronic information processing machine that serves as a tool with which to manipulate data and information.” (McGonigle & Mastrian, 2022).
References
McCarthy, B., Fitzgerald, S., O’Shea, M., & Condon, C. (n.d.). Electronic nursing documentation interventions. Wiley Online Library. Retrieved December 3, 2022, from https://onlinelibrary.wiley.com/doi/abs/10.1111/jonm.12727
McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the foundation of knowledge. Jones & Bartlett Learning.
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Collapse SubdiscussionOdion Iseki Hi Christina,
Great post. Several things could be looked at to determine if this is the best thing to do. But since RN-to-RN verification has more than one step, this is the data to pay attention to. Najafpour et al. say that more than 70% of mistakes happen during a blood transfusion. This makes product safety the most important thing. The nurse will double-check the doctor’s order against the blood bank’s paperwork and the patient’s name, date of birth, and medical record number. She will also compare the patient’s blood type against the donor’s blood type and Rh factor compatibility (Brookline College, 2022).
References
Benner, P., Hughes, RG., & Sutphen, M. (2008). Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US), 6. Retrieved 11/30/2022 from: https://www.ncbi.nlm.nih.gov/books/NBK2643/Links to an external site.
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Collapse SubdiscussionOluyemi Adeagbo The Application of Data to Problem-Solving
Introduction
The healthcare information revolution cannot get underestimated as it embodies a revolution. Clinicians partake in the need to have enhanced access to electronic treatment plans, health records, and diagnostics. Clinical collaboration and communication platforms keep simplifying the management of healthcare coordination, workflows, and patient outcomes (Seckman, 2019). The scenario in this setting exemplifies the use of nursing informatics in enhancing and cultivating patient care. Data access and system integration also showcase the importance of information analysis from an informatics viewpoint that ever happened in the healthcare space.
Data Utilization, Collection, and Assessment
The strategy behind utilizing healthcare data to avail the best care entails the comprehension of nursing informatics, its meaning, and the concepts behind it. Nursing informatics integrates nursing science with other expanses to recognize, manage, communicate, and manage wisdom, information, data, and knowledge. The principal aim behind nursing informatics remains to provide excellent patient-centered care.
Nursing informatics in the mentioned scenario related to improving patient care can get used on different fronts. The areas of nursing informatics use include improving clinical procedures, processes, policies, and protocols, aligning clinical care and workflow with the best nursing practice, and choosing new medical instruments (Nagle et al., 2017). Nursing data also presents a great avenue to make available a learning and training platform founded upon objective data.
Choosing and testing innovative medical instruments connected to the Internet of Things (IoT) can avail enormous amounts of patient data (Seckman, 2019). Nursing informaticists get trained to apprehend the true essence of such data and offer recommendations regarding the most appropriate techniques to record, access, and use the collected data. Nursing informaticists can likewise utilize data collected through inpatient and outpatient care engagements to classify endemic issues connected to the healthcare institution. The above will provide a learning environment for continuing in-house training, orienting new staff, and during external certification and education.
Nurse Leaders using Clinical Judgement and Reasoning
Nurse leaders can adapt to clinical judgment and reasoning within the health organization to collaborate and communicate with interdisciplinary teams regarding patient information. For instance, nurse leaders can identify gaps, offer recommendations, and audit individual patient cases to avert future errors. Clinical judgment and reasoning become the fabric of organizational effectiveness from a management and financial point of view (Lee & Lee, 2020). Subsequently, nurse leaders can produce processes and protocols that warrant adequate interaction and communication between patients, departments, and teams. They can assist healthcare staff in seeking out hidden truths by maximizing electronic health records. From the above, healthcare organizations can help map their sustainable work from an ethical viewpoint by aligning with data insights.
Conclusion
Through nursing informatics assimilation, nurse leaders can recognize high-risk patients and avoid severe conditions by taking preventive actions early. For example, utilizing automated alerts increases the chances of practitioners mitigating warning signals and taking patients from potentially deadly situations. More institutions should embrace nursing informatics as a pathway to improve patient outcomes. Finally, nursing informatics will continue morphing and opening up new frontiers in the healthcare industry as technology advancements keep emerging.
References
Lee, M., & Lee, S. (2020). Implementation of an electronic nursing record for nursing documentation and communication of patient care information in a tertiary teaching hospital. CIN: Computers, Informatics, Nursing, 39(3), 136-144. https://doi.org/10.1097/cin.0000000000000642Links to an external site.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies for Nurses in the Future of Connected Health, 212-221. https://doi.org/10.3233/978-1-61499-738-2-212Links to an external site.
Seckman, C. (2019). Summer institute in nursing informatics 2019 healthcare informatics: Catalyst for value-driven care transitions. CIN: Computers, Informatics, Nursing, 37(11), 558-563. https://doi.org/10.1097/cin.0000000000000599Links to an external site.
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Collapse SubdiscussionOdion Iseki Hi Oluyemi
I like your post it is on point and clear to understand. The significance of the changes brought about by the information revolution in healthcare cannot be overstated. Clinicians want better access to electronic treatment plans, health information, and diagnostics. As clinical cooperation and communication technologies improve (Seckman, 2019), it’s getting easier to manage how healthcare is coordinated, how work is done, and how patients do it. This case shows how nursing informatics can be used to help patients get better and more care.
References
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies for Nurses in the Future of Connected Health, 212-221. https://doi.org/10.3233/978-1-61499-738-2-212Links to an external site.
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Collapse SubdiscussionSheila Ankrah Response,
Hi Oluyemi,
Thanks for such an informative post. The integration of healthcare and technology has resulted in a change in the health care industry from paper data to electronic data-keeping. The innovation in electronic health records makes it easy for nurses to verify physician’s orders via the computerized order entry system (Jimenez, 2017). Nursing informatics is significant in healthcare as it improves nursing practice and patient survival or improvement (Ivey, 2021).
Data collection is paramount in the healthcare industry as it helps in the efficient and effective delivery of care to patients. For instance, the ICD- coded data have been progressively and broadly used for illness surveillance, research, decision and policymaking, resource allocation, quality, and safety to improve peoples’ health (Otero et al., 2021).
At my place of employment, often, informatics experts also come around to keep us updated on any new system upgrade that all nurses need to be abreast with. I understand how we get upset for being distracted with our workload when these IT experts come around. However, let’s not also forget that they do this in the best interest of patients.
Cerner is very effective in identifying code sepsis, and it usually alerts all assigned clinicians, including MOD/MON, charge nurse, and other nursing leaders, for prompt interventions and treatment.
References
Ivey, J. (2021). Nursing Informatics Research. Pediatric Nursing, 47(1), 45–46.
Jimenez, M. (2017). Effects of Barcode Medication Administration: Literature Review. Proceedings of the Northeast Business & Economics Association, 157–160.
Otero Varela, L., Doktorchik, C., Wiebe, N., Quan, H., & Eastwood, C. (2021). Exploring the differences in ICD and hospital morbidity data collection features across countries: an international survey. BMC Health Services Research, 21(1), 308. https://doi.org/10.1186/s12913-021-06302-wLinks to an external site.
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Collapse SubdiscussionOlufunke Ajayi-Festus Oluyemi,
Good post! Healthcare delivery has really evolved since the introduction of healthcare informatics, we are able to do much and collaborate more especially with the automated alerts you mentioned in your conclusion. Lives have been saved through those alerts, if the nurse misses it, the rapid response team will not, t least someone will catch it, especially in case of sepsis alert and this will result in prompt treatment.
Reference
Ivey, J. (2021). Nursing Informatics Research. Pediatric Nursing, 47(1), 45–46.
Jimenez, M. (2017). Effects of Barcode Medication Administration: Literature Review. Proceedings of the Northeast Business & Economics Association, 157–160.
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Collapse SubdiscussionAdrienne Aasand Module 1 Discussion: The Application of Data to Problem-Solving
Description of scenario
I work for a private practice oncology clinic. Within our practice we use multiple different systems to collect patient data. For example, radiation oncology and medical oncology work closely to create treatment plans for patients, and often patients are receiving concurrent chemo and radiation. However, in addition to using the medical oncology EMR, the radiation oncology team has a separate medical record system that only they have access to. In addition, the lab, pharmacy, scheduling and billing departments all have separate systems that nurses do not have access to. “Accessibility is a must; the right users must be able to obtain the right information at the right time and in the right format to meet their needs” (McGonigle & Mastrian, 2022, p. 24). With these different systems, as a medical oncology nurse, I typically have to rely on others in the clinic to provide information to me that I need in a timely manner. This can lead to delayed communication with patients regarding medications, results, or treatment plans.
Access to Data and Knowledge Gained
My proposed change to this scenario is to give medical oncology nurses access to the radiation oncology EMR. With this data, the knowledge gained would include:
- Radiation start dates and length of therapy
- Radiation therapy side effects and held treatments due to toxicity
- Supportive medications ordered for side effects
- Follow up scans and provider visits
With this gained knowledge, medical oncology nurses would be able to easily order the patients’ chemotherapy to be given concurrently with radiation therapy. Specifically, timing of treatments could be properly coordinated as the treatments are given in different facilities. In addition, when patients call our triage nurses with complaints of symptoms or treatment side effects, we would be able to access radiation’s data to determine the cause of symptoms and how to best treat the patient. Last, this data would avoid both the radiation oncologist and medical oncologist ordering follow up scans. We would be able to see what scans are ordered and one can be reviewed by both providers for follow up evaluations. This access to data would save time for nurses and schedulers. “Time management is a prevalent issue in the healthcare setting, thus the use of informatics to aid and organize and not create barriers is essential” (Sweeney, 2017, section 3). Overall, sharing this data would allow both teams to provide more informed, better-quality care to the patients.
Nurse Leader’s Formation of Knowledge
A nurse leader is constantly using clinical reasoning and judgement in the formation of knowledge. In this scenario, the nurse should use their basic nursing education, combined with clinical experience in medical and radiation oncology to better utilize this new access to data. For example, if a patient calls with a new skin rash and he is taking oral chemotherapy while getting concurrent radiation therapy, the nurse leader can use the data from the radiation therapy system, combined with their knowledge of expected treatment side effects to properly diagnose and treat the patient’s symptoms. Data alone cannot help the nurse solve the problem, the “acquired data must be processed into knowledge” (McGonigle & Mastrian, 2022, p. 9).
In addition, it is the responsibility of the nurse leader to be aware that there can be risks to sharing data and to help facilitate this data sharing in a way that is still protecting patient information. According to McGonigle & Mastrian, “solid leadership, guidance and vision are vital to the maintenance of cost-effective business performance and safe, cutting-edge information technologies for the organization” (2022, p. 28). With this gained data and knowledge, it is the responsibility of the nurse and the nurse leader to use the data professionally and use it for the benefit of patients. To do this, communication between the two departments as well as with practice management is essential to detect and resolve any issues that may come from this new process.
References
McGonigle, D. & Mastrian, K. (2022). Nursing informatics and the foundation of
knowledge (5th ed.). Jones & Bartlett Learning.
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
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Collapse SubdiscussionChristiana Nuworsoo Adrienne,
Good post. As a nurse, I would find it quite difficult to work in an environment where patient information is difficult to access. I wonder if there is a specific reason why radiation oncology EMR is different from the medical oncology EMR. At my current place of employment, the ED uses a different EMR from what is used on the units; however, our systems are created by the same company and thus are integrated. Therefore, patient information from the ED EMR can be accessed on the floors for better continuity of care, even though we might not have access to the day to day processes in the ED. Also, patient information is easily accessed by all hospitals within the network.
It seems that your facility needs an integrated EMR. EMR integration connects multiple digital systems or devices enabling the smooth flow of clinical data, communications, and coordination between multiple systems (Majumdar, 2022) With an integrated system, medical oncology providers and caretakers will have access to patient information entered by radiation oncology with just the click of a few buttons. Integrated EMRs offers quick and easy access to patient information as wells as better health outcomes (Hyland Healthcare, 2022).
References
Hyland Healthcare. (2022). EHR integration solutions. Unify your EHR to achieve a truly integrated electronic health record. Retrieved 12/4/2022 from https://www.hyland.com/en/healthcare/content-services/healthcare-integrations/emr-integrationsLinks to an external site.
Mujumdar, S. (2022). EMR Integration: A comprehensive guide. Retrieved 12/4/2022 from https://www.selecthub.com/medical-software/emr/emr-integration/Links to an external site.
