Informatics and technology are subjects that encourage change in healthcare policies and processes. As healthcare providers, we know how scary change can be and how much it can disrupt our routines. However, it is important for nurses to be aware of the technology that is available to them for problem solving purposes. In the end, technology moves us forward and assists us in caring for patients.
According to the Healthcare Information and Management Systems Society, “‘nursing informatics’ is the specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice” (What is nursing informatics, 2019, para. 1). One way I could utilize informatics where I work is by tracking our operating room “in-room” times. Our operating room has been struggling with starting cases on time, and at the end of the day, this puts us behind and disrupts timely patient care. To zero-in on the reasons behind our late starts, we can track the late codes that the nurses put into the EMR. We have the ability to select different reasons why the rooms start late such as: attending physician late, consents not signed, patient in bathroom, room not ready, awaiting orders, and so on. By tracking these different late codes, we will be able to work on each one individually and change policies to hopefully avoid excess late starts. It is important that our team acts on and synthesizes our data as soon as possible because staff and patients have started to get irritated with our current situation. Fortunately, although large scale data collection can take years to synthesize, a smaller scale collection can be interpreted and integrated in a shorter amount of time, allowing for a faster transformation into new guidelines and pathways (Nagle, 2017).
With the help of our collected information, our nurse leaders would be able to meet and discuss the problems that stem from each individual nursing unit and/or physician. They would then have the ability to put late start policies in place such as requiring physicians to arrive at least ten minutes before the scheduled case start time. Maybe they could identify that scheduled surgical times are not being communicated correctly to the physicians and figure out a way to fix this problem. With the help of our data, we would be able to see how frequently certain physicians are late and which ones probably do not need to be talked to because they are usually on time. Additionally, to help our pre-op staff, our leaders could put a standing order protocol in place for the nurses to use when a physician forgets to place pre-op orders. They would also be able to identify which nurses are consistently unprepared for a bedside shift report, which can delay surgery start as well.
Collecting the necessary data through our EMR is the first step towards providing timely patient care. The more our leaders and nurses discuss the information found through this potential data collection, the more a Foundation of Knowledge is built and the more knowledge gets disseminated to others in the unit. The information sharing and feedback provided allows our staff to make the appropriate changes to our department to make it run smoothly (McGonigle & Mastrian, 2017, pp. 7-9).
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge, (4th ed.) Burlington, MA: Jones & Bartlett Learning.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health, 212–221. Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF
What is nursing informatics? (2019). Retrieved from https://www.himss.org/resources-what-nursing-informatics
Discussion: The Application of Data to Problem-Solving
In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.
Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.
In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.
- Reflect on the concepts of informatics and knowledge work as presented in the Resources.
- Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.
By Day 3 of Week 1
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.
Having access to medical records is crucial for healthcare professionals to ensure that their patients are receiving the best care. A scenario that I want to focus on is immunizations. At my current job, I work with schools, parents, and providers on patient’s immunization records. The difficulty that comes with this job is when families move across state lines without their immunization records and are unsure of what the child has/has not received. For parents to track down these records, they may have to contact their child’s previous doctor or clinic, previous state immunization registry, and/or their child’s previous school (“Immunization Information Systems”, 2019). One thing that would make this easier for everyone would be to have a central hub database for all vaccine information.
Currently, information for vaccine data is collected in an online database called, Immunization Information Systems (IIS). This system keeps track of vaccines that are administered to patients and informs providers when vaccines are due (“Immunization Information Systems”, 2019). From there, I would like to have a database that collects all of the vaccine information from each office and puts it into a central hub. Having this central hub of vaccine records would allow providers to pull vaccine records for their new patients. This would allow healthcare professionals to see their patient’s vaccination history and make clinical judgments when it came to vaccines.
There is a lot of knowledge that could come from this data. Healthcare professionals would be able to see coverage rates in areas as well as areas of potential disease outbreak. They would also be able to see how well community immunity (herd immunity) works. According to Vaccines Protect Your Community (2020), community immunity is when enough people are vaccinated against a certain disease, it becomes hard for a disease to spread to unvaccinated people (“Vaccines Protect Your Community”, 2017).
Nurse leaders would use clinical reasoning and judgment with this knowledge because patients would not miss recommended vaccine doses and they would not receive unnecessary, extra doses. Also, when taking care of patients with medical conditions, they would have the capability to add contraindications and notices about certain vaccines into the system. A benefit to this is that other providers would be aware this if the patient ever moved or were sent to the hospital. Having the capability to access a patient’s immunization record from a central hub would be very helpful to not only healthcare professionals but to the patient as well.
Immunization Information Systems. (2019, April). Retrieved from https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunizations/Practice-Management/Pages/immunization-information-systems.aspx
Finding and Updating Vaccine Records. (2020, February 25). Retrieved from https://www.cdc.gov/vaccines/parents/records/find-records.html?CDC_AA_refVal=https://www.cdc.gov/vaccines/parents/records-requirements.html#finding-records
Vaccines Protect Your Community. (2017, December). Retrieved from https://www.vaccines.gov/basics/work/protection