Rnpaula2008's Weblog

Final Blog

rnpaula2008 — Thu, 27 Nov 2008 23:20:39 +0000

Technology is forever changing and we as individuals’ in society are very fortunate to be a part of it. Since I entered nursing in 1997 we were charting on a paper form to keep the status and procedures up to date on all our patients. As time has progressed so has technical momentum in the documentation field. I am thankful for the progress in technology, because I am able to utilize these new technological advancements in my career. Caring for patients is a crucial part of my job and if it was not for the new technology, patients may not get the standard of care they are now accustomed to. Healthcare has developed its own core knowledge base and the equipment we are using in it is top of the line and healthcare workers are very lucky to be a part of this. In implementing a computer documenting system in the Emergency Department has helped to improve patient throughout, obtain complete histories, and aide the nursing staff in rapid assessments. Patients rely on healthcare workers to know how and what we need to do in order to keep patients healthy and safe. It is with this type of technology that we are able to do that. Any type of change that is to be implemented will never come without obstacles, but over time the people participating in the change usually discover the benefit that follows if the implementation process was performed correctly. It is exciting that technology is becoming available in environments, such as the medical field; however, it is important to keep in mind that with advances in technology also comes with different risks than those that have been faced by medical personnel before. One major issue and concern is, not only the ease of use with the new technology, but ensuring that it works properly and quickly. As we have seen in the last few years, information on the computer can be accessed by people, even if there are safeguards in place to keep this from happening. Experiencing an implementation of an electronic medical record system where I am currently employed, has given me the insight and opportunity to be a part of the new technology that is available to aide in caring for patients. Computer technology in the medical field has made a large improvement in the standards of care that are we are now providing to our patients.

References continued:

McLane, S. (2005, March). Designing an EMR planning process based on staff attitudes toward and opinions about computers in healthcare. Computers, Informatics, Nursing: CIN, 23(2), 85-92.

Smith, K., Smith, V., Krugman, M., & Oman, K. (2005, May). Evaluating the impact of computerized clinical documentation. Computers, Informatics, Nursing: CIN, 23(3), 132-138.

Green, S., & Thomas, J. (2008, May). Interdisciplinary collaboration and the electronic medical record. Pediatric Nursing, 34(3), 225. Retrieved November 27, 2008, from MEDLINE with Full Text database

Rosenberg, S. (2006, January). Utilizing the language of Jean Watson’s caring theory within a computerized clinical documentation system. Computers, Informatics, Nursing: CIN, 24(1), 53-56.

Joan, M., & Mayo, A. (2003).The handheld technologies in a clinical setting. AACN Clinical Issues, 14, 342-349.

Wakefield, D., Halbesleben, J., Ward, M., Qiu, Q, Brokel, J., Crandell, D. (2007). Development of a measure of clinical information systems. Medial Care, 45, 884-890.

Puskar, Kathryn, Aubrecht, J., Beamer, K., Carozza, L. (2004) Implementing Information Technology in a Behavorial Health Setting. Issues in Mental Health Nursing, 25:5, 439-450.

Turpin, P. (2003). Transitioning from Paper to Computerized Documentation. Gastroenterology Nursing. 14, 61-62.

Aspden, P., Corrigan, J., Erickson, S.(2004).Patient Safety-Achieving A New Standard For Care.Institute of Medicine. 59-67.

Apkon, M., & Singhaviranon, P. (2001, January). Impact of an electronic information system on physician workflow and data collection in the intensive care unit. Intensive Care Medicine, 27(1), 122-130. Retrieved December 1, 2008, from MEDLINE with Full Text database

Weir, C., & Nebeker, J. (2007, October 11). Critical issues in an electronic documentation system. AMIA … Annual Symposium Proceedings / AMIA Symposium. AMIA Symposium, Retrieved

December 1, 2008, from MEDLINE with Full Text database.

