NURS 6501 Wk 1-Informatics

NURS 6501 Wk 1-Informatics

NURS 6501 Wk 1-Informatics

On November 29, 1999, the Institute of Medicine (IOM) released a report called To Err is Human: Building a Safer Health System. The IOM released the report before the intended date because it had been leaked, and one of the major news networks was planning to run a story on the evening news. Media throughout the country recognized this opportunity for a headline story describing a very large number of hospital deaths from medical errors. The Institute of Medicine’s report on medical errors1 dramatically called attention to dangers inherent in the U.S. medical care system that might cause up to 98,000 deaths in hospitals and cost approximately $38 billion per year. In summary, the Quality Chasm series of reports detailed several key attributes of architecture needed to build a safe, consistently high-performing health care system. One area of research focus was in patient outcomes associated with some technology-based interventions (IOM Report, 1999).

The advantages of health information technology (IT) include facilitating communication between health care providers; improving medication safety, tracking, and reporting; and promoting quality of care through optimized access to, and adherence to guidelines. Health IT systems permit the collection of data for use for quality management, outcome reporting, and public health disease surveillance and reporting (McGonigle, D. & Mastrian, K. G., 2018).

The potential to improve patient safety exists using medication alerts, clinical flags and reminders, better tracking and reporting of consultations and diagnostic testing, clinical decision support, and the availability of complete patient data. Data gathered using health IT can be used to evaluate the efficacy of therapeutic interventions and have been demonstrated to lead to improvements in the practice of medicine. Alerts can optimize adherence to guidelines and evidence-based care. Record uniformity can be designed to reduce practice variations, conduct systematic audits for quality assurance, and optimize evidenced-based care for common conditions. Health IT is increasing patient engagement as consumers of health care. It allows patients access to their medical records, which helps them to feel more knowledgeable about their conditions and encourages them to actively participate in shared decision making.

Outside the patient encounter, it can improve follow-up for missed appointments, consultations, and diagnostic testing. A health care provider can search for specific cohorts of patients within a practice to monitor and improve adherence to indicated health care such as mammograms, Pap tests, or measurement of hemoglobin A_1c levels (American College of Obstetricians and Gynecologist, 2015)

NURS 6501 Wk 1-Informatics

Patient care information systems (PCISs) are lauded as one of the core building blocks for a safer health care system. PCISs are broadly defined here as applications that support the health care process by allowing health care professionals or patients direct access to order entry systems, medical record systems, radiology information systems, patient information systems, and so on. With fully accessible and integrated electronic patient records, and with instant access to up-to-date medical knowledge, faulty decision making resulting from a lack of information can be significantly reduced. Likewise, computerized provider order entry (CPOE) systems and automated reminder systems can reduce errors by eliminating illegible orders, improving communication, improving the tracking of orders, checking for inappropriate orders, and reminding professionals of actions to be undertaken. In this way, these systems can contribute to preventing under, over, or misuse of diagnostic or therapeutic interventions

In their daily practice, nurses in many US health care settings have implemented broad-based transformation of healthcare delivery utilizing electronic health record (EHR) (Warren, J. & Connors, H. R., 2007).

Information technology has made it possible for traditional assumptions about provider-patient relationships to change. Students today are also taught very different relationships that call for them to work with patients to improve their health and functioning. No longer is the provider the only one with a protected body of knowledge. We’ve seen an enormous democratization of information, with consumers having access to more health information. This changes the provider-patient relationship. People now can manage various aspects of their life through the Internet and online services (Laureate Education, 2012b).

My Emergency room went live with Electronic Health Record since June of 2016, and this has made a significant difference in the care we provide and patient outcome. We can triage patients more rapid and accurately utilizing the electronic medical record to update health history and especially medication history. Being able to dial into Patient’s outside medication records gives a more in-depth knowledge the care needed for the patient. Just yesterday, the medics brought in a 40-year-old male with loss of consciousness and hypotensive, the wife was only able to tell us that he had some sort of spinal surgery about 1 week ago. She could not give a medication history but stated he had the “last pain pill” this morning. I was able to ascertain via his electric outside medications that that he had filled a prescription for 30 tablets of 10/325mg Percocet just 6 days ago. At that point, he was immediately given Narcan (a reversal agent for opiate). He was also fluid resuscitated and was discharged home a few hours after that. Prior to the implementation of the EHR, he could have had a poor outcome including death.

 

References

Committee Opinion . (2015, january). Retrieved from American College of Obstetricians and Gynecologists: https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Patient-Safety-and-Quality-Improvement/Patient-Safety-and-Health-Information-Technology

Donaldson, M. S. (2006). Patient Safety and Quality: An Overview of To Err is Human . Retrieved from NCBI: https://www.ncbi.nlm.nih.gov/books/NBK2673/

Laureate Education, Inc. (Executive Producer). (2012b). . (n.d.). Electronic Health Records. Baltimore, MD.

McGonigle, D. &. (2018). Nursing Informatics and the Foundation off Knowledge. Burlington MA: Jones Bartlett.

Warren, J. &. (2007, February). Health Information Technology can and will transform Nursing Education. Retrieved from Nursing Outlook: https://www.nursingoutlook.org/article/S0029-6554(06)00324-1/fulltext

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