Healthcare Informatics Resources

Autism Today

Admin — Wed, 10 Mar 2010 22:53:40 +0000

Information regarding the disorder of Autism is certainly prevalent in our world today. The “Autism Speaks” organization advertises on television that one in one hundred fifty children are afflicted with the disorder. If correct, these are alarming statistics. It is well documented that all socioeconomic groups and boys more than girls are impacted. The diagnostic process often begins when toddlers do not meet speech and other developmental milestones. The current impact to our schools and other systems as attempts to assimilate the children into society are overwhelming at best. The long-term impact to society and public health resources related to the special needs of this group are yet to be fully realized. The impact on a family is more than those of us not experiencing it can understand. I know well a family in which two out of three children are diagnosed as Autistic. One child is profoundly challenged while the other is able to attend schools, but is clearly socially challenged. The family dynamics were not uncommon. The father enmeshed himself in work. The mother blamed herself for being unable to manage her children. It was a very unhappy home. Health care visits did not readily detect the issues for some time, which allowed denial, frustration and blame to continue. It was interesting to observe the relief when finally having a diagnosis and access to the treatment that would ultimately begin to improve the situation. The state of Arizona recently passed legislation requiring insurance companies to fund advanced therapy for Autistic children. Proponents of the bill contended that the early intervention costs would be offset by costs later in life once the children are able to contribute to society. Those arguing against the bill stated that costs will be passed on to all and that it is unlikely that profoundly Autistic children will ever be emancipated from the health care system. Also of note is the fact that our textbook, Health Promotion Throughout the Lifespan, 6th Edition, by Edelman and Mandle does not directly address Autism, probably because it was last updated in 2006. Certainly upcoming editions will address the disorder along with the role of the nurse in working with the child and family members. This is a good example of how the Internet and other sources can provide real time information.

Health Promotion/Disease Prevention Online Class

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Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Informatics Communication, Health Care Informatics References, Health Care Informatics Internet, Health Promotion/Disease Prevention Online Class, Patient Education & Counseling Online Class, Health Care Informatics Online Certificate Program, Healthcare Informatics Internet, Healthcare Informatics Autism

Advanced Physiological Nursing Course via Internet Learning

Admin — Mon, 08 Mar 2010 15:25:26 +0000

I couldn’t agree more with the writer of this discussion forum. I have learned much more from this course than if I was sitting in a traditional classroom. I am able to proceed at my own speed. I can concentrate more on the systems of the body where my knowledge is lacking and less on the systems I know better. It is less stressful also to be able to take quizzes and tests when I actually have time as opposed to on a schedule set by someone else. I can do my readings when I am at my best instead staying up half the night trying to complete them in time for the next class. It has forced me to really utilize my time management skills.

Original Post
March 4, 2010
Title: Advanced Physiological Nursing Course Via Internet Learning
This was a great course, I feel as though I learned more than I would have sitting in a classroom because I not only had to do the reading but also had to research the Internet to find answers and explanations to questions I didn’t know, was unsure about, or didn’t understand. In many ways this course was harder than the past physiology course I took sitting in a classroom. I think in the classroom it is all too easy for instructors to teach to their test (either subtly or overtly) because their success is on the line. With an Internet course the ability to pass the class and do well rests with me. My goal was to come into this class and learn as much as I can, give more than 100% and achieve the highest possible grade I can earn. I feel as though I have accomplished the first goals and will await taking the final to see if I have achieved my last goal of an A in this course.

Online Advanced Physiological Nursing Course

Tags: Healthcare Informatics, Healthcare Informatics Resources, Online Advanced Physiological Nursing Course, Health Care Informatics Nursing Education, Health Care Informatics Education

Medication Safety

Admin — Mon, 08 Mar 2010 15:18:54 +0000

I have been touched by the many recent news headlines of medication errors, especially those involving newborns. In yesterday’s news covering a Las Vegas malpractice case, a sobbing pharmacist was apologizing to the parents of a deceased infant who was the recipient of a drug overdose prepared during her watch. The pharmacist was so distraught that the mother of the deceased infant left her seat in the court room to comfort her. Our text discusses the potentially harmful effects of medications during pregnancy, during labor, and to newborns. In watching the coverage and reading the text, I was reminded of the many times during my career that I have witnessed errors and myself experienced serious near misses with medication administration. It is devastating when such events occur to both the patient and the health care practitioner. Safe administration of medications has always been the goal of healthcare providers, but it seems that despite all of the resources available, errors continue at alarming rates. This is so much the case that The Joint Commission has charged hospitals to improve the safety of medication administration in their National Patient Safety Goals. Information regarding dosing, drug interactions, etc. is readily available in many formats to those preparing and administering medications. We have medications provided in unit dose increments and dispensed by machines. As a standard of nursing care, we perform a minimum of five checks before administering medications. Some medications require two nurses to verify the dose. We have changed our practices with patient identification to reduce the likelihood that medication is given to the wrong person. Yet, with all of the available information and redundancies built into the system, life threatening errors occur. There is a federal movement underfoot for all healthcare organizations to have electronic medical records in place. A medication administration record that does not require manual transcription would be an adjunct in reducing transcription errors. However, the data base is only as good as the information that it is provided with, leaving the potential entry for errors. Electronic data bases provide very useful information for tracking, measuring and determining clinical quality. This would help us evaluate process errors and to revises processes based on the knowledge gained. At the end of the day, with all the tools and information at hand, it is the end user who is the last and most important stopgap in safe medication administration. The available tools are like a hammer. A great hammer still needs a skilled carpenter to achieve a great outcome. It is my belief that our focus should be in development of the “carpenter” and the processes used by the “carpenter” with regard to medications. This would involve more training with medications; time to recalculate what is prepared in pharmacies, and an evaluation of the environment, including patient assignments and ratios. The costs incurred would be minimal compared to the cost of a human life or a lawsuit related to negligent practice.

Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Informatics Medication Administration Record, Health Care Informatics Electronic Medical Record, Health Care Informatics Medication Safety

Advanced Physiological Nursing Course via Internet Learning

Admin — Thu, 04 Mar 2010 20:01:20 +0000

This was a great course, I feel as though I learned more than I would have sitting in a classroom because I not only had to do the reading but also had to research the Internet to find answers and explanations to questions I didn’t know, was unsure about, or didn’t understand. In many ways this course was harder than the past physiology course I took sitting in a classroom. I think in the classroom it is all too easy for instructors to teach to their test (either subtly or overtly) because their success is on the line. With an Internet course the ability to pass the class and do well rests with me. My goal was to come into this class and learn as much as I can, give more than 100% and achieve the highest possible grade I can earn. I feel as though I have accomplished the first goals and will await taking the final to see if I have achieved my last goal of an A in this course.

Online Advanced Physiological Nursing Course

Tags: Healthcare Informatics, Healthcare Informatics Resources, Online Advanced Physiological Nursing Course, Health Care Informatics Nursing Education

Lessons Learned: The Completion of a New Installation

Admin — Mon, 01 Mar 2010 20:02:01 +0000

In August our hospital implemented the e-mar – electronic medication administration record – documentation system. It was decided by the powers to be that a "Big Bang" roll-out would work much more efficiently than trialing the system on one unit first. This decision was made despite the months of "team" meetings where numerous members of lower Leadership expressed their concern and apprehension. Part of the package purchased with the software contract included on-site program developers and support. It was with this promise of guidance and support, that we were urged forward – pressured into meeting our initial launch date. It was said that we were facing a change in "thought process" among the older staff members – we were told that once the product was on the units that "buy in" would be quick – that the system was here to stay and the staff would have no choice but to adapt and accept. It has been and absolute nightmare to say the least. We have literally two nurses assigned to our computerized programming department. Neither one has had actual computer training other than what the emar company has provided. The provided program developers are nonclinical based professionals trying to create in a clinical field. Input from participating departments is often dismissed. Instruction to the staff has been inconsistent with unit based nurse clinicians being forced to teach computer classes with minimal orientation and little to zero resources. Feedback to staff over system errors, challenges and restrictions is inconsistent and varies depending on who is delivering the message. The list could go on for pages and has created dismay and distrust, a sense of failure within the Nursing department. Pharmacy has had an even more difficult struggle – expressing their concern over the timing and method of implementation during a period that their department had several vacant positions, including that of a department director – but we had a deadline to meet after all. In addition we have since discovered that there are several different software systems being utilized throughout the organization, L&D, ASU, Endo, OR, IRU, Dialysis, offsite, Dental and ER – to name a few. Not only do these systems not communicate with each other but they are for the most part not able to effectively incorporate the e-mar system. This has created an environment of half paper half electronic documentation, inconsistent between departments. Errors are being made, system failures and limitations are not being addressed within a timely fashion – if at all. With that said, the e-mar system may be more time efficient, cost effective, and allow for increased patient safety…but without expertly trained program developers, consistent clinical based instructors, adequate and around the clock implementation support staff, consistent and accurate communication between all departments of the organization – including frontline staff, realistic goals and time lines and the ability to make corrective and adaptive changes – the transition for the staff can become difficult, frustrating and unsafe for both patients and healthcare professionals alike.

Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Informatics electronic medication administration record e-mar, Health Care Informatics Electronic Medical Record

Assessments and point of care charting, comment

Admin — Mon, 01 Mar 2010 19:41:20 +0000

I absolutely agree with all the comments presented in the below link. Being that computerized documentation is less than 6 months old in our main facility, bedside point of care charting is a relatively new concept. It used to be that the only documentation performed at the bedside was the patient database and even then, most of that information was gathered on initial assessment and we would then go out to the desk to complete the paperwork. I think as more organizations embrace technology, more thought needs to go into the purchasing of equipment. At our facility, the managers for each unit were given a budget to purchase the style of computer they thought would be best suited for that particular unit. Pods were designed with central computers, handheld devices were purchased as well as COWs (computer on wheels). Many units after the fact discovered that the COWS were too big to get to the second bed in the room. This caused non-compliance with The Joint Commission standard stating that the e-mar must be at the bedside when administering medications. Other units found the hand held devices to small to use – the type to difficult to read. Pods are great for the primary nursing concept but takes the nurse away from the bedside. Many areas discovered just how few available outlets they had how short a battery life really is. We even had to become politically correct when a patient complained to administration that she overheard a nurse in the ER referring to "that stupid COW that had died in the hallway" – not realizing the nurse was frustrated that no one had bothered to plug the computer in to charge. We now refer to COWS as WOWS – work stations on wheels. With all that aside, we are finding that wall based point of care computers work best allowing optimal contact with the patient while gathering crucial information to be utilized in their treatment of care – as long as the computer is not on a wall that forces your back to the patient the entire time you are typing!

