A monumental but favored changed was brought to the healthcare field by information technology. In 1999 The Institution of Medicine released a report called “To Err is Human. This report was to bring awareness on ways to prevent the deaths or injury of patients caused by medical inaccuracy (Donaldson, n.d.). Years ago, people who were patients trusted those people that were in the medical field. They believed everything their doctor told them and never questioned their doctor. The Err is Human report shed light on the hidden facts about what occurred behind closed doors in the health care industry. There have been extraordinary advancements within the healthcare industry that improve patient safety, amplify communications between health care providers and ameliorate the overall outcomes of the healthcare system.
When I first got out of nursing school in May of 2014, I took a job in a major city and they were already charting on electronic systems. I enjoyed the electronic system. I left that hospital after 5 months and took a job closer to home in a smaller hospital. That hospital was still paper charting. It was a different world for me. I couldn’t read the doctors hand writing which could potentially cause me to order something incorrectly. I always had to track down a chart because someone else had it. Medication’s were charted on paper which could easily have been given to the wrong patient if the nurse was not careful. Paper charting to me is a cause for a significant problem. There are many issues with paper charting that could lead to a decrease in the patient’s safety. Electronic records have made a tremendously positive effect on patient care (Manca,2015.).
The biggest area that I feel that the electronic records has significantly increased patient safety is during administration of medications. There are many check-points that medications have to go through before reaching the patient. First the doctor orders the medicine the electronic system will flag the medication if the patient is allergic to the medication, it will flag the system if the medicine cant interact with something else the patient is on and it will also flag them if the medication will have an effect on the patient’s lab that are already outside of the normal range. Then the pharmacist checks the medication for allergies, interactions with other medications the patient is on and checks their lab levels. After the pharmacist has cleared the medicine then becomes available for the nurse to retrieve from the medicine machine. The nurse must access the medicine machine via scanning their badge and then go under the patient’s profile to pull the medications. Once in the patients room the nurse must log onto the computer and go under the patient’s chart, scan the patient’s arm band and then scan the medications. If nurses follow the medication protocols set for them by their hospitals policies there would be minimal errors happening during medication administration. Data can be collected by running reports of what nurses are scanning their patient’s armbands and medication. Using this data, the mangers can discuss and reinforce the importance of following the medication administration polices and how it helps prevent medication errors.
Nurses must acquire the skills needed to become comfortable and proficient in using electronic records. Daily nurses us our skills to observe, recognize, collect data, interpret the data and make an educated decision on what is in the best interest of our patients. Electronic records has made a significant impact on nursing such as all patient information is easily accessible and easy to read, increases patient safety, allows for more one to one interactions between the nurse and patient and it also allows for the providers to collaborate easier through the electronic records (“Technology in Nursing Today”, 2019). Technology has momentous changes over the years and those changes have had a positive impact in the healthcare field. Technology is not a full proof way of preventing accidents but it has drastically increased the patient safety.
Donaldson, M. S. (n.d.). An Overview of To Err is Human: Re-emphasizing the Message of Patient Safety. Retrieved February 24, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK2673/
Manca, D. P. (2015, October). Do electronic medical records improve quality of care? Yes. Retrieved February 24, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607324/
Technology in Nursing Today. (2019, August 9). Retrieved February 24, 2020, from https://thejournalofmhealth.com/technology-in-nursing-today/
Discussion: The Application of Data to Problem-Solving
In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.
Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.
In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.
- Reflect on the concepts of informatics and knowledge work as presented in the Resources.
- Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.
By Day 3 of Week 1
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.
I really liked your post. It captures what I feel like a lot of us have experienced, especially in our era of practice. I imagine all of this age of knowledge and data reliance must have evolved from our aversion to the errors of the past. I can’t imagine, in 2020, having to rely on any physician’s handwritten orders. Now it just seems silly. How could we have ever thought that nurses would have anything but errors, given how physicians seem to universally write. In that sense, the evolution of knowledge and data and getting away from handwriting and paper is an unavoidable and welcome age. I hope we continue to refine and simplify the EMR and all sorts of data-driven tools to promote the safest experience for our patients.
There were two points in the papers that you selected that I thought were good areas to put part of the focus on. First, in the Manca (2015) paper, I feel like what she is suggesting is that if we want to avert medical errors, we need to start with the end in mind and cut down the potential for errors at any-of-many sources. She suggests that doctors tend to have a widely favorable view of the use of EMR because it simplifies their work lives. It allows them to see more patients with ease. As a result of their simplified access to patient histories, lab reports, and other data, they waste less time searching for paper reports and are more efficient (Manca, 2015). I think this leads to a better quality of life and decreased fatigue on the physician. I also believe that this fatigue reduction encourages a reduction of care-based errors. It is like cutting the head off the snake. This is reducing the overall source of potential error. This is what I mean when I say ‘beginning with the end in mind’.
Second, it seems like Donaldson’s (2008) paper has become a seminal and important work in our field. I see it referenced to a lot in several more contemporary works. I feel like when she is referring to changing the workplace culture in an effort to reduce medical error, she is really highlighting greater respect for, and greater latitude within, the role of nurses. I feel like her intent is to elevate the perception of nursing as a critical science and thereby empower nurses with access to better tools and knowledge. She suggests that all team members should pay attention when any staff challenges the safety of a care plan (Donaldson, 2008). I think this speaks to the latitude of nurses who are empowered as knowledge workers as opposed to mindless employees who simply carry out a physician’s orders. I also believe that when she suggests that we should simplify handoffs and protocols, she is suggesting that this may be accomplished through elevating the nurse task-role into more of a clinical leadership role via increased access to knowledge. One great message that feels very empowering and inspirational to me is that I believe she is suggesting that we should cast off the shame associated with clinical errors by improving our knowledge systems. She gave several great examples that were all suggestive of a caregiver with their hands tied by lack of knowledge resultant of system inadequacy and complexity. What a great paper.
Donaldson, M. (2008). An Overview of To Err is Human: Re-emphasizing the Message of Patient Safety. [Review of the book Patient safety and quality: An evidence-based handbook for nurses, by R. Hughes]. Agency for Healthcare Research and Quality. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2673/
Manca, D. (2015). Do electronic medical records improve quality of care? Yes. Canadian Family Physician, 61(10), 846–851. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607324/