NR 512 Week 6 TD: HealthIT Topic of the Week and Impact on Practice
HealthIT Topic of the Week and Impact on Practice
NR512
NR 512
NR 512 Week 6 TD:
... [Show More] HealthIT Topic of the Week and Impact on Practice
Patient safety is regarded as the overall goal in healthcare. Although the healthcare industry has made significant advances in preventing medical errors that impact patient safety, there are still too many errors that occur everyday. I choose the use of electronic medical records (EMRs) and how they impact patient safety as my HealthIT topic. EMR systems have many advantages and the potential to improve patient safety, reduce medical errors, increase patient satisfaction, provide information security,, reduce medical care costs, and organizational efficiency all of which potentially improve health outcomes for patients (Top et al., 2015). The nurses perception of the reliability of the EMR system greatly impacts the belief that the use of an EMR can improve patient outcomes. I choose this topic because when I was a new graduate nurse, I had a near-miss event involving a medication adverse interaction with another medication I administered. At that time, there were no EMRs or clinical decision support systems (CDSS), so I did not have any warnings that there would be a possible adverse interaction between the two medications (one of the medications was a study medication, so very little information was available). The use of a CDSS within an EMR has the potential to significantly decrease medical errors. Even highly experienced nurses may struggle with rapid data processing when caring for complex patients which then can interferee with timely and correct decision-making (Top et al., 2015). EMR systems with CDSS in place can assist with this decision-making in a timely manner.
As an advanced practice nurse educator, I hope to further develop CDSS systems in the field of obstetrics. As a labor nurse, you are responsible for both the mother and unborn baby. Today, we are seeing women with complex health conditions become pregnant and this requires specialized education, knowledge, and skills to respond to rapid changes in the patient status. We currently have a CDSS for early recognition of sepsis and hemorrhage but I would like to focus on on a CDSS within our perinatal system for early detection and recognition of hypertensive episodes and the ensuing results it can have on the fetus. This type of CDSS has the potential to improve patient outcomes for both the mother and baby.
Michele
Student Reply:
Great post! I personally work at a facility that uses at least four different applications to access patient data. As a nurse, this is frustrating and time consuming when trying to obtain patient information. Many of our providers have their own source of electronic health record (EHR) in their offices so we do not have access to the prenatal record upon admission so we have to wait until the office faxes the record over. We often have to repeat pertinent lab tests because we do not have the records, particularly on the weekends and at night. Additionally, the EHR’s use different terminology and format so again more time is spent deciphering the data. Interoperability and semantics between EHR’s is necessary to users embracing the use of EHR’s and the benefits being noted, otherwise, users will not adapt easily to using EHR’s (Martinez-Costa, Kalrab, & Schulz, 2014). The hospital has its main application for all patient documentation but it does not work well for obstetrics documentation. We moved to perinatal application for documentation and this has made a significant difference for nursing documentation but the downside has been double documentation for some items. Initially the interoperability between the main EHR and the perinatal system was limited but we now have a bidirectional interface.
Reply to Professor question: What is a “Never Event” and is a HAI a never event?
This was a great question. A “Never Event” refers to medical errors or adverse events which are clearly identifiable, measurable, and usually preventable which result in death or significant disability that should never occur at a healthcare facility ("Never events," 2018). Since its inception in 2002, the list of never events has been expanded to include 29 reportable events under seven categories. The categories include:
• Surgical or procedural events- e.g.wrong site surgeries
• Product or device events- e.g. use of contaminated drugs, devices, or biologics
• Patient protection events- e.g. Discharge or release of a patient/resident of any age, who is unable to make decisions, to other than an authorized person
• Care management events- e.g. a medication error involving one the Five Rights of Medication Administration. Also includes a maternal or neonatal death that is associated with a low-risk pregnancy
• Environmental events- e.g. events involving electric or gas errors as well as those involving restraints or bedrails
• Radiologic events- errors involving the introduction of a metallic object into the MRI area
• Criminal events- e.g. abduction of a patient, sexual assault or a person impersonating a physician or nurse.
Although hospital-acquired infections can lead to serious complications, they are not technically considered a “Never Event”. All members of the healthcare team are responsible for preventing never events but the reality is these events still occur which is disheartening for consumers who put their trust in the healthcare team.
References
Martinez-Costa, C., Kalrab, D., & Schulz, S. (2014). Improving EHR semantic interoperability: Future vision and challenges. Studies In Health Technology And Informatics, 205, 589-593. http://dx.doi.org/10.3233/978-1-61499-432-9-589
Never events. (2018). Retrieved from https://psnet.ahrq.gov/primers/primer/3/never-events
Nibbelink, C. W., Young, J. R., Carring, J. M., & Brewer, B. B. (2018, June). Informatics solutions for application of decision-making skills. Critical Care Nursing Clinics of North America, 30(2), 237-246. http://dx.doi.org/10.1016/j.cnc.2018.02.006
Top, M., Yilmaz, A., Karabulut, E., Otineo, O. G., Saylam, M., Bakir, S., & Top, S. (2015, May). Validation of a nurses’ views on electronic medical record systems (EMR) questionnaire in turkish health system. Journal of Medical Systems, 39(67), 1-9. http://dx.doi.org/10.1007/s10916-015-0250-2 [Show Less]