Original Post
December 14, 2009
Title: Assessments and Point of Care Charting
Charting patient assessments is often a time consuming task, but vital to the care of the patient and record keeping. Nursing often jot notes down on a piece of paper, to only later record them into the computer system. Much may be lost in the translation. In addition, actions may be taken on the charting that in currently in the computer, though it may not always be the most current reflection of the patent’s status. Point of care systems have become paramount for charting in acute care settings, especially on critical care units. They often interface with medical devices to collect data automatically. These systems are often flowsheet orientated and provide graphing and trending capabilities. Optimally these systems create less redundancy, offer quick responses and interface with other clinical operations such as the laboratory and pharmacy departments. The computer availability is also an important consideration. Central computers have not always enhanced charting as they may take nurse from the bedside. Point of care charting should be convenient points of access to the system. Computers on Wheels (COWS) are found in many organizations. The portable, efficient system allows the nurse to chart in the patients room when appropriate. Bedside systems at the point of care focus on quickly capturing information that a nurse may otherwise jot down on their notes. Computer location should be given thoughtful consideration before investments are made in addition to the device’s speed and ease of use.

Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Informatics Point of Care Charting, Health Care Informatics Computers on Wheels Charting, Health Care Informatics Assessments Charting, Health Care Informatics Work Station on Wheels

Charting in the Era of e-mar, comment

Admin — Mon, 01 Mar 2010 19:28:03 +0000

Part of my role as a nurse clinician is that of ensuring that a newly hired RN is able to independently pass medications. Our facility policy is to have the initial med pass performed with a clinician and once deemed competent the new hire can continue medication administration under the supervision of a nurse preceptor (another RN assigned to that nurse). Like most hospitals, the demand to push these new nurses through the orientation process and into independent practice is tremendous. We often short come the orientation and nurses today are learning on the fly. A proper preceptorship should consist of a seasoned and experienced RN with a smaller patient load, working with the new hire and delegating tasks until they feel the new nurse can perform and handle a patient load on their own. In the real world – the new hires are often treated as additional staff and the preceptor is ending up with double the patient assignment because they have an "extra" pair of hands. The preceptor is so busy trying to complete and care for the additional patients the new hire is often left unattended. During an observed medication pass this morning I was dismayed to watch the nurse flip to the drug information screen on her e-mar instead of actually taking the time to look up the medication in a drug guide. Was it more time effective? Yes, but she just glanced at the first sentence or two grabbed a keyword and assumed that was the drug’s intention. A few times I had to encourage her to go back and read the entire screen – point out that she was glossing over key information such as adverse reactions or drug interactions. With all the tremendous technological advancements we are making in healthcare today, I hope it is not as the cost of patient safety and nursing accountability.

Original Post
January 4, 2010
Title: Charting in the Era of EMR
I am still of the era of nurses that entered a patients room with my rounds sheet tucked into my uniform pocket. The secret was to not let the patient see this sheet, and be able to remember their name, main diagnosis, and what you needed to check in them. You would go through your complete assessment including vital signs, and when you left the room you would pull out your little sheet of paper and write down all of the information you just collected. This procedure was repeated for all eight of your patients. When you were done, you then sat at the nurses’ station and pulled the individual charts so you could transfer the information onto the required forms.

It is not hard to see how the electronic medical record has benefited the role of nursing. The first improvement is in time management. You can actually take the information and enter it once. This is the only time you write the information. The second advantage is in correct data entry. You can enter the data as you gather it. There is less chance of forgetting the information before you write it in the patient record. The third benefit is in gathering the correct information on each patient. Electronic medical records prompt you to gather the required information.

I speak purely from a hypothetical standpoint because I personally have not had the chance to utilize an electronic medical records system. Our hospital is still struggling to come up with the money required to purchase and implement a system. I can, however, dream about how easy it will make my life once we get one!!!

Online Healthcare Informatics Educational Certificate Program

Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Informatics Electronic Medical Record, Healthcare Informatics Electronic Health Record, Healthcare Informatics electronic medication administration record e-mar

Choices that prepared me for my online nursing classes, comment

Admin — Mon, 01 Mar 2010 18:52:00 +0000

I think the biggest hurdle I’ve encountered with the decision to obtain an online degree, is the time management. I have never been a master of my time to begin with and trying to juggle the children, a full time job and school – amongst the hundreds of other commitments we all have, has been quite a struggle for me. I envisioned putting the children to bed with plenty of free time at night to study on line. I now realize that 1000 at night is not necessarily the optimal time to read and retain learning material. I also wished I had taken in account how stressful it can become when your taking a timed exam and the kids are running in and out of the room while the incoming calls are knocking offline! (yes I live in one of the few areas in New York that still uses dial-up service) If any, an important lesson I have learned throughout this experience is to impart time management unto my children – that it is an essential skill needed not just in healthcare but in life in general.

Original Post
February 1, 2010
Title: Choices that prepared me for my online nursing classes
We all made choices about the types of courses we wanted to take when we were in junior high school and high school. I went to high school long before the age of computers but know one course choice I made in 8th grade prepared me well for this class. No, it wasn’t a science class or a health class but instead it was a typing class. I cannot imagine doing the homework assignments if I couldn’t type fast. Thank you to my parents for encouraging me to take typing, I remember telling them, it was a waste of time and I wouldn’t need it as a nurse. I apologize to them both and thank them for guiding me well.

Online Education Health Care Informatics Certificate Program

Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Informatics Education, Health Care Informatics Preparation, Health Care Informatics Online Certificate Program Education, Health Care Informatics Nursing Education

Lessons learned:The completion of a new installation, comment

Admin — Mon, 22 Feb 2010 15:31:14 +0000

The small community hospital where I work is currently coordinating the install of our second electronic charting system. The initial install with the first company was a complete disaster as communication between project managers and management was lacking. It is vital for all departments to communicate in order to best meet the needs of all involved. After training our entire staff, it was discovered that the different departments of the hospital had different goals and needs for their EC and the departments were unable to communicate with each other via the charting system chosen. The entire project was scrapped and a new company chosen that could meet everyone’s needs. It was unfortunate that the time and money was wasted due to each Department manager having separate discussions with the IS department and the IS department not coordinating their discussions amongst everyone. We are two years later, no electronic charting as of yet, still need to train the staff again on the new system, and a lot of money wasted that healthcare just doesn’t have to absorb right now.

