NR-351 Week 6 Discussion Topic, Use of Informatics in Professional Nursing

 

As a nurse I use informatics in numerous ways daily in my patient documentation, use of monitoring devices, by developing and implementing care plans, looking up of previous medical records and imaging, telehealth when patients call for advice, and access and implementation of current practice standards.

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TITLE: NR-351 Week 6 Discussion Topic, Use of Informatics in Professional Nursing

Nursing informatics is defined by the American Medical Informatics Association as “science and practice that integrates nursing, its information and knowledge and their management, with information and communication technologies to promote the health of people, families and communities worldwide” (AMIA, 2009).  As nurses and health care providers we use informatics in the clinical setting which “addresses the needs of nurses and other health care providers to streamline client care documentation, keep accurate client records, and integrate various aspects of client care to improve the quality of care” (Hood, 2018. pg. 370).

Working in the HBV and radiology dept we sometimes do sedation’s on patients without knowing ahead of time it is needed or when the patient is already on the CT or MRI table.  Unlike a scheduled OR case, most of the time I am getting paged and given a verbal order from the MD for Fentanyl and Versed to be administered for procedural pain management as the procedure is being performed.

Now that our hospital has transitioned to the use of EPIC for our EMR, we as nurses can order the medication and pend it to the MD to sign in the future but will still show up in the patients MAR to be linked to the med I over ride and pulled from the PIXAS.  This will trigger any medication interactions and allergies, giving me a second check on the allergies I was quickly reviewing as I am drawing up the medication.  With the MAR now being on EPIC EMR in the procedure room I can quickly see what pain medications if any the pt. has taken previously.

I can also order the medication to be given in interop multiple doses so if the MD orders more I can chart quickly on the same medication pull by administering and scanning the bar code of the pt. and the medication.  This will immediately document the time of administration for helping monitor the patient for the appropriate hospital protocol time frame of post sedation patients.

Ethical issues that I noticed that have arisen from use of informatics in my time as a professional nursing have been that with the ease of access to patients’ medical records there is ease of access to information the intrude on patients HIPPA rights.  Living on a small island that only has one hospital you daily see someone you know coming or going to the hospital or departments, or you see a name you know of friend or family member on the patient lists.

There have been numerous times that myself have gotten a call from a friend that has “someone” here being seen at the hospital and requesting that I review their chart and give them information on there care.  I tell them as diplomatically as I can that I can neither confirm or deny that that patient is in our hospital and that looking into a patient’s medical record chart for someone is not only unethical but also breaches their right to have medical management and records private.   As stated in the Code of Ethics for Nurses provision 3 by the American Nurses Association “The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient” (ANA, 2015).

Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Philadelphia, PA: Wolters Kluwer

American Medical Informatics Association. (2009). Nursing informatics. The Science of Informatics. Retrieved on April 14, 2020 from https://www.amia.org/about-amia/science-informaticsLinks to an external site.

American Nurses Association. (2015) Code of ethics for nursing with interpretive statements. retrieved on April 14, 2020 from https://www.nursingworld.org/coe-view-only

 

Use of Informatics in Professional Nursing How do you use informatics and technology in your nursing practice? How do you see that use changing in the future? What ethical issues have arisen or might arise from use of technology and informatics in professional nursing? — Response 1: 2/7/18 Professor and classmate, According to “nursing informatics (NI) is the specialty that integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice” ( staff, n.d.).

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Using Informatics and technology has become integral part of nursing. There’s different devices and platforms that can be utilized to chart in a patients electronic health record (EHR) which “stores client health information digitally in a secure database” (Hood, 2018). I chart on my company provided ipad and/or iphone into the company’s specific platform and the information is immediately available for the entire team to see.

 

The company also has a secure encrypted program for documents that need to be uploaded into the patients chart, for example DNRs, Advance Directives, or hand written orders. This allows continuous of care since in hospice our patients can be in various locations. The patient could be in the hospital one day then go home and from there go to one of the companies in patient unit and then end up at a nursing home.

The patients history and important documents are at the touch of a finger the whole time. Technology is constantly evolving and improving. Different platforms and updates can streamline and make charting more efficient. With all the changes and new technology’s ethic issues could arise.

 

Conflicts between technology and religion or beliefs. For example, debates over stem cell therapy. Some people argue over when human life actually begin. “Does life begin at conception or when the fetus becomes viable?” (Hood, 2018). Along with technology come advancement in procedures but also cost of those procedures.

 

This is another ethical issue as not all people can afford these procedures, so they can not benefit from them. This can cause a difference in the quality of care a patient receives (Hood, 2018). References: staff. (n.d.). What is Nursing Informatics? Retrieved from : Hood, L. (2018). Leddy & Pepper’s Professional Nursing, 9th Edition. Philadelphia: Wolters Kluwer.

Recently, there has been an exponential rise in healthcare informatics applications. This increase can be attributed to widespread adoption of technologies like electronic medical records (EMRs), mobile phones and telemedicine; all which have had a transformative effect on delivery and management (Sewell 2019).

The advantages of technological advancements in health include data accessibility, improved communication among healthcare providers, faster diagnosis times, and improved patient outcomes are among the many potential advantages. The disadvantages include high initial implementation costs, the potential for technical glitches or system failures, and data security/privacy concerns.

Another contributing factor is the requirements of government and regulating bodies. Governments and regulatory bodies have mandated that healthcare organizations adopt HIT and utilize informatics effectively (Sewell, 2019). Advantages of this include standardizing healthcare data, improving interoperability among systems and better coordination of care delivery. Disadvantages include compliance issues, increased administrative burden and potential for workflow disruption during the implementation phase are some of the potential drawbacks to consider when considering an IT-enabled workflow management solution.

Additionally, the transition towards Value-Based Care has increased demand for healthcare informatics. The healthcare industry is moving toward value-based care models. Pros include improved care coordination, greater patient engagement, focus on preventive healthcare and cost savings through efficient resource utilization (Sewell, 2019). Implementation challenges, the potential for increased administrative burden, and difficulties accurately measuring outcomes and ascribing value can all hinder their successful implementation.

One external force contributing to the increased adoption of informatics includes global health challenges such as pandemics which have highlighted its critical role. Pros of using informatics in managing pandemics include collecting, analyzing, and sharing real-time data for early detection and response (Basit et al., 2021). Disadvantages include data quality/accuracy challenges along with technical infrastructure/interoperability issues, among others.

References

Basit, M. A., Lehmann, C. U., & Medford, R. J. (2021). Managing Pandemics with Health Informatics: Successes and Challenges. Yearbook of Medical Informatics, 30(1), 17–25. https://doi.org/10.1055/s-0041-1726478

Sewell, J. P. (2019). Informatics and nursing : opportunities and challenges (6th ed.). Wolters Kluwer.