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RE: Discussion – Week 3 Main Post

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Introduction

        Informatics plays a crucial role in the advancement and day-to-day function of the healthcare industry.  The nursing practice relies on data and the transmission of technology; therefore, nurses focus on nursing informatics.  (McGonigle & Mastrian, 2017).  Nursing informatics was explicitly created for the nurse’s role in the nursing profession (Sweeney, 2017).  “Nursing informatics has been traditionally defined as a specialty that integrates nursing science, computer science, and information science to manage and communicate computer data, information, knowledge, and wisdom in nursing” (McGonigle & Mastrian, 2017, pg. 7, para. 1).

Experiences and Suggestions

In the hospital that I currently work at, I am a perioperative nurse. The electronic charting system we use is MediTech which the hospital owns. MediTech, although a fully computerized charting system, is highly outdated, complicated to learn, and even harder to navigate. When a new employee is hired, they are sent to a MediTech training class which is an eight-hour class dedicated solely to trying to learn and navigate our charting system.

Due to the overall laborious process of MediTech, we have seen a rise in verbal and written physician orders to avoid the use of MediTech altogether. With the increase in verbal orders, there has been an increase in errors. In 2017, the Institute for Safe Medication Practices conducted a study on verbal orders, and statistics showed that one out of every four orders was a verbal order. Once this was noticed, my hospital implemented a few new procedures. First, they began to reinforce the read-back method. To take this a step further, when we enter the order and state that it was a verbal order, we must specify that the order was read back and confirmed with the provider. The second is to limit the number of verbal orders a physician can give. Each physician has a limit, and once that limit has been reached, the hospital administration is notified, and the physician is brought in and spoken with. I have worked at this facility for almost a year now and have seen a drastic decrease in the number of verbal orders given.

Technology

        Technology has advanced immensely over the last few decades which has allowed for further advancement of the healthcare field (Sweeney, 2017).  These technology advancements have created the electronic health records (EHRs), the ability to scan and administer medications, the ability for vital signs or lab values to transfer from one machine into the computer.  The nursing profession is a profession filled with nothing but teamwork and collaboration.  I believe the continued evolution of nursing informatics and the continued emergence of new technologies will have a positive impact on the healthcare industry.  These two items have helped form healthcare into what it is today.

                                                                                                                                                                                                     References

Institute for Safe Medication Practices. (2017). Despite technology, Verbal Orders Persist, Read Back is Not Widespread, and Errors Continue. Retrieved September 13, 2021, from https://www.ismp.org/resources/despite-technology-verbal-orders-persist-read-back-not-widespread-and-errors-continue

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

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

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

RE: Discussion – Week 3 Main Post

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Thank you Alexisi. Do you have IT or nurse informatics specialist in your facility? If so, how do you, and clinical staff, work with them?

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6 months ago

Alexis Liggett

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Dr. Moyers,

My facility utilizes IT rather than nurse informatics specialists. Our clinical staff works closely with the IT department, although it may not be in the most efficient way. Whenever we find that we need technical support, like most facilities, we have to place a work order or work ticket for what is needed to be addressed. Once this is completed, it could take days before IT can come look at what needs to be fixed. Our facility is currently looking for a new process to enhance what we already have in place and increase IT response time.

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6 months ago

Jessica Ferrin

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Alexis,

        I can relate to your post on so many levels! My hospital also uses Meditech, which has not been updated the 15 years I have worked there. Elshayib and Pawola (2020) discuss the importance of investigating components that can affect the purpose of Computerized Physician Order Entry (CPOE) in terms of patient safety and preventing medication errors. Like your hospital, mine also began holding physicians accountable for the percentage of orders entered by nursing staff in terms of “verbal” and “written.” As stated in my original post, the Leapfrog Hospital Safety Grade survey rates hospitals’ CPOE usage and the computer systems safety alerts for physicians (The Leapfrog Group, n.d.). In previous years my hospital scored significantly low in terms of CPOE and, as your administration, began holding physicians accountable. I agree with you that Meditech makes it quite challenging to remain compliant because the system is so outdated and cumbersome.

        You mentioned your facility does not have a nurse informatics specialist. McGonigle and Mastrian (2017) state that the multidisciplinary team, including the nurse informaticist, must work together to create a culture of safety. Do you feel you could speak to senior leadership or administration to lobby your facility to hire a nurse informaticist?

References
Elshayib, M., & Pawola, L. (2020). Computerized provider order entry–related medication errors among hospitalized patients: An integrative review. Health Informatics Journal, 26(4), 2834–2859.

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

The Leapfrog Group. (n.d.). How safe is your hospital? Retrieved from Why the Hospital Safety Grade Works: https://www.hospitalsafetygrade.org/what-is-patient-safety/why-the- hospital-safety-grade-works

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6 months ago

Tina Alino

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Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

Nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization

Nursing informatics is a field that combines nursing science, computer programming, and information science to find, gather, process, and manage data and information in order to assist nursing practice, management, education, research, and knowledge advancement. It promotes the practice of all nursing specializations in all settings and situations, whether at the entry-level or advanced (Staggers, & Thompson, 2002).

At my current facility, the system entails the primary use of a Computerized Patient Record System (CPRS) chart to interact with other professionals about patient care. This is an electronic medical record for veterans only. This allows all interdisciplinary team members to see what is going on with the patient and communicate with each other. This system is similar to other hospitals in the aspect of being an electronic medical record but the medication administration is a completely separate system.

Strategy on how CPRS might be improved

A computerized patient record system (CPRS) is an older system that the federal government uses for veterans and active military personnel as an electronic health record. This system is very complicated by not being user-friendly. The user will have to click in multiple areas for example to see radiology results. One strategy that might improve this system is to completely get rid of CPRS and implement EPIC. Epics are a useful tool for organizing your work and establishing a hierarchy. The concept is to break work down into shippable chunks so that massive projects can be completed and value can be delivered to customers on a regular basis. Epics allow teams to break down their work while still working toward a larger goal (Rehkopf, n.d.).

The impact continued evolution of nursing informatics might have on professional interactions

As technology improves, the healthcare business has gradually shifted from a paper-based to a digitalized style of storing and managing patient medical information (Ariffin et al., 2019). Computerized health records allow for a more efficient way for all interdisciplinary teams to be aware of the current and past medical issues. It allows for all teams to have a better understanding and communication within the chart. This computerized evolution is always being updated to evolve with the changes the medical field has each year to be more resourceful and effective. By having an electronic medical record, records are not getting lost, it’s all in one place for all teams to see within the chart, and less physical meetings with that individual due to being able to communicate within the chart.

References

Ariffin, N. A. N., Yunus, A. M., & Kadir, I. K. A. (2019). Benefits and challenges of electronic medical records (EMR) implementation in developing countries. International reviewer,175.

Rehkopf, M. (n.d.). Agile epics: definition, examples, and templates. Atlassian. https://www.atlassian.com/agile/project-management/epics

Staggers, N., & Thompson, C. B. (2002). The evolution of definitions for nursing informatics: a critical analysis and revised definition. Journal of the American Medical Informatics Association, 9(3), 255-261.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Tina. What type of interactions do you have with your IT department? How can these interactions be improved?

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6 months ago

Tina Alino

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Thank you Dr. Robin for your reply.

My company’s IT department assists with virtually all electronic devices, including personal identification verification (PIV), user access, password reset, computer troubles, and any other electronic concerns. The IT staff also assists with software changes within the network, such as the most recent CPRS upgrade. I believe that with modifications such as patient Wi-Fi access and upgrading our software to newer versions such as EPIC, Telemedicine software, health tracking apps, and so on, we can do better. According to research, the healthcare IT market is predicted to develop at a compound annual growth rate (CAGR) of 13.8 percent between 2019 and 2027, reaching a value of $511 billion (Dyzma, 2020).

Dyzma, M. (2020, May 6). 13 Types of healthcare software. Custom software development | Netguru. https://www.netguru.com/blog/healthcare-software-types

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6 months ago

Kirsi Hoselton

RE: Discussion – Week 3

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Hello Tina,

Thank you for sharing. I enjoyed reading your post.

Nursing informatics is an essential component of the nursing profession. Nursing informatics is expressed as the implementation of knowledge and technology to understand error and knowledge, utilize decision-making to provide support, and communicate between health professionals (QSEN, 2021). Nursing Informatics was deciphered through studying three variables (Davis et al., 2014). These variables include informatics skills, computer skills, and informatics knowledge (Davis et al., 2014).

I can relate to your post regarding the computerized patient record system, as the facility I work at implements an electronic medical record. Does your facility implement a specific computerized patient record system brand name? Creating strategies is crucial to utilize the electronic medical record within a healthcare organization. For instance, creating workflows within a team setting can reduce duplication of care and improve patient outcomes (What are the key steps of the electronic health record (EHR) implementation planning phase, 2019). Secondly, identifying and understanding how data is imputed into the electronic medical record can provide accurate information that can be communicated throughout the healthcare organization (What are the key steps of the electronic health record (EHR) implementation planning phase, 2019). Lastly, providing accurate and detailed documentation can assist another healthcare provider with the patient’s current.

Reference

Davis, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014, June 25). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science. Retrieved September 13, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825491/.

Q competencies. (n.d.). September 13, 2021, from https://qsen.org/competencies/pre-licensure-ksas/#informatics.

What are the key steps of the electronic health record (EHR) implementation planning phase? HealthIT.gov. (2019, May 2). Retrieved September 13, 2021, from https://www.healthit.gov/faq/what-are-key-steps-electronic-health-record-ehr-implementation-planning-phase.

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6 months ago

Tina Alino

RE: Discussion – Week 3

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Hello Kirsi,

Thank you for your response to my post. To address your question, my facility does have its own computerized patient record system, which goes by the term Computerized Patient Record System (CPRS). As I said in my discussion post, CPRS is an older electronic health record system that the federal government utilizes for veterans and active military people. It still serves its purpose, but it can be a little confusing at times. Most of my coworkers in the private sector believe it is also highly complicated, but I’ve been with the VA for 5 years and am used to it.

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6 months ago

jennifer girgis

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Nurse Informaticist obtains certification after graduation and can be in many positions in nursing, applying data and technology, bringing healthcare information to life. (Laureate Education, 2018) While data technology specialist’s primary focus is scientific and technical issues. (McGonigle & Mastrian, 2018, p.29)They both help shape and are significant resources for health care organizations.

The student experienced firsthand how a technology specialist interacts with another professional. Though the interaction with this student was a pleasant one, a suggestion can be warranted. In this experience, the information technologist (IT) personnel met up with the student. During the process, the IT personnel was mainly focused on solving the problem and handed the laptop back fixed then left. Before the incident, a technical support specialist tried to solve the issue over the phone; after a while, it was unsuccessful. Finally, a ticket was given that described the case. It was time-consuming, especially if one needs the EHR records right away. I recommend that the IT support show the student the “how-to” guide (e.g., short video or common IT troubleshooting links) and incorporate evaluation strategies or feedback at the end of each service. Overall, they take pride in what they do and are very professional.

The continued evolution of nursing informatics as a specialty and the continued emergence of new technologies significantly affect professional interactions. Without people who can articulate and translate data information correctly, I believe everyone will be lost. The support they provide helps an organization excel in quality outcomes both in the system and patient care. Nowadays, professional interactions, especially in healthcare, support or use technology to communicate (e.g., cell phones, laptops, tablets). These prove that geographical location can be a barrier but not a hindrance to providing quality care. According to Alexander et al. (2018), obstacles to implementing services are related to lack of associated costs, conflicting priorities, lack of policy to support the program, and legal issues associated with data security and participant privacy. One good example is when COVID-19 became a pandemic. Remote learning, online meetings, telehealth monitoring became a common way of communication and facilitated interprofessional collaboration across the disciplines. (McGonigle & Mastrian, 2018, p. 547) Physical interactions became limited but did not stop everyone from communicating effectively, an example of evidence-based clinical decision-making strategy at its finest.

References

Alexander, S., Ng, Y. C., & Frith, K. H. (2018). Integration of Mobile Health Applications in Health Information Technology Initiatives: Expanding Opportunities for Nurse Participation in Population Health. CIN: Computers, Informatics, Nursing, 36 (5), 209-213.

Laureate Education (Producer). (2018). The Nurse Informaticist [Video file]. Baltimore, MD: Author.

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Excellent Jennifer. I have had numerous interactions with the IT staff at my VA hospital. I would like to see IT begin rounding in various areas of the hospital to increase their exposure, build relationships, and increase knowledge for clinical staff,

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6 months ago

salome ugwu

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Jennifer

The constant changes due to COVID-19 and the lack of communication can be frustrating. You bring up good ideas on how to improve on these opportunities with communication at your organization. Knowledge being transferred effectively throughout the healthcare team would have the benefits of improving and sustaining organizational engagement, professional competence, and the quality of the work life of the team, McGonigle & Mastrian (2018). Frontline workers also have many fears that they have to deal with and still give quality care to their patients. Improving communication and providing more education would help with easing fear from the healthcare team, Cawcutt et. al. (2020). Your organization should consider utilizing nurse informatics to improve the communication and bring more knowledge to the organization to get through these hard times.

References

Cawcutt, K. A., Starlin, R., & Rupp, M. E. (2020). Fighting fear in healthcare workers during the COVID-19 pandemic. Infection Control and Hospital Epidemiology, 41(10), 1192–1193. https://doi.org/10.1017/ice.2020.315

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge. In Nursing informatics and the foundation of knowledge (4th ed., pp 537-552). Burlington, MA: Jones & Bartlett Learning.

