NR 512 Integration of Nursing Informatics Skills and Competencies
NR 512 Integration of Nursing Informatics Skills and Competencies
Informatics is used in my personal practice through several ways. The first, is obviously through a computer. I work in the operating room, and our charting must be thorough and in-depth so that we are able to describe every event that happened during the patient’s surgery. The charting in the operating room is different than any other charting I have done. We do not do a full head to toe assessment, in fact we do not usually have time! We must be able to realize what happened in that surgery through our charting if it were too appear in court one day.
In the cognitive aspect of informatics, it is a little different in the operating room for nurses. I only get a few minutes to allow my patient to trust me with their care. They are asleep during their entire surgery and I am their advocate. I must use my cognitive intuition to call the shots regarding what this patient may or may not want. I must use my cognitive informatics to collect enough data or information about this patient to learn their needs and wants. Usually I only have about 3-5 minutes to do this. This then puts into effect my work that I do as a nurse and my decision-making skills. I believe that the primary area I use informatics would be my initial interview with my patient.
Before the patient comes to the operating room, I am to interview them, check their health record, check their history, make sure both an anesthesiologist and the surgeon have seen the patient, and find out as much information as I can to learn everything about this patient. In the interview, I ask them questions that pertain to them, what I have learned about them through their record, and any questions I may have, or they may have regarding their surgery.
I believe that both the computer side to informatics and the cognitive side to informatics allow us to ensure patient safety. By viewing my patient’s electronic health record, I am ensuring that everything matches what the patient says. Yes, they had hip surgery back in 2004 and need extra padding, or no they did not have hip surgery back in 2004 and can go in stirrups. As a nurse, I am using informatics to ensure that all benefits to the patient are realized (Strudwick et al., 2016).
Strudwick, G., Booth, R., & Mistry, K. (2016). Can Social Cognitive Theories Help Us Understand Nurses’ Use of Electronic Health Records?CIN: Computers, Informatics, Nursing,34(4), 169-174. doi:10.1097/cin.0000000000000226
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I enjoyed reading your post about how informatics allows and ensures for patient safety and I could not agree more. My top three during admission database is going over the patients medication list, if the patient has fallen within the past six months, and if the patient has been readmitted within the past thirty days or ninety days. It is extremely important to ask patients what medications they are currently taken, what medications have been discontinued, and what medications are new. I make sure that their medication list is updated so that physicians are able to see what medications patients are currently taking, what may need to be re-ordered, or if any medications or dosages may need to be readjusted while they are in the hospital. My second question is about falls because too many times I have patients whom are extremely independent and stubborn (my cute elderly patients in the 80s and 90s) about getting up alone and may think that they do not need any help. It is our duty to ask when the last time patients have fallen and even if patients have never fallen, we still have to use our best judgments to consider if they are high risk for falls. If patients are considered to be high risk for falls, they get a high risk falls band, bed alarm on, and a sign outside their room letting everyone know. Sometimes older patients may be forgetful and confused when they wake up and I like to be safe and prevent a fall when possible. In every room, when patients are lying flat in their beds, there is a huge sign attached to the ceiling that says “CALL, DON’T FALL.” We take falls very serious on our unit and charting and collecting these data is very useful. Asking patients if they have been readmitted within the past 30 days or 90 days is also very important. Informatics help in this department seeing that we are able to look back at the chart to see if it’s the same diagnosis, what kind of treatments were done, and when patients were discharged. This type of informatics also prevents any kind of treatments that may be needed to be repeated and it prevents errors as well. To prevent errors from occurring, there is a need for a set of performance indicators and metrics related to patient safety for classifying and measuring mistakes (Karami and Hafizi, 2017).
Karami, M., & Hafizi, N. (2017). Enhancing Patient Safety Using Medical Imaging Informatics. Radiology Management, 39(2), 27-35.
Nursing informatics and critical thinking is an important component in the delivery of safe patient care and must be
used simultaneously to ensure patient outcomes are positive. Nursing informatics is important to all nursing specialty areas; therefore, it is important for nurses to understand the relevance of incorporating nursing and informatics to the clinical practice, patient tracking, data trending, assessing workload, & appropriate and timely documentation (McGonigle, Hunter, Sipes, and Hebda, 2014). Nursing informatics is such an important concept to safe patient delivery that in 2004, an execute order from President Bush outlined a plan focused to ensuring that every American would have an electronic health record (EHR) by 2014; this executive order brought together a national conference in July 2004, called the Cornerstones for Electronic Health Record that included leaders across healthcare to discuss the technological infrastructure of technology into the healthcare arena (Shaw, Sensmeier, and Anderson, 2017). The Tiger initiative was established because of this conference in 2006, to engage and prepare nurses for the proper use and development of informatics in nursing practice. Therefore, the need for nurses and nurse leaders to understand the significant of informatics in nursing is very important to practice that lead to positive patient outcomes when documentation is detailed, timely, accurate, and within the unit and facility guidelines.
McGonigle, D., Hunter, K., Sipes, C., & Hebda, T. (2014). Why Nurses Need to Understand Nursing Informatics. AORN Journal, 100(3), 324.
Shaw, T., Sensmeier, J., and Anderson, C. (2017). The Evolution of the TIGER Initiative. Computers, Informatics, Nursing, 35(6), 278-280.
What you said about the relevance of incorporating nursing and informatics has never been more true. I am also familiar with the TIGER initiative. I would like to focus on your comments about TIGER because it is such a valuable resource for nurses because of the technology tools the program offers. TIGER is a virtual learning environment (VLE) that has webinars and interactive health IT resources (Schlak, Anderson, & Sensmeier, 2013). TIGER also recommends core global informatics competencies (Schlak, Anderson, & Sensmeier, 2013). If a nurse is looking to boost his or her knowledge of applications of health IT in care delivery, TIGER is the way to go (Schlak, Anderson, & Sensmeier, 2013). The cost to register for TIGER is around $40, but nurses who register get unlimited access for one year. It is self-paced and has three levels. In my other class, Health Care Policy, we learned about the four spheres of political action in nursing. One of the spheres is the workplace. TIGER is a great resource to learn about new technology advances in healthcare, which helps me in the workplace. I can share the information I have learned about data management with colleagues and become a leading team member in helping my facility complete federally mandated goals to implement the “meaningful use” of EHRs.
Schlak, S. E., Anderson, C., & Sensmeier, J. (2013). THE TIGER HAS JUMPED INTO THE VIRTUAL LEARNING ENVIRONMENT! Computer Informatics Nursing (CIN), 31(2), 57-58. doi: 10.1097/NXN.0b013e318289c7a6