Discussion: The Application of Data to Problem-Solving

According to the American Nurses Association (ANA), nursing informatics “integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice” (Ozbolt et al., 2007, para. 2).

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In the U.S., 95% of hospitals use certified electronic health records (EHRs). EHRs will continue to become more sophisticated and more important over the coming years. However, maximizing their effectiveness will require both medical and IT expertise. That’s why hospitals, insurers, providers, and policymakers are turning to healthcare informatics specialists – a new role that’s uniquely suited to nurses (Walden University, n.d.).

Nurse informatics specialists will likely play a key role in the development and support of consumer health solutions such as patient portals and smartphone apps for self-monitoring and management of health and disease. To ensure safe and appropriate use of these tools, nursing input and informatics expertise will be crucial from the perspective of application design and usability (Nagle et al., 2017). 

The scenario I’m going to discuss is the adequacy of treatment of ESRD patients on dialysis.

As a result of kidney failure, dialysis is necessary to remove waste products such as urea from the blood. As urea is only mildly toxic, a high level of urea signals the buildup of other waste products that are much more toxic and harder to measure. Dialysis clinics should periodically test a patient’s blood for urea removal to determine whether dialysis is effective. This is usually done once a month. Dialysis patients have their blood sampled before and after dialysis. Afterwards, urea levels in the blood samples are compared (NIDDK, n.d.).

By using information from patients and treatment centers about patterns and outcomes of care of end-stage renal disease (ESRD), the national ESRD surveillance system in the United States has enabled improvements in kidney failure prevention and care. The system consists of 18 regional networks, Health Care Financing Administration (HCFA), United Network for Organ Sharing (UNOS), and the United States Data System (USRDS) (Mcclellan et al., 2000). 

ESRD surveillance systems provide information to improve the care of patients with kidney failure. The systems have two primary characteristics. First is the systematic and ongoing gathering, aggregation, analysis, and interpretation of data about kidney failure in a defined population. Secondly, the resulting information is disseminated and utilized to improve the treatment and control of ESRD. The surveillance program can provide information for defining epidemiology, detecting epidemics, identifying high-risk populations, assessing treatment outcomes, and planning, implementing, and evaluating disease control. Observational, clinical, and laboratory research can also be enabled by surveillance systems (Mcclellan et al., 2000).

ESRD Core Indicators provided region-specific but not facility-specific estimates of URR (Urea Reduction Ratio). Based on the previously recognized center-to-center variations in case-mix adjusted mortality rates, a second analysis used a survey of all dialysis treatment centers within a region to estimate the appropriateness of dialysis services for each center.

If the patient does not meet the acceptable URR, the nurse must address this issue accordingly. A lot of factors affect this. Sometimes patients like to cut their treatment time, therefore not meeting the prescribed treatment time ordered by the nephrologist. The nurse can encourage the patient to stay his whole treatment time. Another factor is the size of the dialyzer or the needle size, the nurse would notify the nephrologist, and they would order to change either or both to a bigger size.

Reference:

Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. IOS Press. https://doi.org/10.3233/978-1-61499-738-2-212

Walden University. (n.d.). What does a nurse informatics specialist do? https://www.waldenu.edu/online-masters-programs/master-of-science-in-nursing/msn-nurse-executive/resource/what-does-a-nursing-informatics-specialist-do

Ozbolt, J., Eun-Shim, N., Roberts, D., & Wilson, M. (2007, September 11). How about a career in nursing informatics? American Nurse. https://www.myamericannurse.com/how-about-a-career-in-nursing-informatics/

Mcclellan, W. M., Krisher, J. O., (2000, January). Collecting and using patient and treatment center data to improve care: Adequacy of hemodialysis and end-stage renal disease surveillance. Kidney International, 57(74), S7-S13. https://doi.org/10.1046/j.1523-1755.2000.07403.x

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (n.d.). Hemodialysis: Dose and adequacy. https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/kidney-disease/identify-manage-patients/manage-ckd/hemodialysis-dose-adequacy

I enjoyed reading your scenario and explanation; the scenario about ESRD patients is impressive. I agree that nursing informatics has been developed into a colossal system that supports and promotes population health and improves outcomes. As you mentioned, many factors can affect the outcomes of dialysis treatment. Informational technology can significantly impact the results of such therapies through the collection and compounding of essential data to evidence-based practice. As well as, effectively employing electronic medical records (EMR) and informatics nurse specialists in daily practice to improve overall patient health.

Reference:

McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

Walden University. (n.d.). What does a nurse informatics specialist do? https://www.waldenu.edu/online-masters-programs/master-of-science-in-nursing/msn-nurse-

executive/resource/what-does-a-nursing-informatics-specialist-do

Great informational post, Bianca,

And nice discussion points!  I have been noting that one of the concerns we should have as nurses is the lack of usefulness of data in the electronic health record (EHR) for nurses.  There literally is a lack of consistency with our methods of charting and with what we chart.

As noted by Thede (2008) – although still very much an issue today –

Today, nursing care data, beyond basic compliance data, is very seldom included in this data which is being stored electronically, despite studies demonstrating that including nursing problems improves the accuracy of costing healthcare and predicting outcomes (Welton et al., 2006). This means that if electronic healthcare documentation, whether part of an EMR or an EHR, contains no data about the decisions nurses make, such as decisions about nursing problems, independent intervention actions, and the resulting outcomes, nursing data will not be used in healthcare planning and priority selections. Nursing’s role in healthcare will remain invisible, and nursing’s potential contribution will not be considered in healthcare policy (para. #8).

She continues:

We all know what our nursing role is, but we have not yet learned how to communicate it to others. It is not unusual, when one is very knowledgeable about a topic, in this case good nursing care, to subconsciously believe that all people, especially administrators, understand what good nursing care includes. We may find it hard to believe, but outside of physicians, who depend on us, few people really understand that nurses are the eyes and ears of ongoing patient assessment and that we make decisions every time we perform a procedure, give a medication, or provide another type of care. The reasoning behind decisions related to the performance of the procedure is not captured if we simply document that we have performed a specific procedure (Thede, 2008, para. #8).

I find that more than a little unsettling.  In fact, most nurses were never consulted as to what they would like to see in the documentation systems.  That is scary, too.

What does this have to do with informatics, you might say?  Well, nursing informaticists will be in the perfect position to help make changes in that electronic record, changes that can be VERY beneficial to nursing.

What do you think?

Nice work!

Dr. Cheryl

References

Thede, L. (2008) The electronic health record: Will nursing be on board when the ship leaves? OJIN: The Online Journal of Issues in Nursing, 13(3). DOI: 10.3912/OJIN.Vol13No03InfoCol01 Accessed at http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Informatics/ElectronicHealthRecord.html#Thede

Welton, J., Halloran, E. J., & Zone-Smith, L. (2006). Nursing intensity: In the footsteps of John Thompson. In H. A. Park, P. Murray & C. Delaney (Eds.), Consumer Centered Computer-Supported Care For Healthy People (pp. 367-371). Amsterdam, Netherlands: IOS Press.

Hi Dr. Cheryl,

Having a uniform system for charting would be nice. At my current job, each clinic is different, even though it’s the same company!

A nurse plays an integral role in healthcare, and I wouldn’t describe it as invisible. For example, in a chronic dialysis setting, the doctors do not round as often as they do in a hospital setting. The nurse often makes the decisions, of course, within their scope of practice. Nurses also play a significant role in teaching patients about their medical conditions. Supporting patients’ emotional well-being is also an essential part of our job. We are the “eyes and ears,” and as the saying goes, “behind every good doctor is a great nurse Discussion: The Application of Data to Problem-Solving.”

I agree with the second paragraph. Often, administrators who are not in the healthcare field are unaware of our role and the risks involved, especially with poor staffing. Our efforts are underrated, but they have a significant impact on the outcome for our patients.

Yokoyama Scenario – Main Question Post

     Listing the important details of Healthcare Informatics is easily done when we consider the epic workload nursing is faced with today.

Healthcare informatics has created shortcuts and better time management, as well as opened the door to an educated patient.  As stated in

our video file, “Health Informatics and Population Health: Trends in Population Health” 2018, “Consumers are more engaged in their

health now, creating an educated consumer.”  Part of the nurses’ job is to educate the patient, and my patients today seem to know much

more than they did years ago.

     One scenario is the nursing burnout rate, and the general nursing shortage that has been active for a decade.  The shifts I work each

week have a pattern of lower nurse to higher patient ratios, and this seems to be the norm at this time.  The demands on floor nurses

continue to increase with less colleague help available. When a hospital has a high turnover rate of employees, the cost for hiring and

educating the new nurse in transition is extremely high.  The simple truth of why a person is willing to leave their job is of extreme

importance, and information technology can be a tool to help.  “Computer principles and information science are combined to turn data into

knowledge that is useful to people in a variety of professions including healthcare (Laureate Education,2018 “What is Informatics?”)

     The healthcare employee satisfaction data that is available through biannual company surveys is one useful tool that can be accessed by

hospital leadership.  The human resources department and nursing leadership team feel the sense of urgency to fill the open RN positions in

the hospital, especially when there is a high turnover rate. Utilizing the exit interview data is another way to access the “Why?” behind the

nurse leaving her position in the hospital. “The continuously growing field of informatics is of great benefit to healthcare managers at all

levels. Using this growing technology can greatly benefit their role and improve the function of their staff” (Sweeney, 2017).  The data and

information collected from these various tools can provide the knowledge needed for positive change, so the hospitals can keep their expert

staff who have been trained and are familiar with the hospital.

