NURS-6051N Interaction Between Nurse Informaticists and Other Specialists

One of the nursing informatics critical elements is analyzing, designing, implementing, and evaluating information systems data structures that support nursing using today’s computer technologies (International Journal of Medical Informatics, 1997).  

The specialty of Medical Informatics recognizes itself as a distinct discipline in nursing (Journal of the American Medical Informatics Association, 2002).  Nurses today are trained in computer interactions and nursing systems design, which plays a vital role in our healthcare system—Schwirian (Nursing and Computers, 1989).  Schwirian emphasized the need for informatics research to be “proactive and model-driven rather than reactive and problem-driven.” Nursing informatics (NI) aims to improve the healthy populations of families and individuals, optimizing information to help manage their care (Journal of the American Medical Informatics Association).  NURS-6051N Interaction Between Nurse Informaticists and Other Specialists

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Patient care at Capital Health Regional Hospital in Trenton, New Jersey, employs technologies that evolved from nursing informatics such as Computerized Provider Order Entry (CPOE), Electronic Medical Records (EMR), and computerized laboratory test results.  

Doctors are now encouraged to use CPOE to enter orders, lowering transcription errors by nurses.  Verbal doctor orders see a reduction today, eliminating errors given by clinicians once dependent calling in an order.  Using CPOE, we have clarity in our doctors’ orders.  One improvement in CPOE could be to encourage physicians to use this when not in the hospital. Currently, doctors use CPOE only in our hospitals, and doctor orders during evening hours outside our facility are still verbal orders.  

Electronic medical records give both the nurse and doctors vital patient information at a glance.  No longer do we struggle through old, handwritten charts to decipher what the doctor has written.  EMR notes clearly transcribed and stored electronically, makes finding such things as orders and treatments easier to find, saving time, and improving care.  One flaw in the New Jerseys EMR system is that it does not allow information from other state residents.  We often have patients from Pennsylvania and New York whom we treat and have to get their health records faxed to us, delaying patient care.  Access to another state patient EMRs would play an essential role in patient outcomes. NURS-6051N Interaction Between Nurse Informaticists and Other Specialists

Informatics has already improved the analysis and speed of test results.  Routine labs are merged into the patient’s EMR within the hour, eliminating the tedious handwriting of lab slips.  The physician can have results for CAT scans, MRI’s and X-rays faster, sometimes amazingly read by doctors as far away as Australia via the internet.  One improvement for lab results would be sending the nurse an electronic alert (like a text alert) when we have results.  Often, we forget to check our labs, and an alert system would remind us when completed.  Our blood pressure machines, equipped with WIFI, can send vital signs in real-time; however, our current computer system lacks this interface. Hopefully, our new Cerner system will be capable of transmitting vital signs to our computers.  

In 2020, Capital Health Regional Hospital is transitioning into Cerner Computer Systems, which will also include nursing notes, medication records, and progress notes (Registered Nursing 2020).  The decision to start a new computer system became influenced by technical and policy factors that decided to build a new system complementing our existing outdated one (Science Direct, 2019).  My collaboration with our nursing informatics specialist, Barbara Grande (a Walden graduate in NI), is to inquire about possible voice-activated software for nursing notes.  Implementing this new system will focus on preventative medicine informatics to help move our facility into the 21^st century enabling more of our patients to maintain good health (Information Governance World Magazine, 2018). NURS-6051N Interaction Between Nurse Informaticists and Other Specialists  

Informatics holds a bright future for nursing practice moving the health industry towards change.  In 1992, the American Nursing Association stressed the importance of nursing informatics as a vital part of supporting the nursing process, integrating data, information, and knowledge required for clinical decision making (Elite Learning, 2015).  Utilizing new emergent technologies will enable nurses to make healthcare safer, more effective, efficient, and patient-centered, decisions fostering a new and brighter healthcare system.

References

Healthcare Informatics and Cross-Functional Collaboration. (October 16, 2018). Retrieved from https://infogovworld.com/ig-topics/healthcare-informatics-and-cross-functional-collaboration/#:~:text=In%20a%20broad%20sense%2C%20informatics,and%20transparency%20across%20the%20organization.&text=Beyond%20the%20total%20patient%20care,other%20aspects%20of%20patient%20care.

Saba, V. K. (1997, March). A look at nursing informatics. International Journal of Medical Informatics, 44(1), 57-60. http://dx.doi.org/https://doi.org/10.1016/S1386-5056(97)01260-4

Schwirian, P. M. (1989). The NI Pyramid-A Model for Research in Informatics. [Springer Link]. Retrieved from https://link.springer.com/chapter/10.1007/978-1-4612-3622-1_29

Staggers, Ph.D., RN, FAAN, N., & Bagley Thompson, Ph.D., RN, C. (2002, May). The Evolution of Definitions for Nursing Informatics: A Critical Analysis and Revised Definition. Journal of the American Medical Informatics Association, 9(3), 255-261. http://dx.doi.org/ https://doi.org/10.1197/jamia.M0946  NURS-6051N Interaction Between Nurse Informaticists and Other Specialists