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6 months ago

Tanaka Ruzvidzo

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Hi Jennifer, thank you for your informative discussion post. Reading your scenario, it reminds me of something I have noticed lately regarding our charting software. I have been using the same software technology for the last 4 years, so for me it is second nature, and remarkably simple to use. However, as charge nurse I am tasked with ensuring that contract nurses and nurses in orientation are trained to use the software. Prior to working on the unit, they have a training session with the IT department, but I have noticed that most people learn and process information hands on. So, I must sit with them and help them with their documentation until they are comfortable with our charting software. Anyway, of concern to me is the number of times that one must click the “save” button, to either save an order, or to ensure that their documentation is saved. Several times I have seen nurses click “save” once and exit out of the screen, before realizing that they were not done. This has resulted in in multiple issues including incomplete documentation. I have brought this issue up to our IT department and they are trying to find a solution to this problem. “The knowledge and understanding of clinical practice gained through these solutions can be applied to subsequent applications and efforts to refine and innovate within nursing care” (Mosier et al., 2019).

The emergence of innovative technologies implemented with adequate training are sure to save healthcare facilities a lot of money overall and interaction with other professionals within the organization ensures goal alignment. According to (Ng et al., 2018) “Mobile health apps are increasingly combined with telehealth and remote patient-monitoring approaches in many disease management programs designed to reduce hospital readmissions” (Ng et al., 2018). Reduced hospital readmissions equate to less costs incurred by the hospital so it would be in their best interest to take advantage of these technologies and utilize them to their benefit.

References

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A systems-level method for developing Nursing Informatics Solutions. JONA: The Journal of Nursing Administration, 49(11), 543–548. https://doi.org/10.1097/nna.0000000000000815

Ng, Y. C., Alexander, S., & Frith, K. H. (2018). Integration of mobile health applications in Health Information Technology Initiatives. CIN: Computers, Informatics, Nursing, 36(5), 209–213. https://doi.org/10.1097/cin.0000000000000445

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6 months ago

Tae Kim

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How Nurse Informaticists and/or Data or Technology Specialists Interact with Other Professionals Within My Healthcare Organization

As a registered nurse at my hospital, main interaction between RNs and nurse informaticists is communicating technology issues related to patient care and sharing recommendations pertaining to Epic, our electronic health record (EHR) system. When we have suggestions or ideas as to how to enhance our EHR process we voice our concerns to our leadership who then coordinate these recommendations through our IT Department. Our hospital informaticists are also involved in this process. If an upgrade does occur to Epic, we are communicated through pop up notifications after logging into Epic and also by an email. For instance, we recently received an email with “tip sheets” about an Epic upgrade going into effect on September 10, 2021. Nurse informaticists provide training sessions for Epic superusers via Zoom. Subsequently, Epic superusers assist the staff in learning upgrades on Epic and ensuring we understand changes. They also address questions and issues we may have with Epic.

Our IT Department also alert us to planned outages so that we may plan contingencies for the outage time. These contingencies may include paper charting that is put into Epic when the outage is complete. Not all outages, however, are planned and the IT Department works to fix problems to bring our systems back up as quickly as possible.

How to Improve Interactions

Although we are aware of the nursing informaticists and know of their roles and contributions to the hospital EHR process, we have little interaction with them. We know they exist but we hardly know who they are within our organization. I think our hospital can improve the interaction between the bedside RNs who work directly with patients and the informaticists who work to make our jobs more effective and efficient. Part of that interaction can be through education and trainings on many of the other informatics tools available.

One study revealed that most nurse leaders acquired their health information technology (HIT) knowledge through on-the-job (OJT) training. OJT is always critical but we should do more. Nursing informatics and HIT knowledge should be a core competency of professional practice. Nurse leaders should identify areas of nursing informatics that are important in their practice. For example, I will need to identify what areas of informatics will be most valuable to myself as a PMHNP. This can bring greater specificity about domains needed for development. The competencies identified can be applied to residency programs, continuing education programs, and curriculum development. The level of detail within each competency can close education and skill gaps, optimize HIT to improve patient outcomes, enhance the patient’s experience, and improve nursing workflow (Collins et al., 2017). We should work closely with informaticists to identify and develop the necessary informatics skills related to our competency for greater patient outcomes.

How the Continued Evolution of NI as a Specialty and/or the Continued Emergence of New Technologies Might Impact Professional Interactions

The role of nurse informatics specialists is evolving from simply helping IT to design EHRs to where they are now becoming an integral part of healthcare delivery to supports safe, high quality, patient-centric care. Consider how much technology is now at the point-of-care. From physiologic monitoring and “smart” IV pumps to barcoded medication administration, technology is everywhere (“Nursing Informatics: The Intersection of Technology and Clinical Practice,” 2018). Examples of how technology has improved healthcare is using texting to doctors, IPAD for video language interpreter, telemonitoring patients for high fall risk, video assessment by MD for distressed patients, and patient can access their own chart from home by computer, etc. Nursing informatics has significantly impacted nursing by improving education, increasing and simplifying communications, protecting themselves, increasing their efficiency and, most importantly, saving lives (Quinn, 2017).

References

Collins, S., Yen, P., Phillips, A., & Kennedy, M. K. (2017). Nursing informatics competency assessment for the nurse leader. The Journal of Nursing Administration, 47(4), 212 – 218. https://www.njha.com/media/529397/NICANLDelphiStudy.pdf

Nursing informatics: The intersection of technology and clinical practice. (2018, March 27). https://www.wolterskluwer.com/en/expert-insights/nursing-informatics-the-intersection-of-technology-and-clinical-practice
Quinn, J. (2017, September 13). Five ways healthcare informatics help nurses. Retrieved September 14, 2021, from https://www.ebsco.com/blogs/health-notes/five-ways-healthcare-informatics-help-nurses

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6 months ago

Jessica Ferrin

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Tae,

It sounds as though your facility has a very robust IT department! I have used EPIC during a short stay at a local hospital, and it has so many great qualities about it! I am currently operating on Meditech Magic which is a very old DOS system. However, we have been purchased by a large hospital system and will be upgrading to EPIC January, 2022. While your IT department seems to stay on top of communications and notifications in terms of downtime and upgrades, I fear my small hospital will not have the same resources. Rouleau et al. (2015) state Information Technologies can impact the quality of care nurses perceive to deliver. This statement is so true at my facility. As a department manager I had nurses who were extremely happy with the environment, and wanted to come aboard full time but refused due to our charting system as they felt it was unsafe.

I agree that nursing leaders and IT personnel need to work closely together in the hospital setting to ensure individual needs are met. Oftentimes leaders meet with our Metitech team to discuss areas of improvement with our documentation system. The majority of the times their hands are tied since our owners refuse to spend additional money on the charting system. We have had to become quite resourceful in an attempt to improve our documentation system. In order to develop technological systems to support nurses, IT developers and nursing leaders must engage to better understand each other (Hong et al., 2020).

References

Jennifer Y Hong, Catherine H Ivory, Courtney B VanHouten, Christopher L Simpson, Laurie Lovett Novak, Disappearing expertise in clinical automation: Barcode medication administration and nurse autonomy. (2020). Journal of the American Medical Informatics Association, Volume 28, Issue 2, Pages 232–238

Rouleau, G., Gagnon, M. P., & Côté, J. (2015). Impacts of information and communication technologies on nursing care: an overview of systematic reviews (protocol). Systematic reviews, 4, 75. https://doi.org/10.1186/s13643-015-0062-y

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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6 months ago

Tina Alino

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6 months ago

April Ward

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6 months ago

Mauricio De Regules

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6 months ago

Paola Gaudioso

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6 months ago

Marisa Buffa

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Marisa. Do you have IT or nurse informatics specialist in your facility? If so, how do you, and clinical staff, work with them?

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6 months ago

Marisa Buffa

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Hi Professor,

We have IT at my facility. While they are helpful, I feel they don’t really grasp the nursing point of view when interacting with the EMR. I do wish we had nurse informaticists who could better assist us. During on-boarding, we took an EPIC course to learn the system however it was not taught by a nurse which made it frustrating as she was not able to answer some of the questions.

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6 months ago

Miguel Rodrigo Estrera

RE: Discussion – Week 3

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Hello Marisa,

You have an excellent point; Triage has a significant effect on the performance of an emergency department. It is a proactive process that prioritizes patients based on the severity of their conditions. Increased ED congestion has resulted in increased demand and longer time-to-triage and time-to-provider wait times, making accurate triage more critical than ever to avoid adverse patient outcomes and potential hospital liability (Reindhart, 2017).

I found this interesting article that explored a study on developing a novel way to semi-automate decisions to deal with facility-based surge capacity. In particular, the impact of applying the concept of reverse triage through information technology (IT) software application. Reverse triage is a technique for rapidly increasing inpatient surge capacity by prioritizing hospitalized patients who require the least amount of medical assistance and are at a low risk of severe complications from an early discharge. The purpose of this study was to develop an evidence-based information technology (IT) application that utilizes inpatients’ health electronic health records to expedite and guide clinical decision-making during the reverse triage selection process. When a disaster strikes, the application must be capable of identifying hospitalized patients who are unequivocally unable to be discharged early (Pollaris, Note, Desruelles, & Sabbe, 2018).

References

Pollaris, G., Note, S., Desruelles, D., & Sabbe, M. (2018, October). Novel IT Application for Reverse Triage Selection: A Pilot Study. Disaster Medicine and Public Health Preparedness, 12(5), 599-605. doi:DOI:10.1017/dmp.2017.115

Reindhart, M. (2017). A Systematic Approach to Evaluation of Performance Deficiencies in ED Triage. Journal of Emergency Nursing, 43(4), 329-332. doi:https://doi.org/10.1016/j.jen.2017.01.003

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6 months ago

ZULFIQAR ABBAS

RE: Discussion – Week 3

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Hello Marisa,

Thanks for sharing your thoughts. I really like your post. I agreed that the purpose of triage in ER department is to prioritize incoming patients and to identify who can not wait to be seen. Nurses utilize the tool of nursing process and documentation of medical records to allocate pertinent triage for ER patients. Five-level instruments are significantly correlated with resource utilization, rates of admission for inpatient treatment, duration of emergency treatment, and frequency of transfer to intensive care (Christ et al; 2010).

Nursing informatics has been continuously emerging since it was first established as a nursing specialty in 1992 by ANA. Before the COVID-19 pandemic, nurse informaticists in charge of training provided hands-on, face-to-face sessions; however, they rotated efficiently to a hybrid condition due to social distancing guidelines. As a result, electronic tablets were utilized to ease communication between nurses and patients, and nurses used video chat apps to connect patients with their families. For patients on isolation precautions, the use of information and communication technology helped maintain a sense of presence and caring despite the reduced amount of human touch. Implementation of telehealth has promptly developed due to the pandemic. Thus, the healthcare system has required and evolved nurse informaticists to be flexible and adaptable (Garcia, 2021).

References:

Christ, M., Grossmann, F., Winter, D., Bingisser, R., & Platz, E. (2010). Modern triage in the emergency department. Deutsches Ärzteblatt International, 107(50), 892.

Garcia-Dia, M. J. (2021). Nursing informatics. Nursing Management (Springhouse), 52 (5), 56-56. doi: 10.1097/01.NUMA.0000743444.08164.b4.

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6 months ago

Tammy Rodgers

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Response 2 to Marisa

Marisa,

I found your improvement of speech recognition (SR) charting to be intriguing and did some research on the topic. In a survey of 1731 clinicians that have used SR for one year, 78.8% found SR to be effective and efficient (Goss, et al., 2019). In support of this survey, another article regarding error analysis of SR states that of 217 charts analyzed, 7% showed an error rate prior to editing documentation, 0.3% after clinical review and editing (Zhou, et al., 2018). That is amazing statistics and gives hope for the future of documentation in healthcare.

I have not experienced “click fatigue” as my facility is still paper charting but I have experienced a similar issue with written documentation and “checking boxes.” Nursing assessments involve multiple boxes to check nurse observations and having the boxes and sections memorized makes it easy to speed through nursing assessments, which also leads to errors in documentation as complacency and time restrictions come into play. The thought of speech recognition being a possibility in our documentation is exciting. Thank you for your post!

Tammy

References

Goss, F. R., Blackley, S. V., Ortega, C. A., Kowalski, L. T., Landman, A. B., Lin, C.-T., Meteer, M., Bakes, S., Gradwohl, S. C., Bates, D. W., & Zhou, L. (2019). A clinician survey of using speech recognition for clinical documentation in the electronic health record. International Journal of Medical Informatics, 130, 103938. https://doi.org/10.1016/j.ijmedinf.2019.07.017

Zhou, L., Blackley, S. V., Kowalski, L., Doan, R., Acker, W. W., Landman, A. B., Kontrient, E., Mack, D., Meteer, M., Bates, D. W., & Goss, F. R. (2018). Analysis of errors in dictated clinical documents assisted by speech recognition software and professional transcriptionists. JAMA Network Open, 1(3), e180530. https://doi.org/10.1001/jamanetworkopen.2018.0530

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6 months ago

Dorothy Chudi-Agbaku

RE: Discussion – Week 3

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Hi Marisa,

        Good post. Care coordination between the nurses, pharmacists, physicians, social workers and other disciplines is very essential in this age of fast growth in the use of informatics in healthcare system.  Improved healthcare collaboration is one of the several strategies to achieve a better patient outcome including reduction in mortality and morbidity rates, reduction in adverse drug reactions, and adequate medication dosages (Bosch & Mansell, 2015). As nursing informatics specialty continues to evolve with continuous emergence of new technologies, the collaborative interactions among healthcare professionals would be enhanced and this would improve quality, productivity and reduction in cost of health care and services (Wang et al., 2018). There would be an easy accessibility of patient’s data by the clinicians with the emergence of electronic health record mobile applications resulting in the continuity of care irrespective of the locations of the clinicians.

Dorothy.

