NURS 6051 Discussion: Interaction Between Nurse Informaticists and Other Specialists

Interactions between nurse informaticists and other healthcare professionals

In the surgery department where I work as an intraoperative nurse, technology is of the utmost importance in maintaining the health of the patient. Within this department, there is a team approach to caring for patients under anesthesia, which includes, anesthesiologists, surgeons, scrub technicians, nurses, patient care technicians, and others. Once a patient enters the operating room multiple professionals begin documenting and charting the patient’s status including the nurse and the anesthesiologist. An experience that I have had while charting within the intraoperative setting is that once the patient leaves the OR, the documentation that the anesthesiologist and I complete cannot be seen by the nurses on the floor once the patient is recovered. This is a lapse in the system because it increases the likelihood that critical patient information is not relayed to healthcare staff on the floor after a patient has surgery.

Strategy for improvements on healthcare interactions

To improve the communication between healthcare professionals regarding patients in the operating room, access to the intraoperative chart should be extended to those permitted in the patient chart on the nursing units. The surgical application ‘surginet’ cannot be accessed by those on the nursing floors, which creates a gap in care and could result in injury to the patient (surginet, n.d.). The anesthesiologist’s charting also does not carry over to the application ‘power chart’ utilized on the floors, which means the medications that were given during surgery are not saved in the EMR and are only known if anesthesia verbally passes on that information. Communication utilizing technology is the new standard of care and is a way to build knowledge and share it (McGonigle & Mastrian, 2017). Ensuring that these technical gaps do not result in patient injury is essential. The nurse must work as a knowledge worker and use nursing judgment and leadership to keep the patient safe (Sipes, 2016).

Impact of emergence and evolution of new technologies

The changing of technologies within the healthcare setting is an important step in improving patient care. However, the application of informatics in healthcare sometimes takes time to iron out all the unforeseen issues. Therefore, nurses need to complete technology training to overcome the inevitable issues that arise when different programs and machines evolve. In the operating room, there are many different instruments and machines that are being changed out every couple of years. This means that the education process for how to operate the new instrumentation and machinery is always ongoing. For example, this year our department received a new Da Vinci robot that is used for robotic surgeries that span specialties from urology to cardiac. This new robot requires months of training to operate as a surgeon or resident, but the nurse must learn by doing to set up the machine for use. Nursing judgment and experience come into play when technologies evolve in healthcare.

References

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

Sipes, C. (2016). Project management: Essential skill of nurse informatics. Studies in Health Technology and Informatics, 225, 252-256.

Surginet circulators user guide – children’s Minnesota. (n.d.). Retrieved December 13, 2021, from https://www.childrensmn.org/departments/training/doc/surginet-circulators-user-guide.pdf.

     Hello Hannah, thanks for this educative post. Like you mentioned in your post that “The changing of technologies within the healthcare setting is an important step in improving patient care”. This is very true, it helps in Increases Patient-Centered Care by encouraging patients to participate more in their own care, which is very crucial for a variety of reasons, including increased compliance and patient satisfaction.  It also help in facilitating communication between clinicians and patients via web portals, text messaging, and email. It can also improves self-monitoring and patient convenience by increasing access to information such as online medical records (Health it Outcome, (2017).  Introduction of technology in healthcare really facilitating communication between health care professionals, enhancing drug safety, tracking, and reporting, and promoting quality of treatment through enhanced access to and adherence to guidelines are all benefits of health information technology (IT). Data can be collected for quality management, outcome reporting, and public health disease surveillance and reporting using health IT systems. However, there is need for development in all aspects of health IT, particularly in terms of design, implementation, and platform integration inside the workplace. Interoperability is essential for safe care, but it has proven difficult to achieve. Significant patient safety concerns have already been identified; it is critical to maintain a major focus on patient safety and quality (ACOG, 2015). I surely believe Information technology has the potential to have a significant impact on patient safety.

References

Health it Outcome, (2017).4 ways technology is improving patient safety.  Retrieved December 14, 2021, from https://www.healthitoutcomes.com/doc/ways-technology-improving-patient-safety-0001.

