Nurse Informaticists Address Texas Ebola Case, EHR Design Questions

By Susan McBride, PhD, RN-BC, CPHIMS, professor and program director of the Masters in Nursing Informatics Program, Texas Tech University Health Sciences Center, and Mari Tietze, PhD, RN-BC, FHIMSS, associate professor and director, Interprofessional Health IT Program at Texas Woman’s University (TWU). The views expressed are those of the authors and don’t represent those of Texas Tech or TWU.

Silo_-_height_extension_by_adding_hoops_and_staves EHRs: information ‘siloes’ or interprofessional collaboration?

The recent Ebola case in Dallas—in which a patient was admitted to the hospital three days after he visited the ER exhibiting symptoms associated with Ebola and reporting that he’d recently traveled from West Africa—brought this global public health story close to home for many of us residing in the area. As has been widely reported, the patient died last week after nearly 10 days in the hospital.

An initial focus of media coverage was the suggestion that a failure of nursing communication had contributed to the release of the patient from the hospital on his first visit. Partly reflecting evolving explanations offered by the hospital, the media focus then shifted to a potential flaw in the hospital’s electronic health record (EHR) system, in which information recorded by a nurse about the patient’s travel history might not have been visible to physicians as well. […]

2016-11-21T13:03:43-05:00October 17th, 2014|digital health, infectious diseases, Nursing, nursing perspective, Public health|8 Comments
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Telehealth as ‘Disruptive Innovation’ in Nursing

A patient uses telehealth equipment to communicate with his nurse. Photo courtesy of Janet Grady. A patient uses telehealth equipment to communicate with his nurse. Photo courtesy of Janet Grady.

“Telehealth: A Case Study in Disruptive Innovation” is a CE article in AJN‘s April issue. The author, Janet Grady, vice president of academic affairs and chair of the Nursing and Health Sciences Division at the University of Pittsburgh in Johnstown, Pennsylvania, describes the concept of disruptive innovations in nursing and delves into the evolving field of telehealth as a current example.

The article considers the following:

  • uses and potential uses of telehealth in chronic and acute care, home care, and rural medicine, and the evidence supporting its use.
  • obstacles to wider use and acceptance of telehealth, which include cultural resistance within nursing, licensure issues across states, reimbursement challenges, and the need to adapt nursing curriculum to these new ways of delivering care.
  • forces that drive or obstruct disruptive innovations like telehealth.

Here’s the article overview:

Technologic advances in health care have often outpaced our ability to integrate the technology efficiently, establish best practices for its use, and develop policies to regulate and evaluate its effectiveness. However, these may be insufficient reasons to put the brakes on innovation—particularly those “disruptive innovations” that challenge […]

2016-11-21T13:05:00-05:00April 18th, 2014|digital health, Nursing, patient engagement|1 Comment
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Health Technology Hazards: ECRI’s Top 10 for 2014

hazard/jasleen kaur, via Flickr hazard/jasleen kaur, via Flickr

It’s that time of year again—the ECRI Institute has released its Top 10 Health Technology Hazards for 2014 report, and with it come new (and old) hazards to keep in mind.

Alarm hazards still posed the greatest risk, topping the list at number one for the third year running. Other repeat hazards included medication administration errors while using smart pumps (in at number two), inadequate reprocessing of endoscopic devices and surgical instruments (number six), and, at number eight, risks to pediatric patients associated with technologies that may have been designed for use in adults (such as radiology, oxygen concentrators, computerized provider order–entry systems, and electronic medical records). For an overview on these, see our posts from 2012 and 2013.

And here’s a snapshot of new hazards that made the cut, along with some of the report’s suggestions on how to prevent them.

Radiation exposures in pediatric patients (#3)

The risk: Although computed tomography (CT) scans are valuable diagnostic tools, they are not without risk, and children, who are more sensitive to the effects of radiation than adults, are more susceptible to its potential negative effects. According to the report, new empirical studies suggest that “diagnostic imaging at a young age can increase a person’s risk […]

2016-11-21T13:05:37-05:00January 15th, 2014|digital health, Nursing, Technology|1 Comment
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Do EHRs Rob Nurses of Voice and Oversimplify Description of Patient Care?

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology. Editor’s note: this post has been slightly revised for clarity since its initial publication a day ago.

Heroines of Nursing, mixed media collage by julianna paradisi, 2013. Text by Florence Nightingale
Heroines of Nursing, mixed media collage by julianna paradisi, 2013. Text by Florence Nightingale

Previously I’ve written that I have a new employer. Part of this transition is relearning how to use the electronic health record (EHR). Fortunately, this new employer uses the same program as my last. However, that version was EHR-lite compared to the one we use now.

For instance, the new system contains an abundance of “smart phrases” that are used to lessen time spent writing nursing notes. If you are unfamiliar with smart phrases, an uncomplicated explanation is that they are preconstructed phrases chosen from those commonly found in charting, such as “The patient arrived ambulatory for IV infusion.” Instead of typing in this phrase, nurses can click on it from a computer screen menu, and voilà! The entire phrase is electronically inserted into the notes.

Smart phrases, like charting by […]

2016-11-21T13:06:30-05:00September 23rd, 2013|digital health, nursing perspective|7 Comments
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My Supporting Role

In nursing as in acting, connecting is key.

The Actor, by Picasso/Wikimedia Commons

When I graduated from nursing school, I was given a pen, stethoscope, tape, and scissors. In my current practice as a pediatric nurse in acute care, I’ve found that it’s all too easy to let technology with all its conveniences and safety measures take center stage. I have a bedside computer, cell phone, and cardiac monitor, among many other technical tools.

Yet the importance of creating a therapeutic milieu for patients and families has remained unchanged. Now the challenge I have is how best to use technology as a prop and a backdrop and not as the main event, how to prevent data collection from creating a barrier between me and my patient.

Of course technology has many advantages. In the past, I had to spend long stretches of time away from the bedside, creating written medications sheets and care plans. I remember spending hours looking up each medication dose and side effects in reference books. Transcribing written doctor’s orders and medication information was an art form. Now we obtain the most current doctor’s order and medication information in seconds with a click of a button.

Making technology an asset, not an obstacle.

While these conveniences have given me more […]

2020-02-07T11:15:00-05:00September 16th, 2013|digital health, nursing perspective, patient engagement, Patients|3 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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