Paula’s 6th Blog

rnpaula2008 — Sun, 16 Nov 2008 22:48:46 +0000

Computer technology in the medical field has made a large improvement in the standards of care that are we are now providing to our patients. We have looked at a multitude of different avenues of choosing computer technology to implementing computer technology in the hospital setting, and the benefits available regarding the use of the new and improved technology. With all those things in mind, it is extrememly important to remember that by far the most important aspect to cover when speaking of computer based technology in the medical field is patient safety. We have spoken of the many necessary evils that must be looked upon prior to installation of this type of technology. To re-cap a few of these includes the development of comprehensive based systems necessary for delivering the information, making sure your organization has the appropriate communication available to coordinate the care that is being delivered, and supporting patient safety. So many benefits become available to an organization when one chooses to integrate computer technology into one’s plan of care for the patient’s that are being cared for. Even though there are so many benefits it is still of utmost priority to make sure patient safety is on the for front of any technological health care related upgrade. The ultimate goal of this type of implementation is to be able to provide the right information, at the right time, and to the right individuals; while maintaining patient safety so that adverse events or near misses do not occur. The benefits of technology are limitless. It provides opportunities for care access, efficiency, and effectiveness. Not only is the technology assisting in futuristic momentum but it is also helping healthcare to do the same. Take infectious disease for instance, with the capability of electronic records and heightened security can help in aiding early detection and rapid response to disease processes. Many of the benefits are related to the accessibility and research availability. It is very easy to get accustomed to convenience and knowledge when it is right at your finger tips. We must all keep in mind that all of this new technology is to improve what healthcare providers have wanted to give to patients for many years; it is until recently that we have been able to do so. By far patient safety and security should be and will always be the most important factor when anything in healthcare is changed.

Continued References:

Aspden, P., Corrigan, J., Erickson, S.(2004).Patient Safety-Achieving A New Standard For Care.Institute of Medicine. 59-67.

Paula’s 5th Blog

rnpaula2008 — Sun, 02 Nov 2008 21:12:01 +0000

Over time documentation has evolved to meet the changing needs in the healthcare industry. The biggest change with documentation came from the the introduction of computers. As far back as Florence Nightingale is when she began pushing the communication that she felt must occur between caregivers and their patients. She even contributed in helping to make forms to help in the communication process. Once computers were introduced in the late 20th century, this is when all the evolving really occurred. In the 1960′s and 1970′s computers were used more on the administrative end handling accounting systems and finances. As technology continued to improve and the computer capabilities sky rocketed these administratrs began to see a future in different applications through out the organizations. Early on the thought process was just scan all the forms into the computer system, but the nursing staff figured out very quickly that this was not an efficient use of their time. What became the most frustrating was that the awesome paper form, was not the most awesome computerized forms. The forms on the computers had a system to them. They had to be a series of codes which made it very difficult because the data that the computer needed had to be very specific and the original paper form would not work in the computer sytem the way it was inteded to. The typical handwritten charts do not exactly relate to the computer world. It took many years and a large amount of time to adjust the cmputer networking field to work with the needs of the healthcare industries. Many of the healthcare documenting systems became available and are realistic in usage, because it is the medical personnel who are the ones designing it for their use. They are the ones who have the most understanding of what is needed to care for the patients we as healthcare workers are responsible for.

References continued:

Puskar, Kathryn, Aubrecht, J., Beamer, K., Carozza, L. (2004) Implementing Information Technology in a Behavorial Health Setting. Issues in Mental Health Nursing, 25:5, 439-450.

Turpin, P. (2003). Transitioning from Paper to Computerized Documentation. Gastroenterology Nursing. 14, 61-62.

Paula’s 4th Blog

rnpaula2008 — Sun, 19 Oct 2008 19:05:36 +0000

It is exciting that technology is becoming available in environments, such as the medical field; however, it is important to keep in mind that with advances in technology also comes different risks than those that have been faced by medical personnel before. One major issue and concern is, not only the ease of use with the new technology, but ensuring that it works properly and quickly. Before, if you needed a patient’s record, you simply went into a locked closet and pulled it. The only problem that might occur is that you had lost your key, but chances are someone else in the department had one that you could use until yours was found. With technology, there is always the possibility that the system could go down. If this happens, it is imperative that there are people on site, twenty-four hours a day, seven days a week, that could help you fix the problem quickly and efficiently. It is not feasible to wait for hours while the problem is being addressed. Patient’s care cannot stop. There has to be a backup plan in place to ensure that the emergency department continues to run smoothly and efficiently. Without these safeguards in place, it is impossible to implement technology into the medical field.

Another consideration that must be addressed is the safety and privacy of the records that are being housed on the computer. As we have seen in the last few years, information on the computer can be accessed by people, even if there are safeguards in place to keep this from happening. Computer hackers have been busy these past few years getting access to people’s personal information, which could include medical information if the technology continues to grow in the medical field. Being able to access people’s complete medical information is wonderful for providers who benefit from being able to see what doctors the patient has seen, all diagnosis’s, and the entire summary of events with a click of a button; however, it must be known that by putting this information on the internet it does open it up to risks that are associated with the technological field.

