NSG 3039 Week 4 Project Informatics in the Clinical Setting

NSG 3039 Week 4 Project Informatics in the Clinical Setting

Informatics in the Clinical Setting

Improving healthcare quality focuses on reducing the cost of care which a top priority in healthcare reform process. Informatics is one aspect of improving healthcare quality because of the benefits that it provides to practitioners and healthcare organizations. informatics entails the practice of deploying information technology to organize and evaluate health records to ascertain improvement in overall patient outcomes (McGonigle & Mastrian, 2018). By conducting an interview with a clinical system analyst in my hospital, I discuss her role and her perspective on its impact on patient safety and quality of care. The essay discusses different aspects of their role and associated factors and challenges. The essay also discusses insights gained through the interview and impact of Agency for Healthcare Research and Quality Patient Safety Indicators and the Joint Commission’s Patient Safety Goals. The article also highlights the impacts of governing agencies on care delivery through the utilization of Technology Informatics Guiding Education Reform (TIGER) framework in a clinical setting.

The interviewee, Miss Weinstein, is the clinical systems analyst at our organization. Giving a description of her role based on her job title, Miss Weinstein asserted that she develops and builds content used in the electronic health records (EHR) systems and ensures that it is usable for medical recording purposes. The system should also be  efficient for nurses to document patient information. The position also entails building all evaluation tools and protocols for the EHRs system. The analyst also builds a care for particular patients by tailoring it to meet the diagnostic needs (McGonigle & Mastrian, 2018). She is one of the members of the informatics team at the facility. Weinstein has an Associate’s degree in Nursing and got her role due her experience working in clinical practice and having proficiency in computer. She is highly proficient in policies and has a desire to help enhance patient safety through information technology. The interview also entailed a discussion of the challenges that informatics specialists face like need for increased organizational resources for advanced training. She was also categorical that informatics will continue to play a critical role in care delivery focusing on patient safety and improvement of quality care. Therefore, she emphasized the need for increased integration of informatics in nursing and other areas of healthcare provision.

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Patient Safety and Quality of Care

Health technologies are designed for different yet critical functions in healthcare. These include improving patient safety, streamlining work process and enhancement of quality and outcomes (McGonigle & Mastrian, 2018). Miss Weinstein was categorical that informatics as part of the health technologies is essential in improving patient safety and quality in any healthcare setting. For instance, she says that her responsibilities include building risk assessment tools for different events like falls and medication errors. working with a team of quality improvement, the informatics nurse was categorical that it is essential for such tools to have certain measures that allow end-users to understand its effectiveness. Through this tool nurses can ask several questions to assess the frequency and susceptibility of an individual to falls or risk of falling. After the assessment of these factors, a computerized system calculates a fall risk score to determine the kind of interventions required for a particular patient. Some of these interventions include proximity to nursing station, camera monitoring and use of bed alarm among others. The tool and its interventions are focused on enhancing patient safety and quality of care.

A critical part of her duties and responsibilities entails making sure that the EHRs system is user-friendly and incorporates critical components of effective and quality care. The aim of the EHR system is to reduce time taken to chart on patients and increase the time nurses spend in offering quality patient care. However, the nurse was categorical that despite the increased and effective use of EHR, errors still occur when using the technology and informatics. These include human factors and other significant challenges.

Human Factors and Challenges

Human factors in healthcare environment are about how people interact with technologies in particular situations. Despite safety measures, and protocols, health systems and personnel cannot avoid human errors as some of the human factors in care provision (McGonigle & Mastrian, 2018). Miss Weinstein and I discussed about the human factors and other challenges in the organization and others that she has encountered when dealing with nurses who develop loopholes that they can exploit despite the existing quality measures. The most prevalent loophole is the use of patient and medication barcode scanning system. For instance, nurses do not scan patient’s wristband at the bedside but instead place stickers with the barcode on their report sheets. They also scan medications in the hallway before administering. In some instances, they leave the medications’ packages so that they can scan after administering the drugs. These actions defeat the need for safety measures developed by the informatics team to enhance quality care and reduce incidences of medication errors.

The nurse says that another significant human factor has been resistance from the management to help nurses build the EHR system since it is relatively new. Weinstein believes that allowing nurses to manage the system would be essential in helping them make suggestions to make it more user-friendly and meet the stated healthcare goals. However, the management introduced the system with minimal engagement and involvement of nurses leading to significant yet an avoidable aspect. The resistance stems from the inability to use the system and ineffective training. The system’s use also faces network and wireless issues like downtimes that require effective upgrade of the entire EHR in the facility (O’connor et al., 2017). The informatics also discussed complaints from nurses about the delays that they witness when charting; a situation that prolongs time to serve patients. Her future goal is to improve the system and network, train nurses adequately and ensure that the network has the right speed. More fundamentally, she stresses the need for nurses to have a hands-on approach to providing care for their patients and reducing time spent on technological devices like their smartphones.

