Hello everyone, I have been a registered nurse for 6 years. I started out in a level one ICU and worked my way into the emergency room. I graduated with my Adult Gerontological Acute Care Nurse practitioner in November 2020. I started by first NP job as a hospitalist in May of 2021. I currently oversee a 10 bed ICU and 35 bed step-down unit at a small hospital. My goal is to eventually go into nursing management and possibly chief nursing officer. I am passionate about bringing back the satisfaction in bedside nursing. I think being proactive rather than reactive is the first step in finding a way to bridge the gap in the bedside nursing shortage.
Summarize how informatics has impacted or changed nursing practice.
Provide an example from your professional experience
Informatics has changed nursing practice for the better in many ways. The biggest change that has impacted my own personal career is through documentation. I have used both paper and electronic documentation in my nursing career. 0.
Even though I’ve had a personal computer since 1999, computers in healthcare did not become prevalent until the mid-2000s. George W. Bush signed executive order 13335 in 2004 that required all Americans to have an electronic health care record by the year 2014 (Ozbolt & Saba, 2010). It is hard to believe that it’s only been 7 years since it’s been mandatory for all areas of healthcare to be merged from paper to electronic. How many of us have had smart phones longer than 7 years?
This brings me back to electronic documentation. Documentation has not only improved patient safety but also nursing safety. I have become very thorough with my documentation thanks to the electronic healthcare record. I document everything from what a patient says to everything they bring in the hospital. I once had a patient that tried to state that I did not give her a purse when she transferred from our hospital. She then attempted to sue my hospital for the “$20,000 dollars in cash” she had in her purse. I documented not only that she had brought her purse but also that I had given her purse to her when she left my ER. If I would needed to go and physically hand write that all into a paper chart including what the patient brought in with her and left with, I most likely would not have been as detailed with my charting. The ease of being able to open up a computer and quickly type or click a button to chart simple things allows me that time to be more thorough with my charting. It also saved my hospital and my unit from being scammed out of a lot of money. I have also had friends who have used their documentation to help them in court cases.
Evaluate how established informatics competencies influence quality of care, safety improvements, and excellence in nursing practice.
Informatics influence quality of care, improve safety and create excellence by creating standards on how things should be done. Nothing is a better example of this than COVID-19. Many hospitals had to take on a new disease that we knew little to nothing about. As more and more cases started to pour into the hospitals, information was gathered on what was working and what wasn’t working in regards to treatment. At first patients would come in with respiratory or gastrointestinal symptoms and we had no way of triaging to know if this patient could possibly be COVID-19 and require isolation. Patients were sat in the waiting room and mixed with COVID-19 and possibly not COVID-19 patients. This caused a dilemma with patient safety and quality of care.
University of California, San Diego Health (UCSDH) partnered with the electronic health care record (HER) Epic to develop a screening protocol to identify potential COVID-19 patients as soon as they entered a hospital. They gathered information from 300
affiliate physicians, 10 medical groups, and quarantined cruise ship passengers to form basic travel and symptom screening questions (Reeves, et al., 2020). The screening questions ask about recent COVID-19 exposure, symptoms, any recent testing, and any recent travel (Reeves, et al., 2020). The questions were designed to be asked by front desk staff and be easily entered into the EHR. If a person answered any of the questions with a “yes” their chart would be immediately flagged notifying the provider with clinical decision-making information to be able to place that patient into an isolation room away from the general triage population.
I believe this is an excellent example of how informatics was used to influence patient quality of care by assuring possible COVID-19 positive patients could be identified early and separated from the general triage population. It is an example of safety improvements by cutting down on potential exposure to other patients and staff. Lastly, it shows excellence in nursing practice by solving a very new and evolving problem in health care by using the information gathered from bedside nursing.
Assess your informatics strengths and preferences, as well as potential challenges and areas for development. (Be sure to refer to specific TIGER and ANA competencies.)
My TIGER informatics strengths are computer competencies, information management and information literacy competencies. I am very comfortable with a computer and multiple different EHR charting programs which shows my competency with computers and information management. I can chart as both a nurse and a provider. My strength with information literacy competencies comes from years of doing research and writing papers through graduate school.
My weakness with TIGER informatics has to be related to computer competencies. I have used computers for years and know my way around them but I don’t know how they operate or how to fix things that may go wrong. Our book mentions “know the difference between RAM (random access memory) and ROM” (read only memory) (ANA, 2015). Honesty, I have no clue. I would need to take my computer to a repair store if it was not running properly or I did not have available RAM.
ANA competencies go from entry level nursing up to doctorate level nursing. As a master’s degree nurse, I do feel confident with the ANA nursing competency of “analyzing health care information, communication technology strategies to reduce risks, improve care delivery, change policy, and providing oversight and guidance with the integration of technology” (ANA, 2015). I am very involved with the changes in healthcare, improving patient outcomes, and developing new policies at my current hospital. I help lead debriefing meetings and allow myself to be a sounding board to floor nurses in order to help develop change.
I am not yet comfortable in the role of the ANA competency of a doctorate degree nurse. According to the ANA, a doctorate degree informatic nurse should be able to “lead the design, selection, and evaluation of healthcare information care technologies systems that promote effective and ethical use of patient information while using informatics in research and writing” (2015). I am hoping that I can someday get to the point of being this comfortable with nursing informatics.
Describe one strategy for enhancing your informatics skills and competencies.
One strategy I would like to enhance on is understanding the workings of a computer. I will challenge myself to watch YouTube videos on how a computer runs, how to repair computers, and how to add memory to my laptop. I have used computers most of my life in the become to the point where financially they are disposable. It has not crossed my mind that it would be important to learn how to care for my computer or repair it. I do enjoys fixing things so this would be a fun challenge for me to take on.
American Nurses Association. (2015). Nursing informtics: Scope and standards of practice. Silver Spring, MD: Author.
Ozbolt, J.G. & Saba, V.K. (2010). A brief history of nursing informatics in the United States of America. Nursing Outlook, 56(5), 199-205.
Reeves, J., Hollandsworth, H., Torriani, F., Tapliz, R., Abeles, S., Tai-Seale, M., Millen, M., Clay, B., & Longhurst, C. (2020). Rapid response to COVID-19: health informatics support for outbreak management in an academic health system. Journal of American Medical Informatics Association, 27(6), 853-859.