NR 512 Week 1 Pre-TANIC TIGER Assessment plus Discussion Topic
Reflect on your own practice. Discuss how informatics is used in your practice. What is you... [Show More] r primary area where you would use informatics? From completing the Pre-TANIC TIGER assessment for this week, what do you plan to achieve in this course? How did you feel your competency level was compared to the assessment?
Dr. and Class,
As a Labor and Delivery (L & D) nurse informatics is essential to coordinate care. As the population of childbearing women become older and have preexisting medical conditions it necessary to have a complete medical history, and to be able to access health information seamlessly at the point of care to avoid missed care, duplicate testing, insufficient coordination of care, and increased medical costs (Ivory et al., 2017). At my facility strides are being taken to improve the sharing of health information; there has been an implementation of EPIC for every practice and specialty within the system. The system wide use of electronic health record (EHR) allows for primary care, obstetrics, and maternal fetal medicine to see patient encounters, laboratory results, and imaging. The connectedness of the EHR is important in L & D so that appropriate care can be provided regardless of whether it is 2:00 a.m. information can be obtained. Nursing informatics is used in many areas of L & D, the development of computerized charting has improved the workflow tremendously. As I contemplate on a primary area where informatics would be used, it is difficult to select one. Upon admission to L & D the patient’s admission database is reviewed and updated so the all health information is current within the system. Nursing informatics continues to be utilized as labs are drawn and the RN logs into another system called Clinical Collect to verify correct patient, labs ordered, and prints labels. As the patient labors charting is performed in EPIC and the fetal heart rate tracing can also be documented in the GE system. Being in obstetrics for 17 years many changes have been witnessed that have improved patient care, as well as nursing workflow, and these can be directly attributed to the advancement of health information technology.
As I completed the Pre-TANIC TIGER assessment this week, I realized that there are several areas of technology that I am uncomfortable with. I am extremely competent in the technology that I deal with everyday at work. That can be attributed to the education and training that was provided by the hospital system to ensure proficiency. Darvish, Bahramnezhad, Keyhanian, & Navidhamidi (2014) stated that nursing informatics has a huge role to play in improving the quality of care provided but that appropriate education is imperative to ensure the nurse use such technology correctly. One must feel comfortable with the technology they use and understand it’s importance, and in my workplace, I do. However, there are many areas of working with technology that are still foreign, and I have to ask for assistance when working on projects. I anticipate and desire to become more comfortable with technology as a result of this class.
References
Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality healthcare and the need for appropriate education. Global Journall of Health Science, 6(6), 11-18. doi:10.5539/gjhs.v6n6p11
Ivory, C., Fretytis, M, Lagrew, D., Magee, D., Vallejo, M., & Hasley, S. (2017). Standardizing maternity care data to improve coordination of care. Journal of Obstetrics, Gynecology & Neonatal Nursing, 46(2), 284-291. doi:10.1016/j.jogn.2016.07.013
Dr. Glenn,
I work in Labor and Delivery (L &D) and we often rotate to the Obstetrical Emergency Department (OBED). Yesterday a patient arrived at the OBED, she was a Gravida 1 Para 0, 30 weeks gestation and in obvious pain and stating she was having some vaginal bleeding. She was quickly taken to an exam room for assessment and placed on an electronic fetal monitor (EFM). Important knowledge and information was acquired through that assessment. Her abdomen was rigid upon palpation, uterine contractions showed an abruption pattern, fetal heart rate tracing was showing repetitive variables, vaginal bleeding was minimal, however her pulse was rapid and her blood pressure was low. The information was processed and generated based on previous experience, extensive training, and information obtained through the use of health information technologies indicating that the patient may be having a placental abruption. The obstetrician (OB) was called and the knowledge gained was disseminated based on the findings from assessment and the EFM tracing. The obstetrician arrived to the bedside and a quick abdominal ultrasound was performed noting that the patient was indeed having a placental abruption. The obstetrical emergency response team (OBERT) button was pushed and a stat cesarean section was called. The initiation of the OBERT button electronically notifies the L &D charge nurse, anesthesia, surgical technologist (ST), respiratory therapist (RT), blood bank and the Neonatal Intensive Care Unit (NICU) of an emergency and the need for imminent delivery. The patient was transferred to the operating room, it was 8 minutes from decision to incision. The infant was born via a primary cesarean section and was then taken to the NICU, the mother had to receive 4 units of packed red blood cells but was stable. Next week there will be an opportunity for discussion and feedback on this particular event. Obstetrical services have a round table discussion after such events that include Maternal Fetal Medicine, the OB, the charge nurse, the OB manager, the OB educator, staff nurses, anesthesia, and other involved departments and disciplines. Evaluating and processing the knowledge offers and opportunity for feedback on how the situation was handled, identifies what was done well and where there is room for improvement. Feedback is a useful tool to improve patient outcomes, as well as workflow and protocols. The Foundation of Knowledge Model is used in our every day experiences with our patients. Health information technology in combination with critical thinking, training, and past experiences can promote more positive outcomes in the healthcare setting (Dykes & Collins, 2013).
References
Dykes, P., & Collins, S. (2013). Building linkages between nursing care and improved patient outcomes: The role of health information technology. Online Journal of Issues in Nursing, 18(3), 1-17. doi:10.3912/OJIN.Vol18No03Man04
Hi Maria,
I too am in the Family Nurse Practitioner (FNP) specialty track. I believe that nursing informatics can be utilized to enhance the care an FNP delivers. Mysen, Penprase, & Piscotty (2016) stated that use of electronic health records (EHR) enhances care by providing access to valuable information such as built- in evidenced-based decision support and real-time data review. I just saw my FNP yesterday; he was able to access previous imaging and lab results and compare them to current results at the point of care with me. He also used the EHR to electronically prescribe my medication and to print out education material regarding my health issue. Today, he sent me a message through the patient portal attached to my EHR to ask how I was feeling. I can also use that same system to communicate questions or concerns to him. I believe that health information technology can enhance my future practice and be used to improve access to healthcare providers.
Susan
References
Mysen, K., Penprase, B, & Piscotty, R. (2016). Patient satisfaction with electronic health record use by primary care nurse practitioners. CIN: Computers, Informatics, Nursing, 34(3), 116-121. doi:10.1097/CIN.0000000000000218
I am always amazed by the continued advancement of healthcare technology. I have witnessed many advances in my 17 years as an RN. For instance, the management of diabetes has been made much easier for the patient utilizing technology to measure blood glucose levels, calculate carbohydrates, and administer insulin. In my own area of clinical practice waterproof wireless fetal monitoring has increased patient and nurse satisfaction. This advancement has allowed the laboring mother to have more freedom to ambulate during labor, use alternative birthing positions, as well as to labor in the shower or tub. I am excited to see where healthcare technology takes us next.
I can see how challenging it would be to have to go to several different databases to acquire the necessary information regarding vital signs, intake and output, and lab results. I am fortunate to work in a facility that has worked hard to implement a system that can be utilized relatively simply. I use a customized form of EPIC called ConnectCare. It was difficult to get used to in the earlier stages. However, nurses and other disciplines were asked to participate in the continued development of the system. I can access all of the patient's health information, see previous encounters, labs, and imaging results. I believe that this enables me to take better care of my patients. [Show Less]