Original Post
March 9, 2009
Title: Lessons learned: The completion of a new installation
It is said that life imitates art. I have found that for me recently life has paralleled my studies. I have recently completed a project that I followed from inception to completion. It has been an interesting journey.

I began this journey in October of 2006. I was new to healthcare informatics and project management having just taken a new position a month earlier. I was asked by the CNO who I report to directly, to coordinate the demos of three companies who were to show us their vital sign solutions for a system that would integrate with our Meditech EMR. This was a bit of a challenge at first as I had not done anything like this in my nursing career; however my family owned several retail stores so I was familiar with salesmen and felt confident in my ability to deal with them.

After having arranged the demonstrations and gone through the process of narrowing it down to 2 vendors we had many discussions between IS and nursing about which vendor we would choose. The CIO moved ahead and approved purchase from a vendor who would also supply us carts on wheels. After receiving the carts it was found that the vital signs equipment they had shown us in the demo was not what was on the carts. The equipment did not work and there was not a previous interface with Meditech as they had told us.

First lesson, communication is of utmost importance in selecting a vendor and implementing a new system. The CIO had made this decision without the approval of the CNO and had not talked with me about this also. Therefore the system did not meet the needs of the clinical staff though the IS staff felt it was the best choice. This was the second lesson which has been discussed in these chapters of Health Care Informatics, An Interdisciplinary Approach, the need for the healthcare informatics professional to understand the needs of the clinicians.

After more discussion and deliberation another vendor was chosen and we began the task of assessing and deciding how much equipment to buy, getting board approval and going through with the purchasing process. At this time the CNO officially appointed me as the project manager.

I began setting up the acceptance of the products and working with the implementation team to coordinate not only training of the end users but working with the IS staff on the integration with Meditech. This provides the 3rd lesson which is also discussed in this module of my educational program. Never underestimate how many different entities are involved in a project. Not only were IS and the nursing staff effected but so were the bioengineering, purchasing, physicians, of course patients as well as safety and quality assurance departments.

One of the issues that are discussed in this module is the need to meet standards set by many agencies that the hospital answers to from JCAHO and OSHA to IEEE and AHRQ. It was interesting to see how this project required attention to many of these standards.

We came across many “bumps in the road” on this project. There was a previously unplanned upgrade to Meditech which delayed implementation. There then was a problem with Meditech not accepting messages from the PDA’s used to download vitals into the Meditech module which required a “special build” from Meditech. There were wireless assessments, training to both the IS and the bioengineering staff for support and maintenance of the system. There were builds needed both in Meditech and in the software on the PDA’s for the integration and then there was the issue of a lost shipment of PDA’s.
At times I doubted the project would ever come to fruition. However, with much communication, organization and attention to detail we were able to complete implementation of the project with the final go live on March 4th. We are live on 5 inpatient units and are now looking to expand this to the outpatient arena. The staff loves the new processes and feels it has improved safety with positive patient ID and real time documentation of the vital signs. The team worked together, IS, bioengineering, and nursing as well as the other involved entities as well as the implementation team from our vendor, making the actual go live was a very smooth and positive process for all involved.

The final lessons learned, timing is everything, expect the unexpected, communication is essential and there are no small projects!

Online Education Health Care Informatics Certificate Program

Technorati Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Information Systems, Health Care Communication, Health Care Informatics Certificate Program Online Education, Health Care Informatics Electronic Charting, Health Care Electronic Medical Record

Choices that prepared me for my online nursing classes

Admin — Mon, 01 Feb 2010 20:39:39 +0000

We all made choices about the types of courses we wanted to take when we were in junior high school and high school. I went to high school long before the age of computers but know one course choice I made in 8th grade prepared me well for this class. No, it wasn’t a science class or a health class but instead it was a typing class. I cannot imagine doing the homework assignments if I couldn’t type fast. Thank you to my parents for encouraging me to take typing, I remember telling them, it was a waste of time and I wouldn’t need it as a nurse. I apologize to them both and thank them for guiding me well.

Online Education Health Care Informatics Certificate Program

Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Informatics Education, Health Care Informatics Preparation, Health Care Informatics Online Certificate Program Education

Health care Informatics: data, information, knowledge, and wisdom

Admin — Fri, 29 Jan 2010 15:12:01 +0000

Health care informatics, as defined by Englebardt and Nelson, 2002, is the study of how health care data, information, knowledge, and wisdom are collected, stored, processed, communicated, and used to support the process of health care delivery to clients, providers, administrators, and organizations involved in health care delivery. There are many variations of this definition, all with ultimately the same meaning. The statement that effectively explains the importance of this field is by Hannah, Ball, and Edwards, 1999, that stated, health care informatics, is truly interdisciplinary. In its truest form it focuses on the care of the patient, not a specific discipline. Therefore, even though there are specific bodies of knowledge for each health care profession, they all interface at the patient. The increasing awareness health care organizations are developing towards the informatics discipline is proving its value. I realize it is an evolving discipline and will continue to progress and grow in correlation with technology and the electronic medical record. Information systems, information technology, information literacy, information management-information is all around us every day. Understanding how to evaluate the information available is critical to deciphering the true unbiased detail of the data. Although there is no control of the validity of data available on the Internet and the fact that there is an abundance of information, doesn’t necessarily mean the information on the subject is valid. Following criteria designed to evaluate information, will help an individual find and use quality information. Some criteria to use: is the source or authority reliable; is the data current; is it organized logically and easy to navigate; is it objective and free of bias; and is the data accurate and error-free. Developing a checklist and a form to assist with data collecting and decision making will serve as tools to enhance the evaluation of on-line material. In this age, information is plentiful. Understanding how to collect and process information is vitally important. One simply must be information literate.

