Not All Signs of Potential Harm Are Quantifiable
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”