Nursing informatics allows nurses to collect and analyze patient data, monitor vital signs, and access electronic health records (EHRs) to inform patient care decisions. With the use of electronic medication administration records (eMARs), nurses can reduce medication errors and improve patient safety. Nursing informatics is a field that combines nursing science, computer science, and information science to manage and communicate nursing data, information, and knowledge. It plays a critical role in hospital nursing by providing nurses with the tools and technologies necessary to manage patient care more efficiently and effectively (RezayI et al., 2022).

Nursing informatics also helps nurses to communicate with other healthcare providers, track patient outcomes, and manage patient populations more effectively. In addition to improving patient care, nursing informatics also plays a role in hospital administration. Using data analytics tools, hospital administrators can make informed decisions about resource allocation, staffing, and quality improvement initiatives. Nursing informatics also supports research by providing nurses access to large datasets for analysis and exploration. The software used in electronic charting can decrease errors and help save patients’ lives (Sahar et al., 2022).

As a critical care nurse, nursing informatics is crucial for patient care. With technological advancements, medical professionals can observe the severity of the patient’s condition more closely with the data input into the eMARs. Equipment, such as vital machine monitors, can link up to the HER and assist the nurses with trends in the vital signs. The informatics team at the hospital I work just updated their sepsis monitoring alerts on the eMAR to help decrease the chances of patients developing serve sepsis and upgrading to critical care. This alert compares the vital signs and necessary labs showing when a patient is septic. A nurse leader would use clinical reasoning and judgment on this feature by knowing when the patient is already being treated for sepsis versus a new onset. This sepsis alert generates when there is an increase in labs or vital signs, but sometimes the heart rate is inaccurate due to environmental factors. In summary, technology is critical in modern hospitals, helping healthcare providers improve patient care, reduce medical errors, and increase efficiency.

References

Rezayi, S., Amanollahi, A., Shahmoradi, L., Rezaei, N., Katigari, M. R., Zolfaghari, M., & Manafi, B. (2022). Effects of technology-based educational tools on nursing learning outcomes in intensive care units: a systematic review and meta-analysis. BMC Medical Education, 22(1), 1–18. https://doi.org/10.1186/s12909-022-03810-z

Sahar Peivandi, Leila Ahmadian, Jamileh Farokhzadian, & Yunes Jahani. (2022). Evaluation and comparison of errors on nursing notes created by online and offline speech recognition technology and handwritten: an interventional study. BMC Medical Informatics and Decision Making, 22(1), 1–6. https://doi.org/10.1186/s12911-022-01835-4

Today’s technological advancement is solving to increasing adoption and utilization of healthcare IT in diverse roles, including systems to manage patient information and care delivery practices. According to Bates (2000), emerging and modern technologies have transformed the care sector differently. Whether large or small, hospital organizations and healthcare professionals have implemented diverse modern technologies to respond to the ever-changing healthcare environment and increasing calls to improve care quality. The increasing digitalization and adoption of technology in healthcare have resulted in the use of informatics experts. Some tech-trained professionals possess medical and IT knowledge, fostering smooth adoption and use of technology tools and systems in care delivery. This paper provides a reflection on the use of information technology to reduce rates of medication errors in healthcare organizations.

Reduced medication errors have become a significant indicator of quality healthcare care and effectively performing healthcare organizations (Bates, 2000). As a critical metric factor, organizations and physicians are increasingly adopting diverse practices and strategies to ensure minimally, or zero medication errors are experienced. Various ways, including electronic prescribing, have been adopted to help reduce prescription-related mistakes, among other errors, in healthcare settings. According to Agrawal(2019), medication errors are considered preventable events that may result in inappropriate medication, harming the patient. Examples include taking incorrect dosage or the wrong combination of drugs, medication errors that may occur due to incorrect diagnosis, prescription-related errors, miscalculation of dosage, and poor communication.

Different data or information can be utilized to address medication-related errors. These include the frequency of occurrence, patient complaints, and errors such as type of drugs, wrong medication, patient details wrongly captured, wrong patient, and incorrect time. The data can be derived from direct database observations, incident reporting, and patient monitoring reports. The data may collect via reported cases, comments, and patient monitoring programs. Regarding accessing the data, the information may be drawn from patient portals, pharmacy, and physician reports.

The collected data regarding medication errors may provide diverse details regarding the causes and impact on care delivery practices. These may include a need for a defined organization prescription plan, wrong labeling, communication breakdown between the physicians and the pharmacy, wrong patient, etc. On the other hand, by identifying the data behind the causes of medical errors, the organization leadership develops an integrated medication prescription system that overcomes the previously identified barriers to effective and quality care with minimal errors in medical prescription. According to Agrawal (2019), adopting technology and its founded prescription system would automate the medication process. This would lead to reduced chances of medical errors. It utilizes IT innovations such as robots refilling prescriptions, implementing coding systems, and automated dispensing machines. Using an integrated electronic health system for patient records, this workflow can reduce medication errors.

Nurse leaders are critical in linking the nursing practice to desired patient outcomes. Developing and adopting critical clinical reasoning and judgment skills helps nurses adopt the right actions and behavior to address patient needs. Both clinical sense and judgment provide nurses and other healthcare professionals with the right skills and knowledge to evaluate the best scientific evidence by adopting the best treatment for the patient. It also ensures nurse leaders make prompt interventions and patient-based care practices, improving the quality of care and minimizing healthcare and medication-aligned errors. Finally, clinical reasoning and judgment allow nurse leaders to utilize diverse IT and technological tools to make sound and best possible decisions, resulting in improved care delivery, positive patient experience, and decreased chances for medication errors. It provides evidence and data-driven healthcare decision-making, providing quality care and reducing medical errors.

References

Agrawal, A. (2019). 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.

