What is one new thing you learned in this module, or something that you knew but had forgotten?
Well, there is definitely more than one thing that I learned in this module. One point that stands out is in regards to the email use at the University of Utah. I did not realize that email was not considered to be a secure way to share information; who knew that by putting “phi” in the subject line you could send email through a system that is secure and encrypted.
In scanning the article “10 Tips to secure your Laptop”, I realized how little I knew about the safety and security of laptops and computers (Strom, 2007). I believe that this article has taught me several tools and given me resources to secure the use of my computer both at home and on the go. The tips and tools that I was unfamiliar with included securing my connection and using a frequency that is not being used by others (Strom, 2007).
A last piece of information that I learned throughout this module was in regards to Electronic Health Records. I never realized that it was in fact President Bush who mandated a plan that would allow all Americans to access their electronic health record. To implement this plan, he appointed an official at the Department of Health and Human Services to digitalize the United States health care industry (Schwartz, 2004).
References
Strom, D. (2007). Ten Tips to Secure your Laptop. Information Week. Retrieved from
http://www.informationweek.com/story/showArticle.jhtml?articleID=203102748.
Schwartz, N. (2004). A prescription for electronic health records. The Information
Management Journal, July/August 2004, 20-26.
Tuesday, March 29, 2011
Tuesday, March 22, 2011
Module Five
1. How did the readings influence your perception of your own clinical decision-making?
Clinical decision support systems are a tool designed to help improve accuracy with patient diagnoses (Courtney, Alexander and Demiris, 2008). Clinical decision support systems exist in four different ways in terms of providing patient care; systems use alerts to respond to clinical data, respond to decisions to alter care by critiquing decisions, suggest interventions at the request of care providers and conduct retrospective quality assurance reviews. Clinical decision support systems exist for diagnosing chest pain, ventilator management and HIV treatment and guidelines (Courtney, Alexander and Demiris, 2008).
The readings helped me to realize the widespread use of clinical decision support systems used in my own clinical decision making. The readings allowed me to appreciate the systems that were in place to help in patient care activities. Before the readings, I never put two and two together that there was such an abundance of clinical decision support systems in use at my work place.
Starting in triage, we have a sepsis alert system that with uses the collection of danger vital signs and complaint category to notify the nurse of the possibility of sepsis and to consider drawing blood cultures, a serum lactate, fluid resuscitation and antibiotics within three hours. This system prints out an extra triage sheet to bring attention about the possibility of sepsis to the other caregivers, including the physician.
Also in triage, we have a clinical decision support system in place to evaluate any of our patients that present with the chief compliant of ‘overdose’, ‘psych’ or ‘depression’. With any of these chief complaints, the system automatically asks the nurse three questions in relation to safety of the patient; a yes to any one of the three questions directs the nurse to implement a patient safety attendant to ensure the safety of the patient and the staff.
The last clinical support system through triage is our fall risk protocol. At the end of each triage process, criteria come up on the screen to help the nurse determine the fall risk of the patient. If it is chosen that the patient is a fall risk, interventions such as a sign on the patients door are displayed for the nurse to implement.
During direct patient care, we have a critical lab value alert system that allows us to be notified of critical values that our patients have in their results. This system is easily noticed, demonstrated by a black box on the tracking system. Lab alerts must be accepted with comments noted prior to any disposition of a patient, ensuring that the nurse and doctor communicate about these values.
Prior to discharge, we have a system through tandem that forces us to review medications and vital signs. This system helps us with patient care in two ways. First, it allows us to review all medications that were given to the patient, it ensures that we put stop times on all fluids and antibiotics, and it allows us to evaluate as to whether the patient is ready for discharge or within the hour monitoring window of narcotic administration. Second, the system serves as a reminder to document a discharge set of vital signs, and to notify the physician if those vital signs are abnormal in any way.
In addition to these ‘cues’ that are present in my clinical decision making, support systems are also in place for other reasons. We have an antibiotic helper that can guide physicians through the selection and dose of antibiotics. We also have an Emergency Department sepsis protocol that can help guide both physicians and nurses to the interventions required on septic patients. Clinical decision support systems are there to provide help and resources to care givers. Through the readings, I have realized how important these support systems are. In today’s busy healthcare world, support systems are vital to ensure that important information does not go unnoticed.
References
Courtney K. L., Alexander G.L. & Demiris, G. (2008). Information technology from novice to expert: Implementation implications. Journal of Nursing Management, 16(6), 692-699.
Clinical decision support systems are a tool designed to help improve accuracy with patient diagnoses (Courtney, Alexander and Demiris, 2008). Clinical decision support systems exist in four different ways in terms of providing patient care; systems use alerts to respond to clinical data, respond to decisions to alter care by critiquing decisions, suggest interventions at the request of care providers and conduct retrospective quality assurance reviews. Clinical decision support systems exist for diagnosing chest pain, ventilator management and HIV treatment and guidelines (Courtney, Alexander and Demiris, 2008).
The readings helped me to realize the widespread use of clinical decision support systems used in my own clinical decision making. The readings allowed me to appreciate the systems that were in place to help in patient care activities. Before the readings, I never put two and two together that there was such an abundance of clinical decision support systems in use at my work place.
