NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

Professional Interactions

The healthcare organization I work for is made up of clinical and non-clinical employees on several different levels, including customer-facing, client-facing, provider-facing, and internal employees.  As a Utilization Review Nurse, I interact with customers (in this case, members), providers, and internal staff.  My day-to-day tasks are completed using multiple computer programs, including electronic member records, Task list, InterQual database, Fax, Email, Microsoft Teams, and the telephone system.  While having all of these systems and resources at my fingertips is excellent, the frequency in which one or multiple systems crash is highly frustrating. NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

The IT team is available via a ticket submission system that easy to access.  However, submitting a ticket via the IT submission system can be time-consuming, especially compared to picking up the phone and dialing an extension. In addition, the ticket system populates additional questions with required responses based on the type of question and system with said issue. Therefore, I feel an electronic form that shows all required fields from the beginning would be beneficial so the person submitting said ticket can have all the required information ready upfront.

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Strategies for Interaction Improvement

The primary electronic member record we use was created internally by our own IT team, which is pretty impressive.  However, this program was created when the company first opened 20 years ago, and the company has grown exponentially since. As a result, the number of employees requiring access to the computer system and the amount of member and client information stored have increased significantly.  The continued emergence of new technologies will positively impact professional interactions within my current workplace as new and improved programs are released, requiring fewer frustrations and more positivity.

Another way we interact with other professionals is when an internal patient service representative calls a nurse to ask whether a specific diagnosis or situation requires a case management referral.  While there are common chronic illnesses referred to case management per company policy, there are often complex situations in which a member could immensely benefit from a case management outreach.  In this example, the common chronic illnesses would be an example of explicit knowledge, as this information is provided in training and shared in the form of policies. On the other hand, the complex situations that require nursing judgment are examples of tacit knowledge, which reflects one’s skills and beliefs and is more challenging to teach to another (McGonigle & Mastrian, 2018).  Both situations encourage professional interactions. NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

Importance of Nurse Informaticist

The role of the Nurse Informaticist is essential to our ever-evolving world of technology.  I believe professional interactions are becoming more electronic and less personal. For example, several hospital Utilization Review departments have transitioned to “fax only;” information is requested and shared via fax and not by telephone.  This process requires practical written communication skills.  The Nurse Informaticist has the nursing knowledge, intuition, and skills and understands what and how data is best organized and accessible (Sipes, 2016).The Nurse Informaticist can improve nursing practice and healthcare as a whole, promoting best patient outcomes (Ivey, 2021).

References

Ivey, J. (2021). Nursing Informatics Research. Pediatric Nursing, 47(1), 45–46.

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge. Jones & Bartlett Learning.

Sipes, C. (2016). Project Management: Essential Skill of Nurse Informaticists. Studies in Health Technology and Informatics, 225, 252–256.

Main Discussion Post sample 2

Working in the Emergency Department provides for vastly diverse patient interactions throughout each shift. Patients suffering from a mental health crisis can be some of the most challenging for several reasons. Some of those include potentially dangerous behaviors, needing a sitter of some type, and difficulty in finding placement post-Emergency Department treatment and/or evaluation. Patients presenting with psychiatric symptoms have been found to occupy up to 42% more time in the ED than those with non-psychiatric symptoms (Nordstrom et al., 2019). NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

The Emergency Department I currently work in has 34 beds with only one dedicated room for psychiatric patients. This room contains only a mattress on the floor and an emergency call button. There is also a security guard who stays outside that room at all times. There has not been a shift I have worked in that we have only had one patient who needed to be placed into a dedicated and safe room that fits their current needs. The primary nurse for any patients who are not placed into the one psych room is often repeatedly called away from attending to their other patients due to the actions of the psychiatric patient. This can cause both increased mental and physical fatigue for the primary nurse as well as other members of the healthcare team assisting the nurse (TeamHealth, 2019).

Concerns regarding the length of time those presenting with psychiatric symptoms were spending in the ED were brought to the attention of the ED Supervisor who then retrieved statistical information regarding length of stay prior to discharge, admission, or transfer to another facility. The information was eventually submitted to the hospital board. A new system has now been put into place to attempt to move admissions or transfers in a more timely manner. This involves giving a specific call center a “heads up” when a patient arrives in the ED with psychiatric symptoms. This system has helped somewhat, but when the patients do not have health insurance, it becomes a much longer process for both the healthcare staff and the patient. There are a limited number of resources available in Arkansas for those who need mental health admission, especially those without insurance. According to Mental Health America (n.d.) approximately 14.7% of patients with acute mental illnesses remain uninsured, while my home state of Arkansas’s rate is even higher at 18.1% of those same types of patients uninsured. NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

More information is needed to ensure that the best possible care is being given to those suffering from a mental health crisis in the Emergency Department besides the length of stay. I would suggest researching further into insurance status, demographics, past psychiatric admissions or discharges, along with the possible benefits of providing at least one team member per shift who has received specialized training in caring for psychiatric patients.