Bates, D. W. (2000). Using information technology to reduce rates of medication errors in hospitals. BMJ, 320(7237), 788–791. https://doi.org/10.1136/bmj.320.7237.788Links to an external site.

The Application of Data to Problem-Solving

Nursing informatics is the application of IT in nursing practice (Booth et al., 2021). Nurses use nursing informatics to integrate healthcare information and technology to help manage health issues and promote healthcare quality, patient experience, and outcomes. Nursing informatics ensures efficient management of data and IT to ensure the delivery of high-quality patient care. Nurses handle a wide range of data relating to patients’ personal information, healthcare needs, and medical records. Nursing informatics helps nurses organize the data to ensure a seamless flow of healthcare activities. According to Booth et al. (2021), nursing informatics lays a foundation for quality and safe healthcare practices.

One area within my healthcare practice in the mental health practice where data, statistics and information collection, and access would help improve care and patient outcomes is preventing falls among elderly patients. Patient falls are associated with multiple consequences that affect the health and well-being of patients, including prolonged hospital stays, readmission, infections, and even death (Vaishya & Vaish, 2020). Collecting, reviewing, and making accessible data about counts or statistics, causes, dangers, consequences, and prevention interventions of patient fall to healthcare practitioners could be helpful in guiding the formulation of suitable interventions to prevent falls and reduce risks to patients at risk. Data might be collected and accessed by keeping track of the patient’s details and their healthcare needs. Data on the number of patients per ward, their medications, frequency of bathroom use, time of meals, and sleep patterns could be collected and accessed to support the formulation of fall prevention measures (Vaishya & Vaish, 2020). The information would help nurses best strategies that have shown success in preventing hospital falls. Hospitals and nursing leaders can use data on patient falls to determine if there is a need to improve the facility’s design to reduce the risk of falls, prevent patient falls and improve patient safety, well-being, and outcomes.

Nurse leaders use clinical reasoning and judgment by diligently collecting and analyzing data before formulating clinical interventions (Joseph et al., 2021). In this scenario, the nurse leader would diligently collect, analyze, process, and provide the junior nurses with data and information on falls among elderly patients and encourage them to review the data and strategize for solutions. The nurse leader would analyze the data to understand the causes of falls before implementing fall prevention plans. Clinical reasoning and judgment will enhance the nurse leader’s problem-solving abilities, facilitate in-depth analyses of elderly patients’ health problems and enable safe nursing care to prevent falls (Joseph et al., 2021).

References

Booth, R. G., Strudwick, G., McBride, S., O’Connor, S., & Solano López, A. L. (2021). How the nursing profession should adapt for a digital future. The BMJ, 373, 11-90. https://doi.org/10.1136/bmj.n1190Links to an external site.

Joseph, M. L., Phillips, B. C., Edmonson, C., Godfrey, N., Liebig, D., Luparell, S., & Weybrew, K. (2021). The nurse leader’s role: A conduit for professional identity formation and sustainability. Nurse Leader, 19(1), 27-32. https://www.sciencedirect.com/science/article/abs/pii/S1541461220302664Links to an external site.

Vaishya, R., & Vaish, A. (2020). Falls in older adults are serious. Indian Journal of Orthopaedics, 54(1), 69–74. https://doi.org/10.1007/s43465-019-00037-xLinks to an external site.

Week One: Initial Post

The Application of Data to Problem Solving

According to the American Nursing Association (ANA), nursing informatics is the integration of nursing and sciences to collect and interpret data outcomes to assist in evolving healthcare technology such as EMRs, telehealth, and patient safety measures (n.d.). Nursing informatics will always be forever evolving as technology gets more in depth.

The Scenario

Since COVID-19 the use of telehealth has increased greatly, especially for those with mental health disorders. I work at an outpatient psychiatric/behavioral health clinic where we see mostly SMI (serious mental illness) members/patients and the use of telehealth has greatly helped a lot of our members to be able to see a provider without having to come into the clinic. If they do not have a cell phone or computer, generally a case manager or nurse will go to the members residence to assist with a work cell phone/tablet. The clinic lobby prior to COVID-19 restrictions was always very full of many of the members “hanging out” in the lobby. This became an issue as many of the members did not practice good hygiene and the possibility of the spread of the virus was high. The use of telehealth for the members to see the providers decreased the activity in the lobby and clinic and allowed for the providers to see more members and keep everyone (members and staff) safe.

Describe the data that could be used and how the data might be collected and accessed.

The data is generally collected via surveys and by analyzing insurance claims reports. In August 2020 during the pandemic, the World Health Organization (WHO) surveyed 130 different countries around the world and found that approximately 70% of these countries started to use telehealth during the pandemic, specifically for mental health uses (Wu, Y., 2021). These appointments are generally done over ZOOM or TEAMS meeting, and I personally feel like it has increased the consistency of people keeping their appointments, therefor decreasing their risk factors.

What knowledge might be derived from the data?

According to the data from the Centers for Disease Control (CDC), in 2021 the National Health Interview Survey found that “37.0% of adults used telemedicine in the past 12 months” and “telemedicine use increased with age, and was higher among women (42.0%) compared to men (31.7%” (CDC., 2022). Since 2021, the data shows that the value of the telehealth industry is increasing but the information is conflicting on what the current market size value is and will be. I have found that it could be anywhere up to 800 billion dollars by 2030.

How would a nurse leader use clinical reasoning and judgment in the formation of knowledge?

As a nurse leader, there is much clinical reasoning for using telehealth. First it helps for members to meet with the provider, but it also allows for the nurses to be able to connect with the members as well, although not used as much at my clinic. I honestly prefer telehealth for my provider visits as I feel I can open up more to them via phone call vs in person. While the nurses may not perform much telehealth at my clinic, we are all trained on how to work it and how to connect with the provider. Now that COVID-19 has settled down a little, we have been allowing members back into the clinic with proper precautions. Although the members are coming back to the clinic, the providers still prefer telehealth and will ZOOM from home and the member will be set up with a laptop in a team room. The hardest part of working in a clinic like I do, some of the members suffer from paranoia and this makes it difficult for us due to them stating they are “talking to someone in the T.V”. As the nurse, we try to comfort them, but it can be difficult. The data shows that telehealth is up and coming and will become a huge part of providing and receiving medical and mental health care.