Online Education Health Care Informatics Certificate Program

Tags: Online Education Health Care Informatics Certificate Program, Online Education Health Care Informatics Certificate Program, Health Care Informatics Information Systems, Health Care Informatics An Interdisciplinary Approach Englebardt Nelson

Information Technology: A Mandatory Part of Nursing Curriculum

Admin — Fri, 29 Jan 2010 15:02:13 +0000

I feel that most nursing programs do focus on the bedside care of the patients. As a clinical nursing instructor teaching disease process, nursing assessment, medications, clinical skills and patient education are a priority in our program. Our program has integrated technology however. The students that we have are very techno savvy. They have the ability to text page, while taking notes during lecture and respond to IM. These students will have no problem with the new computer charting that many of us “mature” nurses have. Our program gives the students PDA’s with dictionaries, drug books, and lab manuals loaded on them to use as references. Lectures are placed on Blackboard for students to download and study from. We have the ability to interact with our students online for preclinical assignments. This allows the students and instructors to be at home with family and friends rather than back out in the classroom. Nursing schools don’t necessarily have to teach computer skills as part of the curriculum, but can have the students take a class as a prerequisite. Each hospital has their own system and the types of equipment changes as newer and better one arrive. The new nurses will get the training on the equipment and system that is used by that hospital as part of the orientation process. I believe that we are doing a good job of using some of this technology in my program to help better prepare our students.

Online Education Health Care Informatics Certificate Program

Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Information Technology, Health Care Information Systems, Online Education Health Care Informatics Certificate Program

Information Literacy and Information Systems

Admin — Fri, 29 Jan 2010 14:45:16 +0000

Information Literacy There is a phenomenal amount of information available to us every day, which is generally not difficult to acquire: although time-consuming in some instances. We now live in an era where information is all around us, available in various forms and from various sources and relatively inexpensive, and, often at no cost. When an issue requires researching one can gain the knowledge from resources such as: text books, journals, local and national newspapers, television, radio, and the never-ending World Wide Web. To be most effective in utilizing these areas of information gathering, it is important to know how to locate, search, obtain, access, and evaluate the information. This allows for an efficient use of resources. I am pleased to learn of the Information Literacy Competency Standards for Higher Education, which provides a framework for assessing the information by a literate individual. Developing information literacy within an individual is critical to their journey throughout their life. I find it extremely beneficial these standards extend the opportunity to articulate its information literacy competencies within K-12 grades, in order for a continuum of expectations to develop for students at all levels. How fabulous it is to see that information literacy is becoming more of a requirement than a nice-to-know subject in many areas. Additionally, I applaud the regulatory agencies for identifying the need for information literacy to be part of their criteria, this proves how valuable information literacy truly is in the world we live in today. Information Systems is yet another fascinating topic to understand the depths of its function. Basically, this is the “heart beat” of many organizations today. Information systems provide information to the users, which will facilitate the work of the organization. Many times it seems as though Information Systems departments drive an organization and until they say “yes,” to a particular project affecting the company’s infrastructure, it doesn’t happen. This tends to be frustrating for most individuals within an organization. However, understanding the needs, analysis, infrastructure, and resources involved is a critical factor in determining the necessity of implementation of a project request. Unfortunately, moving an organization to another level of automation can be very time-consuming and expensive; however, many times the outcomes can improve workflow processes, increase productivity, and improve data integrity. As I learned, the basic information system consists of 4 elements: people, procedures, communication, and data. As I reflected on these elements, I realized it is an awesome way to identify any “information system” whether manual or automated. For an organization to be successful each element plays a vital role in handling information.

Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Information Systems, Health Care Information Literacy

The Impact of On-line Education in The Rural Setting

Admin — Wed, 06 Jan 2010 15:51:22 +0000

Education of nursing staff in the rural setting has long been a challenge. The cost of bringing educators out into the rural environment to present to a small handful of staff severely limit’s the amount of actual classes a facility can offer. This, coupled with the current economic times, has practically stopped on site education for the rural hospitals. The advent of easy to access and cost effective on line education has been a life saver to the educational component of nursing. It is now possible for the nurses to keep current on trends and standards of practice without having to travel long distances to do so. The hospital doesn’t have to spend as great a portion of it’s to few resources on the education needed by the staff. Those few dollars can now be used for the certifications that need to be done on site, such as trauma nursing core courses. The other benefit to on line courses is that nurses can take these classes while at work, during the times that the unit is patient free. This happens more often than we would like to see, but at least now the staff can use that time for something constructive.

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Online Nursing Courses

Tags: Healthcare Informatics, Healthcare Informatics Resources, Online Healthcare Informatics Education Certificate Program, Online Nursing Courses

Internet Access: Changing Rural Nursing

Admin — Tue, 05 Jan 2010 16:44:32 +0000

Working in a small rural hospital you get used to doing without and making do with what you have. Money is always an issue, and the nursing staff longingly looks at more modern equipment, better forms, and electronic medical records.

While we may be small, we are still held to the same standards of nursing that any nurse is held to. We still need to do patient assessments, carry out doctors orders, and give good, solid patient care. The area that becomes problematic is in the education and discharge instructions that must be given to patients. Without the money to buy programs it has long been a struggle to develop adequate information that can be disseminated to the patient. It is now possible to go on line and take advantage of many free programs that offer patient education materials and discharge instructions.