References

Bosch, B., & Mansell, H. (2015). Interprofessional collaboration in health care: Lessons to be learned from competitive sports. Canadian Pharmacists Journal, 148(4), 176–179. https://doi.org/10.1177/1715163515588106

Wang, Y., Kung, L., & Byrd, T. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126, 3-13. https://doi.org/10.1016/j.techfore.2015.12.019

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6 months ago

Mercy Ambe Mbu

RE: Discussion – Week 3

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Hi Marisa,

Thank you for this insightful post. Isn’t it amazing how technology contributes to making the clinician’s work much more manageable and time-saving? I cannot imagine how many patients may have lost their lives because of a wrong diagnosis or wrong classification of the disease intensity. Thanks to the work of nurse informaticists, these occurrences can be reduced. According to Alotaibi and Frank (2017), up to 30% of higher guideline adherence occurred using electronic health records.

I also agree with you that as new technologies emerge, nursing informatics is expected to grow with them. Informaticists are supported at every level to achieve this perspective. The Federal government and Medicare are making funds available for health facilities to switch from paper to electronic health records and improve technologies. (Howe et al., 2018). Clinicians who are the primary users of these technologies are responsible for building good collaborative relationships with informaticists, giving and receiving feedback, and providing suggestions on improving existing technologies to be more user-friendly and achieve excellent outcomes.

References

Alotaibi, Y. K., & Frank, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173-1180. http://dx.doi.org.ezp.waldenulibrary.org/10.15537/smj.2017.12.20631

Howe, J. L., Adams, K. T., Hettinger, A. Z., & Ratwani, R. M. (2018). Electronic Health Record Usability Issues and Potential Contribution to Patient Harm. JAMA, 319(12), 1276–1278. https://doi.org/10.1001/jama.2018.1171

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6 months ago

April Ward

RE: Discussion – Week 3

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NURS 605

Discussion Week 3

Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

                                                                  Introduction

   The American Nurses Association (2019) or ANA, believes in having a standard electronic health record (EHR) and further assuring that health records are patient oriented.

                                                   Experiences and Observations

   It may seem very odd to some, but after working for eleven years in a local mental health agency, we only went to electronic health records (EHR) this year.  When I started, they said then that we would be using EHR soon, but that did not happen.  Now after a long wait, we are finally able to use EHR, and it is helpful, but there are many issues that need to be worked-out. One of the main issues that we have is that we cannot effectively communicate essential information with the providers in the client’s EHR.  For example, in order to be sure that a provider knows that a client has called and is having side effects from their medications, we must do everything the old-fashioned way, which is to email them or simply leave them a note on their desk.  We are able to leave a note in the chart (under ‘note to chart’), but there is no way to flag our note to let the provider know there is important information that needs to be reviewed.  Our long-awaited computer program is actually antiquated.   The communication between staff nurses and our data technology specialist is usually a telephone call and a screen-share where they can see our dilemma and attempt to assist us.  Studies have shown that nurses who have more experience may need more training in electronic health records.  Nurses with a year or less than one year of nursing experience are faster in charting in EHR and more timely in turning-in documentation, than those nurses who have much more experience.  Informatics specialists will need to continue to assess documentation and assist with this (McBride, et al., 2018). 

                                                      Improvement Strategy

   According to Bredfeldt, Awad, Joseph, & Snyder (2013), electronic health records is comprised of extensive training of personnel.  However, if there is not much follow- up to support the staff in daily work, the use of electronic health records will become more difficult.  I believe that the EHR system personnel can add software that will enable staff to communicate more effectively and therefore have better information management and patient outcomes.  I believe that my facility would greatly benefit from an alert program and proper training on this program given to all staff.

                                                                  Conclusion

Alert management programs in EHR can be used to alert prescribers while also assisting in positive patient outcomes. Prescribers, patients and nurses will all work together to promote overall wellness with electronic health records (McGreevey, et al., 2020). As new technology emerges, nursing informatics will continue to expand and inactions between prescribers and other professionals will be enhanced. Professionals should continue to strive for effective communication while using EHR, which will aid in producing careful diagnosing and treatment.

                                                                     References

American Nurses Association, 2019. Electronic health record. Retrieved from

https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/electronic-health-record/

Bredfeldt, C. E., Awad, E.B., Joseph, K., Snyder, M.H. (2013). Training providers: Beyond the basics of electronic health records. BMC Health Serv Res. 2013;13:503. doi:10.1186/1472-6963-13-503

MMccMcBride, S., Tietze, M., Robichaux, C., Stokes, L., Weber, E., 2018. Identifying and addressing ethical issues with use of electronic health records. The Online Journal of Issues in Nursing (vol 23). Retrieved from
https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Identifying-and-Addressing-Ethical-Issues-EHR.html

McGreevey, J.D., Mallozzi, C.P., Perkins, R.M., Shelov, E., Schreiber, R. (2020). Reducing Alert Burden in Electronic Health Records: State of the Art Recommendations from Four Health Systems. Applied Clinical Informatics. 2020 Jan;11(1):1-12. doi: 10.1055/s-0039-3402715.

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6 months ago

April Ward

RE: Discussion – Week 3

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** some of my references did not copy accurately (ex: McBride)

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you April. Have a split between electronic charts and paper con be burdensome. Do you work in mental health? I am finding that psych hospitals, long-term care, and corrections seem to lag behind in technology in health care.

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6 months ago

April Ward

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Oh, well maybe that’s why we are behind..Lol… Yes, I work in mental health.

Thank you for that information.

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6 months ago

Dorothy Chudi-Agbaku

RE: Discussion – Week 3

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Hi April,

        Nice post. Good to hear that your organization, the mental health agency has embraced the electronic medical record (EMR). Transitioning generally in any situation and especially in EMR is always challenging as many are skeptical and scared of the unknown. My organization is transitioning from Cerner to EPIC fully by October and even though we have been using EMR for a very long time, it is still coming with lots of courses in the HealthStream and lots of batches of training. The truth is that introducing and using informatics in healthcare organization is very beneficial. Nursing informatics and information technology specialty is one of the fastest-growing areas of healthcare today and the benefits include improved processes and workflows, streamlined documentation and communication, and lowered healthcare costs (School of Nursing, University of Michigan, 2020). In terms of the strategies to improve interaction of personnel in this area of healthcare with other healthcare professionals, and in addition to training that you suggested, use of a standard terminology in documentation of patient’s care and services and common software across all departments would improve access, retrieval, and analysis of data representing clinical reasoning (Macieira et al., 2018). And would help to avoid some adverse occurrences such as medication error.

Dorothy.

References

Macieira, T., Smith, M. B., Davis, N., Yao, Y., Wilkie, D. J., Lopez, K. D., & Keenan, G. (2018). Evidence of progress in making nursing practice visible using standardized nursing data: A systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977718/

School of Nursing, University of Michigan. (2020). How Nursing Informatics Can Improve Healthcare. https://online.nursing.umich.edu/blog/how-nursing-informatics-can-improve-healthcare/

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6 months ago

Dorothy Chudi-Agbaku

RE: Discussion – Week 3

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As healthcare delivery continues to evolve and in the area of health informatic as well, it becomes imperative for care coordination between the nurses, pharmacists, physicians, social workers and other disciplines. There are several strategies to achieve a better patient outcome including improved healthcare collaboration and this has resulted to reduction in adverse drug reactions, decreased mortality and morbidity rates, and adequate medication dosages (Bosch & Mansell, 2015). Different healthcare professional can gather and interpret patient’s date more effective and efficiently resulting in delivery of quality care. Nurse informaticists and technology specialists in healthcare organizations interact and collaborate with other healthcare professionals and hospital administrators in order to ensure a smooth process at every level in the hospital and enhance patient health management. They are involved in process design that ensures hitch-free training and implementation of best practices such as new software in the whole hospital. They interact with different disciplines, patients and various department solving any problem encountered technologically to ensure adequate and continued care. These nurse informaticists and the technology specialists ensure that their unit is adequately staffed to ensure availability of personnel to solve any issue arising in any department. They also ensure that patient’s data can be easily accessed by all authorized personnel at any time to ensure continuity of care. The hospital management follow their recommendation to cut down the rising cost of healthcare which is a serious challenge across many organizations (School of Nursing, University of Michigan, 2020).

        One of the strategies on how to improve interaction between the nurse informaticists or technology specialist with other healthcare disciplines is by using a common software across all departments and using a standard terminology to document patient’s care and services which would enable easy retrieval and analysis of data representing clinical reasoning (Macieira et al., 2018). For example, a patient discharged with medication list that has a drug that is not current in it got the wrong drug included for him because the pharmacists were using Enclara Pharmacia software which was different from the MUMMS used by the whole hospital. Such pertinent but very critical information as patient’s current medication can be accessed and seen by everyone involved in patient’s care including the Pharmacist and such mistakes as this could be avoided when all the departments in a healthcare organization are using a uniform software.

        As there is continued evolution of nursing informatics specialty and emergence of new technologies, there would be an enhancement of collaborative interactions among professional and this would improve quality, productivity and reduce cost. (Wang et al., 2018). For example, my organization is currently transitioning to EPIC which I understand is widely used by many organizations and as such communication and transfer of patient’s information would be easier to ensures continuity of care. It also has a way of capturing consumables for billing without manual recording which would reduce cost.

References

Bosch, B., & Mansell, H. (2015). Interprofessional collaboration in health care: Lessons to be learned from competitive sports. Canadian Pharmacists Journal, 148(4), 176–179. https://doi.org/10.1177/1715163515588106

Macieira, T., Smith, M. B., Davis, N., Yao, Y., Wilkie, D. J., Lopez, K. D., & Keenan, G. (2018). Evidence of progress in making nursing practice visible using standardized nursing data: A systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977718/

School of Nursing, University of Michigan. (2020). How Nursing Informatics Can Improve Healthcare. https://online.nursing.umich.edu/blog/how-nursing-informatics-can-improve-healthcare/

Wang, Y., Kung, L., & Byrd, T. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126, 3-13. https://doi.org/10.1016/j.techfore.2015.12.019

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

RE: Discussion – Week 3

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Good points Dorothy. Greater transparency and secured access can reduce error and improve outcomes.

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6 months ago

jennifer girgis

RE: Discussion – Week 3

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Response 2.
Hi Dorothy, Thank you for your informative post.

Data transparency between departments would help secure quality information. Additionally, McGonigle & Mastrian (2018, p. 23) described that “valuable and quality information has the characteristics of timeliness, accuracy, relevancy, completeness, transparency… that directly relates to informed decision making.”

The student had some experiences using different software for healthcare documentation. EPIC was one of them, and I can say that its the most efficient documentation platform I ever had. The student’s company uses EPIC, and like other software, it needs updates now and then, which was necessary to support the system improvements, staff understanding, and patient quality care.

Nursing leaders support their staff by overseeing nursing care and providing a broad understanding of nursing informatics (NI) development. (Mosier et al., 2019) They commit to the tasks and facilitate the structural transition of change in any health care institution. They need to prepare themselves by undergoing educational and training opportunities in NI. Together with the nurse informaticists, they develop a solution to improve patient health outcomes and clinical decision-making skills.

References

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. JONA: The Journal of Nursing Administration, 49 (11), 543–548.

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6 months ago

Sophie Enjema Ndumbe

RE: Discussion – Week 3

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Hello Dorothy,

        Nice  dicussion, Nurse informaticist are well trained, and they collaborate with other staff members to improve patients care. It is good for every facility to have an informatic nurse, they help solve any technological problems which happens in a healthcare facility regarding patients care, they monitor and analyze data. Any facility which does not have a nurse informaticist will find it very difficult to coordinate care thus negatively affecting patient’s care.  Prestigiacomo (2012) states “nursing informatics is gaining prominence on a national scale” (p.40).  

I agree with you that collaboration with staff members improve patient’s care. Working together as a team makes it easy for staff to understand more about the new technologies available in their facility. People who are expertise in informatics can teach their colleagues who find it difficult to navigate through the system. Teamwork and the use of technology makes it easy for nurses to provide high quality and efficient services to patients (Iqbal et al. 2015).

References

Iqbal, U., Syed-Abdul, S., & Li, Y.-C. J. (2015). Health information technology and team work to improve health care. International Journal for Quality in Health Care, 27(6), 423. https://doi-org. /10.1093/intqhc/mzv087

Prestigiacomo, J. (2012). The Rise of the Senior Nurse Informaticist. Healthcare Informatics, 29(2), 38–43.

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6 months ago

Adam Hundley

RE: Discussion – Week 3

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Discussion Post

I guess I cannot say it makes perfect sense and that be the end this post, right? But it does seem fitting if I am only speaking to nurses about whether a nurse should be the one weighing in on how and what information is communicated through technology. I guess the entire population could benefit from a nurse informaticist. Although I have not been directly involved in nursing informatics, I see it working around me all the time. I guess I have been kind of blind to those positions and parts of the ‘behind the scenes’ of any hospital. And it is the people in those positions who are working together with the so many others including the bedside nurses like me. It was not until my most recent job orientation when I noticed the man training for the charting software had an R.N., MSN after his name. Admittedly I thought “this is something a nurse can do?”. I cannot say that I directly see people like that gathering their information, but I do observe house supervisors constantly reviewing the inconstant variables at a hospital.

My improvement strategy would be specific to a circumstance at the job I just left. They have done away with the day time house supervisor position, and they now use a bed control employee for all supervisor duties. The issue with this is that he is not a nurse, so the judgment and experience of a nurse is not in the equation when considering acuities and staffing. If they are going to continue this way, they need to contract a nursing informaticist to make or adapt a software program to assist the bed control employee. The hospital could possibly come up with an acuity score for each patient and then apply, or plug, the result into an equation. Data gathered from nursing can affect many aspects of communication across the board and impacts everything from cost to quality of patient care (Mosier et al., 2019). The results could then be used to make a more educated judgment on part of the bed control person.

Just as I referenced the trainer above, nurses can be nursing informatics specialists. Those nurses can make differences in patient outcomes by integrating nursing care with data and technology (Laureate, 2018). The American Nurses Association has now defined it as “Nursing Informatics (NI) is the specialty that integrates nursing science with information and analytical sciences to identify, define, manage and communicate data, information, knowledge and wisdom in nursing practice. NI supports nurses, consumers, patients, the interprofessional healthcare team, and other stakeholders in their decision- making in all roles and settings to achieve desired outcomes.”(Sipes, 2016). This definition appears to be a fluid one.