     Nursing leadership can utilize the information from these surveys and questions to create a pattern or graph to show the material.  Some

questions may promote the same responses from the employees, sharing critical evidence of what the employees really care about.  “In

addition to enhancements in care and improved evidence-based practice, the increased amount of data collected by EHRs and other data

systems has created a massive amount of data that hospitals and health care organizations now have to manage and analyze” (Sweeney,

2017).  When we collect the data, we must have the manpower to decipher it and communicate it to the leadership team.

References

 Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file].

     Baltimore, MD: Author.

Laureate Education (Producer). (2018). What is Informatics? [Video file]. Baltimore, MD: Author.

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.

Hi, charmagne

Nursing  informaticists  can also reduce the chance of medical errors in a health care  Organization. A combination of staff training , process improvement , and best practice will enhance the quality of care and limit patient risk.

#2 RESPONSE

Hi Eucharia,

Thank you for responding to my original post!  I agree with you concerning informatics can reduce medical errors, and I found a recent

resource that was helpful.  “To conclude, medical errors are an important public health global problem and pose a serious threat to patient

safety and quality of care.  Although medical errors are inevitable, decisive actions can be taken to noticeably lessen them and enhance

patient safety. To attain this, an abiding culture dedicated to decreasing medical errors needs to be created at regional, national, and

international levels. Because of the high-cost factor, many hospitals have been sluggish to invest in technologies, such as electronic

medical records, MERS, CPOE systems, and care bundles that have helped lessen medical errors and enhance patient safety” (Karande et

al., 2021).

Patient safety is our number one priority and using technology to scan medications, scan the patient bracelet, and continue to ask

simple questions about birthdate are crucial to the success of floor nursing.  Thanks again for your input.  Kind regards, Char

Karande, S., Marraro, G. A., & Spada, C. (2021). Minimizing medical errors to improve patient safety: An essential mission

ahead. Journal of Postgraduate Medicine, 67(1), 1–3. https://doi.org/10.4103/jpgm.JPGM_1376_20

Great informational post, Charmagne,

And nice discussion points!  I have been noting in other posts that we as nurses and as potential informatics or graduate degree nurses should be very worried and concerned about the current state of the electronic health record (EHR) because we are not using it to our best advantage.  I see it as a combination of issues, most of which are because nurses were not consulted about what would be helpful for them in EHRs, but also because nurses are not very knowledgeable about what would be helpful for them in EHRs, too.  It is a terrible conundrum and something we should all be working to correct.

According to Thede in 2008 – although old, this is still, sadly, very pertinent today:

To date nursing has failed to acknowledge that the day in which patient data will be stored electronically is fast approaching and that this electronic data will be used for secondary analysis, resulting in decisions that affect all of healthcare. If nursing fails to get nursing care data in an electronic format, healthcare decisions will be made without nursing input, despite the findings that ignoring nursing data results in inaccurate reimbursements (Welton et al., 2006). This causes reimbursements to be inaccurate with the result that they do not represent the actual cost to agencies of providing good nursing care. Lacking this data nursing cannot be represented in the revenue column, which decreases our value (para. #9).

She makes a few stronger points, then, as to what we need to do to fix this issue:

If nursing data is to be part of the data analyzed from electronic patient records, we, as nurses, need to make two decisions: First, we need to decide what data should be included in the electronic record, and secondly, we need to decide what terminology should be used to record this data so that the meaning of the data is clear and consistent ..……. Considerable work has also been done in the area of developing nursing terminologies, yet very little of this work has been implemented in practice settings. Standardized terminologies that are recognized by the American Nurses Association (ANA), and that allow the collection of nursing data in a manner that makes the meaning of each term clear, have also been developed. These terminologies include the Omaha System; the Clinical Care Classification; the Perioperative Nursing Data Set; North American Nursing Diagnosis Association, Inc; Nursing Interventions Classification; Nursing Outcomes Classification; and the International Classification of Nursing Practice. Unfortunately, there are not many agencies that have implemented the use of use any of these terminologies for electronic nursing documentation (Thede, 2008, para. #10).

I think she makes some very thought-provoking comments, and she ends the article with a strong statement that action is needed soon. This was in 2008, and we have not done very much as yet.

What does this have to do with informatics, you might say?  Well, nursing informaticists will be in the perfect position to help make changes in that electronic record, changes that can be VERY beneficial to nursing.

What do you think?

Nice work!

Dr. Cheryl

References

Thede, L. (2008) The electronic health record: Will nursing be on board when the ship leaves? OJIN: The Online Journal of Issues in Nursing, 13(3). DOI: 10.3912/OJIN.Vol13No03InfoCol01 Accessed at http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Informatics/ElectronicHealthRecord.html#Thede

Welton, J., Halloran, E. J., & Zone-Smith, L. (2006). Nursing intensity: In the footsteps of John Thompson. In H. A. Park, P. Murray & C. Delaney (Eds.), Consumer Centered Computer-Supported Care For Healthy People (pp. 367-371). Amsterdam, Netherlands: IOS Press.

Hi Dr. Cheryl,

Thank you for your post, and valued information.  I agree with Thede in 2008 as well.  Nursing is such a specialized, beautiful career with continuous improvements in our practice – we are in GREAT demand for many avenues.  Information technology is definitely an area with extreme future growth and the expert nurse will be needed to help organize and clarify many topics.  Our nursing language is an excellent example Discussion: The Application of Data to Problem-Solving.

Kind regards, Char

Nursing Informatics in Practice

Nursing informatics is defined as incorporating healthcare sciences with computer science, information science, and cognitive

science to help identify and research data for increased effective healthcare practices (Sweeney, 2017). The ability to manage

this data and incorporate it into reality plays a crucial role in how individuals and groups can change their care and make a

difference in their policies.

I worked on a busy medical-surgical unit that specialized in digestive, vascular, and gastric bypass surgeries for three years.

Our Clinical Nurse Leader (CNL) of our unit and surgery teams noticed that the infection rate of our groin sites of our fem-

pop surgical patients increased over the past few months. The CNL and the surgery teams gathered data from patient follow-

ups, readmissions, and adherence to post-operative instructions. Using data collected from the electronic health record

(EHR), the surgical teams started incorporating a wound vac at the surgical incision to keep the incision clean and free of

bacteria. The infection rates slowly declined after this change. Using “data mining” or combining the data to gain knowledge

for best practice was effective. Information from the EHR and patient adherence allowed for effective medical changes for

the best possible care for the surgical patients; this will be helpful for future practices and policies on the medical unit

(McGonigle, 2017).

Nurses are the most significant part of healthcare; using nursing informatics to access knowledge and data to improve

healthcare is key to a successful future for practice. Nurses must remain competent in new technology and access information

science for their healthcare practices (Farzandipour, 2021).

References

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.

Farzandipour, M., Mohamadian, H., Akbari, H., Safari, S., & Sharif, R. (2021). Designing a national model forassessment

ofnursing informatics competency. BMC Medical Informatics and Decision Making, 21(1),

35.https://doi.org/10.1186/s12911-021-01405-0

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA:

Jones & Bartlett Learning.

Hi sara

I believe that informatics competencies can help nurse leader to identify patterns and correlations in the delivery of nursing care. I agree that nurse are the most significant part of health care and the most valuable ways a nursing informatics can enhance patient outcome is through providing training to clinical staff, using data to identify endemic issues in a health care .

Thank you for your post, Sarah.

I agree with your post. Informatics helps both the providers and health consumers. Nurses have the most interactions with patients and collaborate with technology more frequently. Incorporating technology should have a positive impact on nursing productivity (Darvish et al., 2014). Healthcare continues to evolve with every data being collected. Nursing informatics actively supports the improvement of healthcare by supporting reasons about patient outcomes and quality improvement (Charters, 2003).

References:

Charters, K. G. (2003). Nursing Informatics, Outcomes, and Quality Improvement. AACN Clinical Issues: Advanced Practice in Acute and Critical Care, 14(3), 282–294. https://doi.org/10.1097/00044067-200308000-00003

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). https://doi.org/10.5539/gjhs.v6n6p11

Currently, my unit in the hospital I work at is experimenting with a new position on the floor. This is labeled as a throughput nurse. Throughput can be defined as the migration of patients from admission to discharge (Centrak, n.d.). My unit would like to incorporate a new position for an RN to help facilitate discharge planning for patients ready to leave the hospital. This includes home care, rides home, rehab placement, and education. This is a scenario in that data could help determine whether or not this role will help the unit.

To achieve competent throughput for patients, hospitals must maintain careful observation throughout a patient’s stay (Cawley & Hanlon, 2005). This is why the idea of appointing one personal to foresee discharge planning for a patient when their hospital stay is nearing the end is beneficial. While investigating, it does not seem like there is that much data available to base results on. This would definitely be an idea that would benefit from data because it would show whether or not having a designated nurse, to focus on throughput, would improve patient outcomes. It is known that nurses are the backbone of healthcare all over the world (Gray, 2020). I believe that if patients are interacting with a nurse, their throughput experience would be even better since the nurses are the most interactive with the patients.

Cawley, P., & Hanlon, P. (2005, September). Improving Patient Throughput to Improve Quality of Care. Retrieved December 1, 2021, from https://www.the-hospitalist.org/hospitalist/article/122911/maximizing-throughput-and-improving-patient-flow.

Centrak. (n.d.). How busy hospitals can increase patient flow: 6 tips centrak. Retrieved December 1, 2021, from https://centrak.com/increase-patient-flow/.