Our hospital has been able to pick a site that the nurses and providers felt met our needs, and we can go online and print off any education and discharge instructions that will meet each patients needs. We are now able to give disease specific, up to date, instructions. Our patients are now very informed on their disease process, and we passed our Critical Access Hospital survey tag dealing with education and discharge planning.

Online Healthcare Informatics Education Certificate Program

Tags: Healthcare Informatics, Healthcare Informatics Resources, Healthcare Informatics Patient Education Discharge Planning, Online Healthcare Informatics Education Certificate Program

Changes in Cardiac Care

Admin — Mon, 04 Jan 2010 14:21:55 +0000

It used to be that if your heart was “acting funny” you were put in the hospital on a monitor and stuck in one unit in the hospital. Different drugs were tried on you, and you had to stay directly on that unit while someone sat at a desk and tried to capture that “funny” activity on a strip of paper.

We now have technology that allows much more freedom, both for the patient while the heart trouble is being diagnosed, and in the treatments that are available.

Patients are no longer stuck on one unit in a hospital while staff try to catch and document the funny electrical activity. A patient wears a holter monitor that is recording the hearts activity for 24 hours or longer while they continue on with their normal activities of daily living.

If the electrical activity turns out to be a conduction problem, the patient can undergo ablation therapy. This involves putting wires into the heart and stimulating the different pathways of the heart until the one that is causing the interruption is identified. At that point the pathway is ablated, cutting off the pathway. This is all done using computers to analyze the data from the heart.

If the patient does end up in the hospital, the nurse is no longer tied to the desk if they want to watch the patient’s cardiac activity. A patient’s telemetry unit now can be transmitted to small computers that the nurse carries with her as she goes about doing her usual duties. At any time the nurse can check the patient’s status. The small computer will also notify the nurse if it identifies a rhythm that is unusual.

These advances not only help with patient management, but also increase the safety of patient care.

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Charting in the Era of EMR

Admin — Mon, 04 Jan 2010 14:18:01 +0000

I am still of the era of nurses that entered a patients room with my rounds sheet tucked into my uniform pocket. The secret was to not let the patient see this sheet, and be able to remember their name, main diagnosis, and what you needed to check in them. You would go through your complete assessment including vital signs, and when you left the room you would pull out your little sheet of paper and write down all of the information you just collected. This procedure was repeated for all eight of your patients. When you were done, you then sat at the nurses’ station and pulled the individual charts so you could transfer the information onto the required forms.

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Stress and workload, comment

Admin — Mon, 28 Dec 2009 18:54:41 +0000

I also agree with both the original poster and the commentor regarding the stress of completing our nursing degrees and dealing with life in general. I also have a full time job where I travel around the country. I find that our textbooks are too heavy to take on the road so most times, I leave it at home and do my work on the weekends. My family responsibilities have changed as my children have completed their educations and now I feel that I must complete my own education. I am taking the degree completion RN program and find that when I have time to study and read, it is very enjoyable. I do feel stressed during my tests but that was like that 30 years ago in my diploma nursing program. I read that "A state of stress turns on the stress response mechanism" in Thibodeau’s Anatomy and Physiology. Our body helps us respond to stress and usually that works for me. I know that I will feel a lot less stressed when I finish my current class and then my Capstone class. I really feel that I have increased my knowledge and enjoyed learning "again" so much that I learned so many years ago. I think that we will all be better nurses due to this online learning. We should all be so proud of ourselves for pushing through our "stress" and making graduation happen!

Original Post
June 15, 2009
Title: Stress and workload
I thought it was appropriate to discuss stress because that’s exactly what I am feeling about my degree program. It does feature online interaction and computer use. The purpose of my degree program was to prepare myself on how to be a better Community Health Nurse; I did not think it was to send time on academic work. I went to bed last night feeling very stressed. My workday is already 9 hours long and by the time I get to my computer at night I am already tired and stressed. What am I going to do about it? I don’t know. I am sure I am not the only one feeling this way. Many Nurses are already feeling the strain of work, family, education etc. I graduated from Nursing in 1982 at the ripe age of 19; it was a 3-year diploma program. Now it’s all about the degree and it is becoming increasingly difficult for diploma nurses to move forward in their career. With the national nursing shortage one would think the government would concentrate on more effective ways for diploma nurses to bridge over to their degree. I can’t afford to take 2 years off to go back to school and taking a course at a time I will be ready to retire by the time I get my degree.

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Patient Education, Computers, Internet; comment

Admin — Mon, 28 Dec 2009 18:39:16 +0000

I agree that the medical knowledge is much easier for everyone to obtain. It has made it much easier to provide patient education to our patients in the occupational healthcare setting. We simply go to a program called Dynamed and can quickly obtain the information we need, print the patient education flyers, and even obtain continuing education credit for completing the entire reading on the topic. This has made it very easy to provide concise, complete, and up to date information on a variety of topics. I remember 20 years ago in the ER, we had a "card" file on about 20 diagnoses that we gave to patients for information on their diagnosis. It was very generic and non-specific compared to today’s Internet information.

Original Post
May 27, 2009
Title: Patient Education, Computers, Internet
The Internet has made access to medical knowledge much easier for everyone to obtain. At one time the information was only available through books, available at the Dr.’s office, hospital library, or medical library. The information is now available to patients as well as anyone who wants to find more information on a medical subject.
At the click of the mouse, a nurse can find out if 2 medications are compatible in IV form. Before she would have to look it up in an IV handbook, if one was available, or call the pharmacy.
I find that some patients are more informed about their own health, and can participate in their own healthcare, especially when multiple disciplines are concerned. Patients can also look on the Internet and see if there are any natural treatments to assist in their care and then discuss them with their physician. When you pick up an RX, there is printed information about the drug with it.
The Internet has made it possible for many to obtain medical information to either help them as a patient or health care provider.

