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NURS 8210 Differentiate the information needs within your organization

NURS 8210 Information Architecture

NURS 8210 Differentiate the information needs within your organization

Health information systems (HIS) facilitate patient safety in the organization through improved communication between health care professionals, improved tracking and reporting, quality care through clinical decision support systems, and improved medication safety (Ball et al., 2011). At my organization, the HIT system collects data for QI, outcome reporting, and surveillance purposes.

Information Workflow

When the patient enters the facility, the patient details are captured through the patient registration point. The next step in the flow of information is the triage nurse, who inputs the patient history and patient values into the Electronic Health Records (EHR). Next, providers record the patient’s diagnosis, notes, medications, and care plans. The data on medicines flow towards the laboratory and scans for evaluation of diagnostic tests. Afterward, the provider has a chance to integrate changes to care plans based on lab data. The information then flows to the pharmacy department as the patient awaits medications. The information flow represents a multidisciplinary facility. The communication between providers is collaborative and efficient, and gears towards patient-centered care (El-Said & El-Sol, 2018). Information continuity is a feature in the Women’s hospital, and the flow is efficient and contributes to quality care.

HIT Systems and Evidence-Based Practice

The health information system facilitates evidence-based practice through data collection to assess the efficacy of interventions and clinical decision support systems and alerts that optimize best practices. There is record uniformity to reduce variations in care. The HIS can also be utilized for a QI audit to assess compliance with (Evidence Based Practice) EBP. Patients can access medical records and are empowered to take an active role in managing their conditions. HIS can facilitate diagnostic tests and follow-ups for appointments/consultations. However, computerized order entry compromises EBP despite its benefits of decreased processing time and lower risk for adverse events. Clinical expertise is an integral domain of EBP, and automated entry disrupts workflow with incompatibilities that prevent full assessment of the patient’s needs (Oach & Watter, 2016). Improvements in design and integration between platforms and robust interoperability will facilitate evidence-based care. However, the exchange of data across all settings and providers within the organization improves safety.

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References

Ball, M. J., Douglas, J. V., Hinton Walker, P., DuLong, D., Gugerty, B., Hannah, K. J., & Troseth, M. R. (Eds.) (2011). Nursing informatics: Where technology and caring meet (4th ed.). London, England: Springer-Verlag.

El-Said, A., & El-Sol, H. (2018). Technology into nursing practices: Enhance patient’s outcomes. Mansoura Nursing Journal, 5(1), 191-195. https://dx.doi.org/10.21608/mnj.2018.150637

Oach, P., & Watter, A. (2016). Health information management: Concepts, principles, and practice (Fifth ed.). Chicago: AHIMA.

Dr. Bailey,

Thank you for your inquiry. CPOE (Computerized Provider Order Entry) uses the EHR/computer support to process and enter the

NURS 8210 Differentiate the information needs within your organization
NURS 8210 Differentiate the information needs within your organization

orders from physicians. They were initially developed to improve prescribing and enhance patient safety (Abraham et al., 2018). They are, however, used in modern systems to order tests, consultations, and procedures. In the facility, clinical decision support is also integrated into the EHR and serves error prevention. Physicians can confirm the proper doses, frequency, and route of administration of medications. Some features prompt providers for patient allergies, drug interactions, etc. The prompt alerts the providers to follow clinical guideline recommendations in patient assessments, lab requests, and prescription medicine. There is evidence of the efficacy of CPOE in error reduction particularly, medication errors.

CPOE uses hard stops and error prevention functions which limit the provider’s intended action. These hard stops delay clinical treatment. High-profile failures, safety hazards, and other unintended consequences of CPOE disrupt clinical workflow (McGraw Caren, 2021). CPOE implementation disrupts the clinical workflow and may lead to the abandonment of the system. For instance, the clinician is required to perform several tasks, which decreases efficiency due to increases in cognitive load. This can disrupt the clinical workflow and limit evidence-based practice that hinges on the provider’s clinical expertise. Nurses and other providers may have to bypass the safety features and rely on adaptations to navigate these limitations provided by the CPOE commands.

In summary, the challenges of CPOE implementation include confusing displays, lack of standardized warnings and alerts, unfavorable workflow issues, unfavorable changes in communication patterns/practices, overdependence on the technology, never-ending system demands, negative feelings toward the new technology, more or new work for clinicians and new types of errors (Kebede, S. (2016). Integration of CPOE requires careful planning, real-world usability testing, and integration within the CDSS. Maximizing safety and tailoring the system to real-world clinical workflow will achieve a good balance.

 

References

Abraham, J., Kannampallil, T. G., Jarman, A., Sharma, S., Rash, C., Schiff, G., & Galanter, W. (2018). Reasons for computerized provider order entry (CPOE)-based inpatient medication ordering errors: An observational study of voided orders. BMJ Quality & Safety, 27(4), 299-307.

Kebede, S. (2016). Challenges associated with the use of Computerized Physician Order Entry (CPOE): A physician’s perspective. Journal of Health & Medical Informatics, 7(3), 63. http://dx.doi.org/10.4172/2157-7420.C1.010

McGraw, C. (2021, September). Computerized Provider Order Entry (CPOE) System. Prognocis EHR. https://prognocis.com/cpoe-system/