NR 512 Discussion Week 1, Integration of Nursing Informatics Skills & Competencies (Two Versions) - €7,70   In winkelwagen

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NR 512 Discussion Week 1, Integration of Nursing Informatics Skills & Competencies (Two Versions)

NR 512 Discussion Week 1, Integration of Nursing Informatics Skills & Competencies (Two Versions) Dr. Moyers & class With the rapidly changing environment in healthcare and emphasis on improved patient outcomes, informatics has become one of the leading technology industries today. To provide quality patient care, leadership must recognize that the increased challenges in healthcare delivery systems are due in part to advanced technologies, government standards, organizational policies, and social expectations (Hussey & Kennedy, 2016). The ability to share information quickly and easily has significantly improved communications across disciplines thus improving patient care and experiences. The next generation healthcare providers must be proficient informatics leaders in design, implementation, and operation of electronic health record EHR systems to continue with improving patient outcomes and patient experiences (Hussey & Kennedy, 2016). The use of clinical decision support (CDS) systems within the EHR has become the latest and greatest tool in informatics to improve decision-making skills by nurses and patient outcomes (Dunn Lopez et al., 2016). CDS systems incorporates computer-generated clinical knowledge and patient related information to assist the nurse in making appropriate decisions related to the patients clinical picture. Informatics is utilized in many facets of my practice as a labor and delivery nurse. We use two EHR systems that are integrated which is beneficial for the nurse. When the two systems were not integrated, much of the clinical data was lost in translation. At times, this lead to delays in decision making and could have affected patient care. Recently, the OB system we use added an Early Warning System that alerts the nurse when a patient’s clinical picture is declining based on seven clinical assessments. This CDS has shown an improvement in our early identification of sepsis which has improved patient outcomes. After completing the Pre-TANIC TIGER assessment, I hope to gain further knowledge in how informatics is used to improve patient outcomes. My competency level is competent to proficient in most categories with a few expert level. I would say it was accurate with my comfort level. I feel there is a double-edge sword with the use of EHR’s because so much of our time is spent in front of a computer and that has taken away from the face-to-face interaction with our patients and families. Best of luck with the course! Michele Response to professor: Patient safety and providing quality care are the top priority for nurses and healthcare systems. Although EHR’s and Health Information Technology (HIT) were developed with the intention of improving patient safety, there is evidence that suggests patient safety and other unintended consequences result of HIT due to disruptions in clinical processes, unsafe workarounds, and usability issues (Meeks et al., 2014). Most nurses today have never worked in facilities who do not use some sort of EHR, so when the systems are not functioning, they become frazzled when having to use paper records. I have seen delays in orders particularly with lab tests and pharmacy items when our systems are down. This is a patient safety issue when stat labs are ordered. There is a trickle down effect when that occurs. Delays are seen in the lab processing orders and results being reported. After the first major outage of our EHR, the hospital developed a Code Cooper policy to assist in the delays. We now conduct drills to ensure all paperwork is readily available and the staff know the processes to implement during a downtime. Healthcare today recognizes that detecting and preventing EHR-related safety issues is a priority but can be challenging as the concerns are multifaceted due to unsafe technological features of the EHR, user behaviors, rules and regulations that guide EHR-related activities, and organizational characteristics (Meeks et al., 2014). Response to Student: You bring up a valid issue regarding electronic health records (EHR) not being integrated with other clinical systems. I understand there are propriety rules for informatics companies not wanting to fully integrate but this leads to consumer (the patient) frustrations and may possibly affect patient care. My primary care physician is own by the hospital, so he has full access to the EHR but chooses not to access it from his office. Recently, my husband had lab work done and when he went for his follow up appointment, the doctor rescheduled the appointment because he did not have a paper copy of the labs on his chart. To say the least, I was not pleasant when calling the office manager. This was unacceptable as we took time off from work for the visit, there was a delay in his medication adjustment, and consequently have left the practice. The physician had access to the results but as the office manager stated “he is old fashioned and likes the paper document versus accessing the computer”. When systems are not integrated, the users experience frustration related to the number of clicks required to log into hospital networks then the applications themselves, unmet data display needs, and overall functionality between the systems (Meeks et al., 2014). References Dunn Lopez, K., Gephart, S. M., Raszewski, R., Sousa, V., Shehorn, L. E., & Abraham, J. (2016, June). Integrative review of clinical decision support for registered nurses in acute care settings. Journal of the American Medical Informatics Association, 24(2), 441-450. Hussey, P. H., & Kennedy, M. A. (2016, May). Instantiating informatics in nursing practice for integrated patient centred holistic models of care: A discussion paper. Journal of Advanced Nursing, 72(5), 1030-1041. Meeks, D. W., Smith, M. W., Taylor, L., Sittig, D. F., Scott, J. M., & Singh, H. (2014, November). An analysis of electronic health record-related patient safety concerns. Journal of the American Medical Informatics Association, 21(6), 1053-1059.

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