Journal Blog for Nursing Informatics

{ April 8, 2010 @ 7:52 pm } · { Uncategorized }
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Embracing Technology

Technology is the topic of this journal.  How we use it, how it could be used and improved.  The good news about this topic is that it starts with opinions first and then ideas and eventually action takes place and the technology is in place and being used.  I remember thinking of these little gadgets that have come out and thinking, “Hey, they stole my idea!”  I’m sure I’m not the only one!  The most recent idea however, that I am most fond of ,but have yet to be able to use, is the DVR on your phone.  This gives you the ability to record when your out and about and you find out that you were suppose to watch something for school and your going to miss it!  No worries, just get on your phone and if you have Dish you can tell your DVR to record that show via your phone!  Now I just have to purchase the technology to be able  to use this!!  Technology is awesome and never-ending in its advances, but it can be very expensive.  So, as these ideas turn into a product, then there is the selling and training on using that product to make it worth everyone’s time and make it great.

In the world of healthcare and nursing there is little decision left to the individual or unit upon which technology to use.  With our most recent switch to Epic this was a hard transition for all the nurses in Labor and Delivery because we were already on computer charting that meet our needs and had been for 6 years, but we had to conform to use what the rest of the corporation decided to use.  I do appreciate that records flow and we are able to see charting from other units, but would it be so difficult to merge the two systems instead of having to use two separate ones to get the job done?  Again it goes back to cost and is the cost worth the user friendliness or not?  I would like to see the better use of integrated systems so that they are appropriate to each unit and at the same time still communicate and share the information they were designed to do.    Along those lines, we as nursing professionals do need to embrace the change in technology and realize it is a process.  I’ve always despised this statement “it’s a process” because we like to have things now, immediate gratification.  However, there is the learning curve that needs to be encouraged and embraced just like I need to purchase the phone and Dish to be able to use the cool DVR function.  It’s a matter of cost and use that somehow needs to bend to make the technology useful so that we as healthcare workers and individuals feel empowered to use our current technology.

Social Networking in Healthcare

Now as far as social networks go, my hospital to my knowledge utilizes these networks very little.  They actually block them and probably for good reason, but instead of putting a complete halt to the use of these networks did anyone ever think we should use this our advantage?  Our patients are looking on the internet for information on the disease you just told them they had as soon as you walk out the door.  They are communicating with their network of friends and gaining knowledge from other sites that people will chat with them and spend time with them longer then the person who gave the diagnoses.  I would like to see the future of my healthcare facility utilize the internet and these social networks so that the information our clients are getting from these avenues are something we would like them to get.  I think it starts with creating blogs with good information on different diseases that have many links for more information that we as the healthcare facility approve of and find to be reliable information.  I also think we could give them information to find chat rooms or provide them with a social network that would have the people on it to answer the questions in a medically appropriate way and not some lay persons opinion that is being posted.  I think we are very much behind in technology in my healthcare facility.  We are using telephones to still receive verbal orders when we have a system in place that allows them to place their orders where ever they are, also when we could be providing updates without having to call with the details, and we still use IMs to communicate to different units when we could have a network connecting us all.  These are just some of my opinions that maybe one day will turn into an idea and become an effective product or tool in my healthcare facility.

Common Labor and Delivery Questions

{ March 30, 2010 @ 7:32 pm } · { delivery, epidurals, fetal monitoring in labor, iv in labor, labor }
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Labor and Delivery is one of those places and words that most people are trying to quickly backtrack their way out of.  But, for most of you there will be a day that you’ll feel it is your duty to learn as much as you can about this area in a quick timeframe because the due date is soon upon you!  Most of us in this world of technology know how to google and search for keywords that will generally obtain the information that we are looking for; however, most of what is on the internet is personal opinion or research that has not been supported by an accurate source.  So beware of the words epidural, fetal monitoring, water birth, etc. because you just never know who is on the other side writing what their experience was or the experience of a friend of a friend who has distorted the story a little too many times.  We all know it is a more interesting read if something dramatic has happened!  However, when it’s going to happen to you or your loved on, little drama is desired!