References

Mental Health America. (n.d.). Mental health in america – access to care data 2018. https://www.mhanational.org/issues/mental-health-america-access-care-data-2018

Nordstrom, K., Berlin, J., Nash, S., Shah, S., Schmelzer, N., & Worley, L. (2019). Boarding of mentally ill patients in emergency departments: American psychiatric association resource document. Western Journal of Emergency Medicine, Volume 20, Issue 5, 20(5), 690–695. https://doi.org/10.5811/westjem.2019.6.42422

TeamHealth. (2019, May 21). Improving mental healthcare in hospital emergency departments. Retrieved June 15, 2021, from https://www.teamhealth.com/blog/mental-healthcare-emergency-department/?r=1  NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

sample 3

Evolution of Nursing Informatics from a Science to a Nursing Specialty

Nursing Informatics is one of the most current trends in healthcare. It has evolved over the years from a science incorporating the use of technology and tech-based expertise to analyze complex data for information-based care delivery and nursing practices. Now, it is more of a profession; combining computer science, nursing skills and information. The continuous collaboration between Information technology professionals and other care providers serves to prominently advantage all involved, including the patients (Laureate Education, 2018). This means that with the increasing technology and an understanding and support for greater collaboration, the continued evolution of nursing informatics as a specialty and the continued emergence of new technologies might have an overall positive impact on professional interactions.

The skills and competencies required within the informatics specialty reflects the overall expectations in competent and proficient caregivers. Informatics are expected to show a high level of proficiency in analyzing complex unstructured data streams using technology and critical thinking into designing and/or collaboratively providing information-based care. The provision of evidence-based care in nursing is a growing concern and measure of quality, and as a specialty that evolved from information and technology, this expectation is even higher. NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

Experiences with Nurse Informaticists or Technology Specialists within Our Healthcare Organization

The pillar of the healthcare facilities is partnership between the several departments and professionals within and across organization. Collaboration leads to quality healthcare and supports evidence-based practice. This kind of cooperative setting is beneficial to all stakeholders involved (McGonigle & Mastrian, 2017). Studies has revealed that that collaboration facilitates work satisfaction and an improved rate of decrease in healthcare-associated infection (Wang et al., 2018). Reduced rates of infection translate to positive patient outcomes for healthcare organizations, and employees.

In my experience as a nursing practitioner, I have experienced the benefits of collaboration between technology specialists and other healthcare professionals. For instance, the nursing informaticists would perform data analysis regarded in the health patterns of patients with cardiac diseases and determine the trends that were common across the hospital-based patients. The information would be used by the charge nurse within the specific department to identify the most appropriate healthcare interventions. Through this collaboration, the organization was able to improve the patientcare outcomes through evidence-based interventions. Hence, collaboration between nurse informaticists and/or data or technology specialists interact with other professionals is a very important practice in healthcare because it entails the benefits of specialization and division of labor. NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

Through the experience, I learned that there are different strategies for collaboration that can bring positive results to all the parties involved. The results of the practical experience within my organization shown how significant nurse informaticists are in the technological aspect of health care delivery. Regardless of the several improvements that the healthcare system has seen from the collaboration between nurse informaticists and other healthcare providers, there is still an opportunity to do better (McGonigle & Mastrian, 2017). One strategy to ensure that that happens is through knowledge development and understanding the impact of good, clean data being entered into EMRs (electronic medical records), as well as the analyses and the insights that can come out of that and be delivered back to the point of care (Blais & Hayes, 2015).. This is because “having nurse informatics help design workflow and processes can make an EMR system and deployment much more efficient and effective”.

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References

Laureate Education (Producer). (2018). The Nurse Informaticist [Video file]. Baltimore, MD: Author.

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th Ed.). Burlington, MA: Jones & Bartlett Learning.

Blais, K., & Hayes, J. S., (2015). Professional nursing practice: concept and perspectives. Upper Saddle River, NJ. Pearson Education Inc. NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

sample 4

Nursing Informatics integrates sciences in nursing practice using skills to identify, define, manage and communicate    data, information, knowledge, and wisdom in Nursing practice (ANA, 2015).