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Collapse SubdiscussionRaminder Kaur The widespread adoption of technology is transforming healthcare delivery. When treating patients, choosing between an electronic health record and a paper chart has been crucial. Information loss, poor retrieval, and a lack of standards among doctors and healthcare organizations are significant issues with traditional paper medical records. The healthcare industry has been entirely transformed by health information technology (HIT) to benefit both patients and providers. Communication is made more accessible, costs are reduced, efficiency is increased, patient outcomes are improved, and patients are more involved in their care.
With the introduction of the electronic medical record (EMR), the process of finding patient information and interpreting doctor instructions has been streamlined. Electronic medical records, or digitalized paper charts, include information about diagnoses, allergies, medical histories, vaccination dates, lab results, prescriptions, and the doctor’s comments.EMR frameworks are fit for every errand, including logging patient data, setting up arrangements, composing solutions, looking at protection, and so on. One of the forces transforming healthcare is thought to be the electronic medical record (EMR). From a patient care perspective, it is anticipated that an electronic medical record (EMR) will improve information accuracy, facilitate clinical decision-making, and improve information accessibility for continuity of care.
EMRs may provide healthcare workers with a dependable, centralized source of patient data (Jedwab, Chalmers, Dobroff, & Redley, 2019). In the area I work, bustling psychiatric patients in an acute care facility, it is essential for security and safety to identify risk factors for suicide and self-harm promptly. The EMR has significantly impacted time management and improved patient safety by acquiring data information. In the internet age of virtual monitoring and electronic sensors, a new tool has been added to nursing for the ongoing observation required to stop self-harming behavior. According to Nagle, Sermeus, & Junger (2019), many members of the healthcare team now regularly have access to remote patient monitoring, which has the potential to enhance treatment quality and patient safety.
The development of telepsychiatry has also led to improvements in safety concerns. The coronavirus disease (COVID-19) makes it particularly difficult to provide mental health care. An option in contrast to face-to-face assessments is telepsychiatry, which can be imaginatively joined with other innovations to develop care further. Many distressed patients find it difficult or uncomfortable to drive themselves to mental health consultations. In light of the absence of subject matter experts and the developing patient interest, telepsychiatry is presently utilized in more excellent medical services settings (Donley, McClaren, Jones, Katz, and Goh, 2017). Technology has closed the gap between the lack of specialists and patient safety. The electronic psychiatric appointment is delivered to the patient in several inpatient and outpatient settings. A crucial component of psychiatry treatment is the virtual capability of telepsychiatry, which has reduced the risk of harm to patients and staff during appointment transportation.
References
A; N. L. M. S. W. J. (2017). The evolving role of the Nursing Informatics Specialist. Studies in health technology and informatics. Retrieved November 28, 2022, from https://pubmed.ncbi.nlm.nih.gov/28106600/Links to an external site.
Donley, E., McClaren, A., Jones, R., Katz, P., & Goh, J. (2017). Evaluation and Implementation of a Telepsychiatry Trial in the Emergency Department of a Metropolitan Public Hospital. Journal of Technology in Human Services, 35, 292 – 313.
Honavar, S. G. (2020, March). Electronic Medical Records – the good, the bad, and the ugly. Indian journal of ophthalmology. Retrieved November 24, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043175/Links to an external site.
Jedwab, R.M., Chalmers, C., Dobroff, N., & Redley’, B. (2019). Measuring nursing benefits of an electronic medical record system: A scoping review. Collegian.
Nagle, L. M., Sermous, W., & Junger, A. (n.d.). Evolving role of the Nursing Informatics Specialist. Studies in health technology and informatics. Retrieved November 30, 2022, from https://pubmed.ncbi.nlm.nih.gov/28106600/Links to an external site.
Smith, K., Ostinelli, E., Macdonald, O., & Cipriani, A. (2020). COVID-19 and Telepsychiatry: Development of Evidence-Based Guidance for Clinicians. In JMIR Mental Health (Vol. 7, Issue 8, p. e21108). JMIR Publications Inc. https://doi.org/10.2196/21108Links to an external site.
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Collapse SubdiscussionBenedicta Kwevie Hi Raminder
I agree with you and your post. In my early years as a nurse, I had to work with paper medical records and charting. It was efficient at times, but on most occasions, patient records and files had gone missing, and since the patient had a hard time recollecting some information, we were unable to know the things we needed to treat them safely. Checkpoint HER (2017) brings up the matter of the location of files. “Paper records are vulnerable to being permanently lost or temporarily misplaced. Man hours are required to hunt down any missing files. Natural catastrophes such as fires, hurricanes, tornadoes and earthquakes—or even a break-in—can result in a permanent loss of paper records. EHRs are stored digitally on systems that are backed up for safekeeping.” Electronic medical records of a patient can be saved and kept safe from anything that might hinder giving the patient the correct care they need.
Reference
Benefits of EHR vs. Paper Records | Checkpoint by Integrity Support.
(2017, June 12). Checkpoint EHR.
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Collapse SubdiscussionOlufunke Ajayi-Festus Thoughts on how the development of IT has helped address the concerns about patient safety raised.
The Institute of Medicine (1999) published a well-known report that started a national effort to decrease medical errors in institutions across the country. Despite efforts to reduce errors, medical errors continue to occur at a high rate. According to an article written by Kavanagh, Saman, Bartel, and Westerman (2017) there continue to be well over 200,000 preventable deaths each year due to medical errors.
After IOM’s report, there have been significant strides made to encourage healthcare professionals to report errors to improve safety. According to Bleich (2005), before the report came out, 15 states had mandatory error reporting systems. Since the report, the number increased to 22 states (Bleich, 2005). Strides have also been made in technology to assist in reducing errors with medication administration.
We, as nurses, must stay diligent in checking and double-checking ourselves and not try to take shortcuts around safeguards put in place. As younger nurses join the field of nursing, they are much more tech-savvy than ever before. Many times, it is much quicker to cut corners, however, that can be the downfall of progress made.
In hospitals across the country, medication errors have been a common occurrence. I joined my current hospital where I work about six years ago and was very impressed with the IT system they use to administer medication. If followed properly, a lot of medication errors could be avoided, of course, the system is not foolproof. However, there have been great strides made to improve medication administration. Even with all of this improved technology, studies have shown that nothing takes the place of making sure new nurses have the training and mentoring from more experienced nurses (Orbaek, Gaard, Fabricius, Lefevre, and Moller, 2015).
References
Bleich, S. (2005). Medical Errors: Five Years After the IOM Report. Semantic Scholar. Retrieved from https://pdfs.semanticscholar.org/b132/d78f82d6a8f8f724069f6fbe4bdb85181b 2e.pdf
Institute of Medicine. (1999). To err is human: Building a safer health system. Retrieved from
http://webarchive.org/web/20141016134546/http://www.iom.edu/s/1999/To-Err-is-Human/To %20Err%20is%20Human%201999%20%20report%20brief.pdf
Kavanagh, K.T., Saman, D.M., Bartel, R., and Westerman, K. (2017). Estimating Hospital-Related Deaths Due to Medical Error: A Perspective from Patient Advocates. Journal of Patient Safety, 1-5. DOI: 10.1097/PTS.0000000000000364
Orbaek, J., Gaard, M., Fabricius, P., Lefevre, R., and Moller, T. (2015). Learning and Teaching in Clinical Practice: Patient Safety and Technology-Driven Medication- A Qualitative Study on How Graduate Nursing Students Navigate Through Complex Medication Administration. Nurse Education in Practice, 203-211. doi: 10.1016/j.nepr.2014.11.015
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Collapse SubdiscussionRoberto Monroy An electrotonic health record (EHR) is essential in keeping a patient’s complete health history within reach of providers. If utilized correctly, they can significantly improve patient care by bridging the gap between providers. As an article states, “Mental health practitioners interested in adopting EHRs should establish a strong collaborative partnership with primary care physicians and clinic case managers to enhance bidirectional communication and information exchange about patients’ general medical and behavioral health concerns. Doing so will improve care coordination and the likelihood of identifying risk and protective factors associated with treatment planning, adherence, and improved outcomes.” (McGregor et al. 2015)
I currently work in an inpatient psychiatric ICU; In my organization, we lack EHRs and rely only on paper charting. This causes many issues as new patient data is collected at the point of admission. Many times, especially in mental health, patients are poor historians and cannot fully recall their medical diagnoses, medication names, dosages, frequency, etc. This leads to staff playing “catch up” until a caregiver or provider is found. This delay in care can be resolved by implementing electronic health records in our facility. In Mental health facilities, electronic records were shown to be 40 percent more complete and 20 percent faster to retrieve versus paper charting. (Tsai & Bond, 2008)
E-mental health is also an interesting and beneficial approach to treating patients with mental health disorders. Similarly to telehealth, E-Mental health utilizes technology to deliver treatment in remote settings. In addition to providing treatment,”…e-mental health systems can collect individual data to detect mental health symptoms and develop personalized programs that overcome the barriers to seeking help.” (Timakum et al., 2020). By implementing these useful data collection tools, providers and healthcare workers will be provided with clear complete health histories at a moment’s notice, leading to better patient care and better patient outcomes.
References
McGregor B, Mack D, Wrenn G, Shim RS, Holden K, Satcher D. Improving Service
Coordination and Reducing Mental Health Disparities Through Adoption of
Electronic Health Records. Psychiatr Serv. 2015 Sep;66(9):985-7. doi:
10.1176/appi.ps.201400095. Epub 2015 May 15. PMID: 25975885; PMCID:
PMC4558322.Tsai, J., & Bond, G. (2008). A comparison of electronic records to paper records in mental health
centers. International journal for quality in health care : journal of the International
Society for Quality in Health Care, 20(2), 136–143.
https://doi.org/10.1093/intqhc/mzm064Links to an external site.Timakum, T., Xie, Q., & Song, M. (2022). Analysis of E-mental health research: mapping the
relationship between information technology and mental healthcare. BMC
Psychiatry, 22(1), 57. https://doi.org/10.1186/s12888-022-03713-9Edited by Roberto Monroy on Nov 30, 2022 at 5:51pm-
Collapse SubdiscussionMleh Porter Hello Roberto,
I enjoyed reading your post and agree that electronic health records (EHR) can significantly improve patient care by allowing all providers to access vital patient information. All the healthcare systems I have worked in use EHR, making it easier to collect data at the time of admission since the information from other visits also populates. It can be time-consuming and more challenging to collect information when you must do it using a paper charting system with your current health organization. Even with the best historians, some of that information can get lost. In addition, some of the writings may not be legible, which could create room for potential errors.
There are benefits to using an EHR system. According to a source, more than 60% of hospital medication errors were due to illegible handwriting (Hoover, 2017). EHRs have reduced adverse drug events by 52% (Hoover, 2017). Nurses still have to do their due diligence to ensure that they follow the five rights of medication administration. Although the EHR I use in my current hospital is not foolproof, it will alert the nurse if the wrong medication is scanned.
The laboratory (lab) department calls nurses to report critical lab results, but the EHR system also alerts a nurse to critical lab values. Another benefit of the EHR system is showing nurses lab trends for the patient (Hoover, 2017). Fortunately, we have nursing informatics professionals who help healthcare organizations use these technologies and bridge the gap between the healthcare’s clinical and technical perspectives (Healthcare Information and Management Systems Society, 2022).
References
Healthcare Information and Management Systems Society. (2022, June 29). What is Nursing Informatics? December 2, 2022, from https://www.himss.org/resources/what-nursing-informatics
Hoover, R. (2017). Benefits of using an electronic health record. Nursing Critical Care, 12(1), 9–10. https://doi.org/10.1097/01.ccn.0000508631.93151.8d
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Collapse SubdiscussionMansong Ntekim Hi Roberto,
Thanks for sharing your perspective with us. It is surprising that some healthcare facilities still opt to paper charting despite the advantages of EHR over paper charting.
EMR has been recognized as a major transformational tool of the healthcare system. From a patient care perspective, EMR has improved the accuracy of the information, improved clinical decision-making and improved the easy accessibility of information for continuity of care. It has also generated vital health care statistics vital to the planning and management of health care services. (Honavar, 2020).
I am surprised that an acute care setting like yours would lack the benefit of the EHR. As you mentioned that some of the patients have difficulty giving needed information at the point of admission and care, leaving the care givers to guess and play “catch-up” while waiting for a provider. Such delay in care could be eliminated with an electronic system that that readily populates information from prior hospitalizations.
Hopefully, more facilities will adopt the EHR and make information more accessible to the staff for the benefit of the patients.