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Ethics, comment

Admin — Mon, 28 Dec 2009 17:15:02 +0000

Review of Health Care Informatics, An Interdisciplinary Approach by Englebardt and Nelson.

Ethical dilemmas in the workplace can be a very difficult situation to deal with as a nurse. We are often put in the position to be the patient’s advocate and that can be a very tough place to be for the nurse. I, too, have been in a situation where my doctor made a decision on an occupational drug test that was clearly unethical. I had to go to our Medical Director to get advice and when he became involved, the original doctor became very upset. However, that being said, I did the right thing and the outcome was correct. It is very difficulty to make a decision to "go over the doctor’s head" but I was being ethical and I slept much better because I had done it. Unlike the previous poster, the doctor did not understand even after much discussion.

Original Post
May 18, 2009
Title: Ethics
Really enjoyed the chapter on ethics from my textbook in Dr. Johnson’s class; I was lucky enough to attend a 2 day seminar in Ottawa that was mostly focused on ethical dilemma’s in the workplace. We presented different scenario’s which were really useful for future guidance. Of particular interest was the Nurse-Doctor relationship; when to step out of bounds as a patient advocate. We are often faced with difficult decisions regarding treatment of our pts. Do we agree or disagree with what the Dr. has prescribed? In one case I knew if I followed through on the treatment plan that the pt. could suffer undue harm therefore I was left with no choice but to report the problem to a senior medical advisor. It caused an uncomfortable situation for the Dr., and myself however after much discussion he was able to understand I was only acting on behalf of the pt. The chapter really gave me some knowledge of how to handle these situations.

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Nursing Assessment and Simulation Labs

Admin — Mon, 14 Dec 2009 18:51:51 +0000

Gaining much popularity in physician and nursing schools, and in healthcare organizations, simulation labs have proven of benefit. There are especially beneficial applications of the use of simulation labs in the nursing arena. Where physicians often deal in data that is independent of the patient, nursing data is not as abstract. It is generally part of the patient response to a situation or disease process and is often patient specific. The use of simulation labs can identify and replicate patient specific responses. This allows the nurse to use more complex data for identifying patient response patterns. The important development of critical thinking skills is often enhanced. More recently, nursing schools have used their simulation labs to bridge the gap between theory and practice by having student participate prior to their clinical rotations. Hospitals benefit by having students more prepared for real time situations. Students note feeling more prepared and comfortable for their rotations. Applications for hospital organizations is great also. Working with an interdisciplinary team in a simulation setting to critically address an issue is always in the patients best interest.

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Assessments and Point of Care Charting

Admin — Mon, 14 Dec 2009 18:47:36 +0000

Charting patient assessments is often a time consuming task, but vital to the care of the patient and record keeping. Nursing often jot notes down on a piece of paper, to only later record them into the computer system. Much may be lost in the translation. In addition, actions may be taken on the charting that in currently in the computer, though it may not always be the most current reflection of the patent’s status. Point of care systems have become paramount for charting in acute care settings, especially on critical care units. They often interface with medical devices to collect data automatically. These systems are often flowsheet orientated and provide graphing and trending capabilities. Optimally these systems create less redundancy, offer quick responses and interface with other clinical operations such as the laboratory and pharmacy departments. The computer availability is also an important consideration. Central computers have not always enhanced charting as they may take nurse from the bedside. Point of care charting should be convenient points of access to the system. Computers on Wheels (COWS) are found in many organizations. The portable, efficient system allows the nurse to chart in the patients room when appropriate. Bedside systems at the point of care focus on quickly capturing information that a nurse may otherwise jot down on their notes. Computer location should be given thoughtful consideration before investments are made in addition to the device’s speed and ease of use.

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Medical information and the Internet, comment

Admin — Mon, 14 Dec 2009 17:26:51 +0000

I totally agree with you regarding the medical information on the Internet. Have you ever tried to research a medical issue and found so many different sources that even as a medical professional, you don’t know what to trust? I have become very leery of the purpose of each site that I visit for information. Sometimes, they are just trying to sell something like vitamins. I have become aware of the need to check what audience that they are serving in order to determine the validity of their information. Another important issue to check when looking for information is the date that the information was provided since it is very important that medical information is up to date and not stagnant. I always suggest to my patients that they run the information about their diseases past their doctor to determine if it is appropriate to their own personal medical issues.

Original Post
September 25, 2009
Title: Medical information and the Internet
It is becoming increasingly difficult to gauge the reliability of health information on the web. Just until recently, it was extremely difficult for many people to search for healthcare information, but advances in technology, such as the Internet, are making it more accessible. Patient centered medical information on the Internet could provide healthcare professionals with the opportunity to learn more about patients’ and relatives’ concerns and to refer them to such reliable sources of information when and where appropriate. However, little has been done to assess, control, and assure the quality of this medical information that has flooded the web. Difficulty in judging the validity of this influx of medical information thus poses a problem for people using the Internet. The Internet can be a good source of information on common health problems, but advice obtained through the web should not be a substitute for routine care by a family doctor or other medical professional.