Infection control is one of the programs that can largely benefit from the use of Nursing informatics. Through the EMR system, the gathering of data and tracking of infectious cases have been easier compared to manual handwriting and paper charting.  The information needed is obtained with one click on the computer. Informatics tools are becoming integral to routine infection control activities. Informatics has the potential to improve infection control outcomes in surveillance, prevention, and connections with public health. Surveillance activities include fully or semiautomated surveillance of infections, surveillance of device use, and hospital/ward outbreak investigation (Lin & Trick, 2016).

Linking clinical and public health activities through electronic laboratory reporting, syndromic surveillance, and enhanced inter-facility communication, which improves the timeliness of disease reporting, and outbreak detection and intervention. Informatics is used for infection prevention, primarily through clinical decision support (Lin & Trick, 2016). NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

As the Infection control nurse, with the information gathered, I can make the trend charts and graphs, see the number of the cases, and track any potential or present infection outbreaks. These data are then presented to the Medical Director, DON, Nurse Managers, Charge nurses during the morning meetings. Then the staff is given the in-service education portion as to the prevention and management of these cases as well as control of further spread to the facility.

The nurse informaticists, health care providers, patients, ancillary team members, administrators, setting/environment, infrastructure, and technologies must all work together to create a safe culture (McGonigle & Mastrian, 2017).

As technology continues to evolve in the health care profession, the communication between health personnel will be greatly improved. Carrying out the nursing task will be more efficient and address health care needs.

REFERENCES:

ANA (2015) Nursing Informatics Scope and Standards

Lin, MY & Trick, WE. Informatics in Infection Control. Infect Dis Clin North Am. 2016 Sep;30(3):759-70. doi: 10.1016/j.idc.2016.04.011. PMID: 27515146.

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning. NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

sample 5

Utilizing the electronic health record (EHR) in the nursing home tracks infection control, vital sign abnormalities, keeps track of weight trends for those with heart issues taking diuretics, medication trends such as medications for pain, constipation, nausea, or even if they are refusing medications (McGonigle & Garver Mastrian, 2018). These statistics are then shared with other nurses, management, social workers, primary providers, and emergency workers for transport to a trauma center/hospital. The facility also tracks falls, fractures, and skin issues to find interventions for preventing those occurrences in the future.

One strategy of improving the use of electronic records in the nursing home setting is advanced care planning. Most residents in the nursing home are there until they succumb to a life long-lived. Advanced care planning (ACP) is a way to document and record their health care wishes if they can no longer communicate this need to their caregivers. If one chooses to be put on dialysis when their kidneys fail, at least their provider can make it happen (Moses, et al., 2020). I distinctly recall a gentleman at the nursing home where I work on a ventilator, had enteral tube feed and was comatose. He was that way due to having a heart attack while he was having a surgical procedure and because he did not have a health directive at the time, his wife got to decide to keep him alive. She was in denial and thought he would return to normal life; however, he had decerebrate posturing and no response whatsoever. I doubt he would have chosen to live like that. It is estimated that by the year 2050, there will be 84 million people, 65 years of age or older. Moses, et al. report, “Benefits of (ACP) include higher quality life, control over medical decision-making, and less anxiety or stress for the family members of a patient who cannot make their own decisions at the end of life” (para. 2, 2020). NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists

The future of nursing informatics is e-learning through computer simulation training at work or in school, artificial intelligence (AI), robotic engineering through surgical procedures, and information sharing through faster networks (IVANOVA, 2020). Robotic operations can be more precise than humans and could lead to fewer risks of bleeding or death. AI could be used in many ways and is being used, such as robots that deliver meals to hospital patients or surgical supplies, bedding, etc., throughout a nursing facility. The world has changed so much in the last twenty years, and as fast as technology has evolved, I can only imagine what the future holds.

Resources

IVANOVA, M. (2020, June 1). eLearning Informatics: From Automation of Educational Activities to Intelligent Solutions Building. Informatics in Education, 19(2). doi:10.15388/infedu.2020.13

McGonigle, D., & Garver Mastrian, K. (2018). Nursing Informatics and the Foundation of Knowledge (Fourth ed.). Burlington: Jones and Barlett Learning. Retrieved 2021

Moses, A., Dharod, A., Williamson, J., Pajewski, N., Tuerff, D., Guo, J., & Gabbard, J. (2020, March 1). Considerations for Integrating Advance Care Planning Into the Electronic Health Record: A Primer for Clinicians. American Journal of Hospice and Palliative Medicine®, 37(12), 1004-1008. doi:10.1177/1049909120909303 NURS 6051 Week 3 Interaction Between Nurse Informaticists and Other Specialists