References
Honavar, S. (2020). Electronic Medical Records – The Good, the Bad and the Ugly. Indian Journal of Ophthalmology, 2020 March, 68(3): 417-418. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043175/
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Collapse SubdiscussionQuenyaita Ferguson The Application of Data and Problem Solving
It’s exciting to witness how EMR’s (Electronic medical records) have transformed the healthcare system. In the past before computers, using a pen and paper was the only option for healthcare workers. Thankfully, paper charting is history. According to the ARRA (American Recovery and Reinvestment act), all healthcare providers were required to convert all medical charts to a digital form (Burchill, 2010).
I work in a hospital as a lactation consultant. As a lactation consultant, we monitor the infant’s weight and pay close attention to intake and output. Having accurate data is crucial. We use weighted feeds to determine how much breastmilk an infant takes during a feeding session. This data is entered into our EMR. Our system records clinical data keeping records of all intakes, outputs, weights, and lots more. The system not only stores the information, but it also converts the information into a graph or a chart. Just at a glance, I’m able to determine if my patient’s weight is trending up, down, or maintaining. The same information is available to patients. Knowing this information helps when I’m providing recommendations to my patients. It’s also helps with problem solving, decision making, and ensures that I provide quality care.
As a lactation nurse knowing if an infant is transferring milk is essential for mom and baby. When assessing a patient as a lactation consultant our two main objectives are quality of breastfeeding and most importantly weight gain. The nurse leader having this information will assist in determining the best approach to take care of mom and baby. Essentially both the healthcare provider and the patient benefits from the EMR. Having accurate information literally at a glance enables rapid understanding and aids in the quality of care.
Burchhill KR. (2010). ARRA and meaningful use: is your organization ready? Journal of Healthcare Management, 55(4), 232–235.
Game, C. (1996). Nursing-related information and data: what is the role of computers in nursing practice? Collegian (Royal College of Nursing, Australia), 3(3), 20–22. https://doi.org/10.1016/s1322-7696(08)60175-4Links to an external site.
Healthcare Information and Management Systems Society (HIMSS) (2022). What is Nursing Informatics? Retrieved from https://www.himss.org/resources/what-nursing-informaticsLinks to an external site.
McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers.
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Collapse SubdiscussionAndrea M Allen The Application of Data to Problem Solving
Initial Post
During my 22 years of working in healthcare as a registered nurse, both in acute setting and long term setting, Fall Prevention strategies has evolved from identifying patients via Morse Scale and placing high risk patients within eyesight at the nurses station to using various strategies such as call light within reach, positioning patients, checking and treating patients pain to using an Audio Computer-Assisted Self Interview (ACASI) to screen for example older folks that are high risk for falls.
Though Educating patients on fall prevention as well as safety, limiting fall risks that can eventually predispose individuals to injury and untimely death, decrease mobility, nursing home placement, hospitalization or decrease independence has not prevented falls. Research has shown that in empowering nursing informatics, there has been an increase in fall prevention through the use of quality improvement. Data that could be used for example are number of falls each month, number of patients who fall each month, number of patients with two or more falls each month and number of falls with serious injury each month as key indicators. These data could be used as key indicators for outcome measures. In addition, data such as changes in staff awareness and patient satisfaction as well as changes in staff organization could be considered. Gathering this information could identify trends related to falls such as time of day, activity and types of fall. The nurse leader can then use clinical reasoning and judgment with the use of nursing informatics to implement new fall prevention strategies and increase staff awareness for accurate reporting of falls through tracking records. As fall rate begins to decline, eventually more advance measures to prevent falls will be instituted in order to prolong elderly patients independence and eventually their untimely deaths.
Ogbuokin, U. (2022). Using Audio Computer -Assisted Self Interview (ACASI) to S in an Outpatient creen Older Adults for Fall Risk in an Outpatient Primary Setting http://www.himss,org/ojniLinks to an external site.
Sweeney, J. (feb. 2017). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21(1),
McGonigle, D., & Mastria, K.G (2022). Nursing Informatics and the foundation of Knowledge (5th ed.). Jones & Bartlett
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Collapse SubdiscussionRoberto Monroy Hello Andrea!
Gathering data to prevent falls is a great idea; falls, especially in the elderly, could have devastating consequences. As nurses, we have the responsibility to protect our patients from harm. Nazarko states, “Our role is to work with the older person to reduce risk wherever possible and to enable the person to lead a full life. This involves balancing risk and quality of life and supporting the person at risk of falls and respecting choices that the person makes.” (Nazarko, 2012).
One study conducted stated, “Annually, hospital-acquired falls result in an estimated $34 billion in direct medical costs. Falls are considered largely preventable and, as a result, the Centers for Medicare and Medicaid Services have announced that fall-related injuries are no longer a reimbursable hospital cost.” (Bjarnadottir & Lucero, 2018). Implementing measures to predict and prevent falls protects patients’ well-being and safety and can save hospitals substantial amounts of money. In an ideal world, these funds can be used to create more data-collecting programs to help protect patients from preventable accidents.
References
Nazarko, L. (2012). How to reduce risk of injury if a person remains at risk of falls. British Journal
of Healthcare Assistants, 6(9), 432–437.Bjarnadottir, R. I., & Lucero, R. J. (2018). What Can We Learn about Fall Risk
Factors from EHR Nursing Notes? A Text Mining Study. EGEMS
(Washington, DC), 6(1), 21. https://doi.org/10.5334/egems
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Collapse SubdiscussionBarkisu Fortenberry NURS-6051N Week 1 Discussion
Discussion: The Application of Data to Problem-Solving
A pregnant patient requested a doctor’s appointment at the OB/GYN clinic. I was able to learn that she went to the hospital and had tests done while she was thereafter triaging her and asking a few questions. A pregnancy test provides the information that may be used. These outcomes would inform us of any necessary follow-up tests. We could find out if she has been prescribed any meds or is presently doing so. The service provider had access to the hospital’s files. Lab results, ER visit notes, patient medical history, and demographic data were gathered.
The physician may upload the patient’s records if a patient is a mutual patient at our clinic. Additionally, they have the ability to receive faxes with patient data. They have access to information about the patient’s health issues, past and present drugs, results of blood tests, and vital signs. Clinicians and patients use email, personal data devices, electronic medical records, vital sign machines, glucometers, and online portal systems, to name a few, whether they are inpatients or outpatients (Sweeney, 2017). Because electronic nursing documentation enables real-time communication among all healthcare practitioners, health information technology (HIT) and nursing documentation directly affect patient safety (Lavin,Harper & Barr, 2015).
In order to make decisions about the patient’s care, a nurse leader would gather information about their status. They would next create a treatment plan using this information. This will assist in deciding what kind of care should be given. Clinical reasoning and critical thinking go hand in hand. Clinical reasoning involves generating every possible course of action, evaluating all assessment data, anticipating potential consequences for each, prioritizing activities, and remaining flexible and open to alternatives (Manetti, 2018).
References:
Manetti, W. (2018). Sound clinical judgment in nursing: A concept analysis. Nursing Forum, 54(1), 102–110. doi: 10.1111/nuf.12303.
Lavin, M. A., Harper, E., & Barr, N. (2015, May). Health Information Technology, Patient Safety, and Professional Nursing Care Documentation in Acute Care Settings. Retrieved February 23, 2020, from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJ IN/TableofContents/Vol-20-2015/No2-May-2015/Articles-Previous-Topics/TechnologySafety-and-Professional-Care-Documentation.html.
Sweeney, J. (Feb, 2017). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21( 1), Available at http://www.himss.org/ojniLinks to an external site..
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Collapse SubdiscussionBenedicta Kwevie In this scenario, a patient comes in and reports being admitted multiple times before this but cannot recall the specifics or details of the admissions and has missing medical records.
Healthcare providers strive to give patients the best care possible. However, that plan can alter when problems arise, especially with manual charting. With this, some patient records might get lost due to misplacement, which takes up more time than electronic charting. When it comes to manual record keeping, there is a risk of fragmentation due to different records being with different health providers and losing records. There is also more time spent on manual documentation than electronic (Slyngstad & Helgheim, 2022), leading to a loss of productivity. Then there is the issue of the records being accessible to only one person at a time. Technology can help in this scenario by telling whether the patient’s relevant information is collated into an Electronic Health Records (EHR) system, which would not only drastically reduce the risk of loss of records, but will also make it so that moving forward, all Healthcare providers have access to the patient’s past records (treatment regimen and whether they worked) without much trouble. Integrating technology in this scenario would also help make the nurse’s routine tasks quicker and more efficient (Scott, 2021). An example of this will be the nurse’s ability to monitor the patient’s vital signs utilizing portable/ wearable monitoring devices while simultaneously performing other tasks. Using technology here will also enhance communication with other healthcare team members in that any information which may have been missed during the handoff of the patient will be quickly accessible by multiple team members simultaneously.
The data that could be used is their history of admittance in all hospitals, as electronic charting and documentation can keep all patient information and history, test/lab results, demographics, progress notes, medications, and past medical history. The data can be collected by getting the extended and complete history of the patient and reaching out to other facilities the patient has visited or been admitted to and can be accessed by cumulating all the data and information into a patient file that can be easy to find and locate. The knowledge derived from the data collected in the electronic chart can be the patient’s medical history and records, their health history, medications, and all sorts of things that would aid in providing care for the patient. A nurse leader could use clinical reasoning and judgment by reviewing and getting familiar with the different parts and sections of the patient’s electronic file and all the data inserted into it. They can implement their own methods and systems when they are familiar with them and know how to navigate the file and the patient’s history.
References:
Nursing Informatics – Canadian Nurses Association. (n.d.-b). Higher Logic, LLC.
https://www.cna-aiic.ca/en/nursing/nursing-tools-and-resources/nursing-informatics
The Impact of Technology in Nursing: Easing Day-to-Day duties. Available at
Scott, J. (2021).
https://healthtechmagazine.net/article/2021/05/impact-technology-nursing-easing-day-to-day-duties-perfcon
How Do Different Health Record Systems Affect Home Health Care? A Cross-Sectional Study of Electronic – versus Manual Documentation System
Slyngstad, L. & Helgheim, B.I. (2022)
https://pubmed.ncbi.nlm.nih.gov/35237067/
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Collapse SubdiscussionDawn Lorde Scenario:
A 57-year-old male arrives in the emergency department with nausea and vomiting for two days. The patient states that he has a history of diabetes, and his sugar level has been over 400 mg ml. The patient complains of weakness and is slightly confused.
Describe the data that could be used and how the data might be collected and accessed:
The patient is a poor historian and could not tell me everything about his medical history. I placed the patient on a monitor and obtained vital signs. Additionally, I performed an EKG and obtained blood work. The patient was hypotensive and tachycardic, which was concerning. After receiving all the lab results, it was confirmed that many of the tests were abnormal, and the patient was in critical condition.
What knowledge might be derived from that data?
I looked up the patient’s medical history using the electronic patient record [EHR] (Vernice, 2019). I obtained the patient’s pertinent medical history, which revealed a history of diabetes, heart attack, and hyperlipidemia. In reviewing the current lab results, it was evident that the patient was in diabetic ketoacidosis. His blood glucose was 1059, his potassium level was 6, his lactate acid was 4.43, and his Co2 was 8. I knew he was my most critical patient, and I had to prioritize my care and attention.
How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
The patient’s potassium level was 6, his lactate acid was 4.43, and Co2 was 8. I knew he was my most critical patient, and I had to prioritize my care and attention to him. In gathering all the data on the patient’s history and current lab results, I treated the patient quickly with intravenous (IV) insulin and IV fluids. The emergency room is high-stress and fast-paced, which can lead to medication errors if the nurse is not careful. The help of a computerized system can help reduce medication errors by scanning the patient and the correct drug (Suh et al., 2021). A medication such as insulin requires a double check by another nurse to confirm accuracy. With all the data obtained, the patient can be quickly transferred to the ICU to improve his patient care outcome.
References:
Suh, S. R., Kim, J., & Song, Y. (2021). The predictive factors of medication errors in clinical nurse. Journal of Health Informatics and Statistics, 46(1), 19-27.
Vernice, C. (2019). Informatics in nursing. Current and future trends. Applied Medical Informatics, 41, 35.
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Collapse SubdiscussionJodian Walford Healthcare Informatics is “the integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information” (Saba & McCormick, 2015, p. 232). The invention and continuous upgrade of healthcare technology aim to save time and lives by reducing human errors.