Resources

Nursing informatics: Scope and standards of practice, 2nd ed. (n.d.). ANA. Retrieved on March 1, 2023, from

https://www.nursingworld.org/nurses-books/nursing-informatics-scope-and-standards-of-practice-2nd-ed/Links to an external site.

Products – Data briefs – Number 445 – October 2022. (2022, October 12). Centers for Disease Control and Prevention. Retrieved on March 1, 2023, from

https://www.cdc.gov/nchs/products/databriefs/db445.htm#:~:text=Data%20from%20the%20National%20Health%20Interview%20Survey,-In%202021%2C%2037.0&text=Non%2DHispanic%20White%20(39.2%25),Hispanic%20Asian%20(33.0%25)%20adultsLinks to an external site.

Wu, Y. (10, October). Utilization of Telehealth and the advancement of nursing informatics during COVID-19 pandemic. PubMed Central (PMC). Retrieved on March 1, 2023, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8446920/Links to an external site.

Week 1

Main Post: Dewona K. Wilson, RN 

                                                                           The Application of Data to Problem-Solving 

Nursing informatics is a specialty that combines technology and patient care (Symplr, 2023). Nurse informatics acts as the bridge between a healthcare organization’s systems and its providers and clinical staff. Because of their unique training both as registered nurses (RNs) and information technology specialists, nurse informaticists understand how all the pieces fit together and provide valuable input into how systems should be designed from a provider standpoint (Symplr, 2023).

I currently work with the behavioral health unit at our city jail as an RN. I have been in several different scenarios that had a gap in my ability to find data to improve care in my unit. Due to the high-risk population, we have such as drug addiction, alcohol abuse, and self-harm injuries we do have falls. In 2022, we had 18 falls which was an increase from the year before which we only had 11 falls. I collaborated with my manager and asked if we had a way of differentiating between the types of falls. I wanted to know where the falls from possible drug/ alcohol in their system, musculoskeletal problems, cognitive deficit, any prescribed medication, and what was the target and sex with the most falls. Unfortunately, I was advised we didn’t have a system in place to store or collect the data I was requesting.

If we had the proper data to pull the statistics it would help improve the number of falls and injuries. We have no information regarding how or why the falls have taken place. That is viable information in order to find out a solution to the problem. At the time we had an outdated system in place called, “Sunrise.” Since then we have switched over to a system called, “Epic.” The problem I ran into was Epic didn’t have a designated area to pull the demographic data for falls. There are different versions of Epic I was advised by leadership. I collaborated with them voicing the benefits of updating and getting the correct version to allow us to have better patient outcomes and improve the overall health of the high-risk population. Having a fall protocol in place with the proper interventions will not only help the patient but improve costs. It will be fewer visits to the ER and fewer assistive devices needing to be ordered. Nursing informatics is very important in this situation and can help with cost-effectiveness and better healthcare.

As a leader, I would use clinical data to find the root cause of the problem. Then I would come up with multiple solutions to fix the problem. I would hold a meeting with fellow staff to get their input and showcase the data that I was able to obtain. Then I would execute the agreed plan in my organization. In addition, I would create new policies. Some policies would include fall risk assessments done on each and every fall. I would have high-risk patients roomed in cells closer to healthcare staff and have accommodating rooms for people who are fragile like the elderly or any medical condition that would put them at risk for falls. Nursing informatics is essential to track this type of information to improve quality care for patients.

In conclusion, it will better the patients and will help improve the number of falls in the facility. As a nurse leader, I will use my clinical judgment and reasoning skills to find resources to help collect data. The data I receive will help me analyze any adjustments that will need to be made. Online portal systems, electronic health records, and even essential smaller technologies such as vital machines and glucometers make up just part of the nursing informatics that patients and healthcare clinicians use to provide and receive care (Sweeney, 2017).

                                                                                                              References

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics  (OJNI), 21(1).

What Is Nursing Informatics? | symplr. (2023). https://www.symplr.com/blog/what-is-nursing-informaticsLinks to an external site.

Week 1 Discussion

The healthcare system in the United States has experienced significant changes with evolving technology that minimizes errors and allows for greater accessibility for patients to become proactive in their healthcare choices. Not only does it facilitate convenience for providers and patients, but it opens the doors for greater access to healthcare which is a gap we can bridge daily by using technology.

Nurses use informatics and technology daily from the simplest tasks such as collecting vital signs, electronic medical records, and using online portals to communicate with patients. Advanced technology has allowed for evidence-based practice to be easily accessible to health care providers. Evidence based practice and research can help facilitate the delivery of quality care. Today, the use of computers has been a safer method to protect patient confidentiality and reduce medical errors of charting including prescription management (Pearce & Whyte, 2018). Nurses are the bridge that communicated with patients directly and through technology we can follow up on patients and educate accordingly.

The current position I hold is a primary care nurse at a chain of clinics which bases their medicine on tele-health medicine. I never understood the true value of informatics and technology until I started working with a company that based the future of medicine on technology. The company built an application that allows full tele-health visits with providers and allows for prescription and testing follow-up. Patients can get their blood work done at a local office and have all follow up visits including prescription management through the portal. The patient simply schedules a visit with the provider by selecting a timeslot and can have a virtual visit through the app, the patient can directly communicate with the provider and have full access to testing results within one to two days. The patient can request prescription renewals through the app and is alerted for yearly check ups including mammogram reminders and colonoscopy scheduling. Telehealth medicine allows people to be more pro-active about their health simply through convenience. As a nurse I am responsible for reporting results to patients and flagging abnormal results to providers to communicate with patients. Through technology, providers can communicate with each other to reach the best possible healthcare outcomes and attend huddles weekly to discuss any problems or concerns we faced throughout the week.