References
Laureate Education (Producer). (2018). The Nurse Informaticist [Video file]. Baltimore, MD: Author.

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. JONA: The Journal of Nursing Administration, 49(11), 543-548.

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

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Adam. Your post leads me to a question..

Class:

Will technology replace various nurse positions? Is this topic addressed in the literature?

Dr. Moyers

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6 months ago

Mauricio De Regules

RE: Discussion – Week 3

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Adam,

I agree with your ideas of house supervisor and how they should have an acuity system in order to know exactly where each patient should be going instead of just trying to fill in all their available spaces. Nursing informatics competencies are vital to benefit from information technologies to improve patient outcomes (Kaynar et al., 2020). There has been so much change in the hospitals since the pandemic, at least in what I have seen and at least in certain hospitals they are trying to close rooms in order to accommodate the nurses that are short on the floor. Nursing informatics has influenced other disciplines. This study offered an in-depth look at nursing informatics literature, using a systematic approach to identify historical roots and analyze the evolution of topics and themes to gain more information about knowledge development in nursing informatics (Blažun et al., 2020).

References:

Blažun Vošner, H., Carter-Templeton, H., Završnik, J., & Kokol, P. (2020). Nursing Informatics: A Historical Bibliometric Analysis. Computers, Informatics, Nursing : CIN, 38(7), 331–337. https://doi-org.ezp.waldenulibrary.org/10.1097/CIN.0000000000000624

Kaynar, N. S., Secginli, S., & West, K. (2020). Psychometric Testing of the Turkish Version of the Technology Informatics Guiding Educational Reform-Based Assessment of Nursing Informatics Competencies Tool. Computers, Informatics, Nursing : CIN, 38(11), 572–578. https://doi-org.ezp.waldenulibrary.org/10.1097/CIN.0000000000000671

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6 months ago

Ivo Ngosong

RE: Discussion – Week 3

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Data is critical to patient-centered consideration in my association and the medical services office where I work, and the field of health informatics has exploded in recent years with an emphasis on how data is obtained, stored, and utilized in medical care, with a specific focus on data innovation and how it is applied and shared within my medical services office. Subject matter expert or attendant Informatics work with data between individuals from the medical services group to update and provide essential data that can be accessed from various areas within my organization and with electronic types of equipment, specifically getting to the electronic clinical record At my medical services office, there is a great deal of social connection or cooperation amongst partners. Specifically, this refers to how the organization and other employees, including informatics or the Information Innovation group, are available and have easy access to informatics regularly. Informatics and the genius that makes up these gatherings of specialists are critical for clinical overseers or clinicians because they provide us with the learning we require, for example, information and development capacities are essential for safe patient thought, perceiving how to apply information and advancement instruments, and welcoming the requirement for long-term learning are all things that informatics can provide (Glassman, 2017). The collaboration and connection between the informatics authorities and the many experts and clinicians inside my office. Informatics experts in my organization work very well with various people, and they are continuously nurtured to work with care for more excellent tolerant outcomes. Through PointClickCare, Web entries, and office email, the informatics gatherings or information master may coordinate their efforts. Any item updates or individual time provided for staff to prepare for support charting if necessary are usually included in the directions. Bedside and other medical caregivers also get refreshes or assistance from nurture informatics on new electronic planning programs that the delegate should complete or have been completed. A portion of the planning initiatives includes video bearing, internet diagramming or alerting when the new sensitive product becomes available. PointClickCare, which is the setting out structure, disclosure, which is the structure in which we transmit detailed patient information, and particular screens, which is the new structure in which patients may be relinquished through Alexa or Skype, would all be joined by express systems. These are unique devices that have evolved as informatics has progressed for the benefit of patients and have been strongly supported by nurturing informatics within the association.

Increased collaboration may be achieved by updating and converting to current electronic documents with medical attendant informatics or information subject matter experts who are readily available. In a similar vein to nursing legislative or governmental problems, nurturing informatics is a subfield of nursing that may be underrepresented or ignored by different clinical overseers and committees. The fact that bedside attendants are becoming more interested in critical administration and advances in human administration technological undertakings is very significant. Suppose you are someone who follows the program from beginning to finish. In that case, a bedside attendant or professional supervisor, or a parent figure, will surely notice areas that need improvement or modification. These customers should have the option to provide feedback on their experiences in the same way they do daily. Medical attendants used day-by-day stream sheets tailored to each patient’s specific requirements (Glassman, 2017). Nurses and medical assistants perform a significant amount of essential paperwork or require tireless information that should be everything except challenging to locate and simple enough for the clinician or attendant to create rapidly.

The ever-changing informatics as a specialty or development innovation would have a significant impact on professional cooperation. Medical caretaker informatics and attendants promote continuous expert development that cultivates knowledge on attendants, resulting in improved quality consideration and patient outcomes. Medical professionals’ involvement in nursing informatics board meetings may contribute to framework plans, collaborate on interdisciplinary communication, and improve work processes (Madsen, 2017). Attendants are skillfully and ethically convinced to contribute new knowledge, significant improvement, and advancement via an evidence basis dynamic for the benefit of patients (Elkind, 2009).

                                                                                                                                                           References

Madsen, I. (2017).Taking Nursing informatics into the Future. Studies in Health Technology And Informatics, 244, 73-75. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=mnh&AN=29039381&site=eds-live&scope=site

Using data in nursing practice. American Nurse Today. 12(11), 45-47. Retrieved from http://class.Walden.ed/bbcswebday/instituion/USW1/201970_27/MS_NURS/NURS_5051_WC/USW1_NURS_5051_module02.html?course_uid=USW1.48982.201970&service_url=https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/wslinks&b2Uri=https%3A%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN#resources

Elkind, E. C. (2009). Why information systems are helpful to nursing. The Pennsylvania Nurse, 64 (1), 24-25.

Healthcare Information and Management Systems Society (HIMS). (2011). HIMSS nursing informatics position statement. Retrieved from: www.himss.org/files/HIMSSorg/handouts/HIMMSSNIPosition StatemetMonographReport.pdf

Glassman, K. S., (2017). Using data in nursing practice. American Nurse Today, 12(11), 45–47. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2017/11/ant11-Data-1030.pdf

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Good points Ivo. Today, nurses cannot function in a vacuum. Collaboration and partnerships are critical.

Dr. Moyers

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6 months ago

Ivo Ngosong

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I agree with you Dr. Moyers. Thanks so much.

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6 months ago

April Ward

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Response #2

Hello Ivo,

   I agree with your discussion post when you stated that patient considerations should most importantly include gathered data.  I also agree with you that the health informatics field has become a necessary part of our work and is continually growing.  Your discussion post was full of interesting information, including the type of data entry your facility uses.  Your point that healthcare workers should work together, having collaborating efforts with patient care, was a good one.

   Supporting staff in daily work by collaborating information / sharing data makes everyone’s goal of patient care more attainable.  Training staff properly and then supporting them by having periodic updates and ensuring that all nurses understand this information is imperative.  The use of data gathering and entering of data into electronic health records is comprised of extensive training of personnel, to be successful in patient outcomes (Bredfeldt, Awad, Joseph, & Snyder, 2013).  Having a standard electronic health record (EHR) and also assuring that those health records are patient oriented, is the goal of the American Nurses Association (2019).

References

Refe American Nurses Association, 2019. Electronic health record.

https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/electronic-health-record/

             Bredfeldt, C. E., Awad, E.B., Joseph, K., Snyder, M.H. (2013). Training providers: Beyond the basics of electronic health records. BMC Health Serv Res. 2013;13:503. doi:10.1186/1472-6963-13-503

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6 months ago

Tanaka Ruzvidzo

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Nurse Informaticists interact with other professionals in the healthcare organization on a consistent basis. We live in a technology-based and electronic world, and most health care facilities have moved away from paper charting. Technology itself is constantly evolving and healthcare organizations need to keep up to ensure timely and quality healthcare is provided to patients.

Working in a small rural hospital, one way that technology is being harnessed is through the use of tele-medicine. Being a small hospital, not all specialties are available, however using technology and with the help of nurse informaticists more specialties are accessible. “To be truly patient-centered, healthcare must be affordable and accessible (Boxer, 2019). Neurology, Cardiology, Nephrology and Pulmonology are services that can be offered to the community whereby these physicians can dial in remotely on a screen, assess, treat and evaluate patients all within a matter of minutes. They could be across the country in an entirely different state and yet orders may be entered in real time allowing patients to be treated in a timely manner.

According to TigerConnect, “One of the most valuable ways a nursing informaticist can enhance patient outcomes is through providing training to clinical staff. They can use data to identify endemic issues in a healthcare organization and consult on the best way to resolve these problems. These learnings can be integrated with onboarding new staff, ongoing in-house training, or external education and certification. Nursing informaticists can help to create highly-targeted educational programs to deal with specific gaps between ability and provider expectations” (TigerConnect on January 23, 2021). This is an example of the importance of collaboration between Nurse Informaticists and other professionals and clinicians within the organization.

One strategy on how these interactions may be improved is to ensure that communication is ongoing so that issues or challenges that arise may be taken care of quickly. It is important for feedback to be provided to improve the quality of data being provided. In any industry feedback from the “customer” is a welcome opportunity to help improve services, and in this case, to improve the information provided. “Nurse executives are dependent on data for effective decision making” (Mosier et al., 2019), and at this level of the organization these high level decisions are critical and impact a lot of lives.

The impact I believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions is that healthcare will be easily and readily accessible. Diagnostic services and treatment will be wholistic and comprehensive. Clinicians will be able to access data and healthcare records and consult with each other with little to no down time, ensuring a seamless experience for those in their care. Therefore, I believe that professional interactions will be enhanced.

References

Boxer, R. J. (2019). Advantages and utilization of telemedicine. MHealth, 5, 12–12. https://doi.org/10.21037/mhealth.2019.04.02

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A systems-level method for developing Nursing Informatics Solutions. JONA: The Journal of Nursing Administration, 49(11), 543–548. https://doi.org/10.1097/nna.0000000000000815

TigerConnect on January 23, 2019. (2021, July 22). How nursing informatics improves patient care. TigerConnect. Retrieved September 15, 2021, from https://tigerconnect.com/blog/how-nursing-informatics-improves-patient-care/.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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6 months ago

Tanaka Ruzvidzo

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Hi Dr Moyers,

We do have an on site IT department, as well as an off site “HELP” desk. Interaction with the IT department depends on current projects. Right now they are focused on rolling out use of Tele-med specialties and have identified super user’s in each department to help with this project. Whereas, our off site IT is used more for technical support issues.

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6 months ago

Kene Fall

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Hello Tanaka, great post! I do agree that “Nurse Informaticists interact with other professionals in the healthcare organization on a consistent basis.” Information technology and nursing informatics are rapidly becoming an integral part of healthcare. This field of study provides healthcare providers with the tools and expertise to improve their processes and lower costs Darvish, A. et al., 2014). By analyzing a patient’s medical data, healthcare professionals can improve their efficiency and provide better care.

McGonigle et al., 2017, the nurses have to work together with technology experts to ensure that data flow is smooth and accurate. The nursing profession is filled with passion and collaboration. As the healthcare industry continues to evolve, I believe that nursing informatics will positively impact the industry.

Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014, June 25). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science. Retrieved September 13, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825491/.

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

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6 months ago

Paola Gaudioso

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Evolution of Nursing Informatics

            As technology evolves and changes, so does everything else. Nurses know all aspects of their field, and it seems that changes come in the jobs that nurses can do. According to Stodart (2018), nurses should not fear technology. After all, it will only help us because nothing can replace the human touch. Nurses are the best in the informatic field because they know what other nurses need. Being able to gather information and understand it is critical.

Observation and Experience

            I work for a large healthcare company that has both medical and psychiatric facilities. When all hospitals had to have EMRs play, the hospital I work at made a few changes in that direction but still has paper charting. It seems as if many behavioral health facilities did what they could to meet the minimum requirement. We use HCS to enter orders and a program called 3M to store medical records. All charting is done on paper and scanned into a system called 3M. Just like any medical records, they are always behind. Usually, medical records are not uploaded onto the system. If we had an informatics nurse who worked with our hospital, it would be beneficial to work with corporate and administration to determine the best approach for our hospital. As healthcare changes, so do everything else that is involved with it. “Technologies that provide support for the collection and analysis of clinical data are also evolving” (McGonigle & Mastrian, 2018).

Continuing to Evolve

            I find it extremely important to be able to access the patients’ records in a crisis. For example, we may want to see the patients’ behaviors the last time in the hospital, and unfortunately, we are unable to access them. Documenting and tracking patients is critical in figuring out if patients are receiving the care they need. Using ERH can help promote client progress and efficiency in their care (Burns et al., 2018). I feel that my hospital would benefit from an informatics nurse for ERHs and other technology needs. After COVID, we realized the necessity of telemedicine. Nurses could play a crucial role in assessing patients via teleassessment to determine their level of care. Nursing informatics plays a considerable part in healthcare. Nurses that are specializing in this field are essential as healthcare evolves.

References

Burns, E J., Hook, A. N., Parker, E. M., Esposito, I., Sather, A., Parigoris, R. M., Lyon, A. R., & Hyde, K. L. (2018). Impact of a web-based electronic health record on behavioral health service delivery for child and adolescents: Randomized controlled trial. Journal of Medical Internet Research, 20(6). http:/doi-org.ezp.waldenlibrary.org/10.2196/10197

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

Stodart, K. (2017). “Understanding the skills our future nurses need is key.” Kai Tiaki Nursing New Zealand, 23(9), 26–27.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Paloa. Your post leads me to a question…

Class:

Which group in the largest user of the EHR? is this addressed in the literature?

