NR 512 Week 8 Discussion, Reflection, 2nd Life Experiences, Nursing Informatics Skills (Two Versions)

NR 512 Week 8 Discussion, Reflection, 2nd Life Experiences, Nursing Informatics Skills (Two Versions) NR 512 Wk 5 Knowledge Generation through Informatics What are informatics-related possibilities to accelerate the generation and uptake of new nursing knowledge? Consider this does your current work environment support use of informatics tools to generate/adopt new nursing knowledge? If so, please provide specific examples. I look forward to your lively discussions this week. Response : Nursing informatics has opened up the field of nursing to an endless amount of possibilities. It has accelerated the generation and uptake of new nursing knowledge simply by providing nurses to more timely access to data and information. In the past, evidence-based research and practice was difficult to look up due to the large volumes of paperwork that was difficult to even seek out if the individual did not know that the research already existed. Today, nursing informatics is everywhere. It can be seen in the monitoring technology that measures patient’s vital signs, in the bar-coded medication administration system that allows nurses to. There has been rapid growth and expectations of health care information systems and technology in health care settings. With this growth has come the need to ensure that nurses have the necessary informatics competencies (knowledge, skills, attitudes and decision making) to effectively meet their responsibilities and standards for nursing practice. The goal of nursing informatics is to improve the health of populations, communities, families, and individuals by optimizing information management and communication. This includes the use of information and technology in the direct provision of care, in establishing effective administrative systems, in managing and delivering educational experiences, in supporting lifelong learning, and in supporting nursing research. The introduction and use of new technology to support nurses in their care for patients always leads to change and the development of new service repertoires. Changes and innovations contribute to specialization of health care, nursing care, and treatment, and should stimulate discussions of how to harness opportunities, handle dilemmas, and prevent harm from automation during such transitional periods. The purposeful use of digital tools is one of the key strategies to meet foreseen health care challenges locally and globally. Health informatics includes contributions from several areas, e.g., nursing informatics, medical informatics, clinical informatics, dental informatics, etc. These terms are used interchangeably with or are gradually being substituted by the term eHealth. Achievements in biomedical and health informatics are significant contributors to increasingly advanced diagnostic processes, personalized treatment, and advanced health management regimes to control chronic conditions. They also contribute to efforts at prevention, early intervention, or task shifting to meet requirements for independence and aging in place. Over time, several attempts have been made to describe the different subdomains within the interdisciplinary field of health informatics. Health informatics is an umbrella term for a field of study that combines domain knowledge from the health sciences, e.g., medicine, nursing, and pharmacy, with insights from information and computer sciences. Those pursuing a health informatics career are typically cross-trained to skillfully combine domain expertise and insights from information and computer sciences. We will present a conceptual clarification of the field and introduce Electronic Health Records (EHR), Personal Health Records (PHR), and smart, assistive tools as examples of information systems used in hospitals, community care, and home dwelling. Reference; 2nd post The term "nursing informatics" was proposed in 1976, when Scholes and Barber elaborated on the potentialities of computer technology for a practice discipline like nursing, specifically discussing contributions to service, education, and research. Since then, nursing informatics as a field of inquiry has been established as one of the cornerstones of the interdisciplinary field of health informatics. Nursing informatics is also a distinct specialty within nursing, distinguished from other specialties by the focus on information of nursing. Drawing from multiple fields, nursing informatics has contributed significantly to clarifying the components necessary for the representation of nursing practice: assessment, problems, interventions and outcomes, and the standards and strategies for achieving efficient information exchange. Nursing informatics also synthesizes resources for evidence-based practice, patient safety, and professional development. We look further into these contributions in terms of selected conceptual issues such as content representation, standards development, decision support, and knowledge resources. We also examine application oriented aspects such as opportunities following design, deployment, or change in the interest of practice improvements. We will use examples of information systems in hospitals, community health, and the home dwelling. Achievements in nursing informatics have inspired the systematization and formalization of information where data, structured information, and articulated knowledge are important building blocks for the development of IT-based applications. Most attention and in-depth study has been directed to describing information used in clinicians ' judgments and modeling prototype applications for management that are decision-supportive. The studies also strive to provide the best evidence at the point of care to improve decision-making. So far, feasible practice models giving new tools for information handling have received little attention, and reported studies are often examples of workflow failure or unintended consequences. Professional collaboration can be supported by access to and/or contribution to the accumulating body of a person’s specific health information in the EHRs. The EHR offers an interesting collection of quantitative data (e.g., vital signs or lab values), qualitative