NURS 6050 Discussion: Interaction Between Nurse Informaticists and Other Specialists
Futuristic informatics and improvements of care in an inpatient setting.
In a inpatient or hospital setting, you never really know much about the patient you will be getting from triage or maybe off the street. You may receive a report perhaps five minutes of brief history, and it is up to the nurse to then assess the patient, IV the patient, pull labs, complete a patient data screening, place monitors on the patient, and make the patient feel like they are being cared for and important while monitoring your other patients. This is not an extensive description of what the nurse does but, you get the point. The nurse must coordinate with the doctor, the lab, the pharmacist, radiology, social work, the residents, the techs, the charge nurse and with navigation relaying all pertinent information about the patients needs and plan of care.
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Many of these interactions are done via technology like through a pharmacy messaging system, order sets placed, consults inputted and screening alerts. Many times; due to deficits in the systems or missing information, the alerts or messages in the systems can create a lag or disruption in timely care for the patient. An example of this would be for providing the patient with their medications. More often than not, because of the specificity of some of these programs; requesting medication orders may fall short by orders for medications going missing, getting overlooked or not stocked for patients arriving on the unit; ultimately hindering the patient’s medication(rights), disrupting care, prolonging wellness, and shrinking the patient’s faith in receiving excellent personalized care from both the nurse and the establishment.
There is a solution that is both patient centered and informatics driven to ensure this doesn’t happen. Informatics and the other providers, would play a huge part in making sure the patient centered experience is specialized and set up for success and improve the present system utilized now. An example would be informatics and the patient centered approach with the nurse and the pharmacy.
- Navigation would tell the nursing board where the patient will be placed on the unit, alerting pharmacy of the patient arrival with a special message giving the patient allergies, prior medications, current medications and aliments, upcoming orders sets, and existing vitals and comorbidities.
- Pharmacy then reviews information and order sets; then send all medications to the patient room either via tube system or robotic device where the medications are locked and stored in the patient rooms along with Narcan and any other counter active meds that may be needed.
- During the nurse’s admission of the patient in the patient data screening the nurse then verifies all medications, doses, routes. Times, Hx, brief educations, and allergies. This make the patient aware of the upcoming plan of care with medications and make the patient feel like a VIP due to the Services they are receiving.
- The meds are kept in the room under computerized control locks and the pharmacy gets the verifications that the nurse has verified, educated and gone over the plan of care with the patient further solidifying patient history, doctor medication orders and patient medication rights.
The benefits of this process of futuristic nursing and informatics with multiple departments would enhance the patient experience and allow the nurse to focus on assessments, active listening, patient caring, education and ultimately patient wellness (McGonigle & Mastrian, 2022). Something as small as having the patient medications stocked, visually verified, and readily available helps to relax the patient and allows further trust in healthcare system and the team delivering the care.
McGonigle,D. & Mastrian, K.A. (2022). Nursing Informatics and the foundation of knowledge; The fifth edition. Chapter 25 p. 595-607.
McGonigle,D. & Mastrian, K.A. (2022). Nursing Informatics and the foundation of knowledge; The fifth edition. Chapter 26 p. 611-624.
I love your thoughts on giving patients the “VIP treatment.” I agree and believe that people often do not remember what you said to them, but they remember how you made them feel. I am a firm believer in treating people the way THEY want to be treated, and that kindness and consideration go a long way. I advocate for ensuring that patients get their home medications reconciled and restarted when they are hospitalized because I have often seen that patients are not provided with their home medications while inpatient.
Your idea of having medications readily available is right on point with ensuring continuity of care and medication compliance. I work in a psychiatric facility, and noncompliance is a huge issue for my patient population. At this point, I do not believe healthcare facilities would spend the funds to have medications be available in the room. It would be a great idea, especially in emergencies and codes, to get medications quickly from the pharmacy. The cost up-front would be about 12 million dollars, but the investment would decrease the cost spent over time due to healthcare facilities with a poor design (AHRQ.gov., 2017). I am not sure of what type of medication dispensary your facility currently has. However, it would be fantastic and cost-effective if your idea would alert the pharmacy. If the patient’s medication is not located on the unit, the medications can be immediately delivered to the unit to ensure timely administration.
According to Mosier and Englebright, nursing informatics solutions are made with a clear structure and leadership (2019). Working in healthcare, we see things that can be improved, and who is better than us to inform the leadership of things that can and should be improved? In the meantime, I suggest that we get back to building trust with our patients, and I think treating them like VIPs would help tremendously.
Agency for Healthcare Research and Quality. (2017, February). Transforming hospitals. https://www.ahrq.gov/patient-safety/settings/hospital/resource/transform.html#cost
Mosier, S. , Roberts, W. & Englebright, J. (2019). A systems-level method for developing nursing informatics solutions. JONA: The Journal of Nursing Administration, 49 (11), 543-548. doi: 10.1097/NNA.0000000000000815.