Dr. Moyers

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6 months ago

Paola Gaudioso

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Dr. Moyers,

After some research, I did not see what specialty uses EMR the most, but according to the CDC (2020), 85.9% of office-based physicians use EMR systems, and only 79.7% are certified. I know that anytime I have asked about switching to an electronic record system, I was always told that there was not one made for behavioral health.

Centers for Disease Control and Prevention. (2020, March 3). FastStats – electronic medical records. Centers for Disease Control and Prevention. Retrieved September 17, 2021, from https://www.cdc.gov/nchs/fastats/electronic-medical-records.htm.

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6 months ago

Sophie Enjema Ndumbe

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Hello Paola,

Nice write up, Nurses have become more advanced, knowledgeable when it comes to the use of technology. Even though some nurses have difficulties using the system, they should learn because things are changing every day. Paper charting makes things very difficult because some of the patient’s information can be missing which is not good. If nurses and physicians do not have the correct report about a patient, they will not be able to get the right treatment for the patient. Payne et al. (2017) States “we need to raise awareness about the importance of informatics and informaticians in transforming health and health care outcomes” (p. 469).

It is important for any healthcare facility to have an electronic health record this make it easy for the nurses, physician or other people directly involved with the patient’s care. The use of electronic health record has brought positive changes in the health care system, staff can now document well (Chipps et al., 2020).

References

Chipps, Esther, Sharon Tucker, Ruth Labardee, Bindu Thomas, Michele Weber, Ford, Lynn Gallagher, and Bernadette Mazurek Melnyk. 2020. “The impact of the electronic health record on moving new evidence‐based nursing practices forward.” Worldviews on Evidence-Based Nursing 17 (2): 136–43. doi:10.1111/wvn.12435

Payne, T. H., Fridsma, D. B., Payne, T. H. M. F., & Fridsma, D. B. M. P. F. F. (2017). Why informatics? Discovering health insights. Accelerating health care transformation.

Journal of the American Medical Informatics Association, 24(2), 469–470. https://doi-org /10.1093/jamia/ocx001

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6 months ago

Paola Gaudioso

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Hi Sophie,

 Paper charting is not so great in this world of technology. At my facility they are suppose to scan in records once the patients leave. That seems to never happen in a timely manner. There are so many issues when scanning because of bar codes and incomplete records. This system does not seem helpful during the patients current stay.

Paola

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6 months ago

Marisa Buffa

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Hi Paola,

I could understand the frustration with the inability to access a patient’s medical record quickly. In the Emergency Room (ER), our electronic medical record allows us to flag a patient’s chart if they are physically or verbally abusive to staff. This gives us a heads up and allows us to loop in our security officers if needed when providing care. Communicating the risk of violence allows us to take steps to reduce or prevent violent behavior (Lynn, 2021). This option available in our EMR is crucial to our safety.

            As you’ve mentioned, the importance of nursing in telehealth is paramount now more than ever. Some of the benefits of telehealth nursing include the ability to guide patients to ED visits, clarify treatment plans, educate self-care, and assist with appointment scheduling (Mataxen, 2019). Telehealth nursing has also been shown to reduce health care costs by avoiding unnecessary ER visits. This is definitely an exciting avenue for nursing and patients alike and is continuing to grow in popularity. 

References

Lynn, J. (n.d.). Providence launches Epic “risk for Violence” flag to improve safety. Providence launches Epic “Risk for Violence” flag to improve safety | Providence Oregon. Retrieved September 18, 2021, from https://oregon.providence.org/forms-and-information/p/pulse/providence-launches-epic-risk-for-violence-flag-to-improve-safety/.

Mataxen, P. (2019, April). Telehealth nursing: More than just a phone call : Nursing2021. LWW. Retrieved September 18, 2021, from https://journals.lww.com/nursing/Fulltext/2019/04000/Telehealth_nursing__More_than_just_a_phone_call.3.aspx.

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6 months ago

Paola Gaudioso

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Marisa,

 I think it would be amazing to be able to flag patients at our facility just so staff could be prepared. Unfortunately, mental health is a revolving door and many times we recognize names especially if you have worked in the field for a long time. When there is new staff they don’t know so it would be great.

Paola

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6 months ago

Federica Clay

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Nurse Informaticist and technology specialist Interactions

                    Sipes (2016) defined the skills needed for project management of nursing informaticists includes the following: “development/implementation of work plans, design/development of systems, function as lead/project manager in all phases of the systems life cycle, and development and implementation of all organizational documents required as a project manager to successfully manage a project.” Any of the following specialties of healthcare workers in the hospital or other setting has these skills to make their job flow more smoothly.

Nurse informaticists are more likely known as technology specialists in my healthcare organization. They interact with different professionals every day such as nurses and doctors in case one has trouble logging in to the computer system at work. Another example would be if vital signs obtained by nurses or nurse aides do not load from the vital sign machine to the computer. This would be a technology issue. Another interaction would be with the radiology team if the x-rays are not being loaded properly for the radiologist to read. One more example of a nurse informaticist interaction would be with phlebotomy if the labs that have already been drawn on a patient do not seem to be going through and loading into the system for them to be checked off as complete.

Strategy for improvement of interactions

        These interactions might be improved by the healthcare organization making sure that they have an optimal internet carrier as well as back-systems if the main energy source of the building were to be disconnected. Once the energy or electronic connection is restored, the systems would have little trouble getting back that information that could have been lost. This would help specifically in power outages or if switching electronic documentation systems. This strategy would allow for electronic patient charts to be untouched during these crises. Another strategy for improved interactions would be to include SMS messaging for in-hospital users. An article by Ng et al.  (2018) states that “health information technology projects based on SMS can accommodate both basic and smartphone users in the evolving field of mHealth applications, tapping the nonsmartphone’s simplicity to deliver primary healthcare information that may be more effective for users who are less tech-savvy.” This is to say that even those who are not familiar with using smartphones can feel at ease when using this form of communication.

Evolution of Nursing Informatics

        I believe the evolution of nursing informatics and continued emergence of new technologies will greatly benefit professional interactions.  According to findings from a study by Mosier et al., (2019), it was found that “the knowledge and understanding of clinical practice gained through these solutions can be applied to subsequent applications and efforts to refine and innovate within nursing care.” The solutions referred to involve nursing leadership, nursing staff, informatics specialists, and others involved in data retrieval. They involve clinical practice and knowledge formed into improved nursing informatics. I believe that as we learn new ways to share data and information with others on nursing, patient outcomes, nurse satisfaction, and patient diagnoses, we will be able to improve patient care as well as work faster in providing the necessary care to our patients.

Resources

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A systems-level method for developing nursing informatics solutions: the role of executive leadership. JONA: The Journal of Nursing Administration, 49(11), 543-548.

Ng, Y. C., Alexander, S., & Frith, K. H. (2018). Integration of mobile health applications in health information technology initiatives: expanding opportunities for nurse participation in population health. CIN: Computers, Informatics, Nursing, 36(5), 209-213.

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

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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6 months ago

Annisha Mcgowan

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Annisha. Your post leads me to a question….

Class:

What kind of financial assistance is available for organizations to purchase an EHR?

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6 months ago

Annisha Mcgowan

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The Health Information Technology for Economical and Clinical Health (HITECH) act is a government funded program which set aside 27million dollars for hospitals to adopt electronic health records systems.

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6 months ago

Sophie Enjema Ndumbe

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Nursing informatics is very important it is used daily in various health care settings. Data is collected, analyzed, and utilized to improve patient care. Through nursing informatics, we can advance our skills, be more efficient and productive. According to Laureate Education (2018) nursing informatics is a very essential part of the health care system.

Observation

In my health care facility, we all use computers to enter in patient’s data. We use the click point care system, here we can see information from different departments like physical therapy, occupational therapy, infection control, housekeeping, nutrition. We can order labs, review pertinent information needed for patient care. Some of the staff have difficulties using the system so we often call the Information technology specialist to help solve the issue. We stay with them on the phone, and they direct us on how to fix the issues. The IT specialist always makes sure that the computers are updated weekly, any computer that is not working well or has issues, they will remove it immediately.

One strategy on how these interactions might be improved

This interaction might be improved through continuous education of staff, training them on how to use the new system and technology. For example, when our facility hires new staff, they are trained just for 3 days to use the click point of care and trident system. The new staff finds it difficult to complete their daily tasks due to limited knowledge and lack of technological skills, so our facility have decided to train nurses for one month. Good communication among staff members will also help because when colleagues do not understand something they can ask a fellow colleague who is knowledgeable about the issue and the problem can be solve it without calling the Information technology specialist. Another strategy to improve interaction is to train workers well so that they can use the technology provided to them effectively and efficiently (Kuo & Ye, 2010).

The impact of continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

Nursing informatic is making it possible for the health care system to be more advanced. People can now perform many tasks more efficiently and proficiently. Information technology makes it easy for healthcare team to respond and address patient’s health need immediately (Theis et al., 2019). The computerized system is making it easy for people to get a patient’s information faster. For example, after a lab work is done for a patient, a nurse can log into the laboratory department in that facility site to see the results without waiting for labs to fax it. Work is now getting easier and for many staff because of the emergence of technology, another example is the use of the implanted continuous glucose monitoring device for diabetics. Many patients are happy with the device because they do not have to stick their fingers anymore to check their blood sugar levels.

References

Laureate Education (Producer). (2018). The Nurse Informaticist [Video file]. Baltimore, MD: Author.

Kuo Y, & Ye K. (2010). How employees’ perception of information technology application and their knowledge management capacity influence organisational performance. Behaviour & Information Technology, 29(3), 287–303. https://doi-org /10.1080/01449290701852166

Theis, S., Schäfer, D., Bröhl, C., Schäfer, K., Rasche, P., Wille, M., Brandl, C., Nitsch, V., Mertens, A., & Jochems, N. (2019). Predicting technology usage by health information need of older adults: Implications for eHealth technology. Work, 62(3), 443–457. https://doi-org /10.3233/WOR-192878

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6 months ago

Federica Clay

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Sophie,

        I agree that the technical experts in hospitals and any organization are so vital in checking every detail and making sure that staff has all they need to be able to log in and document correctly. This makes the system of healthcare move so much more smoothly. Mosier et al. (2019) states that technology specialists are great at “visualizing the plan, transforming data to usable scoring methods, harmonizing time frames from disparate data sources, and aligning the data to other reports with the same metrics.”

        I will also add that by including all areas of management of the healthcare process such as the Chief Nursing Officer (CNO), clinical manager, and multiple staff nurses in the development of a plan to help staff understand the documentation system faster and better.

Sipes (2016) states that the following certain skills are needed for project management of nursing informatics: “development/implementation of work plans, design/development of systems, function as lead/project manager in all phases of the systems life cycle, and development and implementation of all organizational documents required as a project manager to successfully manage a project.” I believe as staff work together to support each other, we can help those who are struggling a little more in the technological side of healthcare.

Resources

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A systems-level method for developing nursing informatics solutions: the role of executive leadership. JONA: The Journal of Nursing Administration, 49(11), 543-548.

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

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6 months ago

salome ugwu

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Hi Sophi!

I do absolutely support to your post especially when you have mentioned that “Amongst the many responsibilities that nurses have, one of the most important yet biggest frustrations come from EHR documentation burdens that can interrupt patient care. (Boyle et al., 2019) states that two important points to address are “1) implementing true interprofessional teams to improve communication and quality of care and 2) addressing the documentation burden, usability, and interoperability issues of electronic health records through redesign”. The negative aspect of nurse informatics is that it disregards the face-to-face assessment interaction amongst the healthcare team. Group presentations are often helpful because it allows mutual information sharing, memorizing important data, and highlights problems (Johnson, Johnson, & Smith, 2014). While on a positive note, team members can appreciate other viewpoints while expanding knowledge of certain situations. These strategies would allow interaction with CIS to improve on areas needed additional data collection advancing technology within the organization. Therefore, the continued development of nursing informatics has an affirmative impact on professional interactions. This will allow continual education and interaction with other healthcare professionals, keeping them abreast of changes within the system. This interaction also shapes trust amongst all disciplines and count on one another for the up-to-date information and data collection. In the words of McGonigle & Mastrian, nurses are considered knowledgeable engineers, designers and developer, who implement and maintain knowledge (2017). To accomplish these characteristics, the nursing force needs professional interaction with the nursing informatics specialist. This interaction not only exists in healthcare settings, but in the business settings as well. These types of telecommunication will continue to exist as long as there is technology with room for advancement.

                                                References

Johnson, D. W., Johnson, R.T., & Smith, K.A. (2014). Cooperative learning: Improving university instruction by basing practice on validated theory. Journal on Excellence in University Teaching. 25(4). 1-26.

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

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6 months ago

Mauricio De Regules

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Interaction Between Nurse Informaticists and Other Specialists

Modern nurses have demonstrated steady and similar courage and grit as they shift and adjust their practice to flourish in the changing healthcare economy and increased global digital culture. To successfully adapt to the changes witnessed in today’s dynamic health systems, nurses must embrace the advanced technology and participate in their meaningful designs and ethical use. Technological advancement has expanded our boundaries exponentially. Notably, nurses have continued to positively impact both their patients and families in their place of work and every part of their community (Darvish et al., 2014). They do so by utilizing technology to gain a comprehensive understanding of the dynamics of population health and wellness promotion. However, for all the years of practice, under-appreciated is the word that comes to mind regarding the clinical informatics team’s role in collaboration.

Collaborative practice is the backbone of the healthcare system as it helps prevent medical errors, improve patient experience and deliver better patient outcomes. However, the integration of nursing science with several information and analytical sciences in managing, defining, communicating, and identifying data, knowledge, information, and wisdom, which is a crucial source of data for decision making, is often prone to be overlooked (Darvish et al., 2014). With the continuous evolution of the application and use of technology in supporting the delivery of care, the demand for information to support nursing practice and knowledge management has also increased. As Goel (2020) suggested, informatics nurses have shown resilience to withstand the stresses of change witnessed in the current healthcare sector while providing skillful change management for other end users.