data (e.g., patient narratives or evaluation of care efforts), and transactional data (e.g., performed tests or delivered medications). More recent analytic techniques and approaches to the analysis of large amounts of data, or "Big Data," open up new ways of providing evidence to support knowledge development, decision-making, and interdisciplinary collaboration. Using information in the EHR means that the aggregation of authentic, real-time patient data offers opportunities for early intervention to prevent health problems or to manage existing conditions. There are still unresolved issues of a professional, legal, and ethical nature with the new approaches to knowledge generation and to more information sharing within and across settings and levels of care. References; Moen, A., Hackl, W.O., Hofdijk, J., Van Gemert-Pijnen, L., Ammenwerth, E., Nykanen. P., et al. (2012). eHealth in Europe: status and challenges. Eur J Biomed Inform.; 8 (1): en2–en7. Friedman, C.P. (2013). What informatics is and isn't J Am Med Inform Assoc.; 20 (2): 224–226. 2nd discussion The need for establishing an electronic health record (EHR) system that encompassed an individuals medical history from birth to death was recognized many years ago. The current EHR system that my facility uses does not make the most out of captured data. There are multiple computer programs each needing the clinician to document the same data multiple times. There are separate systems for inpatient records, outpatient records, operating room records, and emergency room records. Fortunately, enough my facility has recognized that there was a problem and is in the process of implementing the new EPIC electronic health record system. The benefits of EHRs include improved accuracy of diagnoses and health outcomes, improved quality and convenience of patient care, increased patient participation in their care, and increased practice efficiencies and cost savings. The risks of using EHRs are primarily related to the user inputting data into the system. If an individual inputs incorrect data into an patient chart not only can it be difficult to correct this issue, but it can this error can go on to impact the patients care for many years. Privacy is a major concern when it comes to electronic health records. Using EHR software can potentially put your organization at risk if you do not follow privacy protocols to an exacting degree. While paper records also make it easy to violate a patient’s privacy, the convenience and immediacy of electronic records make it easier to violate privacy at an unprecedented level. Identity theft can occur when unauthorized people gain access to confidential and sensitive records. An unscrupulous person could access patient data and use it to commit fraud. However, EHR software alone is not to blame for such an unpleasant scenario. After all, it’s possible to commit identity theft simply by accessing paper records of patients. There are a number of key benefits to using electronic health records. Chief among them are how quickly and conveniently your staff can enter and access patient data. EHR software typically comes with optional expansion modules, such as templates for specialties like gastroenterology, OB/GYN and Neurology. The software will present the data fields that must be filled out by your staff members, and won’t let you progress to the next page until you enter all the required information. The promise of consolidated records is another major benefit of EHR software. Your patient’s history, diagnostic test results and even medical imaging can be integrated or consolidated into a single set of records, easily accessible via any computer in your medical practice’s network. Reference: Mantalvo, I. (2013). How smart are your data? Nursing Management, 44(6), 2324. doi: 10.1097/01.NUMA.2.80830.e6 2nd post The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 that was signed into law as part of the "stimulus package" represents the largest US initiative to date that is designed to encourage widespread use of electronic health records (EHRs). In light of the changes anticipated from this policy initiative, the purpose of this paper is to review and summarize the literature on the benefits and drawbacks of EHR systems. Much of the literature has focused on key EHR functionalities, including clinical decision support systems, computerized order entry systems, and health information exchange. Our paper describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a "meaningful" way.Data loss is a major issue when it comes to electronic health records. A computer crash could wipe out vital data that you’ve been accumulating for years, jeopardizing your staff’s ability to ensure continuity of care for all the patients. Accordingly, when you use EHR software, you also must put into place a robust backup plan. Many practices opt to conduct offsite backups of their data through a cloud computing services provider. Even if your local servers suffer a catastrophic crash, you will still be able to reconstruct your patient information through the backup in the cloud. EHR software, when updated regularly, will enable your organization to process patient information using the latest version of the ICD code, ensuring prompt payment from entities such as Medicare and Medicaid. With proper training of your staff, any potentially negative aspects of EHR software can be nipped in the bud. Your organization’s use of EHR software will speed up patient processing and help keep you profitable. Ehrs are defined as "a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, and radiology reports ". 7 Some of the basic benefits associated with EHRs include being able to easily access computerized records and the elimination of poor penmanship, which has historically plagued the medical chart. 8, 9 EHR systems can include many potential capabilities, but three particular functionalities hold great promise in improving the quality of care and reducing costs at the health care system level: clinical decision support (CDS) tools, computerized physician order entry (CPOE) systems, and health information exchange (HIE). These and other EHR capabilities are requirements of the "meaningful use" criteria set forth in the HITECH Act of 2009. References;