Nurses vs. Computers: Predicting Risk of Patient Harm

Not All Signs of Potential Harm Are Quantifiable

From chego101, via Flickr

Hospital nurses have many, many responsibilities and tasks, but one of the most important is to ensure patient safety by assessing patients for changes that can signal worsening of a condition or a new potential harm. Creating special units like ICUs, recovery rooms, and step-down units; flags on charts; various alarmed monitors; and safety huddles are a few of the ways hospitals have tried to identify potential problems. Now we have computerized tools to do this—or do we?

The complaint I have heard most from nurses about the electronic health record (EHR) is its inability to capture all the nuances of patient care or various patient problems, especially those that don’t involve easily quantifiable measures like heart rate or lab values. (For more detail, read our November 2016 report on nurses’ concerns with EHRs.)

One cannot accurately use a check mark to convey certain patient behavioral parameters or the “can’t put my finger on it but something’s going on with this patient” assessment that experienced nurses often make. In the April issue of AJN, we published an important study that investigates just this issue: “Identifying Hospitalized Patients at Risk for Harm: A Comparison of Nurse Perceptions vs. Electronic Risk Assessment Tool Scores

Deciding Whether […]

Unheeded Warnings, Last Words, the Value of a Bathtub: More Notes from Alabama

Sue Hassmiller, the Robert Wood Johnson Foundation Senior Adviser for Nursing, has been blogging from the tornado-damaged area in Alabama. This post elucidates some of the philosophic and strategic context for the emotionally challenging Red Cross volunteer work she’s currently involved in. This and all previous posts in this series are being collected on a separate page for easy reference.—JM, senior editor/blog editor

Human Caring
It amazes me how much compassion there really is in the world. You don’t always see it day to day, but during disasters it’s the definitive order of the day. It is so refreshing to be a volunteer in this temporary health care structure we are working in and not have to worry about 10-minute office visits or rushing in and out of patients’ rooms trying to get it all done before the bell rings for the day. The Red Cross simply (with guidelines, of course) directs us to attend to all human needs (ok, yes, we do have forms to fill out). Therefore, a visit to a distraught family could take 10 minutes, 10 hours, or 10 months.

The devastation is so great here that as long as there are people to volunteer and the financial resources to carry on, this job will go on for years. A few of the groups that are here besides the Red Cross […]

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