Starting in triage, we have a sepsis alert system that with uses the collection of danger vital signs and complaint category to notify the nurse of the possibility of sepsis and to consider drawing blood cultures, a serum lactate, fluid resuscitation and antibiotics within three hours. This system prints out an extra triage sheet to bring attention about the possibility of sepsis to the other caregivers, including the physician.
Also in triage, we have a clinical decision support system in place to evaluate any of our patients that present with the chief compliant of ‘overdose’, ‘psych’ or ‘depression’. With any of these chief complaints, the system automatically asks the nurse three questions in relation to safety of the patient; a yes to any one of the three questions directs the nurse to implement a patient safety attendant to ensure the safety of the patient and the staff.
The last clinical support system through triage is our fall risk protocol. At the end of each triage process, criteria come up on the screen to help the nurse determine the fall risk of the patient. If it is chosen that the patient is a fall risk, interventions such as a sign on the patients door are displayed for the nurse to implement.
During direct patient care, we have a critical lab value alert system that allows us to be notified of critical values that our patients have in their results. This system is easily noticed, demonstrated by a black box on the tracking system. Lab alerts must be accepted with comments noted prior to any disposition of a patient, ensuring that the nurse and doctor communicate about these values.
Prior to discharge, we have a system through tandem that forces us to review medications and vital signs. This system helps us with patient care in two ways. First, it allows us to review all medications that were given to the patient, it ensures that we put stop times on all fluids and antibiotics, and it allows us to evaluate as to whether the patient is ready for discharge or within the hour monitoring window of narcotic administration. Second, the system serves as a reminder to document a discharge set of vital signs, and to notify the physician if those vital signs are abnormal in any way.
In addition to these ‘cues’ that are present in my clinical decision making, support systems are also in place for other reasons. We have an antibiotic helper that can guide physicians through the selection and dose of antibiotics. We also have an Emergency Department sepsis protocol that can help guide both physicians and nurses to the interventions required on septic patients. Clinical decision support systems are there to provide help and resources to care givers. Through the readings, I have realized how important these support systems are. In today’s busy healthcare world, support systems are vital to ensure that important information does not go unnoticed.
References
Courtney K. L., Alexander G.L. & Demiris, G. (2008). Information technology from novice to expert: Implementation implications. Journal of Nursing Management, 16(6), 692-699.
Monday, March 14, 2011
Module Four
The Emergency Department is a source of teaching in many ways. The Emergency Department is a portal to health care for many patients, including those who do not have a primary care physician, those who do not have insurance, those with disease processes and those seeking crisis support or services.
In terms of patients without insurance or without a primary care doctor, the Emergency Department can be a valuable tool for education purposes. We as providers can educate patients on preventative measures, care resources and the importance of primary care. We can also teach patients about free resources available in the community such as low cost health and dental clinics and medication resources.
In terms of patients who already suffer from specific disease processes and consequences, we can educate them about life style modifications that can help alleviate symptoms of the disease process. We can educate them about the importance of following their specific medication regiment, about the importance of following physician recommendations and about signs and symptoms to report immediately to their physician or Emergency Department.
In terms of patients seeking crisis support or services, we can educate them about the availability of mental health professionals, about the importance to seek help immediately about any thoughts of self harm and about the resources and support groups available to these patients.
In general, patients in the Emergency Department should be taught at all points of their visit. Patients can be taught about medication side effects, precautions of medications given in the department and signs and symptoms to look out for demonstrating a need to return to the department. Emergency Department patients are very vulnerable, and every attempt should be made to provide them with education and resources.
I believe that every nursing and health care provider role involves some aspect of teaching. Whether it is the endoscopy nurse doing discharge teaching to a patient or the nurse educator of a hospital unit providing education to employees, every health care professional should include teaching in their daily regiments.
I feel that if nursing and health care providers are not involving teaching in their roles, they are providing a disservice to their patients. Having a patient in an office, clinic or hospital provides a great opportunity for teaching and education. When people are sick, they are looking for tools to help them improve their health, and health professionals are ideal people for that job.
In terms of patients without insurance or without a primary care doctor, the Emergency Department can be a valuable tool for education purposes. We as providers can educate patients on preventative measures, care resources and the importance of primary care. We can also teach patients about free resources available in the community such as low cost health and dental clinics and medication resources.
In terms of patients who already suffer from specific disease processes and consequences, we can educate them about life style modifications that can help alleviate symptoms of the disease process. We can educate them about the importance of following their specific medication regiment, about the importance of following physician recommendations and about signs and symptoms to report immediately to their physician or Emergency Department.
In terms of patients seeking crisis support or services, we can educate them about the availability of mental health professionals, about the importance to seek help immediately about any thoughts of self harm and about the resources and support groups available to these patients.
In general, patients in the Emergency Department should be taught at all points of their visit. Patients can be taught about medication side effects, precautions of medications given in the department and signs and symptoms to look out for demonstrating a need to return to the department. Emergency Department patients are very vulnerable, and every attempt should be made to provide them with education and resources.
I believe that every nursing and health care provider role involves some aspect of teaching. Whether it is the endoscopy nurse doing discharge teaching to a patient or the nurse educator of a hospital unit providing education to employees, every health care professional should include teaching in their daily regiments.
I feel that if nursing and health care providers are not involving teaching in their roles, they are providing a disservice to their patients. Having a patient in an office, clinic or hospital provides a great opportunity for teaching and education. When people are sick, they are looking for tools to help them improve their health, and health professionals are ideal people for that job.
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