Gray, H. (2020, May 1). Nurses are the backbone of our healthcare system. Retrieved December 2, 2021, from https://www.jcu.edu.au/this-is-uni/health-and-medicine/articles/why-nurses-are-the-backbone-of-our-healthcare-systems.

 Nursing informatics is the practice of collecting data, analyzing and implementing strategies that will hopefully have positive health outcomes. It a mixture of nursing science, computer science and information science.  Nursing informatics has evolved as technology evolved over the years. Most health care organizations have moved to electronic medical records which promotes safe continuity of care and timeliness in deliverance of care. Electronic medical records play a great part in the quality of patient care.  (Gaudet, 2021). 

I currently work in a facility that uses paper charts instead of electronic medical records. Even though data is collected, and meticulous charting is done, it is very time consuming especially during intake assessments which causes patients to become aggravated even before stepping foot on the unit. There are also greater chances of making errors because patients are not the best historians in time of crisis. So, there might be conflicting information which will eventually affect patient outcomes. Also, using an electronic medical record will give intake nurses the ability to upload information from previous visits and speed up the intake process. The intake process currently goes anywhere from a few hours to about twenty fours. That is frustrating for patients and sometimes escalates to patients being a danger to themselves or a danger to others. We do get frequent flyers and so it will be beneficial to collect data in such a way that will speed up the process, carry over information from each visit as well as get the patients ready for treatment in a more time efficient manner thus increasing quality of care. 

 The institute of medicine has emphasized the importance of technology in healthcare. The institute emphasizes how the nursing process is being reshaped by informatics in so many positive ways. Overall, implementing electronic medical records has improved patient care because doctors are able to provide care with reliable data from their health history versus information gathered at every visit. (Scott, p 80). In the Public health informatics institute video, the nurse explained the informatics process which is like that of the nursing process. He explains that in informatics, a problem is identified, a solution to the problem established which is then implemented. An assessment of the solution is conducted to evaluate its efficacy. I feel if my organization attempted to evolve in informatics, then some processes might become more efficient and will be beneficial for everyone. 

References

Public health informatics Institute. (2017). Public Health Informatics: 

‘        Translating knowledge for help. [Video file]. Retrieved from https://www.youtube.com/watch?v=fLUygA8Hpfo

Monique, G. (2021). Examples of informatics in nursing-applying your Master of Science in health informatics. https://online.une.edu/blog/examples-of-informatics-in-nursing/

McBride. A. B. (2005). Nursing and the informatic revolution. Nursing outlook, 53(4), 183-191. https://doi.org/10.1016/j.outlook.2005.02.006

Scott. T, &Aarts J. E. C. M. (2007). Implementing an electronic medical record system: successes, failures, lessons. Radcliffe Publishing

Hi Josephine! Great Discussion: The Application of Data to Problem-Solving post. This is definitely such an important topic to discuss. Paper charts are such a hassle and make work more stressful. The electronic medical record system gives healthcare organizations many more formats to view than paper charts (Manca, 2015). There is an abundance of data online to help support and justify the benefits of switching to an EMR system. In a study, it was shown that the inpatient mortality rate and readmission rate while using EMR was lower than in the trial without using EMR (Lin et al., 2020). This is such an important topic because EMR, in my opinion, makes the healthcare system much easier to navigate through. For example, if a patient was readmitted and the physician wanted to see old records from the last time they were here, they can easily go in their previous hospital encounters and see everything that was done. If paper charts were still in play, it would take a lot of time to go through several pieces of paper to figure out everything that occurred during their previous stay.

Lin, H.-L., Wu, D.-C., Cheng, S.-M., Chen, C.-J., Wang, M.-C., & Cheng, C.-A. (2020, July 31). Association between Electronic Medical Records and Healthcare Quality. Retrieved December 3, 2021, from https://journals.lww.com/md-journal/fulltext/2020/07310/association_between_electronic_medical_records_and.26.aspx.

Manca D. P. (2015). Do electronic medical records improve quality of care? Yes. Canadian family physician Medecin de famille canadien, 61(10), 846–851.

Hi Josephine

I agree that if organization evolve in informatics , they will be more efficient and beneficial for everyone  because nursing informatics facilitates the integration of data, information, and knowledge to support patients, nurses, and other providers in their decision-making in all role and settings

Hi Josephine! Insightful post!

Interesting to hear that paper charting is used! I know a moderate amount of long-term care facilities still use paper charting occasionally but I know more and more systems are being implemented. We have come so much more advanced with the inclusion of electronic health records or EHR. EHRs have improved our abilities to diagnose, reduce or prevent medical errors and overall patient outcomes. Patients have also become more interactive in their health care due to the introduction and use of EHRs (HealthIT.gov, n.d.). To elaborate on the increased interactiveness of patients with their care. EHRs through the use of on line patient portals have created an easier way for patients to gain access to their reports as well as be interactive with their providers through an on line approach(Graber et al., 2017).This increased interacted has allowed for less readmissions and increased the likelihood that patients will seek out their care team before they need to check-in to an emergency department. This electronic communication is key for a faster approach to making health decisions before they become a problem.

Graber, M., Byrne, C. & Johnston, D. (2017). The impact of electronic health records on diagnosis. Diagnosis, 4(4), 211-223. https://doi.org/10.1515/dx-2017-0012

Health IT.gov. (n.d.) Improved Diagnostics and Patients Outcomes. https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/improved-diagnostics-patient-outcomes

Initial Discussion Post

The science behind healthcare informatics is defined as “the integration of health-care sciences, computer science, information science, and cognitive science to assist in the management of healthcare information” (Saba & McCormick, 2015, p. 232). Nurses working within the healthcare system need to be competent and confident in working with different technologies and data systems to improve the health delivery system to the patient. There are many different scenarios where healthcare informatics is utilized as a standard of care within the healthcare system. A scenario that I find illustrates the use and collection of patient data includes obtaining a blood glucose lab for a patient using a glucometer and having that measurement uploaded to the electronic health record for that patient.

Data Use, Collection, Access & Knowledge Derived

Within the surgery department, where I work as a nurse, blood glucose levels are important data points that need to be collected and monitored regularly. To collect the data from the patient, the healthcare provider must first extract a pinprick of blood and use a glucometer to analyze the sample and determine a blood glucose level (Sweeney, 2017). This type of data is used to determine if glucose levels are abnormal and are documented in the patient’s electronic chart. This lab value can be accessed by anyone with permission to access the patient’s chart and can be used in assessments. This scenario is an example of how nursing informatics can aid in the care of the patient in surgery or anywhere else in the hospital setting. Integrating the electronic health record with the glucose meter can help alleviate mistakes in the record for the patient and increase the knowledge gained in real-time.

Clinical Judgment in Scenario

            Leadership in nursing requires clinical decision-making and strong nursing judgments with regard to the patient. Within the surgery department, there is a team approach to caring for the patient undergoing an operation, which means there are multiple healthcare professionals monitoring different aspects of the patient’s care. Informatics plays a role in this scenario by involving the patient’s EMR and utilizing a glucometer to provide the product of a clear glucose reading. The nurse leader should always consider checking the instrumentation if a measurement seems to be incorrect and re-check it to make sure it is accurate. The use of the data in the EMR can be used for clinical decisions in a leadership role as “it is important for nurse managers to utilize information from the EHR to show ‘meaningful use’ and are important to the process of determining how information is organized and categorized within the EHR” (Pacheco de Souza, et al, 2015). Utilizing informatics is an important aspect of the new evolving standard of care and should be implemented in all appropriate situations.

References

Pacheco de Souza, R., Santiago, L. C., & Izu, M. (2015). Use of an electronic information system in professional practice nurse management. Journal of Nursing UFPE / Revista De Enfermagem UFPE, 9(4), 7281-7288 8p. doi:10.5205/reuol.7275-62744-1-SM.0904201513

Saba, V. K. & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York: McGraw-Hill.

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

Hi Hannah, great post. It’s amazing to see how informatics is affecting every part of health care and mostly for the better. Informatics has increased quality of patient care in various specialties from electronic health records to different monitor like glucometers and heart monitors. I’m very impressed by the advancement in gluccometers, there are applications on smart phones that let patients track their blood glucose and have it integrated into electronic health records. This application is called Health Kit and is connected to Accuchek Aviva Connect and it is supposed to hopefully encourage patients to monitor their glucose better. In researching about health informatics, I found that there are monitors being created that can monitor vital signs remotely without instruments. It’s a virtual radio that tracks heart rates and breathing using wireless signals affected by motion, skin vibration and chest movements. I can see this being helpful to vulnerable individuals with little or no support at home (Adib, 2015).

References

Adib, F., Mao, H., Kabelac, Z., Katabi, D., & Miller, R. C. (2015). Smart Homes that Monitor Breathing and Heart Rate. Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems, 837–846. https://doi.org/10.1145/2702123.2702200

Weatherly, J., Kishnani, S. S., & Aye, T. (2018). Automated Integration of Glucometer Data into the Electronic Health Record. DIABETES, 67. https://doi.org/10.2337/db18-907-P

Consider a patient who visits the hospital for the first time to be tested for prostate cancer, so the Prostate Specific Antigen (PSA) test is performed. This patient had previously visited another hospital, so the attending doctor is obligated to request the patient’s records from that facility. The records will include the patient’s most recent diagnostic results for further review and a better understanding of the patient’s condition and shed new light on other infections the patient may have that may affect the PSA test result. The doctor can diagnose the patient appropriately and effectively using the documents acquired from the other institution, including lab tests and electronic health records (EHR), among other things. These data might be collected and accessed electronically, by fax or text. Alrø et al. (2018) state that when data are accessed smoothly, nurses find it easier to prepare for patient consultations and focus the conversation on the challenges that each patient is currently dealing with.