American College of Obstetrician & Gynecologist. (2015). Patient Safety and Health Information Technology. Retrieved December 14, 2021, from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/01/patient-safety-and-health-information-technology.

Nursing education and practice, as well as management and research, are all impacted by technological advancements. Health informatics (IT) plays an essential role in the coordination of care in the nursing profession. In my Company, MHealth Fairview Health Care IT aids in tracking staffing, workflow, and communication and assisting the nurse in determining distinct needs. (Hessels, Flynn,

Cimiotti, Bakken, & Gershon, 2020). IT includes the clinical workflow process, the design process, the treatment process, and a new diagnostic. IT also gains various perspectives that they can employ to provide patient-centered treatment. IT provide staff with training and assist them in resolving challenges. More specifically, IT reduce medical errors while also enhancing the overall quality of medicine through EHR software. A high level of functional connection between individuals, teams, patients, and other departments ensures good stability of treatment information. Nurses who receive specific knowledge abilities training in learning institutions can address problems and apply telecommunication processes and prepare health care professionals for the informatics field through appropriate collaboration and skill development. As an illustration: Education and e-learning technologies, as well as information reform, are used to manipulate information (Hessels, Flynn, Cimiotti,

Bakken & Gershon, 2020).

in addition, our company has its department dedicated to information technology. The department has brought in many physicians and nurses to integrate computer technology into the healthcare industry better. Medical experts may be employing this type of software in their clinics.

To utilize IT in clinics, they better understand the sorts of technology that healthcare practitioners often employ. In the e-hospital for outpatient clinics, a senior consultant from the neurology department oversees the informatics team, which consists of nurses who act as nurse informatics and work with IT to design user-friendly programs. These nurses get IT training before being sent to other offices, where they train the rest of the employees on these courses and deal with any technical issues that arise.

Not all healthcare providers utilize this software, and the elderly in particular, are reluctant to use it since they don’t know how to use computers. Some employees claim that the application is malfunctioning or that the server is experiencing issues constantly. We must have fully functional software with no server issues to keep this safe. It is essential to make sure that workers can utilize the IT in the hospital to do business by providing them with the necessary qualifications and certifications. An informatics expert should be a member of the clinical team so that other healthcare team members can openly express their concerns and questions about computer use (Ash, Berg, & Coiera 2004).

Reference

J. S. Ash, M. Berg, and E. Coiera (2004). The nature of patient care information system-related mistakes is one of the unexpected effects of information technology in health care. Medical Informatics, 11(2), 104-112.

Hessels, A., Flynn, L., Cimiotti, J., Bakken, S., & Gershon, R. (2020). Impact of Heath information technology on the quality of patient care. HIMSS. https://www.himss.org/resources/impact-heath-information-technology-quality-patient-care

Hello Mariline!

It always surprises me with all the older healthcare professionals who are unwilling to work with the technology that is given. I too work with some older nurses and providers who document just to get by, leaving insufficient charting for the rest of us. After looking through the literature I feel that making “continuing ed” classes for technology is a must for all, especially the older generation who are more likely to refuse using the technology. Just like with anything, when healthcare workers remain up-to-date on all practices, medications patient registrations and procedures are reduced, money is saved and controlled drug-substances are controlled better(Chardalias et al., 2017).

Nurses need to be competent in all aspects of their career, this including both technology and data. Competencies are being created to help nurses to stay on top of the ever changing world of healthcare technology. Competencies should be based on regional needs for a particular system(Farzandipour,2021). The competencies can be based on basic computer skills to advanced knowledge of the system’s electronic health record. Nurses need to maintain a certain competency for their jobs for increased  safe patient care(Farzandiopour, 2021).

Chardalias, K., Magnita, A., Andrianopoulos, C., Koutonias, P., Kefaliakos, A., & Diomidous, M. (2017). Continuous education in community nursing with the use of health informatics. Studies in Health Technology and Informatics, 238, 269–271.