Therefore, it is critical to lean forward and build electronic health records infrastructure that aids excellent professional practice and fiscal success. Moreover, with the continuous evolution in the application and use of technology that supports the delivery of care, it is essential to offer proper educational preparation of nursing informatics specialists, which will aid in optimizing documentation efficiency and usability, as Nagle et al. (2017) observed. This will reduce workflow waste and increase partnering with clinicians while developing standard work for the best clinical outcome.

References:

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

Goel, A. (2020). Informatics Nurses Forge Ahead in Changing World of Healthcare. HIMSS. Retrieved 14 September 2021, from https://www.himss.org/resources/informatics-nurses-forge-ahead-changing-world-healthcare.

Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies for Nurses in the Future Of Connected Health, 1-10. https://doi.org/doi:10.3233/978-1-61499-738-2-212

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Mauricio. Do you have IT or nurse informatics specialist in your facility? If so, how do you, and clinical staff, work with them?

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6 months ago

salome ugwu

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Week 3 Discussion Main Post

September 13, 2021

Salome Ugwu

Nurse informaticists are dependent on data for effective decision making. The American Organization of Nurse Leaders has identified essential competencies in informatics that are necessary for effective leadership of this technology and data-informed environment. (Mosier et al, 2019). Nurse informaticists interact daily with other professionals within the healthcare organization because it takes a village to provide excellent and quality services. One of the most important components of performing our work duties includes having an effective medical record. Electronic Medical Records (EMR) help to put safety measures in place that are standardized and offer safe practices with the terminology offered by the EHR (American Nurse Association, 2018). Using the electronic medical system my company provides includes constant interaction between the information technology (IT) specialists, nurses, certified medical assistances (CMAs), social workers and providers. The IT specialist works with nurse by ensuring that the systems used for work daily are operating in the manner its build for or readily available to fix any issues we might have with the EMR. The CMAs ensure that all delegated tasks by the nurse are completed in a timely and effective manner to meet the goals and needs our clients. The social workers and providers work together with the nurse to provide quality patient care coordination.

One important issue I encounter with doing my job is the inability to find specific medical diagnosis and/or terminologies when recording my patient’s medical history. Health Information Technology enables healthcare providers to capture standardized data and use it to inform patient care and communicate across a range of clinical settings. Health IT also supports one of the strongest tenets of nursing educating the patient and family. (American Nurses Association, n.d.). One strategy is to include nurse informaticist/leaders in the development of these medical record systems. By doing so, frequently used terminologies and medical diagnoses will be identified and included to make charting more efficient.

I believe the continued evolution of nursing informatics is going to have a vast influence in the health care industry. Technology is impacting healthcare and the world at a very fast pace. Informatics is changing the face of healthcare. As technology advances, healthcare organizations and providers can collect, analyze, and leverage data more effectively, influencing the way care is delivered, resources are managed, and teams operate each day. (UIC, n.d.). Informatics has contributed to the progress of the nursing profession. One of the primary ways that informatics has changed nursing practice is through documentation. Gone are the days of paper charts that had to be meticulously updated with handwritten notes. Today, nurses are more likely to input notes into electronic health records and other systems that keep a patient’s medical history up-to-date and easily accessible. (AIC, n.d.).

Reference

Mosier, S., Roberts, W.D., and Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. Available from http://ovidsp.dc2.ovid.com.ezp.waldenulibrary.org/ovid-b/ovidweb.cgi?QS2=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 (Accessed: september 13, 2021).

American Nurses Association. (2018). Nursing informatics: Scope & standards of practice (2nd ed.). Silver Springs, MD: Author.

American Nurses Association. N.d. Health IT. Available from https://www.nursingworld.org/practice-policy/health-policy/health-it/ (Accessed: September 14, 2021).

University of Illinois Chicago (UIC). N.d. The impact of health informatics on nursing practice. Available from https://healthinformatics.uic.edu/blog/the-impact-of-health-informatics-on-nursing-practice/#:~:text=The%20impact%20of%20health%20informatics%20on%20nursing%20practice,-View%20all%20blog&text=Informatics%20is%20changing%20the%20face,and%20teams%20operate%20each%20day (Accessed: September 13, 2021).

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6 months ago

ZULFIQAR ABBAS

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Hello colleagues,

Nursing informatics and nursing practice go hand in hand. In the current era we are so dependent on nursing informatics, I would say we can not survive without informatics or work at a very substandard level. I just started a new job 2 weeks ago and we use 3 EMR for documentation. We got a message yesterday from the help desk that one of our software will be down on Friday 5 am-5 pm. Since we saw the email message everyone was freaked out. It will be hard to work without the EMR. How we can access the MAR, patients’ history, problems, labs, imaging, provider’s orders, or any other updates. It will be very time-consuming and frustrating. Patients’ data is very significant in making a nursing plan of care and the physician’s plan of care to meet the goals. The correct patient data and the medical record plays a significant role to enhance productivity, effectiveness, cost, and nursing care (Mosier, et al; 2019). It is obvious that nursing informatics is so much involved in nursing practice and gives a lot of privileges to all the team members involved in patient’s care physically, clinically, or even in care coordination. Nursing informatics has gone to a very advanced level from its basics over the span of years and proved its importance and application in the nursing specialty.

Paper charts are nowadays obsoleted even in a small outpatient set up or in a small healthcare facility. Most EMR is very expansive but popular in the health industry due to their outstanding privileges, no paper involved. For example, I used work in Primary care and urgent care before nursing and we used e clinical Work (eCW), it is very comprehensive and entirely paperless. It is connected nationwide with all pharmacies, Sure scripts, referring providers, facilities, CMS, and commercial insurances, only need few

clicks. Nurses should have the basic computer skills, knowledge of informatics, and informatics skills to get the best outcome in practice (Darvish, et al; 2014).

Despite that informatics has a lot of benefits in the health industry at the same time it has some shortcomings which need to be improved. For example, Some of the EMR are very complex and difficult to learn especially for the new staff on board. Another problem and drawback are the glitches in the EMR which is a dilemma for the IT team and sometimes it becomes hard for them to figure it out where and what is the problem to come up with a solution. The last important thing is the cost that is increasing frequently, hard to control. I have started a new job in the County hospital, and we are using 3 software at the same time while some small facilities even can not afford the price of even one software.

Informatics works like a nucleus every team members of the healthcare team look around this nucleus while providing the patient’s the care and contributes their part, it shows that everyone can oversee the entire plan of care and all the activities (Reis, et al; 2017). Overall nursing informatics brought innovation and improved the quality of care and healthcare the outcome in a small level or on a larger scale.

                                                                                   References

Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science, 6(6), 11.

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A systems-level method for developing nursing informatics solutions: the role of executive leadership. JONA: The Journal of Nursing Administration, 49(11), 543-548.

Reis, Z. S. N., Maia, T. A., Marcolino, M. S., Becerra-Posada, F., Novillo-Ortiz, D., & Ribeiro, A. L. P. (2017). Is there evidence of cost benefits of electronic medical records, standards, or interoperability in hospital information systems? Overview of systematic reviews. JMIR medical informatics, 5(3), e7400.

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6 months ago

Kene Fall

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 As the healthcare delivery system continues to advance, all the various disciplines involved in the healthcare delivery system must coordinated care coordination. Nursing informatics is a necessary and fundamental element of nursing proficiency. To ensure that the nurses deliver better quality of service, they must work together with the technology specialists to ensure that the flow of information is smooth (McGonigle & Mastrian, 2017). Various healthcare professionals can improve the quality of care provided by analyzing a patient’s data. This process can be carried out in a hospital by integrating multiple systems and processes. 



 Through a study that involved three variables, nursing informatics was deciphered into three key pieces. These included the skills needed to use various electronic platforms and collaborate with other healthcare professionals (Davish A. et al., 2014). There is a protocol for electronic medication administration records (eMAR) at our hospital that nurses and respiratory therapists must follow during medication administration to avoid medication errors. Safe medication administration is an integral part of healthcare. One of the priority steps is scanning the patient’s wristband and medication barcode to ensure the patient is correct. The consequence of Barcode-assisted medication administration (BCMA) helps minimize errors and improve healthcare quality (Heather H.S. et al., 2014). This process involves collaboration between various healthcare professionals to deliver effective services to the patients. For instance, when a nurse or RT does not use the scanner during medication administration, it will have a pop-up to alert the nurse that the scanner is not used, and they can send a notification to IT regarding the issues. This is an essential system that the IT has to make sure it is working at all the time when administering medications. 



Technology plays a vital role in improving interactions between various departments and organizations to quality of care. Its effectiveness can help minimize delays and make processes more streamlined. Direct observation and the use of BCMA-eMAR were proven to improve the accuracy of recording errors and prevent them from reaching patients.

References:

Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014, June 25). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science. Retrieved September 13, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825491/.

Heather H. Seibert, Pharm.D., M.B.A., Ray R. Maddox, Pharm. D., FASHP, Elizabeth A. Flynn, Ph.D., Carolyn K. Williams, B.S.Pharm., Effect of barcode technology with electronic medication administration record on medication accuracy rates, American Journal of Health-System Pharmacy, Volume 71, Issue 3, 1 February 2014, Pages 209–218, https://doi.org/10.2146/ajhp130332

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

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Kene. Do you have IT or nurse informatics specialist in your facility? If so, how do you, and clinical staff, work with them?

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6 months ago

Kene Fall

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Dr.Moyers,

In our hospital, unfortunately, we do not have a nurse informatics expert. However, we do utilize an IT specialist. Whenever issues arise, we contact them in two ways which phone call or email. Most of the time, we get them by phone call and have them troubleshoot the issues. If the problem does not resolve over the phone, then they send IT to our site.

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6 months ago

Bailey Schaal

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My current workplace does not have an informaticist. It is currently my responsibility to keep track of software updates and training staff in on how to use software. I also utilize online training courses to educate new staff on how to use the software. I am currently trying t find a new software to use at our facilities as the current one we use is painfully slow and does not allow for scanning in meds to reduce med errors.

          As the only informaticist, I know I could communicate with my staff better. I have a lot of experience with computers and multiple different charting software. I could definitely cater my approach more to those that have no computer experience and are new to the healthcare field. I employ a lot of staff using English as a second language, are new to healthcare, or have been working for many years using different software or have never used technology. I need to learn the best way to educate these staff members. By including multiple different learning styles into each training I develop, it is more likely to be effective for more staff (UMass, n.d.). I know I have a lot to learn when it comes to educating others.

          The continued evolution of informatics allows for improved communication between patients and their team members. Improved communication has the potential to increase efficiency and increase positive patient outcomes (Krick, 2021). The impact of improved communication can be the difference between life and death for our patients. There will be less medication errors relating to miscommunication. We will also be able to educate our patients on aftercare while better catering to their specific learning style with the use of resources accessible with informatics.

          The advancements in technology will improve charting, nursing interventions, clinical technology and more. The charting will become more accurate, the interventions can be more fine-tuned, and medical supplies more effective and safer (McGonigle & Mastrian, 2018). It will be the nurses’ responsibilities to keep up to date on all advancements, so they are able to utilize these improvements to enhance the quality of care they give, enhance their knowledge, and make their jobs easier and more efficient.

References

Krick, T. (2021). Evaluation frameworks for digital nursing technologies: analysis, assessment, and guidance. An overview of the literature. BMC Nursing, 20(1), 1–19. https://doi-org.ezp.waldenulibrary.org/10.1186/s12912-021-00654-8

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

University of Massachusetts Dartmouth (UMass). (n.d.). How to accommodate different learning styles. https://www.umassd.edu/dss/resources/faculty-staff/how-to-teach-and-accommodate/how-to-accommodate-different-learning-styles/

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Great insight Baily. Sounds you have a challenging and essential function!

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6 months ago

Tammy Rodgers

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Interaction Between Nurse Informaticists and other Specialists

As stated by McGonigle and Mastrian, the definition of nursing informatics is “a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice” (2017, p. 7). The definition alone indicates that the nurse informaticist is required to collaborate with other departments, such as the IT department, in order to effectively aggregate data and information to be analyzed for performance improvement opportunities and to advance nursing practice.

Observation of Interactions of a Nurse Informaticist

The organization that I work for is a small inpatient acute psychiatric facility. We do not have a designated nurse informaticist and we are still in the “dark ages” and do not have electronic health records. Paper charting and written documentation are a large part of every department’s day. This being said, we have one person that makes up our IT department and he handles any computer or electronic issues the facility experiences but is not experienced or knowledgeable in new technologies to advance healthcare.

Our Quality and Performance Improvement nurse is the closest to being a nurse informaticist in our facility and does work with IT in regards to spreadsheet issues and compiling data that is gathered from departmental performance improvement initiatives. She stays abreast of new practices and quality control ideas to create more positive patient outcomes and cut costs for the patients and the facility. Since the hospital is not technologically advanced in ways to treat patients at this time, an example of how she has worked with the IT department and the Director of Nursing to improve healthcare for our patients and lower costs for the facility is the implementation of a new lab processing company that uploads lab values to a database that nurses can access from their workstations. Delays in obtaining lab results from our previous company caused delays in treatment and increased costs for the facility and patients by requiring redraws of labs due to the inability to obtain results in a timely manner. The Quality Director, DON, and IT department worked closely together to begin the new program and to educate the nursing department on how to quickly look at results on the computer and inform the provider.

Strategy to Improve Interactions

Adopting an electronic health record system within the facility would expedite interdepartmental patient care by having the patient’s records readily available. It has made strides in helping organizations “determine optimal patterns of care” (Evans, 2016) and would allow a nurse informaticist the ability to have access to new innovative software programs that could positively impact patient care delivery.