I am an international nurse who moved to the USA recently from a small Caribbean Island. Before coming to the USA, I worked in a small hospital that still uses paper charting, which has been a norm in the nursing forum for years. Coming to the USA, I have upgraded to the use of EHR. Paper charting has been noted to be more time-consuming than electronic Health recording and is also more susceptible to human errors and mistakes. Electronic records organize the data collected, which reduces medication errors and misdiagnoses.
Documentation is vital in treating patients. Care is continuous and relies heavily on shift reports and documentation to ensure patient safety and illuminate errors, especially in medication administration. Let’s use the hypothetical scenario; Hospital A uses paper charting. RN Jane, a new graduate, works in this hospital. She has a patient on once-daily Heparin 5000u SC. Jane did what she was supposed to and got a colleague to check and administer the due medication as prescribed. However, after administration, Jane forgot to go and sign the medication card. She went on to complete other documentation and other assigned tasks. Another nurse comes on and decides to help serve all the unserved medication. As she was ready to serve RN Jane’s patient Heparin 5000u SC, she went and got a colleague to do her second checks and verify the patient. Luckily, the same nurse went with jane to serve the medication. She immediately recalled that she had already checked with RN Jane, who had already administered the drug. Medication errors are estimated to harm at least 1.5 million patients annually in the US, with about 400,000 preventable adverse events (Agrawal, 2009).
Electronic charting would have eliminated that error. The patient armband and medication barcode would have been scanned into the system. Upon entering the same patient data again, it would have given an alert that medication was already dispensed for this patient. RN Jane would not have been able to do another documentation on the same device without signing for that served medication. HealthStream (2021) states that medical errors cost nearly $40 billion annually, and many of those errors are preventable with informatics. Not only does information provide nurses with alerts to avoid mistakes, but it also helps to automate specific tasks, improving nurse productivity and preventing some of the costs associated with health care.
References
Abha Agrawal, A. (2009). Medication errors: prevention using information technology systems. British Journal of Clinical Pharmacology, 67 (6), 681-686.
https://doi.org/10.1111/j.1365-2125.2009.03427.xLinks to an external site.
Healthstream (2021). How Nursing Informatics Benefits Quality Outcomes. Retrieved November 30, 2022 form
https://www.healthstream.com/resource/blog/how-nursing-informatics-benefits-quality-outcomes#:~:text=Here%20are%20some%20examples%20of%20the%20benefits%20of,Cost%20Savings%20…%204%20Improved%20Care%20Coordination%20Links to an external site.
Saba, V. K. & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York: McGraw-Hill.
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Collapse SubdiscussionBenedicta Kwevie Hi Jodian
Your post was great, and I agree with you. Without electronic charting, it could be the difference between the life and death of the patient. Electronic charting can help keep patient information safe, while all sorts of things can go wrong with paper charting. “Beyond that, charts can get lost, and there are not usually backups in these situations. It is easier to make errors or have illegible notes on paper charts, and those can be difficult to catch and correct.” (Hedges 2020). With paper charting, some things written down can or might be incorrect or illegible. With these kinds of mistakes, if not caught soon by others, it will go on, and the mistake can cost the patient their life. “Paper records can be destroyed and impossible to recover in the event of a physical disaster like a fire, floor, or worse.” (Diffendal 2018). With the use of electrical charting, patient records can and will be kept safe, secure, and confidential, unlike with paper charting, there is little to no guarantee that files will be kept private and safe.
References
The Pros and Cons of Paper Medical Records (According to Doctors Who Use Them)
Lisa Hedges
January 7, 2020
https://www.softwareadvice.com/resources/pros-cons-paper-charts/Links to an external site.
The Disadvantages Of Paper Charting For Medical Records—Why You Should Upgrade To An Electronic System (EHR)
Alanna Diffendal
October 25, 2018
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Collapse SubdiscussionSheila Ankrah Response:
Hi Jodian,
I could totally relate to your post. Information technology is rapidly becoming advanced, and it continues to improve the quality of healthcare. The technology advancement provides easy access to needed data, easier access to critical supplied and services for healthcare workers with good enhancement to patient outcomes nationwide. You outlined how heavily we rely on technology to streamline our day to improve patient outcomes. I work on the telemetry unit and nurses have so much to track and monitor. Being able to rely on equipment and healthcare technology like telemetry monitors and consider informatics tools helps reduce the errors and make it possible to keep patients safe. Information technology have been proven to increase efficiency, communication, quality of care, and even improved the Nursing team performance (Silvara et. al., 2018).
According to McGonigle & Mastrian, it can be challenging to introduce and combine new information and old information to further improve knowledge (2018). Understandably there is a generation of nurses that are not prepared to work in the technology rich environment. Many organizations have developed programs to help achieve competency in informatics so that all nurses can feel comfortable working with computerized data.
Reference
McGonigle, D., & Garver Mastrian, K. (2018). Nursing Informatics and the foundation of knowledge (4th ed.). Burlington, MA. Jones & Bartlett Learning.
Silva, A., Santos, A., & Andrade, E. (2018). Mobile technologies in the Nursing area.
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Collapse SubdiscussionMleh Porter Hello Jodian,
I enjoyed reading your post and agree that electronic health records (EHR) can change the quality of patient care and outcome. Nursing informatics help integrates information, computer, and nursing science to strengthen professional nursing practice. When a healthcare system incorporates technology into its routine operation, it helps improve the quality of patient care and makes data management more efficient (Najjar & Shafie, 2022). Nursing informatics aims to incorporate information systems, improve access to evidence, positively impact patient care quality, and promote evidence-based nursing (Najjar & Shafie, 2022). EHR helps decrease medication errors. Illegible handwriting can also lead to medication errors. EHR eliminates the potential for error because of poor writing. EHRs have been shown to prevent many adverse events. (Hoover, 2017). In addition to avoiding medication errors, EHRs also provide vital information to the healthcare team on a patient’s history, medication history, family history, allergies, and other essential data that could also guide providers in making better diagnoses and treatments for the patient (Hoover, 2017). Nursing informatics helps reduce potential medication errors and improves efficiency and communication among the healthcare team, leading to better patient outcomes (Najjar & Shafie, 2022).
References
Hoover, R. (2017). Benefits of using an electronic health record. Nursing Critical Care, 12(1), 9–10. https://doi.org/10.1097/01.ccn.0000508631.93151.8d
Najjar, R. I. A., & Shafie, Z. M. (2022). Impact of nursing informatics on the quality of patient care. International Journal of Medical Science and Clinical Research Studies, 2(5), 418-421. https://doi.org/10.47191/ijmscrs/v2-i5-19
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Collapse SubdiscussionSimranjeet Brar In healthcare, quality improvement is one of the first things that comes to mind when contemplating the use of data for issue solutions as I used to work as Quality Improvement Coordinator for a short period of time within nursing. The process of quality improvement also involves making the right decisions based on the information gathered via monitoring and analysis (HRSA, 2011). The collection and analysis of data is crucial to any quality improvement initiative, since it may shed light on problems and opportunities in patient care, such as how satisfied they are with their treatment (HRSA, 2011). Healthcare data may be managed in the clinical environment, the administrative setting, and the policy setting with the help of nursing informatics, which draws from a variety of disciplines including the health, computer, information, and cognitive sciences (Sweeney, 2017). In light of the fact that technological resources will evolve and expand over time, it is crucial that nurse leaders or knowledge workers, not only informatic specialists, understand how to effectively employ such resources and the data they generate. Nursing informatics is a subspecialty within the nursing profession that focuses on the use of medical data for the purpose of improving patient care (Saputra, 2019). Whether or not a certain professional uses specific data to make judgments is a key determinant of whether or not they are considered knowledge workers.
Informatics, which rely on data to support the implementation of treatments, is a typical fixture of modern nursing practice. Consequently, it is the nurse’s responsibility to ensure that specific treatment or preventative efforts are informed by data. Pressure ulcers are an example of a typical clinical practice problem that necessitates the application of data. Repositioning the patient at regular intervals (say, every two hours) is one evidence-based strategy that has been studied, evaluated, and put into practice to reduce the prevalence of pressure ulcers in hospitalized patients (Sharp, Moore, & McLaws, 2019). In addition, the database identifies the population at risk, such as the elderly, those who are unable to move, those who have had a injury that causes mobility issues, those who are malnourished or dehydrated, or those who have a medical condition that compromises blood flow (Sharp, Moore, & McLaws, 2019). In order to prevent pressure ulcers, nurses must be equipped with a technology that alerts them when to turn patients at risk. When actions are taken and their results are recorded, the information can be stored in a database. In order to assess the efficacy of such interventions, track trends, and investigate recurring mistakes, nurses can use this database containing this vital information. Nurse managers, supervisors, and leaders may therefore place greater emphasis on the turning tool to improve patient outcomes and prevent pressure ulcers in high-risk patients (Sharp, 2019).
One hypothetical scenario would be a patient hospitalized to the intensive care unit who is a high risk for pressure ulcers. In order to prevent the patient from getting pressure ulcers from sleeping in the same position for too long, the hospital administration has suggested using a turn clock instrument. Nurse informaticists have analyzed the implementation of such interventions by obtaining data from a system and closely monitoring trends, relationships, and patient outcomes. The turn clock is still an efficient method for healthcare workers to use the repositioning approach with their patients (Mitchell, 2018). The on-duty nurse is responsible for ensuring that the information from the turn clock is used to help the admitted patient. The tool clock should be built in a way that informs the nurse on duty. Data gathered, analyzed, and interpreted in this case study played a crucial role in reducing hospital-acquired pressure ulcers (HAPUs), a severe clinical condition.
References
Health Resources and Services Administration (HRSA) (October, 2022). Retrieved on 11/30/22 from https://bphc.hrsa.gov/technical-assistance/clinical-quality-improvementLinks to an external site.
Mitchell, A. (2018). Adult pressure area care: preventing pressure ulcers. British Journal of Nursing, 27 (18), 1050-1052.
Saputra, C. (2019). Nursing Informatics System in Health Care Delivery. KnE Life Sciences, 38-46.
Sharp, C. A., Moore, J. S. S., & McLaws, M. L. (2019). Two-Hourly repositioning for prevention of pressure ulcers in the elderly: patient safety or elder abuse? Journal of Bioethical Inquiry, 16 (1), 17-34.
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics. Retrieved on 11/30/22 from https://www.himss.org/resources/healthcare-informaticsLinks to an external site.
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Collapse SubdiscussionErica Schulte The application of Data to Problem – Solving
Describe the focus of your scenario
In past experiences I was lucky enough to spend time on post-partum and mother-baby floors. While this position was extremely rewarding and offered the ability to see one of the most beautiful life-experiences unfold, there were also cases that resulted in a negative outcome. While Post-Partum Depression was not always identified as early as the initial hospital stay, when it was prevalent, the negative impact on mother, baby, and even family members could be excruciating to watch. The scenario that is being considered is the ability to help prevent or minimize post-partum depression in mothers who may be high risk. While the ability to identify these risk factors may be challenging, the times that these issues could be identified early or prior to birth can provide a healthy and positive experience for all. Rather than the alternative, which can result in negative or harmful actions both physically and mentally. According to (Ghaedrahmati et al., 2017), there are five areas for risk factors to PPD. These include psychiatric, obstetric, biological and hormonal, social, as well as lifestyle. While screening options are available, it is not something that is a requirement nor tracked unless identified. I think that OB offices and other related care facilities can begin to emphasize the importance and attempt to identify these risk factors and collect this data at an early stage.
Describe the data that could be used and how the data might be collected and accessed.
The data that can be used in this scenario is understanding the various exposure possibilities that a patient has to these risk factors. This can be monitored at different stages throughout a pregnancy as various events may arise at different times. When a risk factor becomes apparent, tracking this progression through the pregnancy and even after would be beneficial. Nurses and medical professionals alike, involved in the care of a mother throughout the pregnancy should begin the collection of this data through visits and noted opportunities for screening. Through the use of Electronic Health Records, this data could be collected and accessed by the various medical professionals who a patient encounters through the pregnancy and post-delivery experience. The use of an EHR allows for the ability to organize and analyze a large amount of patient information (Kruse et al., 2018), which provides the platform for the collection and access to this information.
What knowledge might be derived from that data?
Knowledge that could be obtained would be the identification of risk factors for PPD and the possible progression of an issue. If a risk factor is identified, treatment could be applied at an early stage to help lessen the negative impact of the issue at a later stage.
How would a nurse leader use clinical reasoning and judgement in the formation of knowledge from this experience?