If you have found this blog I hope you will stay tuned to learn a little more about what a Labor and Delivery Unit is and how you can answer some questions that may prepare you for the most important day of your life.  As a Labor and Delivery Nurse, I am constantly confronted with couples who are scared because they have no information or have been given inaccurate information.  I would like to somehow bridge the gap between the excitement of seeing “pregnant” on your pee stick and the fear that comes with the day of the “birthday.”  I am going to provide you with just a few websites and data sites that has been searched for accuracy and has good credentials behind these topics so that you will feel confident in the information you are reading, but also be prepared to have educated questions to ask your physicians or anesthesiologist. Remember each facility is different and this information provided should prompt you to ask questions of your facility to get the most beneficial answers to put you at ease through the most wonderful day of your life.

The sites provided here have been evaluated for accuracy and objectivity.  I, as a Labor and Delivery nurse, also come with my own biassed opinion on some of these topics; but you will not hear them in this blog unless you ask. I am a true believer in making educated decisions for yourself.  I was part of a health care initiative in our Labor and Delivery Unit that also researched and brought positive change and increased patient safety to our own facility because I wanted to be educated in my job as your nurse.  This blog will provide you with a just a few pages that I feel have good current information and are supported by those who you can contact yourself for further information and have  the credentials to prove it.

We will be looking at just a few common questions in Labor and Delivery at this time, but continue to check back as I hope to update this information to be more specific to my own facility as I gather feedback from you, my readers, and my patients in my own unit and childbirth classes.   We will briefly look at labor inductions, iv’s in labor, electronic fetal monitoring in labor, and epidurals.  These seem to be the most common questions to address first and I will add more as the questions come.

ACOG Education Pamphlet

–Labor Induction

http://www.acog.org/publications/patient_education/bp154.cfm

ACOG is the American College of Obstetricians and Gynecologists that provides guidelines for clinicians.  It is a nonprofit organization of women’s health care physicians that advocate the highest standards of practice and provide public awareness.  This is an educational pamphlet that outlines stages of labor, reasons for inductions (medical or elective),  why inductions may not be done, and how it is done and a brief overview of the risks.

Nursing Center-The American Journal of Maternal/Child Nursing

—Trends and Controversies in Labor Induction

http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=835068

This is from the American Journal of Maternal/Child Nursing Jan/Feb 2009.  This article goes through triggers of onset of labor, indications for induction, costs, preparations, controversies, and more natural induction methods.  This goes into detail about the topics listed above and also recognizes self-induction methods that are rarely discussed and how all types hold risk that may be minor or major.  The data collected in this journal is also helpful for looking at the statistics through the years.

AHRQ- Agency for Healthcare Research and Quality

–Thinking About Inducing Your Labor: A Guide for Pregnant Women

http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?

pageaction=displayproduct&productID=353

This is a wonderful guide that is an easy read for a patient to move through this with ease and accuracy.  It was written by Stanford University-UCSF Evidence-based Practice Center in 2008.  This guide is simply for elective inductions which is mostly where the questions come from.  This guide goes through the changes in your body that are necessary for elective inductions, problems that may occur, answers that we still don’t know, and the part I loved was the section titled “Questions to ask Your Doctor or Midwife.”

Suite 101

–Pregnancy and Childbirth, IV’s During Labor

http://birthing-options.suite101.com/article.cfm/ivs_during_labor

This article was written by Brenda Lane, a childbirth educator and doula who has served on Board of Directors for DONA.  Many of our information for Childbirth/Lamaze classes come from this organization, so I feel it is good to use the resources that they are sharing in the classes.  This short article tells the uses of IVs in Labor, the Disadvantages, and Alternatives to ask your health care provider.

ACOG- American College of Obstetrics and Gynecology

–Fetal Hearth Rate Monitoring During Labor

http://www.acog.org/publications/patient_education/bp015.cfm

This pamphlet was designed for allowing patients to receive current information and opinions related to women’s health.  This educational pamphlet describes the types of monitoring, electronic and internal monitoring, and a very basic overview of what fetal heart rate patterns mean.  This like many other articles should allow you to read, be more informed, and then ask what is available at your facility and in your situation.  Fetal monitoring is a way to check for fetal well-being and should be discussed with your health care provider.

American Society of Anesthesiologists

–Planning Your Childbirth: Pain Relief During Labor and Delivery

http://www.asahq.org/patientEducation/labordelivery.pdf

This tool is one from the source of those placing your epidural/spinals for labor.  I feel that when in labor and have questions, ask those who will be doing the procedure to get the most accurate and beneficial information.  This article is a good start to have an overview of types of pain relief in labor, how it works, and what are common side effects and what are risks.  Again, these are great to have a base to then go forth and ask questions of your anesthesiologist.

