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Health information Technology, EHRs, Meaningful Use, and Nursing

August 15, 2012

By Maureen Shawn Kennedy, MA, RN, AJN editor-in-chief

If you’re like most nurses working in a health care organization, you’ve been involved in a migration to electronic health records, computerized physician order entry (CPOE), or bar code medication administration.

If you’re lucky, nursing input was considered during the planning stages of all this health information technology (HIT). We’ve heard from many nurses (and have had a few submissions from nurses about their experiences—see for example the Reflections essay “Paper Chart Nurse”) who have had “issues” with the systems or who wonder, why the big push?

In the August issue of AJN, which is available online and on the iPad (download the app here), Susan McBride and colleagues John Delaney and Mari Tietze debut their three-part series on HIT. The first article, “Health Information Technology and Nursing,” examines the federal policies behind efforts to expand the use of this technology, the importance of meaningful use, and the implications for nurses. Subsequent articles upcoming in the fall will take a closer look at the use of HIT to improve patient safety and quality of care, and the important role nurses are playing—and could play—in this system-wide initiative.

It’s crucial for nurses to understand HIT. As the authors note,

“If HIT systems are going to truly improve care, nurses need a voice in their planning and development to ensure patient safety and system usability. The success of this technology depends on nurses informing the industry—at all levels, from influencing federal policy to providing feedback to their department and facility leaders—about what works best for the patient and the clinician. If wisely implemented, HIT may eventually free up more time for nurses to spend at the bedside . . . ”

We’d love to hear your experiences: Were nurses consulted and included in planning the implementation of HIT at your facility? Was there a thoughtful plan to “roll out” adoption? Do you see computerized health records as a help or hindrance? What would you change? Let us know how it is in your practice area.

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3 comments

  1. The use of Electronic Medical Records has taken over “paper charting” in a very positive way. For many years issues arose between nurses and doctors because of unknown abbreviations, unclear handwriting, and incorrect dosing and orders. As a nurse in the NICU, the EMR has made a tremendous improvement in decreasing in breast milk errors (wrong patient, wrong milk), dosing errors, etc. At first the older nurses were scared for the “change” that would come from using a new format of documentation, and using technology that was unfamiliar to them, however, it wasn’t long that EMR and computer charting because almost a first nature. With the assistance of “safety stars”, we were up and running quickly and now we almost wonder how we ever used paper charting in the past. I think it is great in the adult areas that with the use of EMR you could possibly view the patient’s health history and medications, appointments associated with each patient. This assists the physicians with the care of the patient and is helpful in the event that the patient doesn’t have recollection of their past medical history.

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  2. I truly believe that the implementation of Electronic medical records is a blessing not only for the nursing profession but for the health care industry in general. I have been able to experience the transition from regular paper charting to electronic medical records in the organization I work for and I must say that I feel that it is a great improvement. The process of change has been tortuous because many nurses and physicians were reluctant to use computers at the beginning but after a while electronic charting has become a great tool and a way to improve patient care. As an operating room nurse I am able to document faster and spend more time making sure my patient is safe and receiving the best care available. Another advantage of electronic medical records is that documentation occurs in real-time, making the patient record a better description of the care provided.

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  3. Great article. I found that our practice went with the requirements, involved the nurses in the initial trial period, but after going live with certain technologies, the nurses weren’t “heard” when they had more feedback after using in the real environment. Working in a testing database is never enough, and a period of “live” work should be part of the go-live timeline for the projects. IT can frequently get caught up in “completing” their initial work, but the feedback after go-live is sometimes the most valuable.

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