Through technology medical professionals including nurses can communicate vastly, efficiently, and timely to address health concerns and come up with better alternatives to treatment. Nursing organizations around the world have been able to communicate research practice through email and webinars which have allowed nurses to become more knowledgeable in their fields. In the world of medicine, technology can be a powerful driving force for our patients to seek our care. After Covid-19, we witnessed the true power of technology, and it pushed people to enter the tech world. Tele-health medicine became a popular solution for many and remains so today. Mental health visits have become a highly regarded and demanded option specifically using tele-health medicine especially since health insurance companies plan on covering mental health visits. Through technology, we can access rural and underserved communities and fill the gap for healthcare needs which will reduce health disparities. Every year we see technological advancements being used to enhance patient care, recently I have been using the vein finder which helps locate veins and reduce the amount of failed IV insertions.

Nursing informatics and technology is crucial part of healthcare because it affects management, clinical outcomes, and legalities when it comes to healthcare. Leaders can use IT to track medical records and preserve patient confidentiality. Through informatics, policies can be made and implemented with data collection and convenience of location.

References:

Pearce, R., & Whyte, I. (2018). Editorial: Electronic medication management: Is it a silver bullet? Australian Prescriber, 41(2), 32–33. https://doi.org/10.18773/austprescr.2018.012Links to an external site.Links to an external site.

Sweeney, J. (2017). Healthcare informaticsLinks to an external site.Links to an external site.Links to an external site.. Online Journal of Nursing Informatics, 21(1).

Walden University, LLC. (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Autho

Nursing informatics is a specialty that has to often adapt to changes very rapidly,  many nurses in this role are often responsible for training, education, and research within their companies (Snipes, 2019). This will continue to allow nursing to be more advanced, while it may not have been defined as a specific scope of practice (Nagle et al., 2017). It is also imperative for companies to see what exactly needs to be improved and what’s working for everyone.

The focus of my scenario is the overlooked mental health conditions of individuals in correctional facilities. Many of these individuals come in for whatever crime they have committed and have to become used to the new normal of losing freedom, time constraints, and the inability to see family or friends anymore. Often incarceration stems from an already existing mental health issue (possibly undiagnosed), or one can be developed from such a significant change.

I can say from personal experience many of the officers within the correctional facility don’t often know some signs of possible mental health crises until it is too late. One of the everyday things the night shift nurses at the correctional facility where I work at PRN are trying to implement is having each individual upon intake have a mental health evaluation by one of our professionals within 48 hours. However, one of the main issues with healthcare in corrections is, you have to put in a request to see medical, mental health, a dentist, etc. Most of these issues aren’t addressed immediately. It could take almost a 2-3months for an inmate to see a mental health professional. On top of that, everything we do is on paper and then transferred into an out-of-date charting system. So there is no way for my nurse manager to see any trends in mental health visits and check for basic charting errors.

With all the issues of getting mental health staffing and implementing mandatory mental health checks within 48 hours, I feel it would be beneficial to incorporate telemedicine behavioral and mental health visits for nighttime staff. This would allow correctional facilities to reach more of the inmate population while preventing many mental health crises among these individuals.

If a nurse informatics practitioner were able to look at a correlation between establishing a mandatory mental health visit, there would be less likelihood of incidents of waiting till it is too late. And if telehealth is used, more inmates could be using the service at once on multiple facilities’ devices, allowing more to get seen in a timely manner rather than one by one as they are doing now.

A nurse leader could use the data from the incidents of telepsychology and mental health crises within the facilities. This would allow not only the medical staff but the warden as well to see if this is something that cuts down on the number of inmates that have to be seen by outside hospitals and would allow for a more stable environment for treating mental health.

References

Jones, A., & Quandt, K. R. (2021, May 13). Research roundup: Incarceration can cause lasting damage to mental health. Prison policy initiative. https://www.prisonpolicy.org/blog/2021/05/13/mentalhealthimpacts/Links to an external site.

Kaftarian, E. (2019). Lessons learned in prison and jail-based telepsychiatry. Current Psychiatry Reports, 21(3). https://doi.org/10.1007/s11920-019-1004-5Links to an external site.

Kucirka, B. G., & Ramirez, J. (2019). Challenges of treating mental health issues in correctional settings. Journal of Psychosocial Nursing and Mental Health Services, 57(7), 7–11. https://doi.org/10.3928/02793695-20190612-02Links to an external site.

Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. Open Access. https://doi.org/doi:10.3233/978-1-61499-738-2-212Links to an external site.

Snipes, C. (2019). Application of nursing informatics (6th ed.). Springer.

THE APPLICATION OF DATA TO PROBLEM-SOLVING.

Informatics is used in a variety of clinical settings. Clinicians and patients use online portal systems, electronic medical records, data collection devices such as vital sign machines and glucometers, personal data devices, and email (Sweeney, 2017). When considering these systems and how they affect the process and flow of the clinical setting, it is critical to consider the technology at hand as well as the workflow and data collection processes. Informatics can help bridge that gap (Sweeney, 2017). Healthcare informaticists can improve care delivery, health outcomes, and patient education, among other things.

Health information technology includes many technologies, from basic charting to more complex decision support and integration with medical technology (Sweeney, 2017). Health information technology offers many ways to improve and change healthcare, such as reducing human errors, improving clinical outcomes, coordinating care, making practices more efficient, and keeping track of data over time (Sweeney, 2017). Barcode medication administration systems are computer systems that use barcode technology and electronic records of how medications are given (Sweeney, 2017). These systems prevent medication mistakes by ensuring the right patient gets the right medicine at the right time.