Clinical reasoning is used here, and Schalkwyk et al. (2020) explain that clinical reasoning is a cyclical process where a clinician deductively evaluates patient data considering biological and clinical knowledge to generate a hypothesis. The patient’s health indicators and conditions, such as blood type, weight, age, blood sugar levels, and blood pressure, may be retrieved from the data transferred over from the patient’s previous hospital, saving time from repetitive tests and improving service to the patient. The clinicians can also learn about the regulations and rules that govern the patient’s treatment and educate the patient on them. Then amended as further supporting and detracting data are assessed and can present a diagnosis and treatment plan.

As a result of this experience, the participating nurse leader will familiarize themselves with the patient’s condition by gathering and reviewing information before making any treatment decisions. As a result of the knowledge gained, the clinician will have relied on clinical reasoning and judgment to make better decisions about the patient’s treatment plan. In nursing practice, decision-making encompasses a wide range of factors and processes. According to current nursing research, nurse experience, nurse practice environment culture, education, nurse understanding of patient status, situation awareness, and autonomy are all factors that influence decision-making. Improved patient care outcomes require excellent nurse decision-making (Nibbelink & Brewer, 2018).

References

Alrø, R. H., Krogh, M.-L., & Gude, C. (2018). Systematic hospital collection of patient-reported outcome data via patient apps. Medical Writing, 27(4), 30–34.

Nibbelink, C. W., & Brewer, B. (2018). Decision-making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5-6), 917–928. Doi: 10.1111/jocn.14151

Schalkwyk, S., Archer, E., Volschenk, M., & Blitz, J. (2020). Teaching clinical reasoning: a new playbook. Clinical Teacher, 17(5), 541–543. https://doi-org.lopes.idm.oclc.org/10.1111/tct.13231

Response #1

Justina, thank you for the informative scenario and description of how healthcare informatics can aid in the continuity of care for patients. Many times when patient records need to be acquired from other hospital facilities it can be a bit confusing and clinical reasoning can play a big role in a timely transition of records. A scenario that I have had to overcome in the surgery department is making sure a patient has a current COVID-19 test prior to their procedure. Accessing the data needed to proceed with surgery means utilizing the electronic health record for the patient, as well as utilizing securely sending records from facility to facility (Alrø et al, 2018). Clinical reasoning to navigate this process is essential to maintain privacy and complete the task at hand.

Technology in healthcare is continuously evolving, which means healthcare professionals need to evolve as well. The electronic health record is a tool to be used to monitor and maintain the health status of patients who are inpatient and outpatient. The EMR is a recording profile that needs to be compatible with labs tests such as a Prostate Specific Antigen (PSA) test in order for data can be shared with the appropriate healthcare professionals (Sweeney, 2017). There are, however, gaps in how healthcare informatics is utilized, which may result in extra time, money, or procedures for the patient. For example, if the nurse is unable to contact the previous facility a patient was at to obtain their current COVID test results, that nurse will have to obtain a new sample prior to the patient’s procedure. Data collection is an important aspect of maintaining health and technology can aid in that collection. Clinical reasoning must also play a role in healthcare informatics to fill the gaps made across multiple healthcare settings with regard to continuity of care (Sweeney, 2017).

References

Alrø, R. H., Krogh, M.-L., & Gude, C. (2018). Systematic hospital collection of patient-reported outcome data via patient apps. Medical Writing, 27(4), 30–34.

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

Nursing informatics refer to the practice and science of integrating nursing information and knowledge with technology to manage and integrate health information.(Canadian nurses Association). Electronic medical, telehealth, healthcare apps, patient portals , are health informatics and data to help improve the safety and quality of patient care. Nursing informatics improve patient care by improving clinical policies, protocols, processes and procedures. And it also aligning nursing best practice with clinical work flows and care, their by reduces medical errors and costs.

Healthcare workfiow management provides better internal controls and improves efficiency to reduce risk, increase compliance, and improve productivity. Health informatics also has ability to track staffing, workflow, and communication that can help nurses to identify areas where current processes can be improve.  This ensure adequate staffing, which is very important for  providing patient with the best care. Maintaining adequate levels of staffing , help nurses provides the best care each day without burning out Discussion: The Application of Data to Problem-Solving.

At my work place, we use healthworkflow  for adequate staffing , which help  reduces nurse burnout,  thereby reduces rates of patient falls, infections, medication error. Adequate staffing ensure better care for patient and reduces nurse fatigue, and increase patient satisfaction.

Reference

Gray,H.(2020,may 2) Nurses are the backbone of our healthcare system. Retrieved December 6, 2020, from https;//www.jcu.edu.au//this-is-uni/health-and-medicine/articles/why-nurses-are-the-backbone-of-our-healthcare-systems

The Application of Data to Problem-Solving

In the present world, the prospects for the complete adoption of information and communication technology to advance the quality of nursing areas’ outcomes are increasingly growing. Nurses are involved in most patients’ communication and have frequent interaction with technology improvements. Nursing informatics supports patients, nurses, the interprofessional team, consumers, and other stakeholders in their decision-making in all backgrounds and roles to attain desired results (Sweeney, 2017). Patient outcomes could be advanced when informatics solutions enable the recognition of risks, retrieval of priority information during care transitions, patient involvement, and clinical decision-making during critical situations. Besides, the use of technology could generate a positive attitude in nursing output. For this post, I considered a patient susceptible to malignant hyperthermia(MH) and about to be admitted to the operating room. The patient was unconscious was not accompanied by any family member. MH susceptibility is an autosomal-dominant trait (Denholm, 2016). The hypermetabolic crisis is mainly triggered by exposure to succinylcholine and volatile inhalational anesthetic agents. I swiftly checked on the patient’s documentation in electronic health records (EHR) which revealed his susceptibility to MH. Data that could be shared and used in this scenario for screening MH vulnerability include the lab tests, patient’s weight, and temperature. The intersection of MH knowledge happens when the clinician infers data from monitoring devices, identifies symptoms linked to MH, and offers electronic interventions for the treatment of suspected cases. A standardized documentation method that is easily retrievable in EHRs should also include correct electronic metric conversions and the US traditional measure units (Kassam et al.,2017). A nurse leader can utilize clinical reasoning and judgment and advance data reporting and accessibility by advocating for diligence in recording reports of suspected MH incidents to current databases. Besides, nurse leaders who adopt an informatics approach are likely to improve patient outcomes due to the capability of informatics solutions to retrieve priority information with ease during crucial care processes.

References

Denholm, B. G. (2016). Using informatics to improve the care of patients susceptible to malignant hyperthermia. AORN Journal, 103(4), 364-379.

Kassam, I., Nagle, L., & Strudwick, G. (2017). Informatics competencies for nurse leaders: protocol for a scoping review. BMJ Open, 7(12), e018855.

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1. (n.d.)

Great post Tokunbo! This is such an important topic to discuss because it affects patients and their outcomes after leaving the hospital. An interview revealed elderly adults expressing their frustrations attributing to the mental and physical deconditioning that occurred during their hospital stay. These patients also stated that there were insufficient activities in the hospital (Guilcher et al., 2021). This is a very important topic to address because it could affect patients going back home to their daily lives, and might have to end up going to a rehab facility. This will affect the hospital scores because the patients will be upset that they came in able to walk and do daily activities, and now after being in the hospital, they have to go to rehab. An article stated that a great way to avoid this from happening is the enhance inpatient programs for patients so they do not decondition (Smith et al., 2021).

Guilcher, S. J. T., Everall, A. C., Cadel, L., Li, J., & Kuluski, K. (2021, March 9). A qualitative study exploring the lived experiences of deconditioning in hospital in Ontario, Canada. BMC Geriatrics. Retrieved December 4, 2021, from https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-021-02111-2.

Smith, T., Sreekanta, A., Walkeden, S., Penhale, B., & Hanson, S. (2021, July 6). Interventions for reducing hospital-associated deconditioning: A systematic review and meta-analysis. University of East Anglia. Retrieved December 4, 2021, from https://research-portal.uea.ac.uk/en/publications/interventions-for-reducing-hospital-associated-deconditioning-a-s.

 I agree that informatics and current technological advancement in healthcare practice are fundamental drivers for the healthcare system. Informatics is the science of using data, information, and knowledge to improve human health and deliver health care services. Health IT enables advancements in Healthcare by providing the tools with which to set learning in motion. Biomedical and health informatics has developed areas of emphasis and approaches that set it apart from other professions and disciplines Discussion: The Application of Data to Problem-Solving.

(HealthManagement.org 2020). IT improves healthcare quality, prevents medical errors, protects data, increases administrative efficiencies, and decreases paperwork. In addition, the most significant benefit of the digital revolution has been the ability to store and access data. Healthcare professionals can now retrieve patient data from anywhere. Also, the intranet and internet have allowed healthcare professionals to share medical information rapidly, resulting in more efficient patient care (N. 2021).

References

HealthManagement.org. (2020). The impact of digital technology on Healthcare. HealthManagement. Retrieved December 5, 2021, from https://healthmanagement.org/c/cardio/news/the-impact-of-digital-technology-on-healthcare.

N. (2021, June 10). Importance of Information Technology in today’s world – digital class. Best Blogs & Insights From Digital Class E-Learning Marketplace. Retrieved December 5, 2021, from https://www.digitalclassworld.com/blog/importance-of-information-technology/.