ACOG- American College of Obstetrics and Gynecology

–Pain Relief During Labor and Delivery

http://www.acog.org/publications/patient_education/bp086.cfm

This pamphlet is another educational tool put out by ACOG, it mimics the words of the American Society of Anesthesiologists as well but gives a little more detail about easing discomforts without medications.

OMNINERD

— Pros and Cons of Epidural Analgesia During Labor: Recent Research

http://www.omninerd.com/articles/Pros_and_Cons_of_Epidural_Analgesia_During_Labor_Recent_Research

This database research does just as the site states, it shows the pros and cons of epidural analgesia throughout the years of research starting in 1996 to 2007 with a summary at the end detailing the risks and benefits and a good conclusion.  There is also a brief study at the end on other pain relief options.

PUBMED.gov

–Maternal and neonatal outcomes of elective induction of labor

http://www.ncbi.nlm.nih.gov/sites/entrez

This brief overview looks at the rising increase of elective inductions and the outcome of the maternal experience and neonatal outcomes.

Journal/Blog for Nursing Health Care Informatics

{ March 7, 2010 @ 9:42 pm } · { Uncategorized }
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A brief overview of What is Health Care Informatics?   The definition our text uses for Health care Informatics is from the Health Information and Management Systems Society (HIMSS) and they define informatics as “the discipline concerned with the study of information and manipulation of information via computer-based tools” (2006, pg. 44).  Or a general description of health care informatics is the combination of health care science, information science, and computer science.  The text gives many definitions but as it states there is a theme, one of combining like the above description details and second of the use of data, information, and knowledge by a nurse.  I especially enjoyed reading the goal of NI from our text from the 2001, ANA Scope and Standards of Nursing Informatics Practice..

  • The goal of NI is to improve the health of populations, communities, families, and individuals by optimizing information management and communication.  This includes the use of technology in the direct provision of care, establishing effective administrative systems, managing and delivering education experiences, supporting life-long learning, and supporting nursing research.

Just as a preface for this next part, this is my opinion with a little research done on other peoples opinions.  Who owns the EHR? is a question that has little answer but brings about a lot of good discussion and a need for clarification.  Electronic Medical Records are now a thing of common use, no longer are they for the future, but will continue to be a central part in creating the future of health care.  Previously, I would have stated without a doubt that medical records belong to the doctors, hospitals, and billing department because they seem to be the only ones with access and who maintained the record for a specific amount of time, depending on the circumstance.  Dr. Robert Rowley, MD and Chief Medical Officer of Practice Fusion states that “now with  the push toward greater interoperability among EHRs, hospitals, laboratories, public health records, and other sources of patient data, we can now see the emergence of a patient-centered unified health record that is shared by all practitioners involved in a given patient’s care, and used for medical decision-making and advice-giving” (posted April 30, 2009).

So paper health records seems to have a more straightforward owner of  insurers and doctors because they  own the actual storage system and paper this information is printed on.  However,  now that the information is digital and it frees it from a particular storage media the confusion still remains.  The questions I ask are who has access?  It’s not the patient.  Due to privacy we still need the safeguards, but have you ever tried to view your records through EHR with any success?  Or has your physician tried to explain your records and storage of information and you truly understand it?  The ease of use and understanding for the layperson, who is the patient, that we are to be moving toward patient-centered care is still left out of the loop.  In my personal and most recent experiences I would have to say the god of the EHR owns the systems because there seems to be no one person who can access everything from every time period in this patient’s chart or care.  It is divided through the different interdisciplinaries,  yet not one person is looking at the exact same information, just bits and pieces and we are all needed to interpret the details of our patient and his patient-centered care.  I feel that the future is bright in regards to EHRs, but that it has yet a long road to go to improve to be a patient-centered entity.

http://www.ihealthbeat.org/articles/2009/3/26/article-electronic-health-record-ownership-needs-clarification.aspx

http://www.ihealthbeat.org/articles/2009/3/26/article-electronic-health-record-ownership-needs-clarification.aspx

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{ March 1, 2010 @ 5:19 pm } · { Uncategorized }
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