As noted in (McGonigle & Mastrian, 2022), Nurse Informatics includes the management and communication of data, information, knowledge, and wisdom. The collection of this data and these risk factors would provide valuable and needed information to treat individual cases as they became apparent and at an early stage. It would also allow the ability of a nurse leader to identify potential trends from the collective data of patients. Nurse leaders would be able to gain experience on these risk factors as well and would become more successful in their treatment as knowledge was able to expand and grow. This could not only help individual patients, but future patients identify potential exposure and risk factors. While the risk of PPD would never go entirely away, providing an avenue for a healthy experience and lowering risk, would benefit mother, baby, and everyone involved.
References
Ghaedrahmati, M., Kazemi, A., Kheirabadi, G., Ebrahimi, A., & Bahrami, M. (2017, August 9). Postpartum depression risk factors: A narrative review. Journal of education and health promotion. Retrieved November 30, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561681/
Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018, September 29). The use of electronic health records to support Population Health: A systematic review of the literature – journal of medical systems. SpringerLink. Retrieved November 30, 2022, from https://link.springer.com/article/10.1007/s10916-018-1075-6
McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the foundation of knowledge. Jones & Bartlett Learning.
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Collapse SubdiscussionQuenyaita Ferguson Hi Erica,
Interesting topic! Post-partum depression is one of the most common conditions that women experience during or after pregnancy and can be very hard to recognize. Having a computerized tool that can assist with diagnosing would be great! Utilizing those five areas for risk factors to PPD in a EHR can make it easier to diagnose. Diagnosing PPD during the short post-partum stay at the hospital is almost impossible. Healthcare professionals should document using a computerized tool that’s made available to all providers that has any interaction with the patient. With frequent follow up calls and post-partum office visits, providers should chart using the tool. Nursing informatics has made tracking data straightforward. With just a glance, a provider could have the ability to know where the patient falls on the scale for PPD. I haven’t seen any EHR, that has a PPD option like this, but I think it’s a fantastic idea!
Reference:
Amit, G., Girshovitz, I., Marcus, K., Zhang, Y., Pathak, J., Bar, V., & Akiva, P. (2021). Estimation of postpartum depression risk from electronic health records using machine learning. BMC pregnancy and childbirth, 21(1), 630. https://doi.org/10.1186/s12884-021-04087-8
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Collapse SubdiscussionJohn Williams I work at an inpatient psychiatric hospital, and I find that the largest issue that we are having is medication errors. There are several reasons why this occurs. Firstly, there is a paper medication administration record. Second, it can be a high stress environment that can create an environment where dictating verbal orders can be challenging. Finally, there is an ineffective shift to shift reporting process that is prone to ineffective communication. Most of these issues are not new and the administration at the facility is aware. Perhaps the extent of the errors is not widely known and therefore, effective data gathering would demonstrate to the administration that an update in the medication technology might lead to improved medication compliance and then improved patient outcomes while under our nursing care. According to Sweeney, “enhanced delivery of care, improved health outcomes, and advanced patient education are just a few aspects that have improved,” (2017). When used effectively, informatics can improve healthcare outcomes quickly.
This topic can be tricky because the first component to date gathering is nurses reporting medication errors. There has to be open and trustworthy communication with management and the nursing staff which then facilitates self-reporting on oneself. The nurse manager would then gather this data as well as potential antecedents that may have contributed to errors such as a patient outburst or being short staffed. In a paper published by the Institute of Health it discusses how medical errors can have any number of consequences, “Errors…are costly in terms of loss of trust in the health care system by patients and diminished satisfaction by both patients and health professionals,” (1999). When working with paranoid schizophrenics, there are not many opportunities to reestablish trust.
A nurse leader is particularly good at evaluating this type of information, because the nurse leader is a person that has real-time knowledge on the effectiveness of solutions proposed. Each solution that has been synthesized, either by committee or an administrative team, can be implemented and evaluated statistically and in real time as it is implemented with patient care and treatment plan objectives. Nagel et al. (2017) talk about how and why it is important to have an RN in this role. And the nurse’s unique ability to perform both statistical analysis through informatics and track subjective patient opinion on changes makes the nurse a well-suited social scientist of sorts.
In the example listed above, the data would likely indicate that a more effective way to deliver medications would be through a more technologically advanced system other than a three-ring binder, with handwritten physician’s orders. That seems like common sense. It is also likely that the department that must find funding to pay for the technology upgrades would like to see data driven funding requests be paid for first.
References
Institute of Medicine. (1999). To error is human: building a safer health system. Retrieved on November 29, 2022, from https://waldenu.instructure.com/courses/23789/pages/doc-sharing?module_item_id=756538
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies for Nurses in the Future of Connected Health, 212-221. https://doi.org/10.3233/978-1-61499-738-2-212
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
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Collapse SubdiscussionRoberto Monroy Hello, john!
I also work in an inpatient psychiatric hospital and have seen firsthand how medication errors are caused by paper charting and MARs. Handwritten orders are notorious for their difficulty to be read, leading to a high potential for orders to be transcribed incorrectly and medication errors to occur. According to an article, “Historically, illegible handwriting has been a prime source of medication errors; in one source, more than 60% of medication errors in hospitals were attributed to poor handwriting.” (Hoover, 2017). There have been times when care is delayed solely because of legibility, which we both would agree is unacceptable.
You are right when you say this needs to be remedied by advanced technology to avoid such errors and, in turn, improve patient outcomes. Another study showed how implementing new medication carts and electronic medication administration programs decreased medication delays by 40 percent and lowered the cost of medication waste from $300 a month to only $30. (Timakum et al. 2022). The benefits of advancing technology in healthcare have been proven time and time again; I do hope to see electronic charting/ordering become the standard in all healthcare facilities.
References
Timakum, T., Xie, Q., & Song, M. (2022). Analysis of E-mental health research: mapping the
relationship between information technology and mental healthcare. BMC
Psychiatry, 22(1), 57. https://doi.org/10.1186/s12888-022-03713-9Links to an external site.Hoover, Robin MSN-HCI, RN. Benefits of using an electronic health record. Nursing Critical Care:
January 2017 – Volume 12 – Issue 1 – p 9-10 doi: 10.1097/01.CCN.0000508631.93151.8d-
Collapse SubdiscussionErica Schulte Hello all,
I fully agree with the points that both of you have made. The motivation for an EHR or some type of advanced system and process is crucial in not only the field you note but all health care fields. (McCarthy et al., 2022) notes the efficiencies and accuracies that can be achieved by utilizing an electronic system. The ability for a nurse, as well as nurse leadership to promote knowledge and continue to better the processes of their system but also beyond is crucial for success. The definition of a knowledge worker includes processing information on a daily basis to make it meaningful. (McGonigle & Mastrian, 2022). The challenge of medical professionals is to strive to maintain that level of insight.
McCarthy, B., Fitzgerald, S., O’Shea, M., & Condon, C. (n.d.). Electronic nursing documentation interventions. Wiley Online Library. Retrieved December 3, 2022, from https://onlinelibrary.wiley.com/doi/abs/10.1111/jonm.12727
McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the foundation of knowledge. Jones & Bartlett Learning.
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Collapse SubdiscussionKatrina Brooks I currently work at an alternate care site facility that offers inpatient care for those recovering from COVID-19 who require continued medical care. Prior to COVID the facility relocated to a new building, therefore the building and equipment is outdated. The electronic health record (EHR) that we use is an outdated version of Cerner. While the system is outdated it does utilize electronic medication administration system (eMAR), which is “a system that uses bar-coding technology to submit and fill prescriptions, typically handheld scanners read bar codes and transmit them to pharmacy” (McGonigle & Mastrian, 2022).
At the beginning of my shift, I do a pain assessment as I introduce myself to the patient, being sure to note exactly what the patient states. Pain management has been an ongoing issue at this facility, partly due to the outdated EHR, Cerner doesn’t require the nurse to perform a pain assessment before administering the medication. “Documentation of pain assessment and the effect of interventions are essential to allow communication among clinicians about the current status of the patients pain and responses to the plan of care” (Wells et al, n.d.).
I recently had a patient who displayed visible signs of pain, grimacing and moaning while putting pressure on her right hand, who gave a pain score of 0 out of 10. I then asked are you having issues with your right hand she stated, “yes it’s been bothering me for about a week but all they do here is give me a Tylenol and keep it moving, if I had to say a number, I would give it a 7”. I assured the patient that I would follow up with the doctor for a better solution. After obtaining an x-ray and adjusting her pain regimen it was determined that she had been admitted for six days with a fractured wrist. It is the nurse duty to do a follow up assessment, but the system should also have alerts in place to ensure the nurse follows up.
An initial pain score should be taken upon admission and documented. A pain assessment should be done at the beginning of the shift and every 2 to 4 hours depending on the type of unit. Epic EHR alerts the nurse to perform a pain assessment upon scanning the medication; if the medication was given intravenously an alert will appear in 30 minutes or 1 hour if the medication was given orally to do a post assessment to rate how effective the medication was. As a result, doctors and nurses can review the pain regimen and suggest or make changes accordingly.
Assessment of pain is the most important step to providing good pain management. “Anderson and colleagues found lack of pain assessment was one of the most problematic barriers to achieving good pain control” (Wells et al, n.d.). The knowledge gained determines whether modifications are needed. “Understanding pain and how it works is a key part of how healthcare providers diagnose medical conditions” (Psychogenic pain: What it is, symptoms & treatment, 2022). A nurse manager/leader could utilize this data to create a daily charting checklist to ensure the full pain assessment is completed on all patients, create an education bulletin board highlighting the steps, create/provide patient education on pain management. Nurse leaders also have the ability of to gather information and meet with other healthcare personnel to brainstorm on new ideas and interventions.
Reference
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Psychogenic pain: What it is, symptoms & treatment. Cleveland Clinic. (2022, August 8). Retrieved November 30, 2022, from https://my.clevelandclinic.org/health/diseases/12056-pain-psychogenic-pain
Wells, N., Pasero, C., & McCaffery, M. (n.d.). Chapter 17 Improving the Quality of Care Through Pain Assessment and Management. Retrieved December 1, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK2658/
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Collapse SubdiscussionJohn Williams Hi Katrina, I agree that good assessment skills lead to better patient care. Pain is especially important to manage well if patients are to feel cared for. I have found that pain control, in general, is a controversial topic within nursing. While I was working at a skilled nursing facility recently, some patients would come to us post op, with prescriptions for very high doses of narcotics for pain control. Others would have conservative prescriptions with low doses and longer PRN frequency intervals.
While nursing Informatics would be important to manage pain most effectively, pain itself is a subjective measurement and when managed liberally with dose strength and frequency, it can lead to post rehabilitation substance abuse disorders. Hath et al. discuss how to effectively mitigate or at least minimize risks for postoperative opioid addiction, “Modifiable risk factors for chronic opioid use after surgery should be clearly delineated and targeted with novel interventions,” (2017). Nursing informatics would be an effective tool to categorically organize risk factors and properly institute interventions based on a specific risk score and types.
Another program that is already in place that uses Informatics is the Prescription Drug Monitoring Programs, (PDMP)’s. In Arizona it is called the CSPMP or Controlled Substance Prescription Monitoring Program and requires all prescribers to report schedule II-V narcotics prescriptions to the program (Arizona Prescription Monitoring Program, n.d.). It is voluntary to utilize, but none the less, it is a great way to use data to manage healthcare and moderate substance use disorders from prescription opioids. Currently, there is not a national database. Hopefully, healthcare practitioners that prescribe narcotics would willingly check to keep their patients safe.
References
Arizona Prescription Monitoring Program. (2020) Arizona controlled substances prescription monitoring program PMP clearinghouse reporting requirements. Retrieved on December 3, 2022, from https://pharmacypmp.az.gov/sites/default/files/2022- 03/PMP%20Clearinghouse%20Reporting%20FAQ%27s.pdf
Hah, J. M., Bateman, B. T., Ratliff, J., Curtin, C., & Sun, E. (2017). Chronic opioid use after surgery: implications for perioperative management in the face of the opioid epidemic. Anesthesia and analgesia, 125(5), 1733–1740. https://doi.org/10.1213/ANE.0000000000002458
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Collapse SubdiscussionMaxine A Lewis Week 1 discussion question Lewis.M
When someone is in extreme distress, they may find it difficult to tolerate what they perceive as “silly and repetitious questioning,” making in-patient admission time-consuming and annoying for the patients. In this scenario Mr. Pink has been admitted to the hospital at least four times in the last year and twice at another hospital in the past and week, now at this facility screaming in pain and also poor historian. There are some red flags but to have a full picture of the issues the health record must be obtained from the prior hospital. The nurse wonders how the utilization of electronic health record could be harness resulting in this patient’s health database being retrievable with the capacity to update the existing admission data base and admission process. Yet another patient, a 94 years old who is also very hard of hearing and 2 months ago had just relocated from another state and has not being able to continue physical therapy post his hip repair 3 months ago: His mobility has declined and now he suffered a broken arm on the opposite side, no health history is available as he is waiting for the release of his medical records from his prior home state. Then there is the “direct” admission lacking vital information as to the reason for the proposed admission by their physician. My proposal is a unified nationwide admission database/ health record system.
