Posted: December 29th, 2022
There are quite a few topics or issues that come to mind when it comes to further data that needs collected, accessed, and then used to better nursing and the quality of care that is delivered. I currently work in a hospital here in Hagerstown, MD. A major issue that needs a new approach is correct patient placement. There are five floors in this hospital, and I work on the pediatric/womans/medsurge unit. There is a lot of criteria that my floor is not supposed to take regarding patient care due to it not being an intermediate or intensive care unit. This is the same with pediatrics. We are not a pediatric intensive care unit either. The system we currently use needs some type of flowsheet or notification that carries over to the physicians with the level of care certain patients need so they get placed on the right unit. Some orders such as stroke scale should flag the physician and the in-house supervisor, so they know where to accurately place the patient (McGonigle & Mastrian, 2017).
The knowledge that could be received from this data can be beneficial. A system that flags certain criteria or specialists that belong on a particular unit can help prevent so much chaos and increase physician knowledge on patient criteria and orders for the current placement. There can be trial runs of a comprehensive unit-based safety program (CUSP) Toolkit to help gather supportive data to either benefit this process or show another option may need to take place (AHRQ, 2021).
A nurse leader would be able to take this information and compare it to all the patients that were wrongly placed and compare it to any issues that have come of the new flowsheet or notifications to physicians and the in-house supervisor. It is a waste of resources and time when a unit gets a chemo patient or peritoneal dialysis patient when the unit the patient was sent to does not specialize in that specific skill. This result is an unhappy patient that just sat half of their day in the emergency room and now must be moved again and it holds up a bed that needs to be re-cleaned. Another issue that is taking place at my current place of employment (that is new) is the ER not calling the floor with report. Once the patient is placed on the board, they must wait 15 minutes for us to look up the patient (if we are lucky to have time right away) and they ask if we have any questions, then send the patient right on up. Another problem that contributes to this issue is a hospital on high census. There are many benefits of implementing the correct patient flow in facilities. The proper care if given, decreases the length of the patient’s stay and improved documentation of treatments (Chcf, 2017). This all has resulted in multiple incidents, including COVID positive patients being brought to a non-airborne unit. I do believe having some sort of tool that triggers where patients should be placed would benefit this whole process and protect other patients as well.
Agency for Healthcare Research & Quality. (2021). AHRQ Patient Safety Tools and Resources.
California Healthcare Foundation. (2017). Using Tracking Tools to Improve Patient Flows in
McGonigle, D., & Mastrian, K. G. (2017). Nursing Informatics and the Foundation of
Knowledge (4th ed.) Chapter 2, “Introduction to Information, Information Science, and
Information Systems” (pp. 21-33). Burlington, MA: Jones & Bartlett Learning.
In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.
Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.
In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.
*Note: Throughout this program, your fellow students are referred to as colleagues.
As a labor and delivery nurse for over 13 years, the most common scenario that data shapes nursing practice is caring for a labor patient. Nursing informatics comes into play incredibly because, like many other units, central monitoring of patients is essential to run a labor unit safely. Electronic fetal monitoring is a fetal heart rate monitor that continuously graphs the fetal heart, and the graph determines the oxygenation level of the fetus (Romo, Huelsmann, & Koperski, 2011). I have been a float nurse among different hospitals and a travel nurse. All nine labor and delivery units had central monitoring to monitor how a fetus is doing in labor, and maternal vital signs are visible to the unit’s staff. In the last decade, the doctors and midwives on the case can also monitor the patients remotely. This data gives nurses and providers the data to make informed choices in how labor must proceed. Some examples are using the maternal vital signs information to draw labs and start magnesium for a patient exhibiting symptoms of preeclampsia or doing a cesarean section due to fetal distress. Many other scenarios arise because nurses and providers have the data to provide care for their patients safely. Electronic fetal monitoring is the standard of care among high-risk laboring patients (Small et al., 2021). The future of electronic fetal monitoring is to beyond remote monitoring and make an intelligent monitor that can help interpret electronic fetal monitoring patterns to better serve the patient population (Knupp, Andrews, & Tita, 2020). Nursing informatics is the center of a labor unit, and the new technology to come will continue to help patients safely deliver their babies.
Knupp, R.J., Andrews, W.W., & Tita, A.T.N. (2020). The future of electronic fetal monitoring. Best
Practice & Research Clinical Obstetrics and Gynaecology, 67, 44-52.
Romo, P., Murray, M.L., Huelsmann, G., & Koperski, N. (2011). Essentials of fetal monitoring (4th ed.).
Springer Publishing Company.
Small, K., Sidebotham, M., Gamble, J., & Fenwick, J. (2021). Does intrapartum CTG save lives? Midwifery
Matters, 168, 20–22.
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