Troseth, DPNAP, M. (2015, March 30). Informatics & the Future of Nursing Practice. Elite Learning. Retrieved from https://www.elitecme.com/resource-center/nursing/informatics-the-future-of-nursing-practice/

Wang, Ph.D., MPH, RN, FAAN, J., Gephart, Ph.D., FNP-BC, S. M., & Bakken, Ph.D., RN, FAAN, FACMI, S. (2019, July-August 2019). Models of collaboration and dissemination for nursing informatics innovations in the 21st century. Science Direct, Nursing Outlook, 67(4), 419-432. http://dx.doi.org/https://doi.org/10.1016/j.outlook.2019.02.003

What is Nursing Informatics? (May 8, 2020). Retrieved from https://www.registerednursing.org/nursing-informatics/

response

You bring up a great point about physicians entering their own orders electronically. This process reduces the chance for errors to occur. The Nurse Informaticist (NI) can help physicians and nurses by educating them on the correct process for order entry and following up when errors occur. The NI may evaluate trends and provide valuable feedback for process improvements. NURS-6051N Interaction Between Nurse Informaticists and Other Specialists

By serving as a leader for process improvement such as the previous scenario, NI can provide valuable feedback and serve as a positive avenue to assist in improving patient outcomes. Of the 21 advanced skills necessary for NI, one of the largest but least understood essential is project management (Sipes, 2016). With the implementation of leadership as a project manager will come a smoother workflow across disciplines.

One interesting tool I find useful is for systems improvement called the HUDDLE (Healthcare, Utilizing, Deliberate, Discussion, Linking, Events) (Mcgonigle & Mastrian, 2017). I used the HUDDLE because it was a requirement from management after we had an episode of restraint or seclusion when I worked at the state psychiatric hospital. The security and nursing staff would meet and answer key questions during a debriefing to learn from each situation. The interdisciplinary collaboration allowed for better outcomes in the end. NURS-6051N Interaction Between Nurse Informaticists and Other Specialists

References

Discussion: Interaction Between Nurse Informaticists and Other Specialists

Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.  NURS-6051N Interaction Between Nurse Informaticists and Other Specialists

In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.

To Prepare:

• Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.
• Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization.

By Day 3 of Week 3

Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

By Day 6 of Week 3

Respond to at least two of your colleagues* on two different days, offering one or more additional interaction strategies in support of the examples/observations shared or by offering further insight to the thoughts shared about the future of these interactions.  NURS-6051N Interaction Between Nurse Informaticists and Other Specialists

In the Federal Bureau of Prisons Medical Center for offenders, my place of employment, the Bureau Electronic Medical Records System, is known as BEMR, the health information system of choice. The BEMR system can collect, keep, maintain, evaluate, and distribute all-inclusive electronic medical records (EMRs) for greater than 200,000 inmates in various federal facilities across the United States (Thompson, 2013). The computer information technologists and a BEMR clinical nurse specialist (CNS) who acts as a liaison to the BEMR program specialist at the center of operations in Washington, D.C. handle issues with the system locally.

The information technologists (IT) interact well with other healthcare professionals to make suggestions and resolve problems quickly. The IT department also has a help desk for staff seeking assistance with the BEMR system or any other computer issues. However, the BEMR clinical nurse specialist (CNS) is only one person and not readily available to address staff’s questions and concerns. Many times repeated voicemail messages are left, and she returns your call when possible. NURS-6051N Interaction Between Nurse Informaticists and Other Specialists

The nurses on the medical/surgical floor made a recommendation to have the peripherally inserted central catheter (PICC) line dressing change template built into the BEMR. The nurses had to copy and paste the template into the system. The CNS was receptive to the idea but emphasized the cost of making the change. The CNS completed the data analysis to determine the number of PICC line dressings in a selected timeframe to justify the additional programming. After the evaluation, the change occurred. However, many weeks passed from the initiation of the inquiry to the adjustment. The added programming to incorporate the PICC line dressing change template into the BEMR system made patient care more efficient with real-time charting.

One strategy to improve the CNS interaction with staff and reduce the timeframe for change is communication through nursing management. The staff nurses should first notify the nurse manager with the concern. The nurse manager could apply knowledge as a manager and evaluate the situation with competence and distribute the information to the CNS for approval (McGonigle & Mastrian, 2017). The nurse manager functions as a knowledge worker in this circumstance and improves the process.

The evolution of nursing informatics (NI) specialty will continue to progress and invent new technology innovations. NI is not only defined by data analysis, but also by being an integral part of nursing science that supports a multidisciplinary team in their decision-making to improve patient outcomes (Sipes, 2016). Additionally, NI improves healthcare professionals’ interactions through their expertise and competence.

References

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

Sipes, C. (2016). Project management essential skill of nurse informaticists. Studies in Health Technology and Informatics, 225, 252–256. https://doi.org/10.3233/978-1-61499-658-3-252

Thompson, S. (2013). Federal Bureau of Prisons, Privacy impact assessment for the bureau electronic medical records initiative.   Federal Bureau of Prisons. https://www.bop.gov/foia/bemr.pdf  NURS-6051N Interaction Between Nurse Informaticists and Other Specialists