I worked in a nursing organization that relied entirely on paper charts. Many facilities continued to use paper charting to keep patient records and day-to-day care because they needed an up-to-date technology system. Medication errors were one of many incidents that occurred weekly in our facility. Interruptions during medication administration or human error in mixing medication names or similar patients’ names were among the causes of the high number of medication errors in my facility. Handwritten prescriptions have resulted in numerous errors in the entry of medication orders at my facility. Using technology can reduce medication errors by 50%-80%. (Alotaibi & Federico, 2017). Medication orders will be available to multiple healthcare providers before they are administered to patients (Alotaibi & Federico, 2017). Medication errors have been reduced by using multiple methods to identify patients before administering medication (Alotaibi & Federico, 2017). Overall, using health information technology in an inpatient or outpatient settings has resulted in significant improvements in reducing medication errors and improving patient safety.

Health informatics and nursing Informatics is crucial in evolving healthcare systems. New technologies and initiatives are constantly being developed. These innovations have implications in the clinical, managerial, and policy settings. Informatics are tools that leaders can use to achieve their goals and improve our healthcare systems (Walden University, 2018). As technology evolves, bright, innovative, and transformative leaders must understand how to leverage these tools and use them appropriately to achieve their goal of providing safe and effective patient care. 

Reference

Alotaibi, Y. K., & Federico, F. (2017, December). The impact of Health Information Technology on patient safety. Saudi medical journal. Retrieved February 28, 2023, from https://pubmed.ncbi.nlm.nih.gov/29209664/Links to an external site.

McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.

Sweeney, J. (2017). Healthcare informaticsLinks to an external site.Links to an external site.. Online Journal of Nursing Informatics, 21(1).

Walden University, LLC. (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.

Main Post  

Health informatics is not new to the healthcare system, but it is evolving, expanding, and creating new ways to deliver health care more efficiently and cost effectively. With modern technology and digital world teaching us to be time efficient and new possibilities of health improvement strategies. But there is still a lack of processing technology in our health system. With use of data collection, electronic health records, use of digital devices and knowledge of informatics, we can bridge the gap between technology and its implementation process (Sweeney, 2017).  

In today’s world, nurses are also taking interest in informatics and specialization (Nagle, Sermeus, Junger & Bloomberg, 2017). Getting knowledge of the technology and informatics can nurses bring change in health care system and evidence-based practices with digital delivery care system not only improve quality care, also enhances nurse’s role and function (Sweeney, 2017). Policy makers are also using digital data collection and informatics to improve policies, but with digital data it is crucial to have policies in place for confidentiality of the data, and while communication between providers via electronic basis (Sweeney, 2017).  

In my organization we have technology used to have wristbands for every patient in the facility with one barcode. With help of the barcode and using 6 rights of administration, providers, and healthcare givers collect and submit electronic health records and before any procedures or care given barcode get scanned, that way all the data is visual just with one click. It sure has a risk of breach of confidentiality but with the policy of HIPAA regulation we can manage. Moreover, Nurses and health care professionals needed training in electronic health records and using modern technology, tablets, and computers to implement this in the facility. But these barcoded wristbands surely save time and this experience for health care professionals, especially nurses connect with technology and creates insight, wisdom about informatics and more innovative ideas related to technology prone health industry. Moreover, communication is easier between healthcare professionals and more error free.  

Having the data at one place, it is easier for healthcare professionals and nursing leaders to examine any issues when they arise (Walden University, LLC), 2018). And with knowledge of health informatics nursing leaders can make policies, and decisions regarding errors or the issues by consulting IT specialists in the departments and with nurses to overall improve delivery care. (Nagle, Sermeus, Junger, & Bloomberg, 2017).  

The health care industry is changing as we are adapting technology in every aspect of our life. Health informatics and use of artificial intelligence can evolve care delivery systems significantly (Walden University, LLC, 2018). In future, Modern technology will not only with the help in diagnosis for providers and for consumers when they need in emergency, they can ask for help to artificial intelligence what they can do in emergency situations (Walden university, LLC, 2018). 

 It is more important for us to know up to what extent we need this in healthcare system so everyone can benefit and not get harm and having constant human touch for quality care.  

References 

Nagle, L., Sermeus, W., Junger, A., Bloomberg, L. S. (2017) Evolving role of Nursing Informatics specialists. In Murphy, J., Goosen, W., & Weber, P. (Eds), Forecasting Competencies for Nurses in the Future of Connected health (212-221). Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF 

Sweeney, J. (2017). Health informatics. Online Journal of Nursing Informatics, 21 (1). Retrieved from https://www.himss.org/resources/online-journal-nursing-informatics 

Walden University, LLC. (Producer). (2018). Health informatics and Population Health: Trends in population health (Video File). Baltimore, MD. Author. Retrieved from https://waldenu.instructure.com/courses/52929/pages/module-1-learning-resources?module_item_id=1039506 

Throughout the world, nurses are engaging in academic pursuits to
advance the knowledge base of nursing informatics through the conduct of research.
Nurses have pursued these opportunities recognizing the necessity of informatics knowledge and skills now and particularly into the future, as they face an increasingly connected world of digital healthcare. To a large extent, the core competencies of the nursing
informatics specialists have become essential for all nurses, and expectations of the
specialist role will continue to evolve even further.
Challenge is that clinical practice in the future will be primarily team-based.
The nature of teams will include interprofessional teams, patients and their relatives, and a wide range of virtual devices (internet of things – IoT) that are all connected.
Teams will work across the boundaries of organizations and will organize around a particular patient. This notion of teamwork contrasts with what we usually see as teams organized in organizations, departments, and units. In experience, conversation with the primary nurse, case manager patient, and case manager of the patient via telehealth gives a better understanding of the discharge planning scenario of the patient. The patient’s case manager gave Information that the patient could not give and succeeded in the patient’s continuity of care outside the hospital. In addition, medication via technology is the pharmacy of choice for patients who can get their medication or deliver it in their own time.
In a hospital setting, we can access patient health care history such as past procedures, doctors and diagnoses, health care plan, and previous medication with technology when the patient continues seeking health attention in the same hospital. Otherwise, we can access records with communication and technology if a patient comes from another hospital. Still, Information from the patient may give an update on what is going on with the patient’s health care. In some cases, for patients with the cognitive issue, past Information via technology can be a huge help, and relative or first contacts of the patient can be essential for the health welfare of the patient.
Also, taking care of mom by checking blood glucose and vital signs and appointments with a physician via telephone is easy to access for all of us—no need to come to the clinic for a check-up.