The Evolution of Nursing Informatics

The delivery of healthcare is always changing as new digital technologies arise. This will require the nursing profession to be involved with research and the adoption of new technologies in the digital era (Booth, et al., 2021). This will require nurses to have computer skills and competency which foster relationships between nurses and other departments and will improve the delivery of patient care (Booth, et al., 2021) This essentially will require all nurses to be informaticists and gives the opportunity to positively impact and expand the nursing role.

References

Booth, R., Strudwick, G., McMurray, J., Chan, R., Cotton, K., & Cooke, S. (2021). The future of nursing informatics in a digitally-enabled world. In Health informatics (pp. 395–417). Springer International Publishing. https://doi.org/10.1007/978-3-030-58740-6_16

Evans, R. S. (2016). Electronic health records: Then, now, and in the future. Yearbook of Medical Informatics, 25(S 01), S48–S61. https://doi.org/10.15265/iys-2016-s006

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

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6 months ago

Tiffany Turner

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Tammy I can definitely relate to your post. I’ve worked in a 95 bed psychiatric facility and they’re using paper charting as well. There are definitely some pecks to paper charting. However, many of the psychiatric hospitals are claiming a hardship which allows them to avoid penalties which would have been implemented by Medicare back in 2017 (Xiao & Acosta, 2016). For organizations such as those that you and I work for suffer a great loss by not employing informatics. Informatics allows for important information that impact patient care to be dispersed quicker and efficiently (Sweeney, 2017). Thanks for your post.

                                                                                                                    Reference

Xiao, A. & Acosta, F. (2016). Implementation and Impact of Psychiatric Electronic Medical Records in a Public Medical Center. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075233/

Sweeney, J. (2017). Healthcare Infomatics. https://www.himss.org/resources/healthcare-informatics

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6 months ago

Tammy Rodgers

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6 months ago

TYLENEA JONES

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Discussion #2

I currently work for a long-term care facility for people with disabilities. My majority of the population have a diagnosis of Multiple Sclerosis, some type of congenital defect or motor vehicle accident and require many different specialized services.

The nurse informaticist interacts with the other professionals within the organization by consistently researching new technology and the improvements of the current ones being used. Through his/her research, the facility is able to explore the possibilities of maintaining their primary goal of improving the quality of life for the residents. The nurse informaticist notifies the administrative team who then reviews and develops a plan to implement this new technology. The nurse informaticist is also involved with the education of the staff once this new technology is approved for use. Staff can include physical therapists, nurses, physicians, administrative teams etc.

One strategy on improving the interaction between the teams would be to develop a framework and “establish clear lines of responsibility and authority, respect for each type of expertise necessary to the project, and clear commitment to the aims of the project” Mosier et al. (2019). Everyone involved in the implementation of the project such as therapy is allowed input based on their professional expertise and experience in dealing with the residents. Ex. Include knowing that there are residents who require equipment that is hands-free since they are paralyzed from the neck down.

I believe the evolution of nursing informatics and emergence of new technologies impacts healthcare interactions by constantly producing faster ways of communicating and ease of retrieving current data statistics. According to Sipes (2016), expectations of the healthcare industry is that nurses will have informatics competencies including project management skills which are critical for improved quality outcomes and safety for patients.

References

Mosier, S., Roberts, W. D. & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions. JONA: The Journal of Nursing Administration, 49 (11), 543-548.

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

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6 months ago

Amy Birkenstamm

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Nursing informatics is expressed as the implementation of knowledge and technology to understand error and knowledge, utilize decision-making to provide support, and communicate between health professionals (QSEN, 2021). Informatics provides the necessary skills to provide education regarding the application of technology and identify key information before providing medical care (QSEN, 2021). As nurses, it is imperative to understand and utilize informatics within our healthcare environments in order to operate efficiently and build proper communication patterns amongst our teams. I have worked in both a clinical hospital setting as well as operate as a practitioner and business owner, I have grown to understand the importance of effective communication using informatics.

When I worked in the Emergency Department, we used informatics to build a gap between triage, the main Emergency Department, physicians, nurses, support staff, etc. With utilizing a computerized system and informatics in this environment, the whole healthcare team was able to communicate through the system such as place medicine and procedural orders. An additional important feature beginning in the triage department was identifying levels of priority of care and labeling within the system. This helped with treating all of the patients according to their various conditions and chief complaints which would then notify through the system of who to treat first. This ultimately improved patient satisfaction and safety.

Currently, as a business owner and practitioner, having a system that caters to our specific needs is imperative in order to operate my extremely high volume practice. As an owner, I chose to invest in the best operating system available for aesthetic practices. This has helped streamline our processes, improved our overall flow of the practice, as well as allow online booking for certain procedures. All of the above has improved quality of care and increased revenue from a business perspective. Being in the role as a medical practitioner and business owner, I of course always go with patient satisfaction as being the utmost priority. Likewise as an entrepreneur, I also see the business end of efficiency of proper informatics and how it helps the business side of a practice. In addition allowing this access through a protected cloud being an EMR, you can also effectively access through mobile devices. Providers and patients now can access EHR through mobile devices with the expansion of infrastructure (Ng et al., 2018).

In conclusion, I also feel that telehealth, especially through the pandemic, was an amazing way to stay connected and communicating when providers and patients were unable to see each other in person. I believe that informatics will continue to improve overall and support the delivery of improved processes and procedural care of our patients.

References

Ng, Y. C. , Alexander, S. & Frith, K. H. (2018). Integration of Mobile Health Applications in Health Information Technology Initiatives. CIN: Computers, Informatics, Nursing, 36 (5), 209-213.

Qsen competencies. (n.d.). September 13, 2021, from https://qsen.org/competencies/pre-licensure-ksas/#informatics

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6 months ago

Tae Kim

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6 months ago

Adam Hundley

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6 months ago

salome ugwu

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Amy

I do agree with you. Nurse informaticists are instrumental in bridging the gap between the IT technicians and clinicians to improve the quality of services offered. In the new era of advancement of information and technology, nurses should be on the forefront to revolutionize the nursing practice to make it quicker and efficient (Knox, 2019). The nurse informaticist promotes the use of technological devices to improve collection, analysis, storage and retrieval of crucial patient’s data. They are involved in the processes that help to design the workflow, diagnostic processes and the technological treatment plans. The nurse informaticist also guides the healthcare systems in development of better communication systems that help in on quicker and more reliable reporting hence improve on the response to emergencies. The nurse informaticists are crucial as educators. They help in providing training to the other clinical and non-clinical staff members. These can be achieved since the nurses have skills and techniques required in the analysis of data and have the ability to articulate some of the challenges faced at the facility to the other members of the staff and guide in the deliberations about how best to tackle them (Kirby, 2015). They are in the best position to offer advice to policy makers and administrators on critical issues that have to be considered for quality service delivery. Additionally, nurse informaticists can provide information that will help in the identification and testing of the emerging technologies in the clinical field and guide on their usage, efficiency and cost implications (Kirby, 2015). Moreover, they are better placed at ensuring that the clinical errors minimized. This is achieved through adequate training of the new staffs, effective and continuous communication and promotion of better nursing practice.

References

Kirby, S. B. (2015). Informatics leadership. Nursing, 45(4), 21–22. https://doi.org/10.1097/01.nurse.0000462394.23939.8e

Knox, A. (2019). Informatics in nursing leadership: Leading in the age of technology. Canadian Journal of Nursing Informatics, 14(3), 1-2. https://cjni.net/journal/?p=5979

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6 months ago

Mercy Ambe Mbu

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6 months ago

Tiffany Turner

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Collaboration

I could not imagine working within healthcare without Informatics. An observation as well as an experience that I’ve had with the technology specialist was in the process of transitioning to FirstNet system which required the Physicians and NPs to discontinue the use of their personal phones between the nursing staff. The request was a rationale one as utilizing a certified cellular system to communicate with the clinicians provides seamless data flow, increase accuracy and provide convenience (Sunhasane, 2018). Moreover, utilizing a secure communication system decrease HIPPA violations (Godard, 2021). The Clinicians had great difficulties with implementing the FirstNet system. The battle between the technology department and clinicians took place for approximately six months. I would like to say there was a resolution for some but not all. If the technology specialist would have held a luncheon to debut the new system and took at minimum three weeks to continue to introduce and demonstrate the new system, the clinicians would have been more receptive to FirstNet.

The Future of Informatics

Often times clinicians are the most difficult to get on board regarding changes and updates. However, informatics is vital to the healthcare system. Informatics helps streamline important clinical data amongst interdisciplinary teams (Roback & Herzog, 2003). Considering the Baby boomers are aging and hospital beds and personnel are scarce, IT is growing in popularity to remedy these demands. Informatics will allow healthcare to be delivered to the end-users in a self and cost-efficient manner and will definitely be in demand within nursing.

References

8 Key Benefits of Mobile Devices in Healthcare. (2018, July 10). https://mobisoftinfotech.com/resources/blog/mobile-devices-in-healthcare/

Godard, R. (2021, March 22). Mobile phone usage & hipaa regulations | healthcare compliance. I.S. Partners. https://www.ispartnersllc.com/blog/hipaa-compliance-cell-phones/

Roback, K., & Herzog, A. (2003, May 21). Home informatics in healthcare: Assessment guidelines to keep up quality of care and avoid adverse effects – ios press. https://content.iospress.com/articles/technology-and-health-care/thc00302

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6 months ago

Mercy Ambe Mbu

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Hi Tiffany,

Thank you for your post. I agree that it will be tough to work in healthcare without electronic health records. A study review on the importance of electronic health records concluded that institutions using electronic health records had a 30% higher guideline adherence, 54% reduction in medication errors by 54%, and 36% fewer adverse drug reactions (Alotaibi & Frank, 2017). These successes have placed health care professionals with no other choice than to build strong collaborative relationships with the informatics staff to enhance this technology to promote patient safety and improve outcomes.

Thank you

Mercy

References

Alotaibi, Y. K., & Frank, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173-1180. http://dx.doi.org.ezp.waldenulibrary.org/10.15537/smj.2017.12.20631

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6 months ago

Chaquita Nichols

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Ever since I became a nurse, the hospital has been trying to do away with paper charting. Every year there are changes that are made to how we chart and what we chart. I never thought about who was responsible for coming up with ways to make our jobs easier. I would have never thought it would be a specialty known as nursing informatics. But what exactly is nursing informatics? Nursing informatics has played a part in designing a system for nurses. “The American Nurses Association (ANA) identified nursing informatics as “a specialty that integrates nursing, science, and information science to manage and communicate data, information, and knowledge in nursing practice” (Sweeney, J (n.d.)). It is data that is put together so that our jobs are made safer and the information we use is easily accessible.

I have worked in several different hospitals that use different types of charting systems. From paper charting to computer charting, I had to learn to adjust to both ways of charting data. I did find it easier to computer chart because if I was looking for certain information, I could easily type in a word, or that would bring up the information I was looking for. They are trying to make it so that we can look up patient information from outside sources which I find is very helpful, but everyone must do their parts when it comes to updating information. For example, a patient doesn’t know their medications, so I am able to look at an outside source to get their medications. But what if someone didn’t update the medications that the patient took, we are basically at square one with having to assume the patient is getting all their medications. Another way they make it easier for us to chart is doing admissions. A lot of nurses dread doing admissions because of how long the process is and sometimes you have your frequent flyers, so that meant constantly re-entering the information over and over again. But with the new data system, the information automatically saves so you basically are reviewing to make sure the information is still current. A lot of times the nurse manager asks the nurses what are some things that could be added to the database, and we usually tell them. We also have to take training courses anytime something has changed on the database, so we are kept knowledgeable. I feel that nursing informatics plays a pivotal role in helping design the healthcare setting because they have gained knowledge from their experience as nurses in the field. “Knowledge is the awareness and understanding of a set of information and ways that information can be made useful to support a specific task or arrive at a decision” (McGonigle D., Mastrian K. G. pp.9).

Even though nurses play a pivotal role when it comes to nursing informatics, they do not work alone. They also work alongside the Information Technology (IT) crew. I have never worked with someone in nursing informatics, but I have gotten to talk to IT on multiple occasions. IT usually helped with system updates, passwords, and issues with the system not working properly. It is a team effort. There are 3 guiding principles to make the process of teamwork run smooth and it involves “clear lines of responsibility and authority, respect for each type of expertise necessary to the project, and a clear commitment to the aims of the project” (Mosier et. al., 2018). So if everyone knows their job, has the same goal which is safe patient care, and respect for each other’s job purpose, the outcome would be successful.

References

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

Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. JONA: The Journal of Nursing Administration, 49(11), 543-548.

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

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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6 months ago

Chaquita Nichols

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6 months ago

Annisha Mcgowan

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Chaquita, I enjoyed reading your post. When I first started out as a new nurse, I did paper charting on my first job. I was a License Practical Nurse (LPN) working in a long-term care facility. I found that paper charting was time consuming which took away time from patient care. Within that facility we later transferred our charting system to computer charting. I had to take a weeklong educational class to learn how to operate the new system. There were also 24-hour support help when we needed it. I too never thought about who creates the electronic charting systems and what data goes into creating the systems. A question that I am curious about is how long it takes to create an electronic health record. How much money does an electronic health records system cost?

Electronic health records (EHRs) are complex systems with direct effects on the documentation and coordination of care and indirect effects on process efficiency, quality of care, staff satisfaction, and hospital finances (Hertzum & Ellingsen, 2019). I have worked with many different charting systems. EPIC charting system has been the most common medical records system I have used. I used EPIC in Louisiana and in Texas throughout my career although they were different. Major differences between the same EHR product when installed at different health care institutions: this is because they are tailored to organizational and clinical preferences and integrated with other ancillary (Scalia et al., 2021)

References

Hertzum, M., & Ellingsen, G. (2019). The implementation of an electronic health record: Comparing preparations for epic in Norway with experiences from the UK and Denmark. International Journal of Medical Informatics, 129, 312–317. https://doi.org/10.1016/j.ijmedinf.2019.06.026

Scalia, P., Ahmad, F., Schubbe, D., Forcino, R., Durand, M.-A., Barr, P. J., & Elwyn, G. (2021). Integrating Option Grid Patient Decision Aids in the Epic Electronic Health Record: Case Study at 5 Health Systems. Journal of Medical Internet Research, 23(5), e22766. https://doi-org.ezp.waldenulibrary.org/10.2196/22766

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Chaquita Nichols

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I started off working in a nursing home with paper charting and I didn’t like it at all. Most of the time we couldn’t read the doctor’s handwriting and had to call them when no other nurses could read the orders. Also, as you stated, it is very time consuming. Sometimes computer charting can be time consuming also because of having to go to different areas to chart the same thing. I love the fact that we can easily read the doctor orders and access patient information. I just started using Epic and it is taking me a while to learn it. It didn’t take me long to learn Cerner or Mckessen.