The database begins at the initial patient contact within the medical system and travels with the individual i.e., consults, specialists, surgeries, treatment options, recommendation, plan of care as well as any pertinent information such as family involvement, issues, contact information, current medications: basically a complete electronic patient health diary. At any type of patient provider contact/appointment the info is loaded into the electronic patient data base which is updated and reviewed by providers. This data collection will now become an electronic patient health diary containing detailed patient health history at the tip of providers fingertips just like Star Trek!
The benefits of such a database result in continuity of patient care which leads to better doctor-patient relationships and medical outcomes through improved quality of care, as well as reduced healthcare costs and economic benefits (Kim ,2017). Decreasing patient admission wait time or incidence is another benefit of nationwide electronic health records (EHR). According to Furukawa, Emergency departments (EDs) with fully functional EMRs had significantly lower length of stay (LOS) and shorter treatment times compared with EDs with minimal or no EMRs and EDs with simple EMRs. However, the relationship between EMR and efficiency depends on the severity level of the patient and the diagnostic services provided (2011).
Nurse leaders represent almost 3 million nurses, the biggest part of the US healthcare profession, in hospital, ambulatory, community, home, and long-term-care settings (Collins et.al 2017) therefore nurse leaders must endeavor to achieve competency in big data collection and interpretation in order combine their medical knowledge and analytical skills in caring for their patients; regardless of their future positions in healthcare, nurses must grasp the ethical application of information, computer, and cognitive sciences to improve nursing science and develop the nursing knowledge base (McGonigle and Mastrian, 2022).Health care Information is changing every second and the key to manage this evolving data is to make it “ meaningful” by understanding “ how people obtain, manipulate, use, share, and dispose of information” (McGonigle and Mastrian, 2022).
References
Collins, S. , Yen, P. , Phillips, A. & Kennedy, M. (2017). Nursing Informatics Competency Assessment for the Nurse Leader. JONA: The Journal of Nursing Administration, 47 (4), 212-218. doi: 10.1097/NNA.0000000000000467.
Frukawa, M. F. Electronic Medical Records and the Efficiency of Hospital Emergency Departments. MEDICAL CARE RESEARCH AND REVIEW, [s. l.], v. 68, n. 1, p. 75–95, 2011. DOI 10.1177/1077558710372108. Disponível em: https://search.ebscohost.com/login.aspxead Acesso em: 30 nov. 2022.
Kim S. Y. (2017). Continuity of Care. Korean journal of family medicine, 38(5), 241. https://doi.org/10.4082/kjfm.2017.38.5.241Links to an external site.
Dee McGonigle D., Mastrian K., Nursing Informatics and the Foundation of Knowledge, 5th edition, Jones & Bartlett Learning, 5 Wall Street, Burlington, MA 01803,978-443-5000, info@jblearning.com, www.jblearning.com.
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Collapse SubdiscussionJohn Williams Good evening, Maxine. Great post, and I am thrilled that someone proposed a national health record system. This would be the best to provide continuity of care for the entire country, at least those that were willing to sign up for the system. Imagine going to any healthcare facility in the country and having a comprehensive health history available to physicians waiting to treat patients. The medication errors would decrease dramatically, and the continuity of care would be transformed. Interestingly, the Department of Veterans Affairs is in the midst of nationalizing their EHR with community providers and Military Base specific providers into one unified project that will be accessible to all necessary healthcare providers, (va.gov, 2018). Once completed in use this will be an amazing tool that could also be scaled up and utilized by the federal government.
Ironically, this project is not yet completed. A classic complaint of Big Government Bureaucracy is the inefficiencies and slow pace to project completion. In an article from October 2022, it talks about the EHR project completion being delayed until June of 2023, (va.gov, 2022). Privacy would also be another large concern. I can already hear the alarm of concerned citizens claiming that Big Government was forcing them into an information pool that was not its business. Even websites as large as Facebook and Twitter have been hacked. The issue is especially pronounced in Arizona, where I reside, where government overreach is already a serious concern.
I still think that it would be useful to try. And the VA project still does have an estimated completion date, so there will eventually be a pilot program. If successful with the VA, it could be rolled out as a national program for civilians. It would require tremendous collaboration of many RNs skilled in Informatics as well as those possessing high quality head-to -toe assessment skills to collect field data.
References
va.gov. (2020, Sep. 18). VA EHR Modernization [Video]. YouTube. https://www.youtube.com/watch?v=ul30_5S6_c4
va.gov, (2022, Oct 23). VA extends delay of upcoming electronic health record deployments to June 2023 to address technical and other system performance issues. EHR Modernization. https://digital.va.gov/ehr-modernization/news-releases/va-extends-delay-of-upcoming-electronic-health-record-deployments-to-june-2023-to-address-technical-and-other-system-performance-issues/
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Collapse SubdiscussionBertina Boma Soh In the medical field, access to data can be extremely beneficial in solving problems and forming new knowledge. This is especially true in the field of nursing, where nurses must have access to the correct data to provide the best possible care for their patients. One of the ways that data can be used to improve patient care is using nursing informatics. Nursing informatics combines nursing and computer science to provide nurses with the data they need to make informed decisions about patient care (Nagle et al., 2017).
One example of a situation that could benefit from data access is managing chronic conditions. Chronic conditions, such as diabetes and heart disease, are very common in the elderly and can be difficult to manage. Nursing informatics allows nurses to access data on the patient’s medical history, medications, lab results, and other important information. This data can then be used to develop a personalized care plan tailored to the patient’s needs.
Another area that could benefit from improved access to data and utilization of nursing informatics is the prevention of hospital readmissions. According to the Centers for Medicare and Medicaid Services, hospital readmissions cost the United States over $41 billion each year (Murphy, 2017). To reduce readmissions, nurses need to have access to data that can help them identify at-risk patients and intervene early to prevent readmissions. Nursing informatics can help nurses access the appropriate data to make decisions about patient care, including information about a patient’s medical history, medications, and lab results. By utilizing nursing informatics, nurses can develop a plan of care that focuses on preventing readmissions and improving patient outcomes (Nagle et al., 2017).
Data can also be used to identify trends in patient care. For example, nurses can use data to track the effectiveness of certain treatments or medications, and make adjustments as needed. By using data to identify trends in patient care, nurses can ensure that they are providing the best possible care for their patients. Finally, data can be used to add to the body of knowledge in the nursing profession. By tracking and analyzing patient data, nurses can better understand which treatments and medications are most effective, and what care strategies are most beneficial for certain patient populations. This data can then be used to inform future practice and research (Sweeney, 2017).
In conclusion, access to data is essential in the modern era and is especially important in the nursing profession. Data can be used to solve problems, make informed decisions, and add to the body of knowledge in nursing. Nursing informatics is a great tool for improving patient care and should be utilized by nurses to ensure that their patients are receiving the best possible care.
References
Murphy, J., Goossen, W., & Weber, P. (Eds.). (2017). Forecasting informatics competencies for nurses in the future of connected health: Proceedings of the Nursing Informatics Post Conference 2016 (Vol. 232). IOS Press.
Nagle, L. M., Sermeus, W., Junger, A., & Bloomberg, L. S. (2017). Evolving role of the nursing informatics specialist. Stud Health Technol Inform, 232, 212-22..
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
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Collapse SubdiscussionQuenyaita Ferguson Hi, Bertina
Nursing has come a long way! The ANA describes nursing informatics as, “the specialty that integrates nursing science to identify, define, manage and communicate data, information, knowledge, and wisdom in nursing practice” (Reid, et al, 2021). Technology has contributed to problem solving and creating new ways to become extremely efficient in health care. Having the access, we have to specific data eliminates confusion and makes caring for patients manageable. Currently we’re dealing with a nursing shortage, due to the rising demand to provide care to an aging population. Could you imagine having the patient loads you have now without the many advances made in nursing informatics? Having the ability to track data and follow trends has mitigated the number of medical errors and has given us the ability to provide patients with quality healthcare.
Reid, L., Maeder, A., Button, D., Breaden, K., & Brommeyer, M. (2021). Defining Nursing Informatics: A Narrative Review. Studies in health technology and informatics, 284, 108–112. https://doi.org/10.3233/SHTI210680
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Collapse SubdiscussionJamee Renee Linnenbrink Bertina,
Nursing Informatics as you stated can be used to improve patient outcomes. Combining or using nursing informatics is key to evidence-based practice to continue to collect and analyze data to improve patient outcomes. Also, along with collecting and analyzing data for patient outcome improvement. The study of nursing informatics is also important to continue to advance the field of informatics to better support the nursing practice and advance patient care (Darvish, et al 2014). According to the American Nursing Informatics Association, there are thousands of nursing informatics jobs within the US (ANIA n.d.). There are degrees that you can get in nursing informatics, and Walden even offers them all while maintaining the same goal of improving patient outcomes and bettering the nursing profession as a whole.
References
American Nursing Informatics Association (n.d), History, https://www.ania.org/history
Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics in promoting quality of health care and the need for appropriate education. Global journal of health science, 6(6), 11–18. https://doi.org/10.5539/gjhs.v6n6p11
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Collapse SubdiscussionGuoming Feng Initial Post – The Application of Data to Problem-Solving
“Nursing informatics is the specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice” (What is nursing informatics, 2019). As a charge nurse in a busy medical-surgical acute care unit, one way I could utilize informatics where I work is by quickly tracking the patient’s information before they are assigned to the appropriate room. In our unit, there are share patient rooms for non-infection isolation rooms, semi-private patient rooms for contact and special contact isolation patient, and negative pressure private patient rooms for airborne infection isolation patients. When the bed czar assigns patients to our unit, I must quickly access the patient’s EMR and check the patient’s diagnosis, history, and infection isolation status, and based on these data, and I can assign the right patients to the right room These smaller-scale data collection can be interpreted and integrated in a shorter amount of time, allowing for a faster transformation into new guidelines and pathways (Nagle, 2017).
With the help of our collected information, our nurse leaders such as the nursing supervisors and the unit managers would be able to meet and discuss the best on-time patient transferring. we will be able to work on each one individually to hopefully avoid delayed patient care, which is essential to decrease patient mortality. It is important that the nurses and healthcare providers in the emergency room and other setting acts on and synthesizes our data as soon as possible because the following nursing care and other healthcare will be largely based on their initial data collection. Collecting the necessary data through our EMR is the first step toward providing timely patient care. The more our leaders and nurses discuss the information found through this potential data collection, the more reasonable and appropriate, and effective patient assignment will be achieved, and the better patient care outcome will result. The information sharing and feedback provided allows our staff to make the appropriate changes to our department to make it run smoothly (McGonigle & Mastrian, 2020).
McGonigle, D., & Mastrian, K. G. (2020). Nursing informatics and the foundation of knowledge, (5th ed.) Burlington, MA: Jones & Bartlett Learning.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health, 212–221. Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF
What is nursing informatics? (2019). Retrieved from https://www.himss.org/resources-what-nursing-informaticsLinks to an external site.
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Collapse SubdiscussionSimranjeet Brar Guoming,
I enjoyed your post. As you’ve mentioned, Informatics is a great resource when it comes to EMRs, bed assignments and array of other tasks which has contributed in making healthcare more organized. As a result of the advancements in information and communication technology, the healthcare industry has undergone significant change during the past decade. The use of technology to better organize and communicate patient records is known as nursing informatics, a rapidly expanding branch of healthcare. To put it another way, it is a hybrid of information technology and nursing science. To that end, nursing informatics has the potential to aid healthcare personnel by facilitating decision-making and decreasing administrative burdens (Farokhzadian et al., 2020). Information systems software and procedures allow us to achieve this goal. Improved healthcare quality and inter-professional efficiency can be achieved by the widespread adoption of computerization in the medical and nursing professions (Moore et al., 2020). Generally speaking, execution is linked to improved nurse documentation and fewer medical mistakes in hospitals. This means that nurse informaticists are frequently called upon to contribute to the development of processes, clinical workflow reviews, and innovative diagnostic and therapeutic approaches. They weigh the available treatment choices and utilize evidence-based research and analysis to decide what steps would result in the highest quality, most cost-effective care for each individual patient (Gilmore et al., 2022).
