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Health information Technology, EHRs, Meaningful Use, and Nursing

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 […]

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Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2016-11-21T13:09:28-05:00August 15th, 2012|digital health, nursing perspective|3 Comments

A Slyly Witty Essay on an Apparently Aphasic Patient, Plus a Plug for Submissions

By Jacob Molyneux, senior editor/blog editor

I edit many types of articles, but one certainty each month is that I’ll be editing our Reflections essay. This month’s is by Kathryn Mason, MSN, RN, PCCN, formerly a clinical educator and now a QM/PI project manager at the same hospital. Called “A Man of Few Words,” the essay is about that patient who is hard to connect with because she or he can’t (or won’t) speak. The piece has a surprising ending. Here’s an excerpt from the opening paragraphs, but please click the title above and read the whole short essay.

The nursing care plan called for dressing changes to the foot four to five times per week. I made at least three of those visits each week and my routine with Willy became fairly rote. He sat in the same chair each time, with his foot propped on an ottoman; I was positioned in front of the foot, my back to his decrepit television. I would chatter away to compensate for his lack of dialogue, regaling him with stories of my children, the weather, or whatever other bits of news came to mind. Sometimes he would give me his rapt attention and at other times he would be more intent on the news or a game show. (To read more, click here.)

To submit an essay for consideration, please take two minutes to read the Reflections guidelines, a short Word file that describes what we are looking for and not looking […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:09:29-05:00August 13th, 2012|nursing perspective|0 Comments

Campaign-Inspired Hot Summer Friday Thoughts

By Shawn Kennedy, AJN editor-in-chief

Commuting in and out of Manhattan gives me plenty of time to listen to the radio and of course, with Election Day a mere 90 days away, the presidential campaign offers reporters a lot of fodder for commentary. And of course, the evening papers and television stations—both national and local—augment what’s on the radio all day. Here’s a sampling of health care–related campaign news that I’ve heard and read this week.

According to the Kaiser Foundation’s Health Tracking Poll, July figures show that overall, two thirds of Americans support Medicaid expansion under the Affordable Care Act (ACA), but when it comes to whether their own states should expand programs, support drops to less than half (49%), while 43% want to keep the status quo. Importantly for candidates, “four in 10 Americans say they could still change their minds on the law.”

My take: The failure of the Democrats to adequately explain the reforms, together with the misinformation from the Republicans (death panels—need I say more?), are leaving the public confused. The winner in November will be the candidate who can convince the voters that the ACA is either good or bad for them on a person level. (And yes, the economy is now the overriding issue, but health care will keep resurfacing as an emotional and “values” issue in the coming months.)

Senate Majority Leader Harry Reid (D–Nevada) accused candidate Mitt Romney of not paying taxes for 10 years while he was […]

Amy M. Collins, managing editor2016-11-21T13:09:30-05:00August 10th, 2012|health care policy, nursing perspective|0 Comments

Success Being Relative

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN.

blood bags/ by montuno, via flickr

We trouped in from the parking garage through the fading starlight of early dawn to find most of night shift gathered in one room. Portable surgical lights added to the overhead fluorescence, casting a striking glare on the scene. The patient was ominously flat: his positioning and pallor an instant indicator of his perfusion status, which was confirmed by a quick glance at the monitor. His blood pressure, we said among ourselves, was “in the toilet.”

He’d been in a motor vehicle accident and had suffered a prolonged extrication. There’d been a fatality at the scene. He wasn’t my patient (although he was everyone’s patient, really), so I’m not the one who got the long report. I didn’t know each and every one of his injuries, but I knew the only one that was relevant at the time—his liver was badly fractured and he was bleeding out. His abdomen was hugely distended and firm. He was cold to the touch, and his skin bore the expected pallor of a man in shock.

We […]

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:09:30-05:00August 8th, 2012|nursing perspective, nursing stories|2 Comments

Like ‘Being in Jail in a Way’: A Study Investigates How Anorexic Adolescents and Their Nurses View Inpatient Treatment

By Sylvia Foley, AJN senior editor

Bar the View by HereStanding, via Flickr

For adolescents with severe anorexia, experts have long relied on treatment in specialized pediatric acute care settings, using programs that are based on behavior modification principles and that promote stability through refeeding.

But what is it like to be a young inpatient in such a program? And how does the behavior modification approach affect the nurse–patient relationship? To learn more, nurse researcher Lucie Michelle Ramjan and colleague Betty I. Gill conducted a study in an Australian acute care facility. Their findings are reported in this month’s CE: Original Research feature, “An Inpatient Program for Adolescents with Anorexia Experienced as a Metaphoric Prison.”

The research. Ramjan, the study’s principal investigator, conducted in-depth, face-to-face interviews with 10 adolescent patients being treated for anorexia and 10 pediatric nurses. The interviews were audiotaped; the tapes were then transcribed verbatim, read and reread, and subjected to thematic analysis. As another writer has noted elsewhere, in qualitative research, metaphors often “illuminate the meanings of experiences.” In this study, the researchers found that both nurses and patients “consistently used the metaphor of prison life to articulate their experiences.”

That striking metaphor offered Ramjan and Gill a framework for interpreting […]

Guest Author2016-11-21T13:09:31-05:00August 6th, 2012|nursing research, patient engagement|3 Comments