The use of informatics is helpful in many processes within the clinical setting. Whether inpatient or outpatient, clinicians, and patients utilize online portal systems, electronic medical records, data collection devices such as vital sign machines and glucometers, personal data devices, and email, to name a few. When considering these systems and how they affect the process and flow of the clinical setting, it is essential to consider not only the technology at hand but furthermore the workflow and the data collection process. Norris, Hinrichs, & Brown tell us that “gaps exist between the technology and the process. Informatics can help bridge that gap. Skills needed include understanding data collection, storage, and extraction, as well as an appreciation for the power of data to drive and inform practice” (2015, p. 11-12). Healthcare informaticists, especially nursing informaticists, are the prime group to help bridge that gap. Gaps will remain without a strong clinician presence in the building and implementation process. With healthcare informaticists involved in the development, a strong product can be helpful to all healthcare team members.

References:

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
• Sweeney, J. (2017). Healthcare informatics

 Links to an external site.. Online Journal of Nursing Informatics, 21(1).

Week 1 Discussion Main Post

Knowledge is a collective process of information acquisition that is carefully assimilated to be disseminated and undergo development to be processed, evaluated, and utilized if proven significant to the majority. In the current era, knowledge is heralded as the most reliable tool for involvement in the community and individual aspects. Sources of knowledge relevant to practice in the form of research articles, scientific experimentations, and clinical experiences are the backbone of the present-day healthcare delivery system (McGonigle & Mastrian, 2022). The advent of technology has made a revolutionary development in the healthcare industry. Scientific healthcare information underwent computer and informatics upgrades and continues to evolve to enhance care delivery in an organized, systematized, and accessible manner (Sweeney, 2017).

The organization I am working with is a network of hospitals and clinics serving the Central Illinois region. A healthcare application on a computer and mobile devices has already been utilized for a couple of years; however, further enhancement has been made to address patients with chronic conditions such as COPD, hypertension, heart failure, and diabetes. An interactive tool within the application triggers enrollment to specific guidelines related to the chronic illnesses stated once the provider adds them to their problem lists. This update is designed to keep patients on top of their care, and providers and their teams can monitor chronic conditions. Patient plans containing evidenced-based protocols from the hospital network and other research organizations provide education and information to keep patients engaged and confident in managing their needs. The information and data supplied by the provider and the patient will serve as an invaluable tool that will also alert rural healthcare networks within the organization about the care plans due to the centralized information system, which will help address future problems for those individuals residing in rural communities.

Due to the ever-demanding and complex healthcare system in the United States, informatics is the only solution to fill the gap between the shortage of health professionals and sick individuals. Integrating new knowledge in electronic patient records will aid clinical practice through easy access by the provider or a team of providers. Remote monitoring devices in the form of sensors and telehealth are part of the informatics revolution toward a healthy future (Nagle, L., Sermeus, W., & Junger, A., 2017). There is so much promise in health informatics, and we, as nurses advocating for the best practice care among our patients, are first-hand users of this technological breakthrough. Nurses should be at the top of every assessment, formulating or continuing plans of care and evaluating them to provide effective and quality health care. However, this healthcare advancement will evolve to address needs and priorities relevant to keeping the world healthy.

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), 4–1. Retrieved on March 1, 2023, from

https://eds.s.ebscohost.com/eds/detail/detail?vid=0&sid=e70cef09-1d15-4050-8eee-aca4a3e20236%40redis&bdata=JkF1dGhUeXBlPXNoaWImc2l0ZT1lZHMtbGl2ZSZzY29wZT1zaXRl#AN=128848047&db=rzhLinks to an external site.

Nagle, L., Sermeus, W., & Junger, A. (2017). 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 on March 1, 2023, from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REFLinks to an external site.

MAIN POST FOR MICHAELA MANNEY

Week 1 Discussion

When I worked as a progressive care nurse, I utilized different types of data sources to better take care of my patients during a critical time in their life. According to Anderson & Jackson (2018), nursing informatics can help facilitate the delivery of quality healthcare for critically ill patients. However, it takes a considerable amount of time and energy by the healthcare organization to implement these high tech changes.

At the long-term acute care hospital I worked at as a staff nurse, leadership opened up the intensive-care unit during the COVID surge to help offload some of the other hospitals in the Denver metro area. It was a small ICU-only four beds and each nurse wanting to qualify for the ICU had to take a four hour class and a test. Looking back, this was not even close to enough time needed to take care of one or two critically ill patients on vasopressors. The first night I worked the ICU, I had two patients on norepinephrine and I was titrating them both the whole night. Fortunately, my charge nurse that night had extensive ICU training and helped me get through the night but it was terrifying. Most ICU nurses get months of training before being on their own.