References
Farokhzadian, J., Khajouei, R., Hasman, A., & Ahmadian, L. (2020). Nurses’ experiences and viewpoints about the benefits of adopting information technology in health care: a qualitative study in Iran. BMC Medical Informatics and Decision Making, 20(1), 1-12.
Jamieson Gilmore K, Corazza I, Coletta L, Allin S. The uses of Patient Reported Experience Measures in health systems: A systematic narrative review. Health Policy. 2022 Jul 20:S0168-8510(22)00192-0. doi: 10.1016/j.healthpol.2022.07.008.
Moore, E. C., Tolley, C. L., Bates, D. W., & Slight, S. P. (2020). A systematic review of the impact of health information technology on nurses’ time. Journal of the American Medical Informatics Association, 27(5), 798-807.
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Collapse SubdiscussionKatrina Brooks Hi Guoming,
At the last facility I worked at we utilized that same system but in a different way. As a floor nurse when we were assigned a patient from the emergency room, we had 30 minutes to check the EMR to obtain diagnosis, history, recent lab results and vital signs, isolation precautions and read the notes because the ER nurses did not call to give report. If we had any questions or concerns we had to call the current nurse or explain to the charge nurse why we feel this patient isn’t stable to be transferred to our unit. At first I did not like the system because I was used to getting report from the nurse but I slowly found this system to be better. We have had issues where the nurse tells us one thing in report and the patient arrives to the unit completely different, with this new system in place we were now able to access the chart before accepting the patient. “EHRs and the ability to exchange health information electronically can help you provide higher quality and safer care for patients while creating tangible enhancements for your organization. EHRs help providers better manage care for patients and provide better health care by:
- Providing accurate, up-to-date, and complete information about patients at the point of care
- Enabling quick access to patient records for more coordinated, efficient care
- Securely sharing electronic information with patients and other clinicians
- Helping providers more effectively diagnose patients, reduce medical errors and provide safer care
- Improving patient and provider interaction and communication, as well as health care convenience
- Enabling safer, more reliable prescribing
- Helping promote legible, complete documentation and accurate, streamlined coding and billing
- Enhancing privacy and security of patient data
- Helping providers improve productivity and work-life balance
- Enabling providers to improve efficiency and meet their business goals
- Reducing costs through decreased paperwork, improved safety, reduced duplication of testing, and improved health (What are the advantages of electronic health records, 2022).
Reference
What are the advantages of electronic health records? HealthIT.gov. (2002, March 8). Retrieved December 3, 2022 from https://www.healthit.gov/faq/what-are-advantages-electronic-health-recordsLinks to an external site.
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Collapse SubdiscussionJamee Renee Linnenbrink Nursing Scenario
Most of my experience has been in the Emergency Department where (mostly) emergencies are happening. Floor nurses are also at some of the highest risks for back injuries. Although, there are devices such Hoyer lifts, sara-steadys, and other equipment that is safe for the patient and also for the nurse. Unfortunately, in emergency situations, there may not always be time to stop and use such devices. Back pain can be detrimental to the quality of life and can cause long-term difficulties for the nurse (Boughattes et al, 2017) . Being able to collect data, nation or even world wide on how the back injuries occur could be extremely beneficial in finding safe practices or inventions that can help prevent the injuries.
Data Collection
Being able to collect data and compare/ collaborate with other nurses that are going through the same things can be extremely beneficial to change. Collecting the exact way that the back injury happened would be important in this case. Being specific would also be important. Specifically saying “injured during patient lift” would be vague. More specific information would be needed such as “back injured during the lift of patient from the ground back to a stretcher after twisting motion”. If multiple nurses are having the same issue then a safer practice can be investigated by the nurse leaders and evidence can be provided to back the information up. When detailed reports happen like this, it is hard to set classifications for the data separate it into more detailed categories. But that is what would have to happen. identify detailed categories, separate the data and evaluate trends (National Library of Medicine, 2022).
References
Boughattas, W. , Maalel, O. , Maoua, M. , Bougmiza, I. , Kalboussi, H. , Brahem, A. , Chatti, S. , Mahjoub, F. and Mrizak, N. (2017) Low Back Pain among Nurses: Prevalence, and Occupational Risk Factors. Occupational Diseases and Environmental Medicine, 5, 26-37. doi: 10.4236/odem.2017.51003Links to an external site..
National Library of Medicine (2022) Data Collection Reviews, https://www.ncbi.nlm.nih.gov/books/?term=data+collection
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Collapse SubdiscussionOluyemi Adeagbo Hi Jamee,
Reading through your prompt, I have seen some great insight, particularly from the Emergency Department perspective. Nurses in emergency cases must comprehend nursing protocols such as risk management, equipment safety, and nursing interventions (French et al., 2019). Improving the quality of life for all patients necessitates the comprehension of collected data and matching them to nursing evidence. For instance, nurses understand the issues related to back pain in medication administration, treatment, and monitoring of patients. Subsequently, nurses ought to conform to skills that assist in observing, speaking to, and observing patients. Likewise, data collection mechanisms should focus on information that helps in evaluations geared toward safer practices (Halstead, 2019). Additionally, interdisciplinary teams should find methods to boost their collaborations and information sharing strategies.
References
French, S., Gordon-Strachan, G., Kerr, K., Bisasor-McKenzie, J., Innis, L., & Tanabe, P. (2019). Implementing the emergency severity index triage system in Jamaican accident and emergency departments. Journal of Emergency Nursing, 45(2), 124-131. https://doi.org/10.1016/j.jen.2018.11.010Links to an external site.
Halstead, J. A. (2019). Program evaluation: Common challenges to data collection. Teaching and Learning in Nursing, 14(3), A6-A7. https://doi.org/10.1016/j.teln.2019.04.001Links to an external site.
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Collapse SubdiscussionKatrina Brooks Hi Jamee,
I worked in the emergency department for two months and quickly realized that it was not for me due to the fast pace which can sometimes be unsafe for staff. In emergencies we don’t think about back injuries and etc. we just perform. “Among healthcare personnel, nurses and operating room staff are known to have the highest rate of back pain with an annual prevalence of 40 – 50% and a lifetime prevalence of 35 – 80%, these injuries are due in large part to repeated manual patient handling activities, often involving heavy manual lifting associated with transferring, repositioning patients and working in extremely awkward postures” (M, n.d.). Six ways nurses can protect their back on the job includes: “using appropriate lifting and bending technique, avoiding overuse and repetitive situations, applying heat and cold therapy, getting a good night’s sleep and wearing the right shoes” (Care, 2021). Wearing the proper shoes is more important than what most people think, they help keep your feet secure, promote healthy posture, and helps improve your endurance and stamina while working. Other data that can be collected is whether the nurse experienced lower or upper back pain, how long did the pain last and was it relieved by medication.
Reference
M; A.K.J.Y.S.S.O.O.M.O. (N.D.). Prevalence, perception and correlates of low back pain among healthcare workers in tertiary health institutions in Sokoto, Nigeria. Retrieved December 1, 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870785/#:~:text=Among%20healthcare%20personnel%2C%20nurses%20and,prevalence%20of%2035%20%E2%80%93%2080%25.Links to an external site.
Care, B.A.Y.A.D.A.H.H. (2021, February 6). 6 Nurse-approved Ways to Protect Your Back on the Job. BAYADA Blog. Retrieved December 1, 2022 from https://blog.bayada.com/work-life/6-nurse-approved-ways-to-protect-your-back-on-the-jobLinks to an external site.
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Collapse SubdiscussionMleh Porter Introduction
Data collection and documentation have evolved in the past decade of healthcare. Many healthcare settings have moved from paper charting to electronic charting systems. According to the Healthcare Information Management Systems Society (HIMSS), Nursing informatics professionals help incorporate nursing science with information technology to help improve nursing practice through the help of healthcare technologies such as electronic medical records (EMR) and other computerized data entry systems with the focus of maintaining patient safety (HIMSS, 2022).
Description of Scenario
In my experience working in an intensive care unit, one issue that stands out is hospital-acquired infections (HAI), such as central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI), and other infections. CAUTIs are the second most common HAIs and occur more often in ICUs. Unfortunately, like other hospital-acquired infections, CAUTIs could often lead to poor patient health outcomes and increased healthcare costs (Shadle et al., 2021).
Data Collection, Assessment, and Knowledge Derived
EHR can be effective in the prevention of CAUTIs in ICU settings. With CAUTIs and CLASBSIs, some data that can be collected and assessed to help prevent these serious issues in a hospital setting will include documentation of every urinary catheter or central line placed, including documentation of evidence-based criteria for the insertion of these devices in the ICU setting, number of days the device has been in place, the necessity of continuing the device, nursing care of the insertion site, and description of the insertion site. All these data can be collected and documented by the nurse in the patient, which allows the nurse and other healthcare providers responsible for the patient to access the data and determine whether these devices are medically necessary for the patient, the number of days the device has been in place, signs of infection, and catheter care. The hospital where I currently work uses Cerner as its EHR system. Following a CAUTI protocol, nurses are prompted by the EHR system on each shift to reassess the necessity of the urinary catheters on patients with a urinary catheter and discontinue them if unnecessary. EHR systems have been shown to significantly decrease CAUTIs by improving catheter care practice and limiting catheter usage (Welden, 2013). Incorporating education, a daily electronic checklist, and removal protocol for nurses for indwelling urinary catheters was associated with reducing CAUTIs in critical care settings (Shadle et al., 2021).
Benefits to Nurse Leaders
EHRs benefit patient care because they help facilitate the quality and effectiveness of patient care (Nagle et al., 2017). The EHR system allows information such as the necessity of indwelling catheters, catheter care, length of catheter usage, and rate of CAUTI on the unit. Nursing leaders can analyze these CAUTI data trends to help develop the most effective plan of action to improve their unit’s CAUTI or HAI prevention. Improved CAUTI trends will also improve patient outcomes considering HAIs are often associated with poor patient outcomes and increased healthcare costs (Shadle et al., 2021).
References
Healthcare Information and Management Systems Society. (2022, June 29). What is Nursing Informatics? Retrieved November 30, 2022, from https://www.himss.org/resources/what-nursing-informatics
Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A bundle-based approach to prevent catheter-associated urinary tract infections in the Intensive Care Unit. Critical Care Nurse, 41(2), 62–71. https://doi.org/10.4037/ccn2021934
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist Links to an external site. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF
Welden L. M. (2013). Electronic Health Record: Driving Evidence-Based Catheter-Associated Urinary Tract Infections (CAUTI) Care Practices. Online journal of issues in nursing, 18(3), 6.
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Collapse SubdiscussionSimranjeet Brar Hello Mleh,
Very thorough and informative post. A healthcare-associated infection (HAI) can happen in any healthcare facility, not only hospitals. This includes ambulatory surgical centers, nursing homes, and even emergency rooms (NCDHHR, 2020). The CDC reports that 5% of all hospital admissions are the consequence of HAIs (NCDHHR, 2020). Each year, this results in 722,000 infections, 75,000 fatalities, and a cost to the healthcare system of almost $28 billion (NCDHHR, 2020).
The Centers for Disease Control and Prevention (2019) warn that hospitalization increases the risk of HAIs. When healthcare providers don’t practice good hand hygiene, patients might be exposed to pathogens that are then passed on to other people (CDC, 2019). To reduce the transmission of illness, washing one’s hands often is essential (CDC, 2019). Florence Nightingale, using this knowledge, recommended that nurses routinely wash their hands throughout the day (Dexter Hillier, 2020).
The data obtained from HAIs would be crucial in creating strategies to boost patient safety and enhance results. Reviewing existing tactics and figuring out how to enhance existing protocols for reducing health-related infections would benefit from the role that nursing informatics (NI) has played in the creation of policies, procedures, and software used by nurses on a daily basis (McGonigle & Garver Mastrian, 2022).
References
Centers for Disease Control and Prevention (2019). Patient safety. CDC. Retrieved on November 30, 2022, from https://www.cdc.gov/HAI/patientSafety/patient-safety.htmlLinks to an external site.
Dexter Hillier, M. (2020). Using effective hand hygiene practice to prevent and control infection. Nursing Standard. Retrieved on November 30, 2022, from https://www.mghpcs.org/munncenter/Documents/weekly/apr-29/Hand-Hygiene-Practice.pdfLinks to an external site.
