NR 393 Impact in the 21st Century

NR 393 Impact in the 21st Century

NR 393 Impact in the 21st Century

Technology is an event of the 21st century that has made a huge impact on evidence in professional nursing practice.  The patient’s electronic health record puts a plethora of information at the nurse’s fingertips, with nurse charting, doctor and nurse notes, test results, orders, medications, and treatments, to name some of the valuable communication available.  “RNs utilize Internet resources . . .”, (Judd & Sitzman, 2014), also for patient care.  Not to mention, that all this information is quick to look up and record data, thus leaving more time to enhance the patient’s quality of care.  With information so readily available, and with computer charting saving time, evidence has shown that nurses have more time for “value-adding” activities, such as talking with patient’s families, increased time with the patient, communication with other team members, and personal satisfaction in their job performance (with less burnout).  (Moore et al, 2020).

Health information technology also plays a part this century with patient safety, by using a barcode to scan a patient’s medication and the patient, and with information being in a typed form vs. handwritten (such as in doctor’s orders), to name a couple.  According to an article from NCBI, “The impact of health information technology on patient safety”, it states, “In 1999 the Institute of Medicine’s report “To err is human” called for developing and testing new technologies to reduce medical error. . .  This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes.  We conclude that health information technology improves patient safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines” (Alotaibi & Federico, 2017).

Technology is ever changing and there is no getting away from it.  Technology is created to improve care and provide faster care.  Sometimes technology is good and sometimes not.  Transitioning from paper charting to computer charting was a plus.  Nurses do not have to keep track of papers during their work shift.  Thanks to the role of the nurse informaticist, the flow of nurse charting on the computer has been arranged for easier charting.  The computer also has all the patient information right there for you, if you need to look something up, rather than rifling through papers.  Patient safety with using technology has improved by no longer having to read a doctor’s handwriting for orders, and with medication errors.  The barcode scan is a safety measure for medications that works effectively, to stop from giving a patient a wrong medication or dose.  Of course, technology cannot always be relied upon.  Equipment does fail at times or can give a wrong result.  I have had the electronic Dynamaps read a blood pressure that did not seem correct, and in checking the blood pressure manually, there was quite a difference.  Even with technology, nurses must still check the patient, as machinery cannot replace eyes, caring, and the nurse’s knowledge.  Patients still need the human touch.

References

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631

Judd, D., & Sitzman, K.  (2014).  A history of American nursing:  Trends and eras.  (2nd ed.).  Jones & Bartlett.

Moore, E. C., Tolley, C. L., Bates, D. W., & Slight, S. P. (2020). A systematic review of the impact of health information technology on nurses’ time. Journal of the American Medical Informatics Association : JAMIA27(5), 798–807. https://doi.org/10.1093/jamia/ocz231Links to an external site.

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I can see why technology are so important in nursing. While most nurses do think about technology equaling EMR,

NR 393 Impact in the 21st Century
NR 393 Impact in the 21st Century

nurses use so much more technology than we realize. On our newest unit in the hospital we have beds that speak to the patient and tell them to not get out of bed and to call the nurse. Rather than just a loud alarm going off, the alarm only sounds on the nurses vocera and at the nurses station. The mirrors also tell the patient good morning. We have voceras that ring a patient’s call light to the nurse in case we are not at the desk and to decrease alarm fatigue.  We utilize programable IV pumps, for heparin drips, you program the patient’s weight the desired mg/kg/hr, then the pump will set the ml/hr based off the same and once the nurse programs the desired ML to infuse the pump will determine the length of infusion. The nurse just has to make sure that the ml/hr is not over the max infusion rate. In nursing school we learn how to calculate drip rates, how to calculate infusion rates, while a lot of the time the IV pumps are now doing it for you. Nurses most know how to do these things on their own to make sure that the pump is correct.

I love that you made a point to address that students coming into the nursing field, aren’t trained like nurses are today. In school, one of my instructors taught me “treat your patient – not the machine”, and I couldn’t agree more! We have become so reliant on technology that there is no underlying, baseline understanding of things like drip rates or manually taking vitals! I went to see my doctor a few days ago and the tech put a cuff that was too small on me – and my pressure was through the roof! The doctor saw this and addressed it, but it made me wonder how many students are being taught to treat the machine. I personally find it extremely important to instill these traits into our students today, even new employees. Much of my nursing knowledge and experience is from being shown how to complete tasks and document findings from older nurses who have shown me “the old fashion way”.

Smart beds are an excellent example of technology improving care. There is debates regarding the value of bed alarm. Some people believe that by the time the alarm sounds it is to late and that the bigger issue is how can we prevent the patient from attempting to get out of bed or medications that are increasing  a patient’s risk for falling.

I have been at my current place of employment for 4 1/2 years.  When I started working there, I was surprised to learn of a device called a telesitter.  I had not heard of this before.  Telesitters watch patients from a remote area.  They watch patients for safety reasons such as confused, unsteady patients getting out of bed alone, pulling on lines such as IV lines, removing oxygen, or any other reasons that leaving the patient alone can be unsafe.  I remember being told for the first time to get a telesitter for a patient I had, and I had no idea what that was.  This is a piece of technology that can be helpful to patient safety, with a watchful eye on the patient, as the nurse cannot remain in just one patient’s room.  Besides watching the patient, the telesitter can talk to the patient.  The telesitter is a helpful device, however, if the person in the remote area is not paying attention to the patient, accidents can still happen.  Usually, when something is going on in the patient’s room that the nurse needs to address quickly, the telesitter will alarm, or the person watching the patient will call the nurse’s station.  There have been incidents where patients have fallen and no warning was given ahead of time.  Did the telesitter step away? Did the telesitter look away? Is one person watching too many patients? Was the patient too quick for a warning? But, patients have fallen and no after warning even occurred.  Telesitters are a good tool, as long as the patient is always being viewed.  I do not know if also having a picture of the patient at the nurse’s station is feasible or not, for more sets of eyes on the patient for safety.