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Patient Interaction with their Disease, comment

Admin — Mon, 14 Dec 2009 17:15:57 +0000

Although I believe you have a great idea about patient’s interacting more with their disease, I am very wary about how the patient would get this disease information. It would be hard for each individual institution to have their own body of knowledge and keep it up to date and accurate. As we both know, the Internet medical information is often more like "mis-information." I don’t know how many times that I have heard people quote Internet medical knowledge to be factual when in fact, it is very bizarre. I like the idea of a "pathophysiology" session for each patient. Remember the old days, when as nurses, we were able to educate our patients regarding their diseases? When we had time to sit at their bedside, and do our "patient teaching" without worrying that we really didn’t have time? I believe all patients have the right to information and details about their disease. I think disease management companies with health educators that are dedicated to assisting the patients with daily disease management are a step in the right direction and hope that someday they become an integral part of our insurance companies offerings. I think we both agree that our patients need quality disease education.

Original Post
August 20, 2009
Title: Patient Interaction with their Disease
Wouldn’t it be cool if patients who are admitted to the hospital for a chronic illness could be connected with an online program that teaches them about their disease? Maybe the patient could check out a laptop for a few hours and then there could be information given to them about their disease. Medications and the important information that goes along with them could be reviewed (this could be tailored specifically to the medications the patient is taking/will be sent home with). Also a little pathophysiology lesson could be given in an interactive exercise that reviewed anatomy and then changes at the cellular level due to the chronic disease. The program could then go into warning signs of an exacerbation of the disease and when to contact their health care provider or call 911. At the end it could talk about how the patient can work to control their illness at home. The program could include print offs of the medications and disease information. If the patient had questions they could take notes and ask their health care provider before their discharge. I think it is so important for a patient to feel that they can have control over their chronic illness. I think that if patients were better educated about their disease processes that hospital admissions/exacerbations would decrease. I firmly believe in educating patients about their illnesses and believe that a user-friendly computer program would greatly benefit patients.

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The use of learning aids, comment

Admin — Mon, 14 Dec 2009 16:59:18 +0000

I agree wholeheartedly with the post about the value of the chapter learning aids for the Advanced Physiology course. I believe even as an "old-timer" nurse that they are very valuable. I have not taken an A/P college course for 32 years and through study of this course, I am finding out that I really needed the review. I believe the tables summarize very well the information that I need to review. I am amazed at the quality of this text compared to the texts that I had in my previous educational experience. Also, a visual learner, I appreciate the illustrations and find them very valuable in "seeing" what is being taught. I am finding that studying and testing in an online course situation, is in fact a great way to get the educational credentials that are needed in today’s workforce. I appreciate the organization of this text book and find that the time that I am taking to use the textbook is lessened due to the valuable format. I am in Dr. Johnson’s class using ANATOMY & PHYSIOLOGY, 6th Edition, by Thibodeau and Patton.

Original Post
September 14, 2009
The use of learning aids
The use of the chapter learning aids for the Advanced Anatomy and Physiology course are excellent tools for any student, whether you are a novice or expert nurse. I am sure I am not the only student who has not done an in depth review on A& P for quite some time. The tables really help to summarize the information and the boxes give you a visual description of the illustrations; which definitely enables me to take the material I have read and apply it to the concepts. On line study is difficult at times, it allows the convenience of working at your own pace but at times the lack of classroom interaction proves challenging for me. I am more of a visual learner and I really appreciate all of the added material and tips this course has to offer. It is a lot of information to process but the aids definitely help!

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Nursing Electronic Charting

Admin — Tue, 08 Dec 2009 15:58:36 +0000

The use of electronic charting has increased the accuracy and completeness of nursing documentation, eliminated redundancy, automated the collection and reuse of nursing data and facilitated the analysis of clinical data. The ability to quickly retrieve nursing data promotes decision-making at all levels of healthcare delivery. In addition, the use of electronic charting has provided consistency with the Joint Commission indicators, and federal or state mandated and facility specific data. The ability to effectively manage and communicate data using computer systems and telecommunications has catalyzed the emergence of the science of nursing informatics. With that being said, patient charting still requires substantial time to record the variety of complex care delivered to the patient. One would think that a nurse could quickly go in and check a few boxes and be done with it. However, that is not so. There may be several programs to access, multiple tabs to click and numerous entries to account for. Charting thoroughly on patient assessments, medications, treatments, teaching, changes in condition, physician contact, care plans, etc. can account for a significant amount of time. Though charting methods have improved remarkable over the years, it remains a vital, but incredibly complex and time consuming component of the delivery of patient care.

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Foundations of Health Care Informatics

Admin — Thu, 19 Nov 2009 16:00:33 +0000

Overall I thought this Module 2 of Healthcare Informatics certificate program was a good next step from Module 1. And that it got a little more in depth with the topics presented. I am glad that I have continued in this program and look forward to Module 3.

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Clinical decision support systems

Admin — Thu, 19 Nov 2009 15:52:16 +0000

We discuss clinical decision support systems on a daily basis where I work. We discuss the pro’s and con’s of it. Some of the older providers do not like the idea because they do not want someone or something telling them how to practice medicine. I think it should be mandatory for all providers in our organization to take a class on clinical decision support and how it can benefit them. We work in a very litigious environment and in part most of our lawsuits stem from providers not being thorough enough. A good clinical decision support system would prompt them to ask certain questions or order certain test.

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Support Systems

Admin — Thu, 19 Nov 2009 15:04:20 +0000

In this assignment within my Health Care Informatics online certificate program, I learned about administrative decision support systems. My organization is in the process of purchasing a new EHR and there are so many factors that play a role in this. We need an EHR that does more than track patients visits. This assignment touched on the different types of decision support systems and what each system could be used for.

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Blum’s Model

Admin — Thu, 19 Nov 2009 14:30:17 +0000

I am glad that this Module 2 of Healthcare Informatics took up where Module 1 left off. There was a whole chapter (3) on databases in the first assignment. That was one of the topics that I wrote about in Module 1 that i wanted to learn more about. I also learned about the Blum model. No one has ever mentioned that model before.

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