McGonigle, D. & Garver Mastrian, K. (2022). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.
North Carolina Department of Health and Human Resources (NCDHHR). (2020). Healthcare-associated infections (HAIs). Retrieved on November 30, 2022, from https://epi.dph.ncdhhs.gov/cd/diseases/hai.html
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Collapse SubdiscussionJamee Renee Linnenbrink Mehl,
I am appreciating the conversation here. As another colleague has pointed out that it is now referred to as a healthcare-associated infection. This is news to me as it has always been presented in my career as hospital acquired infections specifically related to things that happen within the hospital setting. The CDC describes HAI as infections that is acquired at a health care facility while receiving care for another condition (CDC n.d. a).
EHRs in the hospital setting have great programs to help detect and track some of these HAIs such as the CAUTI notifications, Sepsis detectors, and more depending on what programs you are using. Using this technology and tracking systems makes this much easier to keep track of then back when I started and using paper charting. The CDC also maintains the National Health Care Safety Network. This is the most widely used HAI tracking system, tracking across facilities states and the nation (CDC n.d b).
Reference
The Center for Disease Control and Prevention (n.d), (a) Healthcare- Associated Infections, (b) National Healthcare Safety Network, https://www.cdc.gov/
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Collapse SubdiscussionOluyemi Adeagbo Hi Mleh,
The data collection and documentation process have changed in several ways, especially in the healthcare industry. I concur that healthcare institutions moving from paper-based healthcare to electronic platforms yield superior results in patient care. Leveraging electronic methods, especially nursing informatics systems in hospitals, can reduce response times and patient assessments. As about Hospital Acquired Infections (HAIs) represent prevalent infections in healthcare settings, as depicted in many healthcare studies (Kong et al., 2021). You have pinpointed the need to collect data by leveraging technology to assess infection tendencies, infection signs, and nursing responses. Healthcare institutions that advance the knowledge among their nurse leaders will find improved, healthier outcomes as patient safety will get maximized (López, 2020). Therefore, educating nurses on electronic healthcare records and technologies should be echoed without ceasing.
References
Kong, A., Botero Suarez, C. S., Rahamatalli, B., Shankweiler, J., & Karasik, O. (2021). Hand hygiene and hospital-acquired infections during COVID-19 increased vigilance: One hospital’s experience. HCA Healthcare Journal of Medicine, 2(5). https://doi.org/10.36518/2689-0216.1296Links to an external site.
López, O. (2020). Technologies supporting E-records integrity (1). Ensuring the Integrity of Electronic Health Records, 141-162. https://doi.org/10.4324/9781003105695-18Links to an external site.
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Collapse SubdiscussionJodian Walford Hi MLeh,
Great Points.
The healthcare system is evolving with the expansion of the knowledge base and the invention of new technology. This allows for improved uses and access to resources. EMR provides for the smooth flow of information specific to the patient being treated, from the nurse at the bedside to the physician prescribing treatment to the pharmacy (Cipriano, 2011). HealthStream (2021), many errors are preventable with informatics, and as such, we depend on technology to modernize and improve patient safety. Informatics increases productivity, quality of care, saves time and lives. Patient records are better secured and confidential. Informatics blends technology and information to create something new that people, organizations, and society can use” (Laureate Education, 2018).
References
Cipriano, P. E. & Murphy, J. (2011). Nursing informatics. The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 282, 286-289
HealthStream (2021). How Nursing Informatics Benefits Quality Outcomes. Retrieved December 02, 2022, from
Laureate Education (Producer). (2018). What is Informatics? [Video file]. Baltimore, MD: Author.
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Collapse SubdiscussionRemi Oluremi Ojo Hi Mleh.
Thank you for the informative post. I agree with you that catheter-associated urinary tract infections (CAUTIs) account for most healthcare-associated infections (HCAIs). CAUTIs have a negative impact on patients, it is expensive and increases the length of hospital stay. To make matters worse Medicare does not reimburse medical facilities for some HCAIs (Welden, 2013). Thankfully, medical facilities are reducing the rate of infections by using electronic health record (EHR) systems to streamline workflows to ensure that healthcare professionals follow the best clinical practices. For example, in the past, catheters could be placed in many patients that are hospitalized, but now patients will have to meet a specific clinical criterion for catheters to be inserted and for a specified length of time. Once a catheter is placed, the EHR systems can be leveraged to remind healthcare providers that a patient has a catheter and recommend removing it at the specified time or document why it should remain. EHR can also help to minimize a patient’s risk of infection; many medical facilities still have interdisciplinary members performing retroactive chart reviews of healthcare-associated infections occurrences to find what can the done differently to lessen or alleviate the risk of infection. This can be effectively achieved by a well-organized EHR, where a large data set can be looked at and sorted to find patterns and make proactive suggestions for healthcare providers (Walker-Czyz, 2016). When clinicians identify an infection in a timely manner, consistent procedures such as isolating the patient, putting on special personal protective equipment (PPE), and handwashing procedures to prevent the spread can be communicated to the staff using EHR.
References
Walker-Czyz A. (2016). The Impact of an Integrated Electronic Health Record Adoption on Nursing Care Quality. The Journal of nursing administration, 46(7-8), 366–372. https://doi.org/10.1097/NNA.0000000000000360
Welden L. M. (2013). Electronic Health Record: Driving Evidence-Based Catheter-Associated Urinary Tract Infections (CAUTI) Care Practices. Online journal of issues in nursing, 18(3), 6.
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Collapse SubdiscussionRemi Oluremi Ojo Transforming Nursing and Healthcare through Technology
NURS-6051N Week 1 Discussion.For nearly four decades, nurses have been involved in working in the informatics field, and the term nursing informatics (NI) has been studied as a specialty in the resources of nursing since 1984. In 1985, nursing Informatics is defined as the application of information technology (IT) in the field of nursing. It includes the incorporation of nursing science, information science, and computer science to support the management of knowledge and the practice of nursing. Nursing informatics is defined by the American Nurses Association as: “the specialty that integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice. NI supports nurses, consumers, patients, the interprofessional healthcare team, and other stakeholders in their decision-making in all roles and settings to achieve desired outcomes. This support is accomplished through the use of information structures, information processes, and information technology.” (ANA, 2016). Presently, it is believed by most nursing professionals in nursing that NI is the integration of IT and entire aspects of nursing such as education or research, clinical nursing, and management (Darvish et al., 2014). Many aspects of NI such as electronic patient records, telenursing, data recovery, e-learning, patient care, imaging informatics, ethics, security, decision support system, intelligent system, computer science, human-computer interaction, and information science have been added to the field. Considering the definition, history, and competencies of NI, it is evident that NI is an important field that automatically integrates nurses into the IT field. For this reason, nurses should be required to study the impact of NI on healthcare and be provided with appropriate IT education so that they are able to apply IT in the field of successfully to improve the quality-of-care outcomes (Darvish et al., 2014). In the global world, health IT is being implemented rapidly and widely in healthcare settings. Nurses represent the largest group of health professionals worldwide, therefore they are the largest group to use these technologies. Nurses in various settings now use health information technologies, Nevertheless, nurse leaders do not often have the necessary strategic competencies in informatics to effectively ensure their adoption and use. As a result, a collaborative effort has been put in place in several countries to ensure that nurses that are planning to practice in various settings hold competencies that will enable them to apply technologies in productive and useful ways that will benefit the professionals and patients
An hypothetical scenario based on my own healthcare practice or organization that would require or benefit from the access or collection and application of data is the Care everywhere (CE) electronic record. I worked with the elderly in the Program of All-inclusive Care for the Elderly (PACE) which is an alternative to nursing facilities. The participants receive customized healthcare at the PACE center on Monday to Friday 8:30am to 4:00pm and at home after regular working hours. Most of these participants have multiple medical problems and see other providers and specialist apart from the PACE providers. In time past, when they have an appointment with providers outside of PACE, they hand carry their records to the appointment. When they are being seen in the Emergency Department (ED), the providers in the ED usually struggle with getting information they need to provide care. This usually result in duplicating tests some of the participant recently had. To avoid the gap in communication between providers and medical facilities, my facility implemented the use of EPIC system corporation Electronic Health Record system (EHR) which includes the Care everywhere (CE). The CE is a part of a comprehensive EHR system that can be used to exchange records with other EPIC or non-EPIC users that use EHR that supports the same standard based messaging. When CE results are uploaded in the EHR an icon appears on the front page of the chart to indicate to the user that CE records are available for viewing. A written consent is required from the patient at each encounter with the provider due to privacy laws involved in the exchange of protected health information. Physicians believes that CE is an invaluable asset, especially in the ED; it bridges the gap in information, helps to reduce duplicate diagnostic testing and procedures and eventually save time and improve patient outcomes (Winden, et al, 2014). As patients receive and transition in care, it is important to share accurate information in a timely manner, that’s why medical records are being transitioned from paper-based health records to electronic records for easy access and exchange of health information (Health Quality Ontario, 2013).References
American Nurses Association, & American Nurses Association. ANA (2016). Nursing informatics: Scope and standards of practice. American Nurses Association.
Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science, 6(6), 11–18. https://doi.org/10.5539/gjhs.v6n6p11
Health Quality Ontario (2013). Electronic tools for health information exchange: an evidence-based analysis. Ontario health technology assessment series, 13(11), 1–76.
Kassam, I., Nagle, L., & Strudwick, G. (2017). Informatics competencies for nurse leaders: protocol for a scoping review. BMJ open, 7(12), e018855. https://doi.org/10.1136/bmjopen-2017-018855
Winden, T. J., Boland, L. L., Frey, N. G., Satterlee, P. A., & Hokanson, J. S. (2014). Care everywhere, a point-to-point HIE tool: utilization and impact on patient care in the ED. Applied clinical informatics, 5(2), 388–401. doi:10.4338/ACI-2013-12-RA-0100 -
Collapse SubdiscussionColleen Lewis Discussion post
I currently work in the Emergency Department of a pediatric hospital where we receive many patients presenting for suicidal ideation, suicide attempts, and aggressive behaviors that parents feel can no longer be managed at home. The number of children presenting to the Emergency Department for psychiatric or behavioral concerns has increased significantly over the past decade. “This increase in mental health issues coupled with inadequate treatment options are contributing to an expanding role of emergency departments (EDs) in managing acute behavioral health crises” (Rana et al. 2022). “Increased use of the ED by this patient population makes it essential to better understand factors that influence ED care and ED visit outcomes” (Brathwaite et al. 2022). Given this increase, there is a need for an improved system to accommodate these patients’ needs and track their care during their stay in the ED.
From my experience, many of these kids already have prescription psychiatric medications they are taking at home. Between the focus on caring for immediate needs of these patients when they present and the regular bustle of the ED, sometimes their home medications needed during the stay are not raised to attention during the initial conversations with nurses and physicians. Patients may miss one or even a couple doses of regularly scheduled home psychiatric medications while waiting in the ED for placement in a behavioral health facility or to be cleared to return home. I think it would be helpful if there were a reminder to ask about home medications set to auto-populate when entering the chart of a patient who has a chief complaint of intentional overdose, behavioral issue, psychiatric problem, or aggression, for example. It’s unfortunate there’s not currently a better system in place to ensure these patients are administered their home medications in a timely manner. Since the ED is where these patients are held and receive care to support them until placement, it is totally counterproductive and unacceptable for them to miss psychiatric medications at their regularly scheduled times.
A report could generate when these reminders are overridden or accepted without documentation of medication(s) reported by patients and/or parents. In the case that there are no medications taken at home, the provider can select an option such as “no home medications reported”. While this may seem like an extra click or an annoyance for some nurses or providers, utilizing reminders and collecting data in this way benefits the patient. It “will allow clinicians to provide comprehensive, safe, evidence-based care to all of their patients” (Sweeney, 2017). This use of data could help to identify gaps in care for this growing population of patients in the ED.
References
Brathwaite, D., Strain, A., Waller, A. E., Weinberger, M., & Stearns, S. C. (2022). The effect of increased emergency department demand on Throughput Times and disposition status for pediatric psychiatric patients. The American Journal of Emergency Medicine. https://doi.org/10.1016/j.ajem.2022.11.028
Rana, G. S., Nordsletten, A., Sivananthan, M., & Hong, V. (2022). A 6-year retrospective review of Psychiatric Emergency Service Utilization by school-age children. Clinical Child Psychology and Psychiatry, 135910452110709. https://doi.org/10.1177/13591045211070924
Sweeney, J. (Feb, 2017). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21( 1).