            A health care professional is known as a knowledge worker because he or she deals with and processes information daily to make it meaningful and inform his or her practice. (McGonigle and Mastrian, 2018). Having worked in hospitals with both paper charting and computer charting, I find that hospitals with computer charting are much more efficient and are safer for patients. At the hospital with paper charting, staff had to find the physical chart or the Kardex when codes were in progress. This is because allergies need to be determined before medications can be prescribed and administered. Carrying around a Kardex is a HIPPA violation waiting to happen as one could accidentally leave the Kardex in an unsecured area.

The use of informatics is seen in a multitude of 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, as well as personal data devices and email, to name a few (Sweeney, 2017).

Using electronic health records (EHR) has been life-changing. As an example, EPIC has a “care everywhere” tab which allows providers to see the patient’s past visits to various providers. The widespread implementation of EHR, has promoted collaboration among the public- and private-sector stakeholders on a wide-ranging variety of healthcare information solutions. (McGonigle & Mastrian, 2018).

Another excellent electronic record program, PDMP or prescription drug monitoring program can save lives. PDMPs could track and report changes in standardized outcome measures, such as the percentage of patients seeing five or more doctors for controlled substances within the past 6 months or the receipt of multiple overlapping prescriptions (Pallouzi et al., 2011).

References:

McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

Paulozzi, L. J., Kilbourne, E. M., & Desai, H. A. (2011, May). Prescription drug monitoring programs and death rates from drug overdose. Oxford Academic. https://academic.oup.com/painmedicine/article/12/5/747/1909814

Sweeney, J. (2017, February). Healthcare informatics – ProQuest. ProQuest. https://www.proquest.com/openview/0692fa0057e41f0972dd03e36230f738/1?pq-origsite=gscholar&cbl=2034896

Hello Marco,

I agree with you when you say Electronic Health Records  (EHR) has been life-changing.  Until six years ago, I always had direct patient care, but with EHR, I have been able to be a telecommuter.  EHR has given me access to my patients’ medical records remotely and the ability to care for my patients efficiently. Additionally, if I need assistance with a patient, my colleague or supervisor can review the patient’s chart simultaneously, providing me with the assistance I need promptly; this ensures that a patient will have optimal health outcomes.  According to Chips et. al. (2020). “The electronic health record (EHR) is a widely used tool in today’s healthcare environment for communication, documentation and billing.”

                                                          References

Chipps, E., Tucker, S., Labardee, R., Thomas, B., Weber, M., Gallagher, F. L., & Melnyk, B. M.

(2020). The Impact of the Electronic Health Record on Moving New Evidence‐Based Nursing

Practices Forward. Worldviews on Evidence-Based Nursing, 17(2), 136–143.

https://doi.org/10.1111/wvn.12435

I agree EHR is life-changing. EHR increases the logistic productivity of workflows and offers a safer way to care for patients. to ensure efficiency. The provider’s staff must follow a series of steps to ensure proper implementation and handling of the EHR system. Testing the implemented EHR that every system in place is put through its paces to ensure data tables and files are loading correctly and data collected are processed and stored correctly (Aguirre, Suarez, Fuentes, & Sanchez-Gonzalez, 2019). Even though EHR is the safest and faster way of charting and keeping medical records in storage, some healthcare organizations still do paper charting. Having an EHR at a healthcare organization is a pure and safest charting system.

References

Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation: A review of resources and Tools. Cureus. Retrieved December 2, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822893/.

Good day colleague Marco Paolo,

Thank you for sharing your experience with electronic and paper medical charting. It is a clear example of successful nursing transformation throughout recent decades. I also had an opportunity to work with both medical documentation systems and agree with you that the digital version of the medical records is definitely more secure, reliable and gives easy access to authorized healthcare users. Informational Technology plays an essential part in our daily work and has the potential to remain in focus for many more decades in the future.

Nursing leaders can participate in research and data collection in their units and determine what improvements are needed to produce the most competent, quality patient care (McGonigle, 2017). A multidisciplinary approach is crucial in managing the new technology initiatives and transforming nursing. All stakeholders, whether the manager, doctor, nurse, politician, lobbyist, economist, must be on the same page to develop a trusted, reliable healthcare system to provide safe and efficient care to the public. (Sweenew, 2017).

Reference:

McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

Sweeney, J. (2017). Healthcare informatics: OJNI. On – Line Journal of Nursing Informatics, 21(1) https://www.proquest.com/scholarly-journals/healthcare-

informatics/docview/1984364678/se-2

Marco-

I agree computer charting has been advantageous to patient care.

Technology is becoming a more integral part of nursing.  Data collection, utilization, and dissemination are imperative in order to improve education and ultimately patient care.  Data can be collected and shared through a variety of platforms and through integrated systems in order to best serve a person, and or population. Nurses are “knowledge workers” who process and apply data that has been generated, and then disseminated to them (McGonigle & Mastrian, 2017).

In corrections we rely on the electronic medical record to determine plan of care. We assess patients and collect data at intake. This data includes vital signs, past medical history, mental health history, prescription medications, drug/alcohol history, infectious diseases, and sexual history. While we rely on objective and subjective data, part of our assessment is reviewing prior bookings. This is imperative to help decrease the risk of negative outcomes. An example of this would be an individual that comes in with mental health and or suicide alerts who denies any mental health history and/or suicide attempts. We would chart as such; however, if there are active mental health and/or suicide history alerts, prior mental health medications we would create referrals based on the data from prior bookings.

Through the use of electronic medical records, nurses are able to review pertinent patient data to help create care plans. Nurse leaders are also able to help steer where data is logged and how best to utilize the abundance of data in order to provide comprehensive care for the patients that they serve (Sweeney, 2017). An example of this in our correctional facility is reviewing the patient/inmate summary, problem list, active alerts, and medication history to help determine referrals and plan of care.

References

McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

Sweeney, J. (2017). Healhcare Informatics. Online Journal of Nursing Informatics, 21(1), 4-1.

Hi Marco,great post on Electronic Health Records. Health informatics and Nursing Informatics are very relevant in evolving health care systems.Before the coming of electronic health records and EMARS,we had the paper MARS and chats.Information could easily get lost with papers flying around.With the computers now,health care records are safe in cloud which  makes retrieval easy.

References

Sweeney, J. (2017, February). Healthcare informatics – ProQuest. ProQuest. https://www.proquest.com/openview/0692fa0057e41f0972dd03e36230f738/1?pq-origsite=gscholar&cbl=2034896

Hi, Marco Paolo.

When we have a unified database, “new knowledge will be automatically integrated and embedded into electronic patient records, and include new algorithms for decision support systems (Nagle and Sermeus, et al., 2017). I agree that an EMR (Electronic Medical Record) like the one you described is offered by Epic would be great for all patient referencing. A true story that my mother needed serious medical care, and as she was transferred in between health care offices, she would receive two to three different name bands. One facility had her name as one thing and the next another. All these facilities were either under the same hospital system or had a partnership with the main hospital. I always felt this is probably how med errors occur with those of similar name receiving like services. Dr. Grant Shevchik says, “And so I think, as we begin to collate information and look at things, and let IT benefit us, let artificial intelligence assist us, and I think we will make better diagnoses” (Laureate Education, 2018).

References

Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in

Population Health [Video file]. Baltimore, MD: Author.

Nagle, L., Sermeus, W., & Junger, A. (2017).  Evolving Role of the Nursing Informatics Specialist. 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

Technology is revolutionizing the way that health care is delivered, this is not limited to only heath care workers only both clinicians and consumers are incorporating technology into daily lives. Nurses who specialize in informatics incorporates tools such as Health portal which include social networking , mobile devices and telehealth platform. These technologies in the health care marketplace transform the time and place for how care is provided. The  electronic medical record (EHR)is very useful for the nurses to provide  quality care and spend less time gathering information needed for patient care.

These new informatics executives incorporate technology in patient care thus bridging the new care delivery models into clinical practice this assist in changing the management effort to stage behavior and think beyond current models.

The advent of tele health assist the clinician to evaluate a patient in a long term setting without sending the patient to the ER, the doctor was able to pull up the patients’ record  which include  the medications the patient is currently taking, recent labs, this prevented a trip to the ER, the medical team will spend the time in the ER to take care of the acute and seriously ill patients in the hospital

References:

Laureate education (producer). (2018) what is informatics

Baltimore MD. author.

Sweeney, J. (2017) Health care informatics

Hello Cynthia,

Indeed technology has given us different options on how to interact and care for our patients.  With the COVID-19 pandemic, I had an opportunity to assess our elderly patients’ for community-based adult services. During the assessments, I had a lot of patients’ that I referred to mental health services.  According to Padala (2020).  “The COVID-19 pandemic has accelerated the need for telehealth at home.”  Fortunately, with technology, our patients could receive mental health services virtually.

Telehealth provides patients’ a degree of comfort as the care they receive is in the comfort of their homes; they do not need to travel back and forth to their appointments, hence saving time.  Some of the benefits of telehealth include a reduction of emergency room visits, an opportunity to have access to health care with primary care providers to assist with chronic health conditions, and a decrease in healthcare costs. Ultimately patients have better health outcomes.  Bradford et al. (2016).