Insight Gained from the Interview

The interview was critical in understanding and appreciating the role played by informatics and other health technologies to improve patient safety and quality of care in healthcare settings. The interview provided an opportunity for me to understand the critical role that informatics nurses play in health care settings; especially developing interventions to enhance overall safety (O’connor t al., 2017). Informatics plays a critical role in developing electronic health record systems to improve care delivery and make nurses’ work simple and easy. I also realized that implementing measures and systems to enhance quality and safety requires the involvement and participation of nurses as end-users since they can identify ways to improve its working. Direct feedback from the end-users is the best way to improve the working of such systems to improve care delivery. The interview demonstrates the significance of inter-professional and interdisciplinary collaboration and teams to develop system-wide safety controls that include working in conjunction with other professionals to develop risk management tools to reduce medication errors.

Governing Agencies Influencing Direct Patient Care

i). Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators

The Agency for Healthcare Research and Quality (AHRQ) is one of the agencies that contributes to best practices and quality measures for organizations in healthcare. The agency’s main role is to bridge the gap between research and practice. The organization developed a list of patient indicators (PSI) framework that guide organizations and practitioners on how to attain quality care in clinical settings (Nguyen et al., 2018). The agency asserts that patient safety indicators offer information on possible in-hospital complications and adverse events following certain treatment interventions that include surgical procedures, and even childbirth among others.

Providers, especially risk managers in healthcare organizations use these indicators as guidelines to assist measure and reduce risks that can impact patient safety like hospital-acquired infections and even injuries from falls. The providers use the informatics system to gather data about the incidences of different adverse events like central-line acquired bloodstream infections (CLABSIs, catheter-associated urinary tract infections (CAUTIs) and injuries among others. collected information can help identify safety issue, prevent occurrence of adverse events, and contribute to the reimbursement to the facility. More fundamentally, the data allows healthcare facilities to improve their overall systems on quality to get better accreditation and even quality status like being a magnet organization.

ii). The Join Commission’s Patient Safety Goals

The Joint Commission (TJC) is an autonomous, not-for-profit accreditation body with a mission to improve health care for the public by working collaboratively with stakeholders and evaluating health care organizations. The commission inspires these entities to excel in provision of safe and effective care to the highest quality and value. Many institutions, including our organization, take best practices from the commission’s National Patient Safety Goals framework (TJC, 2021). The hospital uses different measures and aspects of the commission’s patient safety framework; right from hand hygiene measures and protocols to patient identifies and risk reduction measures. For instance, a core goal of the facility is to have effective communication among staff. Through the approach, the facility has developed policies and protocols that implore laboratory technologists to provide critical laboratory values to nurses immediately they are obtained. A second goal that has a direct influence on patient care is preventing infections and adverse events. the facility focuses on infection prevention by using the guidelines from the commission’s patient safety model.

Technology Informatics Guiding Education Reforms (TIGER)

Technology Informatics Guiding Education Reform (TIGER) is a framework that integrates informatics and technology into practice. The framework’s leaders have focused on implementing informatics courses in all nursing education levels with the aim of enhancing technology in healthcare. Upon finishing this goal, they will embark on reaching out to practicing nurses that may not be in any academic program (O’connor et al., 2017). The incorporation of the model with informatics competency collaborative framework aims at promoting the involvement of nursing staff in informatics and technology. Organizations, including our hospital, uses TIGER as part of its continuing education for nurse practitioners since informatics has become a critical part of nursing today.

NSG 3039 Week 4 Project Informatics in the Clinical Setting Conclusion

Informatics in clinical setting entails allowing evolution of the healthcare field to heights that promote patient safety and quality of care. integration of nurses, providers and patients as end-users of the system is essential in attaining its goals and helps in avoiding human factors that include errors. models like TIGER and patient safety indicators form agencies like AHRQ and The Joint Commission are essential in enhancing overall safety and integration of informatics in care provision. The interview demonstrates the need for nurses to understand critical roles that informatics nurses and specialists play in healthcare delivery and patient safety.


NSG 3039 Week 4 Project Informatics in the Clinical Setting References

McGonigle, D. & Mastrian, K. (2018). Nursing Informatics and the Foundation of Knowledge

(4th ed.). Burlington, MA: Jones & Bartlett Learning.

Nguyen, M. C., Moffatt-Bruce, S. D., Van Buren, A., Gonsenhauser, I., & Eiferman, D. S.

(2018). Daily review of AHRQ patient safety indicators has important impact on value-based purchasing, reimbursement, and performance scores. Surgery, 163(3), 542-546.

O’connor, S., Hubner, U., Shaw, T., Blake, R., & Ball, M. (2017). Time for TIGER to ROAR!

Technology informatics guiding education reform. Nurse Education Today, 58:78-81.

doi: 10.1016/j.nedt.2017.07.014.

The Joint Commission (TJC) (2021). National Patient Safety Goals.