NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology
As a visiting nurse, I heavily rely on my tablet, cellphone, and more recently telehealth. Patient care starts over the phone. At the start of my shift, I do not receive a report from the prior shift nurse. NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology I start collecting data by looking at the electronic record, hospital discharge attachments, and through the initial conversation over the phone. I start “acquiring, processing, and generating information or knowledge” about my patient and the plan for our visit before I even meet my patient. (McGonigle & Mastrian, 2018) (p9). I then call the patients to set up a visit time and obtain basic information this is the point in which my brain becomes a computer (McGonigle & Mastrian, 2018) NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology. During my visits, my documentation is 100% on my tablet in the electronic health record. I use my work cellphone and a HIPPA secure app to upload wound photos and legal documents into the patients’ electronic records.
My home health agency uses a system called “Homecare Homebase” for documentation and charting. We are affiliated with Atrius Health and have many referrals from Lahey and Partners owned hospitals and medical offices. These agencies all use the software, EPIC. NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology By not sharing the same network and software, I am limited in my practice. Networks, agencies, students, and universities would be wise to collaborate on software and understand that “the important use of informatics has to do with how you use those tools strategically” (Laureate, 2018).
Patient John Doe is admitted to the Lahey Hospital on Sunday for fluid overload, heart failure exacerbation. While hospitalized, he received IV Lasix, which caused an electrolyte imbalance. On discharge, the patient’s medications for oral diuretic and potassium supplement doses were changed. I admit the patient to homecare VNA following hospital discharge on Tuesday. NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology My medication reconciliation requires a call to the primary care doctor’s office and the cardiologist’s office since my electronic health record system does not sync with the hospital or physician’s systems. Thursday, the patient sees his cardiologist for a hospital follow-up, and the cardiologist makes additional medication changes based on recent lab work and patient symptoms. A second visiting nurse goes out on Friday for a follow up revisit with the patient for additional education and a skilled assessment. NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology The patient tells the nurse that the cardiologist made medication changes, but the patient could not pick up the prescriptions. The nurse now needs to call the cardiologist to obtain a verbal order to update the patient’s electronic medication record in the VNA system. The VNA has no access to EPIC in which the hospital, primary care doctor, and cardiologist all have their updated visit noted, medication changes, allergies, and lab results NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology.
Hospitals, doctor’s office, VNA’s, and specialty teams involved in patients care should have a shared “system(s) for coordination and communication to ensure the continuity of care” this would only improve patient outcomes (Nagle, Sermeus, & Junger, 2017) (p217). The problem with the above scenario is that it is all too familiar and unlikely to change. Companies who create and sell software will not collaborate to make universal communication, commercial, and productivity software for all of healthcare. NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology.
Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge. Burlington, MA: Jones & Bartlett Learning.
Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Studies in Health Technology and Informatics, 232, 212–221. NURS 5051/NURS 6051: Transforming Nursing and Healthcare Through Technology
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