                                              References

Padala, K. P., Wilson, K. B., Gauss, C. H., Stovall, J. D., & Padala, P. R. (2020). VA

Video Connect for Clinical Care in Older Adults in a Rural State During the

 COVID-19 Pandemic: Cross-Sectional Study. Journal of Medical Internet

Research, 22(9), N.PAG. https://doi.org/10.2196/21561

Bradford, N. K., Caffery, L. J., & Smith, A. C. (2016). Telehealth services in rural and

remote Australia: a systematic review of models of care and factors influencing

success and sustainability. Rural & Remote Health, 16(4), 1–23.

Hi Cythia- I enjoyed your post about using telehealth for analyzing individuals in long term care  if possible for a trip to the emergency roo(ER). I think that this would alleviate a large amount of individuals who actually do not need the evaluation that is required in the ER. As an ER RN we face this problem daily. It is always nice to find possible options that could work for us to change this problem.

Although that I think this would be beneficial for the majority of our long term care facilities. Cost and inclusion strategies can be difficult for some. According to Blandford et al.,  the systems need to be regulated for privacy, possible security breaches and quality of software used. Some facilities to not have the capabilities to hold a system that can provide such high level of care(2020). Outside resources may be beneficial for gaining the funds and knowledge to incorporate an effective telemedicine program into the facility.  A current study did look at the use of telemedicine overall for pre-hospital evaluation, the study indicated that it reduced overall emergency medical transports but not necessarily the final destination for the patient(Champagne-Langabeer et al, 2019). I think that telemedicine will continue to a hot topic and potential use for pre-hospital knowledge and overall status for a patient for their care.

Blandford, A., Wesson, J., Amalberti, R., AlHazme, R., & Allwihan, R. (2020). Opportunities and challenges for telehealth within, and beyond, a pandemic. The Lancet Global Health, 8(11), e1364-e1365.

Champagne-Langabeer, T., Langabeer, J. R., Roberts, K. E., Gross, J. S., Gleisberg, G. R., Gonzalez, M. G., & Persse, D. (2019). Telehealth impact on primary care related ambulance transports. Prehospital Emergency Care, 23(5), 712-717.

Hi Cynthia,

I take your point regarding virtual medicine. The advent of telehealth systems has been a boon to the distribution of health services. It is not only an efficient method of delivering quality healthcare; it also cuts costs by preventing medication misuse, unnecessary emergency room visits [as you illustrate in your post], and prolonged hospitalizations (Gajarwala, S.N., & Pelkowski, J.N., 2021). Notably, the COVID-19 pandemic has really highlighted the importance of virtual medicine. For many who were self-isolating at home, telehealth was an safer alternative to in-person visits to help curb the spread of the virus (Monaghesh, E., & Hajizadeh, A., 2020).

References

Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth Benefits and Barriers. The Journal for Nurse Practitioners, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013

Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC public health, 20(1), 1193. https://doi.org/10.1186/s12889-020-09301-4

Hello Cynthia,

You are correct in stating that technology is transforming the delivery of health care. This is so true in that if you don’t know how to use it, you won’t be able to operate properly. The question is what impact does technology have on nursing? Technology allows RNs to be more efficient and communicate more effectively in the profession of nursing. In fact, technological advancements have changed the medical environment dramatically in the previous 30 years. The days of diligent charting and filing records by hand are numbered. Patients now have more access to their data than ever before thanks to advances in telemedicine and electronic recordkeeping. Technology allows RNs to be more efficient and communicate more effectively in the profession of nursing. To begin with, electronic health records (EHRs) have revolutionized the field of healthcare information technology. A digitized recording of a patient’s medical history is known as an electronic health record. It could include things like progress notes, providers, issues, prescriptions, lab results, and so on. By enhancing the accuracy and clarity of medical records and making data freely accessible to healthcare providers, doctors, and patients, EHRs can improve patient care. I admire technology as someone who has worked in nursing for decades (Avant Healthcare Professionals, 2019).

Reference

Avant Healthcare Professionals. (2019, September 10). How technology is impacting nursing practice in 2020. Avant Healthcare Professionals. https://avanthealthcare.com/blog/articles/how-technology-is-impacting-nursing-practice-in-2019.stml

        Nursing informatics is the “combination of nursing science, information science, and

computer science” [McG15]. As nurses, we must provide our patients with safe and

effective care. Before electronic medical records (EMRs) and information technology (IT)

approximately 44,000 to 98,000 individuals die yearly from preventable medical errors [Pla09].

The goal of information technology is to improve the safety, quality, and efficiency of care.

[Cip11]. “The use of IT has focused on automation of clinical information, improving

communication between patients and providers, reducing errors, and bringing evidence to the

point of care” [Cip11]. Cipriano (2011) stated that information technology has already minimized medical errors and improved patient safety.

I currently work at the Department of Corrections. When Covid-19 originated, the nurses were on the front lines recording daily temperatures directly on the inmate’s complexes for early detection of an elevated temperature. It was essential to keep track of all the inmates’ temperatures during Covid to identify and immediately place individuals with symptoms under medical isolation.

Understanding the significance of reporting symptoms immediately to management and using

informatics enabled management to keep track of all the incarcerated individuals with symptoms and those to be tested for covid.

Informatics blends technology and information to create something new that people,

organizations, and society can use. Computer principles and information science are

combined to turn data into valuable knowledge to people in various professions, including healthcare (Laureate Education, 2018). Informatics during this pandemic has enabled

nurses to collect and document data on an ongoing basis. Daily temperatures were recorded on

flow sheets which made it easier to compare data.

Nurses, more than ever, during a pandemic depend on clinical rationale and judgment by

attentively collecting and developing information regarding early detection of Covid-19, such as

keeping track of daily temperatures before implementing any sort of treatment plan to recognize

the importance of early detection and the purpose of quarantine and medical isolation to prevent

the spread of Covid-19.

References:

Cipriano, P. F. (2011). The Future of Nursing and Health IT: The Quality Elixir. Nursing

Economic$, 29(5), 286-289.

McGonigle, D., & Mastrian, K. G. (2015). Nursing Informatics and the Foundation of

Knowledge (Third ed.). Burlington, MA: Jones & Bartlett Learning.

CDC. 2020. Guidance on Management of Coronavirus Disease 2019 (COVID-19) in

Correctional and Detention Facilities. Retrieved December 01, 2021, from

https://www.cdc.gov/coronavirus/2019-ncov/community/correction-detention/guidance[1]correctional-detention.html/

Laureate Education. (2018). Health Informatics and Population Health: Trends in Population

Health. Baltimore, MD: Author. Retrieved December 01, 2021, from

https://cdnfiles.laureate.net/2dett4d/managed/WAL/MMHA/6520/11/WAL_MMHA6520

_11_A_EN.pdf/

Stanley,

I think your example of EMRs is the broadest choice that affects every aspect of healthcare. Working within several facilities, I have had the opportunity to compare several systems. The reports within each system can allow for the effective analysis of valuable information, such as COVID risk factors or symptoms. Creating systems that help to identify concerns or reduce errors are of great value to health care workers and patients. Thank you for sharing your research!

Collection, processing, and utilization of data into medical practice is an integral part of nursing informatics.  There are a unlimited amount of scenarios providing examples of how data is collected and assessed and applied to practice.  X-rays, or electromagnetic radiation, provides a picture based on how different tissues of the body absorb the radiation (U.S. Department of Health and Human Services, n.d.). X-rays are a great tool to collect data for medical purposes.

Consider the following scenario. A patient  presents to the clinic with left ankle and foot pain beginning earlier that day. Patient is a basketball player and has no previous injuries. Patient report pain with ambulation, plantar and dorsiflexion, and medial and lateral rotation. There is no swelling present to ankle and foot area. X-ray of left ankle and foot was ordered by provider to assess for injuries.

Utilizing images from radiology is an example of how data was collected from an assessment by the provider and an X-ray order based on assessment and symptoms. The results from the X-ray will provide additional data the will help the provider form a diagnosis and treatment plan.  Image data includes scan such as X-rays, MRI, ECG, and CT (McGonigle & Mastrian, 2017).  Informatics is designed to help the provider deliver evidence based care to the patient improving patient outcomes. Some medical professionals believe that informatics will eventually evolve into artificial intelligence that provides diagnosis based on data inputed (Laureate Education, 2018). Whatever the future holds, the present utilization of informatics is a game changer in patient care.

References

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

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

U.S. Department of Health and Human Services. (n.d.). X-rays. National Institute of Biomedical Imaging and Bioengineering. Retrieved December 2, 2021, from https://www.nibib.nih.gov/science-education/science-topics/x-rays.

Tina,

Your example of x-ray pictures as data that is collected for nursing infomatics was a great choice. Finding effective ways to communicate information between varying disciplines can always be a challenge. This is especially true if the patient and provider are not in the same location. Radiologists are often employed via telemedicine to diagnose patients that are great distances from themselves. Utilizing effective nursing informatics can improve patient care greatly. Thank you for sharing your research!

Hello Tina you make valid points using Nursing informatics includes all aspects of data collection, processing, and use in clinical settings. An infinite number of situations can be used to demonstrate how data is gathered, analyzed, and implemented in the workplace. Based on how various tissues absorb radiation, X-rays or electromagnetic radiation create an image of the body (U.S. Department of Health and Human Services, n.d.). For medical purposes, X-rays are an excellent way to gather information.
Let’s have a look at this scenario. Earlier that day, a patient first came to the clinic complaining of left ankle and foot pain. No prior injuries have been reported by the patient, who is a basketball player. Ambulation, plantar and dorsiflexion, and medial and lateral rotation are all painful for the patient. Ankle and foot edema is non-existent. The doctor requested an X-ray of the patient’s left ankle and foot to rule out any damage.
An example of how data was gathered from a provider’s assessment and an X-ray order based on the assessment and symptoms is the use of images from radiology. The results of the X-ray will aid the physician in determining a diagnosis and a course of therapy. X-rays, MRIs, ECGs, and CT scans are all examples of image data (McGonigle & Mastrian, 2017). It is the goal of information technology (IT) to assist healthcare providers in providing their patients with high-quality, evidence-based treatment. Some doctors anticipate that in the future, medical informatics will develop into artificial intelligence capable of making diagnoses based on data that is entered into computers (Laureate Education, 2018). The current use of informatics in patient care, whatever the future holds, is a game-changer.