5051 Response 1 discussion 2
Within our system, we do not call report except to ICU. With the assistance of our NIs, we have an electronic report sheet called PassMeSafeLee that contains all the information you’ve mentioned. Completing the home medication list is the responsibility of the ED RN or ED Pharmacist. Some medications cannot be sent through the tube system, such as very expensive monoclonals, chemotherapy drugs, or blood products (due to current shortages). It is crucial that you have included the need for that individual patient-centered interaction. Technology should add to our care, not replace it (McGonigle & Mastrian, 2021).
Transfers to nursing homes can have an 11% incidence of medication errors (Tong et al., 2017). How do you envision this system to work in the transition of care? Not just from within the hospital, but to SNFs or rehabs? Do you foresee more accurate discharge medication reconciliations with your proposal?
McGonigle, D., & Mastrian, K. G. (2021). Nursing informatics and the foundation of knowledge.
Tong, M., Oh, H., Thomas, J., Patel, S., Hardesty, J. L., & Brandt, N. J. (2017). Nursing home medication reconciliation: A quality improvement initiative. Journal of Gerontological Nursing, 43(4), 9–14. https://doi.org/10.3928/00989134-20170313-04
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
- Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)
- Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)
Do you feel that the electronic report is more or less accurate and accepted versus the verbal report? I am actually asking because I was recently asked to collaborate with my emergency department. They want us to come up with a plan to standardize and expedite our report process from the ER to the floors, except for the critical care units. I would love to hear what you think.
A standardized method of giving report is important to reduce the chance of medical errors due to lack of an efficient handoff report. (Blazin et al., 2020) Often while giving a verbal report, it is easy to forget to mention something. Many times, I have had to track down the nurse I gave report to because I forgot to tell them something. A cheaper method was proposed of sending a written standardized report through the pneumatic tube station. I feel this may lead to the report not getting to the nurse in a timely manner though. “The use of an electronic, standardized handoff communication process resulted in decreased boarding time and increased bed flow efficiency.” (Potts et al., 2018) I am leaning towards following your hospital’s example and recommending an electronic handoff. Your post really helped me by leading me in the right direction for my research.
Blazin, L. J., Sitthi-Amorn, J., Hoffman, J. M., & Burlison, J. D. (2020). Improving Patient Handoffs and Transitions through Adaptation and Implementation of I-PASS Across Multiple Handoff Settings. Pediatric Quality and Safety, 5(4), e323. https://doi.org/10.1097/pq9.0000000000000323
Potts, L. , Ryan, C. , Diegel-Vacek, L. & Murchek, A. (2018). Improving Patient Flow From the Emergency Department Utilizing a Standardized Electronic Nursing Handoff Process. JONA: The Journal of Nursing Administration, 48 (9), 432-436. doi: 10.1097/NNA.0000000000000645.
I believe you articulated all that needed to be said precisely, since by providing patients the “VIP treatment,” they will feel more at ease and cooperative with us, which will help us ensure they are receiving the right professional help they deserve. The notion of having pharmaceuticals readily available at all times is a fantastic one that will improve how patients feel about coming to medical centers and asking for treatment, knowing that help will always be available to them. It will make patients more cooperative and trusting, and it will play a significant role in enhancing the patient-nurse relationship. Furthermore, returning to the “VIP treatment,” I wanted to emphasize that having the meds on hand at all times is not what makes the treatment a “VIP treatment,” rather it is more than that. When people deal with a VIP, their attitude toward them is significantly different; they are very pleasant and cooperative with the VIP member, which helps the VIP member feel more at ease. All I want to emphasize is that the nurse’s attitude toward the patient is the most important aspect of the “VIP treatment,” and having the medication on hand will only assist and assure that the patient feels that way. According to Iddirsu (2021), a study was conducted to determine how nurses’ attitudes toward patients influence their collaboration, and it was discovered that in health care settings, the contact between nurses and patients is crucial in sustaining effective and efficient health care delivery. Many of the participants had good opinions of nurses’ attitudes, which influenced their hospital attendance, whereas others believed that nurses’ attitudes toward them caused them to attend a private facility. Almost all participants agreed that patients should have a positive attitude and behavior toward nurses, and that better communication between patients and nurses is essential for enhancing the nurse-patient relationship.
Kennedy Diema Konlan, Joel Afram Saah, Abdul-Razak Doat, Roberta Mensima Amoah, Juliana Asibi Abdulai, Iddrisu Mohammed, & Kennedy Dodam Konlan. (2021). Influence of nurse-patient relationship on hospital attendance. A qualitative study of patients in the Kwahu Government Hospital, Ghana. Heliyon, 7(2). https://doi.org/10.1016/j.heliyon.2021.e06319