As far as the amount of time it takes to create an electronic health system, it varies. “As a general estimate, a health care organization can set up a novel EMR system within a year. EMR implementation for smaller practices (or modifications of an existing system) may take six to nine months, and cloud-based systems may take weeks rather than months” (Uzialko, A. 2021). As far as the cost of an electronic health record, I can imagine that to be very expensive, but the hospitals are usually responsible for the EHR system. “Direct A. Health Affairs study estimates that the typical multi-physician practice will spend roughly $162,000 to implement and EHR, with $85,000 going toward first-year maintenance costs” (McElroy, R. 2021). But the prices may vary depending on the system.

Ryan, R. (2021, July 26). EHR Implementation Cost: A Logistical Breakdown. SelectHub Confidence in Software. https://www.selecthub.com/medical-software/ehr-implementation-cost/

Ulzialdo, A. (2021, February 19). How to Implement an Electronic Health Records System. Business News Daily. https://www.buisnessnewsdaily.com/9102-implement-an-electronic-records-system.html#how-long-is-the-implementation-process.

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6 months ago

Tammy Rodgers

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Chaquita,

After doing research on the benefits of EHR, I was surprised to learn that most providers are not satisfied with the technological advancement. A study by Hochman (2018) states that EHR has been less than successful in reaching the goals of the quadruple aim and another study reports that when EHR was down, there was an increase in patient interaction and bedside care by providers due to decreased documentation time (Zhao, et al., 2019). Although there are many benefits to EHR, such as quick access to records and lab values, EHR still has a long way to go before reaching its full extent of benefits in healthcare. With this being said, I look forward to my facility converting to EHR in the future.

Tammy

References

Hochman, M. (2018). Electronic health records: A “quadruple win,” a “quadruple failure,” or simply time for a reboot? Journal of General Internal Medicine, 33(4), 397–399. https://doi.org/10.1007/s11606-018-4337-6

Zhao, J. Y., Kessler, E. G., & Guo, W. A. (2019). Interprofessional communication goes up when the electronic health record goes down. Journal of Surgical Education, 76(2), 512–518. https://doi.org/10.1016/j.jsurg.2018.08.024

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6 months ago

Chaquita Nichols

RE: Discussion – Week 3

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“While the new technologies such as smart pumps, bar-code medication administration systems, electronic health records (EHRs), wearables, and smart phones being introduced into our practice environments are designed to increase efficiency, promote safety, and streamline the work of nursing, we need to ask: To what extent do these technologies disrupt the nurse-patient caring encounter? How can we continue to care effectively for our patients and promote a healing environment while incorporation the advantages and efficiencies that technologies provide? (McGonigle D, Mastrian K. G., 2017, pp.525-526, para 2). I do agree that even though a lot of information, it can take away some of the time we as health care providers spend with the patient at the bedside, especially nurses. A lot of nurses come to work and try to get started early so they will be able to get their charting done. We do spend a lot of time on our computers whether it is charting patient care or looking up patient information. I feel that everything has a pro and a con, and I can agree that the con is the charting system. Depending on the charting system, we have to do a lot of double charting and that is very time consuming. Some nurses try to spend more time with their patients by charting in the patient’s room, but the patient may still feel ignored because you are continuously looking at a computer screen. So we have to find a balance between technology and still providing the necessary interaction time with our patients.

” In today’s high-tech world, expectations of the healthcare industry is that nurses will have informatics competencies including project management skills which are critical for improved quality outcomes and safety for patients” (Sipes, C. 2016). I do feel like having this technology is important because as you stated we can easily pull up patient’s labs, also procedures, and different notes. Nursing informatics continues to pave a way that is efficient for the healthcare community.

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.

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6 months ago

Paola Gaudioso

RE: Discussion – Week 3

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Chaquita,

            I also never knew that nurses played such a critical role in the technology department in a hospital. The more I learn about nursing informatics and the critical role these nurses play in patient care, it makes sense. Nursing informatics has been around for hundreds of years because Florence Nightingale used statistics to study patient information, such as disease percentages and mortality rates (Betts & Wright, 2020). Florence Nightingale would have been amazed at how far nursing informatics has come in the last 200 years. COVID has increased the need for technology to care for patients. According to Garcia (2021), the pandemic has caused a rapid expansion of telehealth use and has also shown a light on all the barriers that need to be fixed to provide proper care to patients.

References

Betts, H. J., & Wright, G. (2020). 200 Years Since the Birth of Nursing Informatics? Studies in Health Technology and Informatics, 272, 28–32. https://doi-org.ezp.waldenulibrary.org/10.3233/SHTI200485

Garcia-Dia, M. J. (2021). Nursing informatics. Nursing Management (Springhouse), 52 (5), 56-56. doi: 10.1097/01.NUMA.0000743444.08164.b4.

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6 months ago

Mercy Ambe Mbu

RE: Discussion – Week 3

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Productivity, efficiency, performance, effectiveness, cost, and value of nursing care depend on how information is collected and used. (Mosier, Roberts & Englebright, 2019). The role of the nurse informaticists is crucial, especially in this epoch where data management has quickly shifted from paper to software. Informaticists have specialized skills in building technology to manage and communicate data information knowledge and wisdom in nursing practice (McGonile & Mastrain, 2017). According to Sipes (2016), Nurse Informaticist supports nurses, consumers, patients, the interprofessional team, and other stakeholders in their decision-making in all roles and settings to achieve desired outcomes. The outcome of their duties determines how well the interdisciplinary team receives information, generates orders, and communicates in an organized and effective manner.

Enhancing collaboration entails establishing effective communication channels between electronic health records (EHR) creators and users. A carefully conceived EHR like Epic, which we use in the hospital, has several opportunities for collaboration. According to Edmund Funai, M.D of the Yale School of Medicine, “we are building an EMR, but the true power of the Epic project may lie in helping us to form better collaborative teams that would transform our health care culture.” The epic EMR has transformed how medicine is taught and practiced, and Epic has helped achieve a higher quality of care than ever before. (Yale School of Medicine, n.d.). The advantages brought by this EMR include improved communication among providers, communication with patients (mychart), immediate secure electronic access to pertinent patient information like allergies, vital signs, medications, lab tests, and imagery. Smart features such as drug interaction warnings, wrong medication, or maximum daily dose help increase patient safety. Epic also provides information about treatment protocols and facilitates the interpretation of orders since nurses and other users do not have to struggle with the handwriting of providers.

The Information Technology Service (ITS) or EPIC service desk is available 24/7 to resolve all Epic-related issues. There is a quality assurance committee made up of informaticists and representatives of all departments and specialties. The informaticist leader is a nurse with specialty education in informatics. This committee meets twice a month to discuss Epic maintenance and improvement. Nurses and other users can communicate problems and suggestions through their representatives, email, or ITS contact. During EPIC upgrades, messages are posted as pop-ups on the Epic home page – written in purple. Emails are sent out to all staff members, tips and tricks sheets are created, and an education page on the upgraded flowsheet is created to help navigate through changes. The service line nurse educator – a committee member, is responsible for educating all nurses in their department.

The ITS works to make sure that Epic is user-friendly. Epic is vast and comes with much information, easy to navigate and document. The issue I find with Epic is that documentation is time-consuming, and there is a possibility of shifting nurse’s focus from patients to computers. Duplications of documentation further aggravate issues with time management. I believe that the nurse informaticist should work together with staff nurses to identify all areas of duplication and make improvements.

Technology has brought much improvement in health care through efficient EHR. The federal government established policies for health institutions to switch to EHR due to the positive impact on patient safety. (Howe et al., 2018). Through its Health Information Technology for Economic and Clinical Health (HITECH) Act, the Federal government made available $20 million to Yale. Epic is personalized to fit each organization’s need; it is further personalized to meet individual patient care needs and the nurse/user’s needs. EHR has helped improve patient safety and the quality of care. Despite the challenges involved in the use, the pluses outweigh the minuses.

The continued evolution of nursing informatics and new technologies will enhance healthcare and improve interprofessional interaction. For example, the availability of mobile heartbeats (MHB), which are customized phones used for patient care. MHBs contain the EHR, and all data could be collected, documented, and disseminated with them. Using these phones reduces the equipment volume to be carried around by nurses, which can be tiring and reduce clutter, which is a risk of falling for patients. With MHBs, communication with providers is done directly from the patient’s chart making communication faster and more efficient.

References

Howe, J. L., Adams, K. T., Hettinger, A. Z., & Ratwani, R. M. (2018). Electronic Health Record Usability Issues and Potential Contribution to Patient Harm. JAMA, 319(12), 1276–1278. https://doi.org/10.1001/jama.2018.1171

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

Mosier, S., Roberts, W. D. & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions. JONA: The Journal of Nursing Administration, 49 (11), 543-548. https://oce-ovid-com.ezp.waldenulibrary.org/article/00005110-201911000-00008/HTML

Sipes, C. (2016). Project Management: Essential Skill of Nurse Informaticists. Studies in Health Technology and Informatics, 225, 252–256.

Yale school of Medicine (n.d.). Yale’s Epic challenge. Retrieved September 15, 2021, from https://medicine.yale.edu/news/yale-medicine-magazine/yales-epic-challenge/

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6 months ago

ZULFIQAR ABBAS

RE: Discussion – Week 3

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Hi Mercy,

I agreed with you, that nurse informatics will need to work together with staff nurses to resolve issues, upgrade and strengthen the nursing care with the collaboration of all health care team members.

Nowadays in the health system, technology plays a significant role in education and nursing work. The key elements of nursing informatics implementation considering healthcare promotion, advanced systems, network, internet in critical assessment of emerging technologies. Utilization of nursing informatics in the nursing outcome, quality of health care, and education (Darvish et al; 2014).

Nursing informatics could be applied in several ways to all areas of professional nursing practice such as clinical practice, research, education, and administration. According to McGonigle & Mastrian (2018), nursing informatics integrates nursing science, information science, computer science to manage and communicate data, knowledge, wisdom, and information in nursing practices (p.54).

References:

Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science, 6(6), 11.

McGonigle, D. & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett.

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6 months ago

Mercy Ambe Mbu

RE: Discussion – Week 3

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Hi Zulfiqar,

Thank you for your response and insight.

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6 months ago

Annisha Mcgowan

RE: Discussion – Week 3

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Hi Mercy, I enjoyed reading your post. I agree with you that electronic health record system does Improve communication. Use of electronic health records (EHR) within clinical encounters is increasingly pervasive (Moerenhout, Fischer, & Devisch, 2020). During the epidemic I had the privilege to work at our cancer center because all ambulatory surgery centers were closed. I worked at the cancer center for 4 months. I enjoyed learning something new in my career. While working on this unit I was able to communicate with the doctors via and instant chat portal that is incorporated into EPIC. The doctors were working from home and was available to us when we needed them. This was my first time using an instant chat and I enjoyed it. Also, I was able to communicate with lab regarding patient’s lab values and pharmacy regarding any medication adjustments via chat on EPIC. I was able to communicate with patients via EPIC to follow up after treatments and to answer any questions they may have. Happier patients who receive timely, appropriate feedback and whose needs are addressed expeditiously (Ringel, 2020). I believe that informatics is involving, and it will only get better in time.

References

Moerenhout, T., Fischer, G. S., & Devisch, I. (2020). The elephant in the room: a postphenomenological view on the electronic health record and its impact on the clinical encounter. Medicine, Health Care, and Philosophy, 23(2), 227–236. https://doi-org.ezp.waldenulibrary.org/10.1007/s11019-019-09923-5

RINGEL, M. (2020). Patient Portals: An Underused Communication Tool: Take advantage of this useful mechanism…Reprinted with Permission from The Journal of Medical Practice Management, Mar/Apr 2020, pgs 275-278. Podiatry Management, 39(8), 83–86.

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6 months ago

Tiffany Turner

RE: Discussion – Week 3

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You made excellent points regarding many of the benefits that informatics provides in the delivery of the healthcare system. Healthcare facilities without informatics often do not receive the max in reimbursements from Medicare (Xiao & Acost, 2016) and thus loss funding. Also, informatics impact on communication amongst interdisciplinary teams improves patient outcomes (Dienemann & Van de Castle, 2003). Overall, informatics plays a major role in nursing care.

Reference:

Xiao, A. & Acosta, F. (2016) Implementation and Impact of Psychiatric Electronic Medical Records in a Public Medical Center. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075233/
Dienemann, J. & Van de Castle, B. (2003). The Impact of healthcare informatics on the organization. https://journals.lww.com/jonajournal/Citation/2003/11000/The_Impact_of_Healthcare_Informatics_on_the.1.aspx
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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

RE: Discussion – Week 3

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Class,

Today is the last day for the Module 2 discussion thread on communication with informaticists. Building good strong relationship between clinical staff and informatics staff is paramount in today’s health care environment. The discussion thread topic for Module 3 will occur in week 5.

Dr. Moyers

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3 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

RE: Discussion – Week 3

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Class,

Today is the last day for the Module 2 discussion thread on communication with informaticists. Building good strong relationship between clinical staff and informatics staff is paramount in today’s health care environment. The discussion thread topic for Module 3 will occur in week 5.