Reference

Agency for Healthcare Research and Quality. (2019). Medication Reconciliation. Retrieved from https://psnet.ahrq.gov/primer/medication-reconciliation

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

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.

Zimmerman et al (2017) opined that it is crucial to have an accurate medication lists in the patient’s health biography. One strategy of improving accuracy in the medication lists is provision of multiple opportunities for data collection. In the registration process, patients should be allowed to access patient portals which are protected by passwords to access their health records (Rose et al., 2017). Also, patients should be allowed to seek for editing in case they discover some health history was omitted or there are changes in their current address. Detailed information can be collected during the admission process as a patient/caregiver is able to provide all the required information they seek treatment. Patients are sometimes seen by more than one provider which can result in medication list inconsistencies (Zimmerman et al, 2017). To avoid the inaccuracies, information submitted by the patient should be verified for accuracy and then added to a patient chart. When a patient visits a new provider, they should list the provider’s information for reconciliation if they are prescribed with new medication.  In a clinical setting, a pharmacist should be tasked with conducting medication reconciliation to improve the accuracy of a patient’s medication list. 

A nurse leader can use the data collected to improve patient outcomes. A nurse leader can consider including patient education to the medication list on their portals to improve patient’s knowledge on the prescribed medication. A nurse leader should conduct follow up with staff to ensure correct and accurate documentation. Rose et al (2017) asserted that an accurate medication list a crucial tool that can promote patient safety by preventing medication errors. To improve the accuracy of the data on the medication lists, a nurse leader should create multiple ways of collecting data and verifying it. In addition, the applicable knowledge should be accurate to improve patient care and mitigate the risk of an adverse reaction to medication (AHRQ, 2019). An accurate medication list should be made available on the patients’ portal for ease of access

Response #2

Hello Tina

I agree with your point, Nursing informatics is concerned with the collection, analysis, and incorporation of data into medical practice. There is an infinite number of scenarios that may be used to demonstrate how data is collected, evaluated, and then applied to practice situations. X-rays, also known as electromagnetic radiation, are used to create an image of the body by observing how different tissues absorb the radiation (U.S. Department of Health and Human Services, n.d.). X-rays are an excellent tool for gathering information for medical purposes.

Reference

Agency for Healthcare Research and Quality. (2019). Medication Reconciliation. Retrieved from https://psnet.ahrq.gov/primer/medication-reconciliation

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

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.

The Application of Data to Problem-Solving

Health informatics involves data entry, processing, storage, and retrieval, and evaluation. Use of health informatics has had a positive impact on the health profession as their proper use makes works easier, helps in prompt decision making, and improves on accuracy (Nagle et al., 2017). In my practice, I have interacted with electronic health record (EHR) system. The EHR system serves as a health biography for patients. The data stored in EHR system is used to develop comprehensive care and treatment plans for patients. According to McGonigle and Mastrian (2017), electronic health records have been used to improve patient care outcomes, increase patient safety/satisfaction, reduce medication errors, enhance communication, and interaction between providers and patients.  One valuable piece of information stored in EHR system is a patient’s medication list (McGonigle & Mastrian, 2017). Empirical evidence has revealed that some patients take less than half of the medications listed in their treatment plans (Ryan et al., 2017). In addition, some of the medications prescribed to patients are not listed in their medical records. Therefore, there is need to improve the documentation process of a patient’s medication list. 

I have worked as a nurse in the emergency room. In the course of my practice, I have encountered inaccurate medication documentations in several charts. When a patients comes to the emergency room, it is a procedure to complete and update the medication list during the triage process. In case a patient is admitted, medication reconciliation is done during the admission process. Inaccurate medication documentations are encountered when some nurses do not update or reconcile the medication lists resulting in some drugs being omitted from the list (Rose et al., 2017).  Zimmerman et al (2017) opined that it is crucial to have an accurate medication lists in the patient’s health biography. One strategy of improving accuracy in the medication lists is provision of multiple opportunities for data collection. In the registration process, patients should be allowed to access patient portals which are protected by passwords to access their health records (Rose et al., 2017). Also, patients should be allowed to seek for editing in case they discover some health history was omitted or there are changes in their current address. Detailed information can be collected during the admission process as a patient/caregiver is able to provide all the required information they seek treatment. Patients are sometimes seen by more than one provider which can result in medication list inconsistencies (Zimmerman et al, 2017). To avoid the inaccuracies, information submitted by the patient should be verified for accuracy and then added to a patient chart. When a patient visits a new provider, they should list the provider’s information for reconciliation if they are prescribed with new medication.  In a clinical setting, a pharmacist should be tasked with conducting medication reconciliation to improve the accuracy of a patient’s medication list. 

A nurse leader can use the data collected to improve patient outcomes. A nurse leader can consider including patient education to the medication list on their portals to improve patient’s knowledge on the prescribed medication. A nurse leader should conduct follow up with staff to ensure correct and accurate documentation. Rose et al (2017) asserted that an accurate medication list a crucial tool that can promote patient safety by preventing medication errors. To improve the accuracy of the data on the medication lists, a nurse leader should create multiple ways of collecting data and verifying it. In addition, the applicable knowledge should be accurate to improve patient care and mitigate the risk of an adverse reaction to medication (AHRQ, 2019). An accurate medication list should be made available on the patients’ portal for ease of access

References

Agency for Healthcare Research and Quality. (2019). Medication Reconciliation. Retrieved from https://psnet.ahrq.gov/primer/medication-reconciliation

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

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.

Ryan, T. P., Morrison, R. D., Sutherland, J. J., Milne, S. B., Ryan, K. A., Daniels, J. S., & Daly, T. M. (2017). Medication adherence, medical record accuracy, and medication exposure in real-world patients using comprehensive medication monitoring.  

Rose, A. J., Fischer, S. H., & Paasche-Orlow, M. K. (2017). Beyond medication reconciliation: the correct medication list. Jama, 317(20), 2057-2058.

Zimmerman, K. M., Salgado, T. M., & Dixon, D. L. (2017). Medication reconciliation vs medication review. Jama, 318(10), 965-966.

Response #

Hello Isatu, i agree with you

Health informatics encompasses the collection, processing, storage, and retrieval of data, as well as their evaluation. The use of health informatics has benefited the health profession because it simplifies tasks, expedites decision-making, and increases accuracy (Nagle et al., 2017). I have worked with an electronic health record (EHR) system in my practice. The EHR system acts as a patient’s health biography. Patients’ comprehensive care and treatment plans are developed using the data collected in the EHR system. McGonigle and Mastrian (2017) report that electronic health records have been utilized to improve patient care outcomes, patient safety/satisfaction, prescription mistakes, and communication and engagement between physicians and patients. A patient’s medication list is one of the most valuable pieces of information kept in an EHR system (McGonigle & Mastrian, 2017). According to empirical research, some patients take fewer than half of the prescriptions prescribed in their treatment programs (Ryan et al., 2017). Furthermore, several drugs provided to patients are not documented in their medical records. As a result, there is a need to enhance the process of documenting a patient’s drug list.

Refrence

Denholm, B. G. (2016). Using informatics to improve the care of patients susceptible to malignant hyperthermia. AORN Journal, 103(4), 364-379.

Kassam, I., Nagle, L., & Strudwick, G. (2017). Informatics competencies for nurse leaders: protocol for a scoping review. BMJ Open, 7(12), e018855.

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1. (n.d.)

                                         The Application of Data to Problem-Solving

In a healthcare setting, data allows for efficiency while still aiding in solving problems. Precisely, data paves the way for the visualization and reframing of decisions to build measurable success standards. With organizations entrusting their process to data, the healthcare system has not been left behind. The healthcare sector now prides itself in up-to-date health data to help adjust health quality and safety (Data Saves Lives, 2021). More importantly, data is central to decision making and solving problems. Undoubtedly, solving problems with data has turned out as an appealing endeavour because of effectiveness. Furthermore, apart from care departments and systems, patients, too, have benefited in knowing how healthcare evolves. Practically, nurses heavily rely on health informatics to provide better care.

Hypothetically, in the quest to realize personalized care for the mentally ill and those struggling with substance abuse, data and informatics would guarantee the needed solutions to treat mental health. According to Lumby (2021,  data goes a long way in presenting information, awareness and treatment alternatives for mental illness. Firstly, applying data in psychiatric departments would help identify patterns of patient behaviour and overall well-being. In other words, data analytics would help trace the much-sought answers pertaining to prescription and diagnosis. This means that nothing would appear difficult to detect. Moreso, intervention measures and approaches can be associated with the access/collection and application of data.

In the aforementioned scenario, access to data would benefit the patients, healthcare system, care providers and researchers. Whereas patients receive quality care with improved outcomes, the healthcare system can disseminate knowledge thus enhancing efficient health strategies for all (Grenuk, 2021). Above all, it will be easier to predict outcomes. As for care providers, it will be easier to redesign better care pathways for the ill. At another level, research level, access to data will yield new treatment methods. In the context at hand, mental health data help implement the right treatment, track improvements and investigate prevention measures. All these parameters reflect solutions to healthcare problems.

