Week 2: Experiences With Healthcare Information Systems (graded)
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This week's graded discussion topic relates to the
... [Show More] following Course Outcome (CO).
• CO1 Describe patient-care technologies as appropriate to address the needs of a diverse patient population. (PO 1)
Share your experiences with healthcare information systems, past or present. Has it been an easy transition or difficult? Why do you believe your experience has been positive or negative? If you are currently not working, how has the medical record exposure in nursing school impacted your current knowledge?
Hello Instructor and Class,
My experience with healthcare information system has always been a positive one. I have a growth mindset that motivates me to be open to new ideas and systems. I always thought in the past that we are limited in resources to provide safe and quality patient care. It used to be a lot of medication errors and limitation in patient history information. Nowadays, information is given to us in a more clear and safe ways and I see that patients care has improved. However, Information Health System continues to need everyday enhancement and nurses, as a main witnesses of evidence-practice, can provide new thoughts and concepts to improve it. According to Jennifer Tieman and Sandra L. Bradley, “The online environment has changed the ways in which health consumers and health professionals seek and engage with health information, but our understanding of how effectively information is being provided and used through this medium remains limited”.
Transition experience had dual movement because, naturally everybody has his or her comfort zone of using the same program, plus for some age group response to computer program changes is different. Some of my colleges had trouble with transition process because their computer knowledge and experience was limited.
Our hospital’s nursing education department was very supportive. Nursing staff was provided with technical and information support for a few months. Additionally, super users were created in each unit to continuously provide help to nurses who had trouble with computer transition.
The Information Health System modification is an ongoing process and it does not only reflect on medical personal, but on our patients as well. Today’s Electronic Medical Records (EMR) can be opened trough patients’ portal via computer and we are teaching our patients everyday how to use patient’s portal applications. However, patients, at time, like to have a printed medical record because they do not have a computer at home or they are afraid that their medical record will be stolen. In addition, patients may speak and/or read different language, and it could limit his/her ability to understand a process of obtaining and reading medical records. Our hospital has made some changes in patient portal access and added three main languages ( Spanish, English,
Russian). However, patient diversity in our hospital is much bigger and we need to make improvements in our system to support each patient who is unable to speak and/or read English. I am excited to witness and be a part of the future improvements in the system.
Reference:
Tieman, J., & Bradley, S. L. (2013). Systematic review of the types of methods and approaches used to assess the effectiveness of healthcare information websites. Australian Journal Of Primary Health, 19(4), 319-324. doi:10.1071/PY13030
Hebda, T., & Czar, P. (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.). Boston, MA, Pearson.
Answers to classmates
Professor and Class,
I mentioned in the introduction that I work on a Progressive Care Neurology unit. In June of this year we moved to the brand new tower that has been under construction for three years. It was very exciting, and everything was brand new with many improvements and new equipment and technologies. There is always stress associated with growth as everyone tries to learn and get efficient with all the newness that comes at once. It is starting to flow better after months of adjustment! One of the really neat things that came with our new tower was a system called "The Get Well Network".
Every room has a TV equipped with access to the internet, medication information, multiple health journals, and reliable websites for patients to educate themselves on their own condition. There is an introduction video explaining the use of these amazing resources that every patient is required to watch on admission before the TV will allow any channels or movies. I absolutely love it. I've been able to teach so many interested patients research their own medical needs. I love having reliable resources at my fingertips right there in their own room to access.
Hello ………,
I am excited about the changes in your hospital. This changes will not only reflect on you, but on patients as well. Our hospital is very old. We celebrated the 100 year university a couple of years ago. The patients still use old “box TV” which doesn’t always work. Additionally, old landline phones are still used. The hospital requires the patient to pay a daily charge for the use of the TV and phone. It is sad that in 2018, patient continue to experience old fashion system.
“The adoption of information technology (IT) has been slow in long-term care for many reasons, including fragmentation among facilities, limited operating budgets, high implementation costs, and multiple providers in one facility” (Hebda & Czar, 2013, p. 117).
I wish my hospital will update and improve their technology so that patient’s comfort will be accommodated better and it will help them to use new technology to research their own
medical needs. However, at time of emergency, such as Hurricane Sandy, a landline is the best way of communication.
The new system education process takes a lots of time and patience. It is good it took for your hospital only two months to learn how to use a new system, it can take significantly longer and there can be a lot of resistance from the staff. Although, patients come and go, but their education process never stops.
I have been a nurse for 12 years at a small community hospital. I feel like I have seen quite a bit as far as the technology goes around our hospital. When I started, we were all strictly paper charting. Paper MARs, paper flowsheets, paper orders, and labs. Then we progressed to have electronic labs and the barcode reading system for medication administration. Progressively we moved to order entry through the computer however, our secretary was entering the orders except for the medications. If there were medications on the order sheet, we had to fax them down to the pharmacy and they would enter all the medications. Fast forward to where we are now. We now have all electronic charting, but there is a catch. According to Hebda, “CPOE is a major initiative on the part of Institute of Medicine and Leapfrog group to improve the quality of care and decreased medication errors.” (Hebda, 2013) Most of our younger physicians are very good at putting in their own orders but a lot of the older ones really struggle and ask us to do them. We can take verbal orders from the physicians and place them in the computer, but it is supposed to only be when they cannot get to a computer to put them in for themselves. As you can imagine this policy is constantly be taken advantage of. I have had patients crashing before our eyes and I don’t have a few minutes to put orders in the computer with a physician standing in front of me telling me what to place in the computer. At that point you must look at them and say politely, “I’m very sorry at this point I don’t have time to put them in the computer could you do that please?” Most of the time they are receptive but occasionally, you will get push back for asking them to do their job appropriately.
As far as the transition has been, I think it truly depends on your age. I am only 31, so for me to have technology it wasn’t that hard for me to pick up on how to chart in a new electronic record. When I was in school most of my charting was done on Cerner or Meditech, depending on which hospital we had clinicals at. In my experience I have seen most of the older people struggle with the technology and the younger people soar. Unfortunately, I think that it is just a generation gap. As a child we got our first computer in our house when I was 4 so for me I cannot remember a time where we didn’t have a computer. It was second nature for me to pick up everything that was electronic.
Although for some it was a difficult transition I do think this helps increased the quality care of that we give to our patients. According to Baba Farid University Nursing Journal, “Nurses who are skilled in using technology and data bases can retrieve information to make sound decisions based on evidence-based practice.” I find this especially true. If you have all the facts in front of you then you can use your critical thinking skills and
nursing judgement to make the best decision for the patient to deliver safe, effective quality centered care.
Hi ………,
Thank you for your post, I am totally agree with you that experienced and technology savvy nurses are processing computer information easily, applying evidence-based practice and making the best decisions to deliver the safest patient care.
However, we are all different and each of us has own views, opinions and reflections to the new changes in Information Health System, for example, I am currently precepting new graduating nurse, who is much younger then me and I would assume he should like computer charting. To my surprise, he told me that EMAR created very inconvenient for him and by his opinion the nursing charting system should be different. On my question if he had experience to work with different system, he said “No”. Although, he doesn’t like this system, he could be the one who will improve that system in the future. “Nurses must be involved in identifying and defining data elements that an interface may be able to supply. One way to ensure this is to recruit
staff nurses to provide input during the interface design”( (Hebda & Czar, 2013, p. 270).
Reference:
Hebda, T., & Czar, P. (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.). Boston, MA, Pearson. [Show Less]