Electronic Health Records: Still-Evolving Tools to Help or Hinder Nurses

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Photo by Marilynn K. Yee/New York Times/Redux Photo by Marilynn K. Yee/New York Times/Redux

One of my earliest memories of electronic health records (EHRs) is the day I had to review a chart at another hospital in the city. As I headed over to medical records, I expected at worst a “big” chart—one of those 15-inch stacks of multiple folders from a long hospitalization. I wasn’t allowed access to their system to view the chart online, so I was escorted into a separate room, in which the printed-out chart was waiting for me.

But their electronic chart wasn’t “printer-friendly,” and the hard copy version now consisted of thousands of pages of documentation spread out over a nine-foot long table. Many […]

2016-11-21T13:01:40-05:00December 14th, 2015|digital health, Nursing, nursing perspective|2 Comments
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Nursing and Social Media’s Limits: Real Change Requires Moving Beyond Hashtags and Selfies

Karen Roush, PhD, RN, is an assistant professor of nursing at Lehman College in the Bronx, New York, and founder of the Scholar’s Voice, which works to strengthen the voice of nursing through writing mentorship for nurses.

by rosmary/via Flickr by rosmary/via Flickr

The recent #ShowMeYourStethoscope media campaign has been hailed as a powerful demonstration of the unified voice of nurses and what it can accomplish.

In case you’re not familiar with the incident that led to the outrage–after a Miss America contestant, Kelley Johnson (Miss Colorado), a registered nurse, delivered a monologue about her work for the talent portion of the yearly pageant while dressed in scrubs and wearing her stethoscope, hosts of the television show The View derided her, with one asking why she had on a “doctor’s stethoscope.”

There was soon a vigorous backlash across social media as nurses posted, blogged, and tweeted photos of themselves with stethoscopes, often adding moving descriptions of the situations where they use them or witty comments illustrating the absurdity of the hosts’ remarks.

I found it a heartening response to disrespect and ignorance. Nurses felt empowered and celebrated the opportunity to show the public what nursing is really about.

But has anything really changed? Yes, The View lost some sponsors and was forced to air an apology (albeit unconvincing […]

2016-11-21T13:01:57-05:00October 2nd, 2015|digital health, healthcare social media, Nursing, nursing perspective|8 Comments
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A Tech-Savvy Nurse’s Initial Take on Uses for the Apple Watch

Megen Duffy, RN, BSN, CEN, is currently working in hospice case management and writes AJN‘s iNurse column, which focuses on technology and nursing.

AppleWatchMegenPhotoBPMI’ve had my Apple Watch for several months now. I ordered it at 12:01 the morning they went on sale, and it arrived the Saturday after its Friday release. I was fairly certain I’d return it or sell it for a profit, but I still have it and keep finding new uses for it. I also have ideas for how it could be handy for a variety of fitness and health care scenarios.

Health tracking. Even at this early stage, though, patients and their families are using Apple Watches to track and enhance their health. The Watch tracks your heartbeat—not every second, but often enough that a useful bank of data results. Rumors say that a mystery port on the back of the watch will allow SpO2 tracking soon. I have already busted out my phone to show my cardiologist my heart rate trends, and it saved me from wearing a Holter monitor. That kind of thing is exciting!

Fitness wearables (e.g., Fitbit) and smart watches (e.g., Pebble) have been around for a few years, with sharply increasing popularity. The (often) colored plastic bands people wear around their wrists are the kind of wearable I mean. Pedometers (included in the wearables category) also […]

2016-11-21T13:02:11-05:00August 5th, 2015|digital health, nursing perspective, patient engagement, Patients|2 Comments
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Never Too Late: One Family Practice’s Shift to EHRs after 50 Years of Paper

Editor’s note: We hear a lot about the stress and lack of time for direct patient care that nurses (and physicians) have experienced with the movement to EMRs or EHRs. We’re in a transitional period, and in some instances the use and design of these systems has a long ways to go. But here’s a story with a positive slant, written by someone who might easily have responded very differently, given the circumstances. Change is inevitable; how we react to it throughout our lives, less so. 

By Marilyn Kiesling Howard, ARNP

Niklas Bildhauer/ Wikimedia Commons Niklas Bildhauer/ Wikimedia Commons

I am a nurse practitioner and my husband of 60 years is a family practitioner. We still work full time in our Gulf Breeze, Florida, practice. About five years ago, we first learned that our paper records were becoming archaic and that Medicare was planning to penalize providers who didn’t switch to the use of electronic health records (EHRs) by a certain date.

It was terrible news—we had 50 years of work in the paper chart genre, and were unsure about how to make the transition. Some who were in our position took the pending requirements as an opportunity to retire, but we weren’t ready for that.

Embracing a predigital innovation. In the 1960s, we started a small family […]

2016-11-21T13:02:42-05:00April 16th, 2015|digital health, Nursing, Technology|4 Comments
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Paired Glucose Testing With Telehealth Support to Empower Type 2 Diabetes Patients

Jacob Molyneux, senior editor

bloodglucosetestingType 2 diabetes is challenging for those trying to meet blood glucose target ranges, often requiring one or more daily medications, increases in exercise, changes in eating habits, and self-monitoring of glucose level. Those who are willing and able to learn about factors affecting their glucose level and to make small daily efforts in one or more areas have the potential to radically improve their sense of control over their diabetes.

This month’s Diabetes Under Control column, “Better Type 2 Diabetes Self-Management Using Paired Testing and Remote Monitoring” (free until April 1), presents a successful story of patient engagement in diabetes self-management. It describes the case of a participant in a clinical trial who, with clinician support, incorporated paired glucose testing (self-testing before and after meals) and telehealth (remote patient monitoring, or RPM).

The article is easy to follow and gives a series of biweekly updates on the patient’s progress. Before the study starts, she’s not very engaged in self-management. For example, she’s only testing her own glucose level three to four times a month. To get a sense of how much more empowered she’s come to feel by week 12 of the protocol, consider this brief excerpt: […]

2016-11-21T13:03:02-05:00February 13th, 2015|digital health, Nursing, patient engagement, Patients|4 Comments
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