Paula’s 3rd Blog

rnpaula2008 — Sun, 05 Oct 2008 20:43:53 +0000

In the two previous blogs we have talked about what our facility has implemented and some of the different risks that are associated with the new implementation of an electronic medical record. Technology is a key player in helping to improve the type of care that we provide to our patients. Nursing is required to provide thorough assessments and complete care to the patients they come into contact with. Technology is opening helping to assure that this is happening. Since the implementation of our very own EMR, we have not stopped in regards to investigating technical momentum. The facility continues to evaluate new technology that is available for use. One piece of equipment we have recently been looking at is the use of hand held charting devices to be used in the clinical setting. The benefits seem fairly favorable in the amount of time saved using some sort of hand held device for documentation. If you think about the process of receiving a new patient, gathering all the appropriate information, and then finding a computer to input all the data into. It is likely you have added some substantial time onto that admission. If you had the ability to use for instance, a hand held device for inputting data you could then place everything into the chart real time and cut out many steps that are currently in the middle. The next major concern of any type of hand-held device is the ease of use and the charting capabilities. Nursing tends to be chaotic and stressful in nature and to implement any new piece of technology in the medical field, must be very user friendly. Portability in my opinion is by far the biggest advantage to this type of available device, but with that being said it also requires someone to be responsible enough to keep up with it. This is a concern, because nurses spend a large majority of their time tracking down equipment and making sure the equipment functions properly. Any purchase of this nature would need an IT department to be responsible for the maintenance and up keep of the equipment. It is exciting to think we will continue to move forward in technology and the fast paced world, but it is also scary considering we are dealing with individuals life while implementing it.

References used so far:

Joan, M., & Mayo, A. (2003).The handheld technologies in a clinical setting. AACN Clinical Issues, 14, 342-349.

Green, S., & Thomas, J. (2008). Interdisciplinary collaboration and the electronic medical record. Pediatric Nursing, 34, 225-240.

Wakefield, D., Halbesleben, J., Ward, M., Qiu, Q, Brokel, J., Crandell, D. (2007). Development of a measure of clinical information systems. Medial Care, 45, 884-890.

Paula’s 2nd Blog

rnpaula2008 — Mon, 22 Sep 2008 02:35:42 +0000

When looking at the different possible methods of documentation in the medical field there are some things that we must take into consideration. One of the biggest concerns in the health industry is that of risks. The primary risk involved in the electronic medical record implementation process involves the risk of an improper system selection. Selecting a system that will not interface with other systems in your facility and does not fit well in your work environment can be a very costly mistake. Assuming that a facility completely investigates their options than it is likely that this type of costly mistake can be avoided. Many of these documenting systems impact both the work flow and the productivity of both the staff and the physicians. Other benefits that may be obtained by the use of this type of technology is that of paper reduction cost and improved charge capture. When deciding whether or not an electronic medical record is right for your facility you must look at the whole picture and make sure that you are doing what is in the best interest of the particular facility in which you are employed. Sinceour implementation of an electronic system I can say that our clinical pathways and decision support has significantly increased. With the use of these systems many of them are able to guide a provider or staff member down the appropriate clinical pathway to help keep one on track especially in the ED when it is very busy and chaotic. It only takes one mistake to have a really bad outcome and when the tension is high and the ED is overwhelming the chances of that happening are a risk. The electronic medical record is geared to help guide one to complete the picture of the patient so that one can make sure everything was done. The EMR cannot do everything for you , but it can definitely be a prompt to make sure you are in the right direction. It does seem to be the new technology in the medical field of the future. You hear more and more facilities in health care moving in this direction.

Paula Brookings

First Blog-Technology in my field of study.

rnpaula2008 — Mon, 08 Sep 2008 02:29:10 +0000

In my field of study as a registered nurse in an Emergency Department, I can tell you technology has definitely changed over the years. Since I entered nursing in 1997 we were charting on a paper form to keep the status and procedures up to date on all our patients. As time has progressed so has technical momentum in the documentation field. Before computerized technology was being used, the nursing staff would spend a large amount of time sitting behind desks handwriting every single thing that happened with their patients. What is so ironic is really the impact is had on the entire facility as a whole. What I mean by that is every time you needed an old medical record on a patient, someone in the medical records department would have to physically pull the paper chart and run it up to the Emergency Department. Do keep in mind that medical records is only open during normal business hours, so after hours you were then utilizing a house supervisor or someone else to get the records. Many copies had to be made when you were admitting the patient to the hospital so that the admitting unit would be aware of what happened in the ED. It is now that I really look back at how much time was actually wasted charting and running paper forms all over the hospital. The staff was accustomed to it, so since things have now changed everyone realizes the benefits of new and improved technology. For the last several years our entire hospital has been computerized. Every single thing documented on a patient is placed in the computer system. The hospital is now capable of looking up anything you can imagine on one computer to include every ED visit, patient admission, and outpatient procedure. Since the computer charting upgrades in our facility we have also had to upgrade scanners for scanning of any paper forms not on the computer and IDX for radiology imaging. The images are immediately downloaded for physician viewing which has played a huge role in decreasing time patients wait for results of radiologic images. As you can see technical momentum is forever evolving. It has played a large role in our facility.

Paula Brookings