Nursing informatics is the concept of mixing computer science, nursing science, and information science to help nurses access the appropriate data efficiently(McGonigle & Mastrian, 2018, p. 7). Online portal systems, electronic health records, and even essential smaller technologies such as vital sign machines and glucometers make up just part of the nursing informatics that patients and healthcare clinicians use to provide and receive care (Sweeney, 2017).

   I work on a behavioral health unit at a small community hospital in Northeastern Maryland. There has been a scenario that I have experienced where there has been a gap in the ability to find data that is essential to improving care on the unit. In fiscal year ’20, there were 16 falls, an increase over the goal of under 12. I investigated for a leadership academy that I was part of at that time to improve fall numbers. When I went to my manager, she said that there was no way to differentiate the diagnosis of who these patients were, the age, the medications they were on, or where the falls occurred. The knowledge that could be derived from this data could help improve safety education for those who are a fall risk and analyze if the fall risk policies for the geriatric population or those on alcohol withdrawal are being put in place or need to be updated.  At the time, we had an older EHR, Meditech. We soon switched over to Epic, but when I investigated tracking the data so far for this year, Epic does not have a way to track these demographics either before or after the patient has been discharged. It would be helpful if Epic had a way to track this data, and I have already sent a request to the liaison for our hospital.

   A nurse leader would use clinical judgment to gain knowledge by looking at this data and creating new policies such as implementing new fall risk assessments, converting rooms to accommodate geriatric showers, and find out more about what made the numbers increase. Nursing informatics is essential to track this type of information to improve patients’ safety and make day to day processes more streamlined for healthcare clinicians to reduce errors.

References

McGonigle, D., & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics  (OJNI), 21(1).

Discussion: The Application of Data to Problem-Solving

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.

By Day 3 of Week 1

By Day 6 of Week 1

*Note: Throughout this program, your fellow students are referred to as colleagues.

response

Your topic is a significant concern when you cannot track the data to improve patient safety.  I applaud you for taking the initiative in trying to improve this.  It is an integral part of nursing informatics.  It can also save the institution money.  Falls that occur in the hospital rake in about $34 million a year, preventing Medicaid and Medicare Services from covering fall-related injuries (Bjarnadottir & Lucero, 2018).  Regrettably, not tracking the demographics of a fall results in no change and decreases patient satisfaction and safety.

A study was done at a large Midwestern Oncology Unit at a large medical center in the United States.  The study was done to gather data on better fall preventions and what barriers were encountered.  According to Tucker et al. (2019), nurses on the Oncology unit gave their feedback through surveys that the lack of communication between their staff and the inability to track the data in EMRs were hindering their success in low fall occurrences.  Most of the fall risks were charted in the nursing progress notes that were often overlooked.  By not having a designated data collection for falls made it challenging to re-evaluate their fall assessment protocols.

Just as you did, it was taken up to the review board on trying to improve their communication, collecting data, and having this data available for every patient to review later.  While their request was being reviewed, they devised a plan.  The plan included that all the data from falls would need to be reported on a template.  This way all information is available to improve patient care now instead of later.  They also made it a requirement to include such data collection in hand-off reporting to the next shift.  Maybe this is a good plan of action to implement while you await your response?  If you are not improvising a plan at the moment.

References

Bjarnadottir, R. I., & Lucero, R. J. (2018). What Can We Learn about Fall Risk Factors from EHR Nursing Notes? A Text Mining Study. EGEMS (Washington, DC), 6(1), 21. https://doi-org.ezp.waldenulibrary.org/10.5334/egems.237

Tucker, S., Sheikholeslami, D., Farrington, M., Picone, D., Johnson, J., Matthews, G., Evans, R., Gould, R., Bohlken, D., Comried, L., Petrulevich, K., Perkhounkova, E., & Cullen, L. (2019). Patient, nurse, and organizational factors that influence evidence‐based fall prevention for hospitalized oncology patients: An exploratory study. Worldviews on Evidence-Based Nursing, 16(2), 111–120. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12353

sample response 2

I can relate to your post, as we have had several falls on our unit as well. From what we have collected in our unit, falls are more so common in elderly, especially when trying to get up to go to the bathroom. We have no way of tracking specifics as well, but we do make notes and fill out paperwork that comes along with falls. Our hospital that I work at also noticed that elderly patients who are getting pain medications tend to be more vulnerable for falls. We have noticed that if we put the bed alarms on and place patients who are a high fall risk near the nursing station our numbers decrease. As a bedside nurse and spending most the time with the patient, we gather data and information to put forward knowledge that will benefit our patients’ care (Mastrian & McGonigle, 2017).  I have always used EPIC software in hospitals and I do agree with you that it would benefit tracking specific demographics that lead up to these circumstances for patients. It is important that we provide our patients with safe and effective patient care (Sweeney, 2017).  As of now, we chart under the notes and thoroughly state how the patient fell and what could have caused it. You are doing a great job trying to solve this issue and by making it aware to your manager.

References

Mastrian, K., & McGonigle, D. (2017). Nursing science and the foundation of knowledge. In Nursing informatics and the foundation of knowledge (4th ed., pp.  7–19). Jones & Bartlett Learning. 

Sweeney, J. (2017). Healthcare informatics . Online Journal of Nursing Informatics, 21(1).