Looking back, I think a few things would have helped me feel more confident and comfortable taking care of hypotensive patients. A virtual program taking care of critically ill patients would have helped prepare the staff better as well as more up to date technology for monitoring vitals. I have taken an ACLS class virtually before where you have various situations and need to respond accordingly and each action needs to be in the right order. I think some kind of virtual simulation with various critical situations would have better prepared me for the real life scenarios. There was also no barcode scanner for medications at this hospital, which almost led to a medication error with one of the ICU patients. While scanners don’t completely eliminate medication errors, they greatly improve patient outcomes. One study states that medication scanners can decrease the incidence of errors by 20% (Truitt, et. al., 2016). Data related to how well these training implementations have gone should can be gathered. Nurses going through ICU training should be asked questions by leadership so that training policies can be tweaked as needed. Nurses should also be trained on how often to take critically ill patients vital signs and what to do with that information. For example, if the patient’s MAP is below 65, titrate per MD order. The importance of using MAP and other vitals to titrate should be reinforced and the collection of data is imperative for proper medication titration.

Nursing informatics can be incredibly useful in helping prevent errors and helping the nurse better take care of their patient load. This improves care quality and ultimately patient outcomes are also improved.

References:

Anderson DC, Jackson AA, Halpern NA. Informatics for the Modern Intensive Care Unit. Crit Care Nurs Q. 2018 Jan/Mar;41(1):60-67. doi: 10.1097/CNQ.0000000000000186. PMID: 29210767; PMCID: PMC7906092.

Truitt, E., Thompson, R., Blazey-Martin, D., NiSai, D., & Salem, D. (2016, June). Effect of the implementation of Barcode Technology and an electronic medication administration record on Adverse Drug Events. Hospital pharmacy. Retrieved March 1, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911988/

MAIN POST: Sherrona Wiggins

Week 1 Discussion

Computer technology has played a major role in the transformation of healthcare services. It has become an essential part of the operational infrastructure and is dependent upon the intricate care that is administered to patients, and the ability of healthcare workers to learn and improve for advancement. In healthcare, computer technology has surged, and it is considered one of the key components of nursing informatics (Gibson, 2022).

For example, for many years healthcare workers have relied on paper charting before the emergence of Electronic Health Records (EHRs). Despite the advancement of technology, there are many facilities that still utilize paper charting. In my facility, it would be beneficial to use electronic charting, and one of the main reasons is to minimize errors, especially with the administration of medications. The development of managing medications electronically ultimately has proven to enhance patient safety (Pearce & Whyte, 2018). The issue that EHRs can solve in my facility related to medication administration is the errors caused by legibility, avoidance of late medication administration, and overall, the detection of human error. I’ve seen many times where patients have missed medications from medication administration times being overlooked, the wrong dose of medications given because of transcription issues, and the wrong medications being given due to transcription errors. Implementing technology would not only avoid the aforementioned errors but would also aid in higher-quality care, efficacy, and accuracy (HealthIT.gov, n.d.).

The data that could be extracted in this scenario is the advantages of paper charting versus electronic charting. The pros and cons can be gathered to determine which is most essential for the use of the evidence-based practice. The clinical reasoning and judgment that can be formed from this experience are what effects it has on patient safety and organizational enhancement.

References

Gibson, D. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Independently published.

HealthIT.gov. (n.d.). Advantages of electronic health records. Retrieved March 1, 2023, from https://www.healthit.gov/faq/what-are-advantages-electronic-health-recordsLinks to an external site.

Pearce, R., & Whyte, I. (2018). Editorial: Electronic medication management: Is it a silver bullet? Australian Prescriber, 41(2), 32–33. https://doi.org/10.18773/austprescr.2018.012Links to an external site.

MAIN POST

Nursing is a profession that continues to change, we are constantly modifying and improving how we care for our patients.  We do this by collecting data and through explicit knowledge which translates into letters, words, and numbers (Gonigle & Mastrian, 2022).  I have worked in the recovery room area for over 12 years and I love what I do; one area that we work diligently on is to control patients’ pain post-surgery. Because  pain is something that varies on patients tolerance to pain as well as their tolerance to pain medication. An article discussed the process of assessing patients prior to surgery to gage the probability that the patient will  have issues with pain control.  There were several disorders that predisposed patients to pain issues such as issue with anxiety, depression, and chronic pain patients (Dagyaran, Olesen, & Brix, 2022) .  I believe it would be helpful to utilize a tool to assess the patients before surgery as well a after surgery to ensure that the interventions that were used were successful.  The importance of pain control is of great significance to our patients and is associated with quality of life and as part of the control they have over their quality of life (Steffensmeier, et al., 2022) An assessment of this nature will have a positive outcome for both the patient as well as the nurses, it is also helpful in establishing expectations of pain control and allowing the patients to be a part of the plan.

References

Dagyaran, I., Olesen, C. M., & Brix, L. D. (2022). Patient-Exaperienced Quality During Postoperative Pain Management-A Phenomenological-Hermeneutic Study. Journal of PerAnesthesia Nursing, 37(2), 253-259. doi:10.1016/j.jopan.2021.09.007

Gonigle, D., & Mastrian, K. (2022). Nursing Informatics and the Foundation of Knowledge (5th ed.). Burlington: Jones & Bartlett Learning.

Steffensmeier, K., Van Tiem, J., Obrecht, A., Conrad, M., Vander Weg, M. W., & Hadlandsmyth, K. (2022). The Impact of Preoperative Distress: A qualitative Analysis of Perioperative Pain Self-Management Intervention. Pain Management Nursing, 23(2), 212-219.

Main Discussion Post

All nurses use data and information, this information is then converted to knowledge (McGonigle & Mastrain, 2022). With this data and information we continue to evolve our nursing practice. Since the nursing profession is ever changing, the nurse must continue to acquire new knowledge using information and evidence-based practice.