The use or rather application of data will continually field dramatic transformations in nursing. As diseases continue to emerge, more effective and smarter care options are necessary. Achieving optimal results within reasonable budgets can only be possible through the application of data.  Data, which back nursing informatics, is accurate and cost-efficient. Therefore, data has solutions to numerous healthcare and nursing problems. With the evolution of information, nurses have access to electronic data about every health issue, including critical conditions. This enables swift management of healthcare, improved coordination and enhanced patient outcomes. In essence, data has birthed nursing integration, wisdom, knowledge and skills.  Indeed, data saves lives.

References

Data Saves Lives. (2021). Why is health data important? Data Saves Lives. Retrieved December

1, 2021, from https://datasaveslives.eu/why-is-health-data-important.

Grenuk, J. S. (2021, October 12). How nursing informatics improves patient care. TigerConnect.

Retrieved December 1, 2021, from https://tigerconnect.com/blog/how-nursing-informatics-improves-patient-care/.

Lumby, A. (2021, June 28). How data science can improve mental health care. Master’s in Data

Science. Retrieved December 1, 2021, from

https://www.mastersindatascience.org/resources/how-data-science-can-improve-mental-h

ealth-care/.

Hi, Silvanus.

I thought your scenario was interesting. Data programs that can predict mental health patients’ behavior trends like with repeat visitors. Being of a vulnerable state, having an information hub to review in times of crisis may be useful to aid the psych patient. The patient benefits as they too might need clarity on their situation. Dr. Grant Shevchik speaks on how an artificial intelligence device can expidite processes like in diagnoses of a migraine sufferer, for example, as it narrows the presented symptoms; thus, not taking the place of the practitioner but partnering with him (Laureate Education, 2018). Be it that information and treatment plans are ever-changing, to have a digital system that can pinpoint what works and what does not in a time-efficient manner would be better. Nurses may need more information, and information systems may help them learn faster. “In the future of connected health, there will be direct links to knowledge generated by specialists from around the world” (Nagle and Sermeus, et al., 2017).

References

Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in

Population Health [Video file]. Baltimore, MD: Author.

Nagle, L., Sermeus, W., & Junger, A. (2017).  Evolving Role of the Nursing Informatics Specialist. 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

Informatics can be utilized to help improve patient care and patient outcomes. The collection of data is important, but there also must be timely and efficient dissemination of this knowledge. Unfortunately there is often a delay which in turn means that there is a delay in the application of evidenced based practice. This delay is noted to be on average 17 years. Furthermore, in conditions such as alcohol addiction indicators marking that evidenced based practice was implemented by doctors and nurses is at an alarming low rate of ten percent (Nagle et al., 2017).

As technology is becoming a more integral part of nursing, nursing practice can improve in a timelier manner.  Data collection, utilization, and dissemination are imperative in order to improve education and ultimately patient care.  Data can be collected and shared through a variety of platforms and through integrated systems in order to best serve a person, and or population. Nurses can use data as “knowledge workers” by processing and applying the data that has been generated and then disseminated to them (McGonigle & Mastrian, 2017) Discussion: The Application of Data to Problem-Solving.

In the county jail we work with a lot of individuals going through drug and alcohol withdrawals. Individuals withdrawing from alcohol and or benzos are at an increased risk of seizures and alcohol DTs. Some sites automatically start individuals on both withdrawal monitoring and withdrawal medications. Medications can be given STAT, or are to start within 4 hours of them entering the facility. Other sites start these individuals on withdrawal monitoring, and only start them on medication after their withdrawal score reaches a certain score unless they have certain risk factors. Some nurses prefer the former school of thought and some prefer the latter. This is an area in which informatics can be utilized for improved patient care and patient outcomes. Data would have to be tracked and collected at individual sites – marking negative outcomes associated with the two practices. Currently the Site Medical Director and prescribing Providers at our site prefer medications to be initiated based on score unless the patient presents with higher risk factors. Some nurses feel that this potentially leads to a greater incidence of potential negative outcomes.

Once high quality data is collected and reviewed, policy needs to be reviewed to reflect best practice. A nurse leader would then be able to present this data collection (from multiple sites) to support one practice over the other. If there is integrity in the data collection then it can be processed into information that in turn supports best practice. This information is then disseminated to the clinicians caring for this population (McGonigle & Mastrian, 2017).  Nursing leaders can help their team and support best practice by reviewing data within the electronic medical record, and sharing with their team how this data was used to make decisions. This illustrates how decisions are driven by data and best practice (Sweeney, 2017).

Informatics is utilized in the dissemination of knowledge and data sharing as I mentioned above, but it is also utilized in the initial review and collection of data. Information is obtained from vital sign machines, and then input into electronic medical records which are then reviewed. In the withdrawal situation that I briefly touched on above, nurses are utilizing this system to review drug and alcohol history, withdrawal score at intake, vital signs, and fluctuations between assessments in order to make informed decisions and plans of care (Sweeney, 2017).

McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

Nagle, L., Sermeus, W., & Junger, A> (2017). Evolving Role of the Nursing Informatics Specialist. In J, Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). Clinton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.

Hi Kalar,

I agree with you, informatics can be utilized for better patient outcomes.

Health informatics involves data entry, processing, storage, and retrieval, and evaluation. Use of health informatics has had a positive impact on the health profession as their proper use makes works easier, helps in prompt decision making, and improves on accuracy (Nagle et al., 2017). In my practice, I have interacted with electronic health record (EHR) system. The EHR system serves as a health biography for patients. The data stored in EHR system is used to develop comprehensive care and treatment plans for patients. According to McGonigle and Mastrian (2017), electronic health records have been used to improve patient care outcomes, increase patient safety/satisfaction, reduce medication errors, enhance communication, and interaction between providers and patients.  One valuable piece of information stored in EHR system is a patient’s medication list (McGonigle & Mastrian, 2017). Empirical evidence has revealed that some patients take less than half of the medications listed in their treatment plans (Ryan et al., 2017). In addition, some of the medications prescribed to patients are not listed in their medical records. Therefore, there is need to improve the documentation process of a patient’s medication list. 

References

Agency for Healthcare Research and Quality. (2019). Medication Reconciliation. Retrieved from https://psnet.ahrq.gov/primer/medication-reconciliation

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

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.

Ryan, T. P., Morrison, R. D., Sutherland, J. J., Milne, S. B., Ryan, K. A., Daniels, J. S., & Daly, 

Thank you for your informative post, Klara.

I agree with you, informatics improves efficiency and productivity. The delivery of healthcare is governed by a myriad of policies and protocols. One way to better manage the complex nature of healthcare delivery is through the incorporation of information technologies (Kudyba, 2010). Health informatics is built to support staff, improve patient care, and protect patients. Health informatics will implement knowledge algorithms, such as prompt on the appropriateness of admission or identification of patients at risk of being readmitted as an emergency (Health informatics, 2012).

References:

Health informatics. [electronic resource] : improving patient care. (2012). British Informatics Society Ltd.

Stephan P. Kudyba. (2010). Healthcare Informatics : Improving Efficiency and Productivity. CRC Press.

COVID Testing for Daycares

Since the onset of the COVID pandemic in 2020 all health authorities have been gathering data on the number of new cases, deaths, recovered, those tested and vaccinated. Organization tasks have ensued on how to carry out getting this information. Presidential mandates to get all Americans vaccinated have stepped into play too. Companies, especially with 100 plus employees have been in the spotlight on the topic. Some companies have lobbied to see how they can forgo the imperative for vaccination. Some dialogue has existed to allow said companies to test their employees weekly instead of forcing shots. What about testing in facilities of our most vulnerable population?  Daycares in most of the US have not made their staff to be vaccinated as most aren’t larger than a few staff members. What about the franchise daycares?

In my scenario the franchise daycares as well the smaller daycares in my area would have an employee health office where nurse practitioner medical care and evaluation could be performed. Also, weekly testing would occur to see if daycare workers without vaccination, and who don’t wear masks are bringing COVID into their work places. This data would be gathered with weekly testing of the staff. The antigen testing would be utilized for computer based rapid testing. Data received could be given to the local health department. The only way forward is to integrate and embed the new knowledge in electronic patient records using algorithms and decision support systems so that practice remains aligned with new knowledge and insights (Nagle and Sermeus, et. la, 2017). The data gathered would then be accessible just as the new cases, deaths, and recovered are reviewed. These are public health websites for COVID data points in the region. NPR.org (2021) David Folkenflik says, “We’ve heard that the Biden administration intends to distribute 50 million tests, at-home tests, for the uninsured to get. At the same time, there are 20 some million uninsured. It’s just there’s only, you know, two tests per person, give or take, who doesn’t have health care insurance.” Hence encouragement for testing by a clinical professional on the continuum would be ideal for daycares. This will allow for better data review over the long haul. As said by McGonigle and Mastrian (2017), “The integrity and quality of the data, rather than the form, are what matter Discussion: The Application of Data to Problem-Solving.

References

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge

(4th ed.). Burlington, MA: Jones & Bartlett Learning.

Nagle, L., Sermeus, W., & Junger, A. (2017).  Evolving Role of the Nursing Informatics Specialist. 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

NPR.org. (2021). Maine CDC director underscores importance of accessible rapid COVID testing

All Things Considered. Retrieved from https://www.npr.org/2021/12/04/1061539829/maine-cdc-director-underscores-importance-of-accessible-rapid-covid-testing