Farzandipour, M., Mohamadian, H., Akbari, H., Safari, S., & Sharif, R. (2021). Designing a national model for assessment of nursing informatics competency. BMC Medical Informatics and Decision Making, 21(1), 35. https://doi.org/10.1186/s12911-021-01405-0

Being employed at a federally qualified health center (FQHC) has often meant that some technology and processes are antiquated. The main source of health information in the clinic is the electronic health record (EHR) that staff uses to document various aspects of care.  One glaring issue is the inability to communicate with other medical institutions electronically because of the difference in EHR being utilized. These EHRs are examples of clinical information systems (CIS), where clinical appointments are linked to the billing system ( McGonigle & Mastrian, 2017).  A vast majority of healthcare institutions have converted to the use of Epic in Wisconsin and the FQHC that I’m employed at utilizes AthenaHealth.

The result of utilizing an EHR that is not able to electronically sync care is the receipt of hard copies of medical records being faxed into the clinic. The medical records are then read by providers and utilized to provider continuing care and eventually are sent to the medical record department. The health information technicians then scan the hard copies of the patient’s medical record from other healthcare institutions into the electronic chart. The clinic does not employ any nurse  informaticists so the health information technicians are responsible for interacting with clinic staff to accurately maintain electronic health records of all clinic patients. The health information technicians are also responsible for completing valid requests for medical records  (U.S. Bureau of Labor Statistics, 2021). The health information technicians are extremely helpful and knowledgeable, but are severely understaffed and have issues with updating the electronic record with hard copies within seventy-two hours.

Attempting to provide care to a patient by reviewing a chart that has not been updated with new information within the seventy-two hour turnaround period can cause improper care. Operating as a project manager to help convert the hard copy medical records in a timely manner is a skill set that a nurse informaticist possesses (Sipes, 2016). There have been issues with locating EKG tracings for pre-operative exams. Often times the office of the surgeon will not receive the fax and the information will need to be resent. When this occurs, it is often difficult to locate the tracing to be resent because it has not been uploaded into the EHR. A nurse informaticist would be able to prioritize what needs to be uploaded quickly and offer a storage system for other records to be readily available until they are uploaded to the EHR. This is an issue that was recently addressed at the department meeting and I am eager to see resolution offered by administration.

References

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

Sipes, C. (2016). Project management: Essential skill of nurse informaticists. Studies in Health Technology and Informatics, 225, 252–256.

U.S. Bureau of Labor Statistics. (2021). Medical records and health information specialists : Occupational outlook handbook. Retrieved December 15, 2021, from https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm#tab-2

Hi Tina,

Nice post. Communication is important when dealing with data information on electronic health records. Communication is pivotal to the effective care and treatment of patients in our health care systems (Stephens et al., 2021). At my place of work, we utilize Cigna. The system allows staff to communicate with each other through perfect serve. The nurse reaches to the physicians through perfect serve in regard to patient condition. The physicians utilize the same process as well to communicate to the nurses. Adequate communication among healthcare professionals helps improve patient quality of care, prevent harm to the patient, and promote safety.

It is good that your workplace addressed the issue of locating EKG tracing and prioritizing uploads in the EHR. An important challenge associated with making the transition from paper to electronic documentation systems is achieving consensus regarding priorities for electronic conversion across diverse groups (Dykes et al., 2006). At my place of work, we recently addressed the issue of manually inputting vital signs in the system. The manual charting creates more workload for the staff. The new vital sign machine allows staff to scan the patient identification band, and take the patient vital signs, which automatically goes to the patient record in the computer system. The new system made our work less easy.

Reference:

Dykes, P. C., Spurr, C., Gallagher, J., Li, Q., & Ives Erickson, J. (2006). A systematic approach to baseline assessment of nursing documentation and enterprise-wide prioritization for electronic conversion. Studies in Health Technology and Informatics, 122, 683–687.

Stephens, E., William, L., Lim, L.-L., Allen, J., Zappa, B., Newnham, E., & Vivekananda, K. (2021). Complex conversations in a healthcare setting: experiences from an interprofessional workshop on clinician-patient communication skills. BMC Medical Education, 21(1), 343. https://doi.org/10.1186/s12909-021-02785-7