As a flight nurse, waiting for a trauma patient to decompensate to initiate lifesaving treatment is too late. Often trauma patients are under triaged and sent to a lower level of care. A simple yet valuable tool to help navigate the plan of care for trauma patients is pre-hospital point-of-care ultrasound or POCUS. The focused assessment with sonography for trauma (FAST) exam has been used to evaluate the trauma patient for years. It is a quick glance into the thoracic and abdominal cavities to look for bleeding and pneumothorax. This exam can help determine if immediate intervention is needed or if further diagnostic testing should be done. The role of the Pre-hospital POCUS is to help with quick initial assessment, hospital designation, detecting aberrant pathology and assisting in diagnosing or ruling out diagnoses in the medical and trauma patient (lenghong et.al., 2022).

Flight nurses identified areas of deficiency of serial abdominal examines in the trauma patient, serial lung exams in the trauma patient, early identification of blood loss in the trauma patient. Without external signs of trauma, the flight nurse can perform a FAST exam and scan the abdomen looking for free fluid or blood around the liver, spleen and kidneys.  Also included in the fast exam is a quick view of the cardiac silhouette.  This view would help determine if there was cardiac tamponade or pulse-less electrical activity. The lungs are also scanned in the FAST exam. When scanning the lungs, the flight nurse checks to see if there is lung slide which indicates there is no pneumothorax. The flight nurse can also use Ultrasound on the medical patient to check their IVC and the lungs to assess for fluid overload status.

The flight nurse collects data from the POCUS, his/her physical assessment, and vital signs, interprets this data, and formulates treatment. This treatment could include an immediate transfusion of PRBCs, a chest needle decompression, or the continuation or cessation of CPR. The flight nurse bases these interventions off of knowledge gained in hands on training with clinical experts, clinical practice guidelines, and evidence-based practice. The information acquired and the patient care rendered is then disseminated to the healthcare team at the receiving facility. This helps the receiving team decide on their initial treatment needs whether that be another units of PRBCs or an immediate chest tube.

Ultrasound is employed in the prehospital setting to differentiate reversible causes of pulseless electrical activity (PEA), assess for pericardial, intraperitoneal, and pleural fluid in trauma, and to differentiate between pulmonary edema and emphysema (Alyami et.al., 2022). Having pre-hospital POCUS is another valuable tool for the flight nurse to be able to treat the critical medical and trauma patient.

Nurse leaders along with the flight program Medical Director, would use clinical reasoning when performing a monthly review of the ultrasounds performed. A case by case review could be performed for accuracy of exam, patient diagnoses, and treatment options. This feedback would continue to build the flight nurses knowledge base and accuracy of performing POCUS.

References

Ienghong, K., Cheung, L., Tiamkao, S., Bhudhisawasdi, V., & Apiratwarakul, K. (2022). The Utilization of Handheld                 Ultrasound Devices in a Prehospital Setting. Prehospital and Disaster Medicine, 37(3), 355-359. doi:10.1017/S1049023X22000644

Alyami, H., Alzubaidi, M., Alyami, N., Al Mansour, A., Al Mansour, H., Al Salem, A., Alyami, A., & Al Mansour, A        (October 2022). Impact of Portable Pre-Hospital Ultrasound on Patients’ Outcomes: A Narrative Review. Annals of Clinical and Analytical Medicine, 10(1390) 390-395

McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning. Chapter 1, “Nursing Science and the Foundation of Knowledge” (pp. 7–17)

The Application of Data

The cost of healthcare in the United States has become exceptionally high. One reason why healthcare remains high is due to uncoordinated care. The Affordable Care Act was enacted in 2010, and the goal was to make health insurance affordable to all to help lower healthcare costs (ASPA, 2022). The legislation aimed to provide better-managed and coordinated care to specific populations. Care Coordinators assist the Integrated Care Team by proactively coordinating patient care to achieve quality and cost-effective outcomes.

As Care Coordinators, we perform numerous assessments on at-risk populations. These assessments identify members’ needs. Care Coordinators are responsible for communicating with the interdisciplinary care team, managing referrals, care plans, the transition of care, and medication reconciliation. Care Coordination is aimed to ensure that all needs of the member are met and added services are offered (Hannigan et al., 2018)

Data

One example of data used is the personal care service allocation tool. After an assessment is completed on an at-risk member, the member’s ability to perform their own activities of daily living (ADLs) is measured using this tool. An Allocation Tool determines how much help the member needs for each functional ADL. After completing the tool, it is totaled, and the Care Coordinator can determine how much help the member requires. The member is allocated a certain number of weekly hours for personal care services.

The data collected about the members’ functional status is confidential. The insurance company’s Care Coordinator and Supervisor can access this data only. The data as a whole can be accessed through the Medicaid portal.

Knowledge Obtained

Based on the Personal Care Service Allocation Tool results, we can determine how many hours of personal care services the member is qualified for. The utilization management team can then total the budget for each service the member qualifies for and approve a budget for the upcoming level of care date.

Clinical reasoning & Judgment

            Information science allows us to be able to enter information into a system and process the information, which can connect people with technology (McGonigle & Mastrian, 2022). The utilization management team or the nurse manager will review the allocation tool, or the information and data that was entered into the system, to determine if the amount of personal care service hours awarded to the member is appropriate. From there, they can create a budget that the insurance will pay towards personal care services. The team will provide a summary report of all services.  A summary is a consolidated description of the initial data (McGonigle & Mastrian, 2022). The Care Coordinator will then receive an alert on her end to notify the agency and the member of the approval or denial of services.

References:

Assistant Secretary for Public Affairs (ASPA). (2022, March 15). About the ACA. HHS.gov. Retrieved February 28, 2023, from https://www.hhs.gov/healthcare/about-the-aca/index.html

Hannigan B, Simpson A, Coffey M, Barlow S, Jones A. Care Coordination as Imagined, Care Coordination as Done: Findings from a Cross-national Mental Health Systems Study. Int J Integr Care. 2018 Aug 23;18(3):12. doi: 10.5334/ijic.3978. PMID: 30220895; PMCID: PMC6137622.

McGonigle, D., & Mastrian, K. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.