Nursing Informatics 

 

 Introduction

Executing a new EHR program or even substituting to a more innovative one can be one of the utmost disrupting expectable actions that can be practiced in a hospital, affecting almost every employee and work flow with the facility. Instantaneously after the execution, workflow disturbances that are formed by technologies like automated admission can give rise to a widespread range of inadvertent significances for example incompetent workarounds, disturbances in steadiness of care and other automatically rooted mistakes.  Eminence could also agonize because the health care workers might be confused by the unexpected changes in the manner in which test results are retrieved, consultation notes, prior admission or discharge documentation and the manner in which they document patient care.

Numerous concerns have in the past been raised in regard to EHR implementation and the way that the switching can unfavourably impact patient well-being and eminence in the few months after conversion. There are hospitals that have reported an amplification of death rates in the first several months after the new program was executed. The fear that the shift may principal to harm is also reasonable given that apparently less upsetting work flow fluctuations such as admittances on the weekend or new beginners in the hospital have a tendency of causing negative outcome on the patient for instance increased death rates.

Graduate QSEN Competencies in EHR Implementation

QSEN (Quality and Safety Education in Nursing) is a national movement that helps guide nurses to reshape the ‘reason’ and ‘manner’ that they convey nursing care so that they can safeguard high quality, benign care (Dolansky & Moore, 2013). The general objective of QSEN is to look into the challenge of formulating future nurses with the information, abilities and approaches that are essential to incessantly advance superiority and well-being of the health care structures that they work in. QSEN is a significant component when it comes to implementing a new EHR program because nurses need to be educated about the manner in which that they are supposed to take care of patients which includes even the administration of medicine at the right time and in the right quantity (Skiba, 2011).

There are five competencies that guide nurses in providing effecting patient care and they comprise; patient centred upkeep, cooperation and partnership, evidence based practice, prominence upgrading, well-being and informatics (Dolansky & Moore, 2013). The EHR program that will be developed will be designed in such a way that it is able to identify the patient as the foundation of control and also full partner in offering empathetic and corresponding care that is grounded on the respect of the favourite, standards and requirements of the patient. It will be capable of analysing multiple dimensions of patient centred upkeep which include the coordination and incorporation of care and also participation of close relations. The EHR program will take into considerations the social, political and economic dimensions of patient care processes and the implications that the patient centred care will have.

An effective EHR program is one that is able to assimilate philosophies of cooperation and actual communication with awareness of eminence and wellbeing capabilities. It should be easy to use for the patients, their family and also for the entire medical staff in order for it to be effective and to avoid any confusion (Dolansky & Moore, 2013). Before it is implemented in a hospital setting, the program will be analysed whereby, input from all team members will be assessed to help improve its performance. Doing this will empower contributions of other members of the society, and it plays a great role in helping patients achieve health goals.

Before any implementations of programs, it is important to have proper research conducted to understand the impacts that a programs would have on the health facility. Conducting research using correct research methods helps to understand the best techniques to use to implement the EHR program in a manner that makes it effective (Skiba, 2011).

The best EHR program is none that has the least negative impacts on the patient care and the overall work performance of the workers. When implementing the EHR program proper safety measures will be put in place so that in case of any errors with the program, it will be easy to correct them in good time to avoid more damage getting done. Families, patients and the health care team will always be alerted when an error occurs with the new system to ensure that the avoid making any erroneous inputs in the course of providing health care.

Security and Ethical consideration in implementation of the new EHR program

Ethical issues that are related to EHR confront health workers, when information on a patient is shared or connected without the knowledge of that patient; their independence is put in jeopardy.  This may lead the patients to keep some of the information to themselves because they lack self-confidence in the safety of the hospital structure keeping their personal data which may compromise their overall treatment (Papoutsi et al., 2015). In the past, thousands of patient’s health data have been risked through mistakes and others through theft. It is hence important for health workers as well as policy makers to come to an agreement on the best strategies to ensure that patient’s data is safe and medical care is ethically provided.

Privacy is an important concept when it comes to medical information. Patients have the right to keep their medical information private without having it disclosed to others. Information of a patient should only be disclosed to a third party only after permission has been granted by the patient or allowed by the law (Papoutsi et al., 2015). The new EHR program will be structured in such a manner that patient information is kept private and also safe. Only authorised individuals will have access to patient information for instance insurance and health care institutions. So the first stage in establishing the EHR program will be to establish the authorised users, which will be founded on pre-recognized role based freedoms. The manager will begin by identifying the user, determining the level of information that they will be answerable for, the usage and the misappropriation of the data that they look at. They will only have entrée to the data that they require to carry out their errands.

Security measures will also be put in place to ensure that there is no security breach that could threaten patient privacy. The EHR program will include safety actions including antivirus and intrusion detection software as well as firewalls, which will greatly help to protect data integrity. There are also policies and procedures that will be put in place to help maintain patient privacy and confidentiality. For one, employers will be expected not to share their ID with any person, to always use their ID as right of entry to the patient automated records and to always ensure that they log off when leaving a terminal. Security personnel will be selected by the institute to work with the group of health IT specialists.

There will always be regular random routine audits which will guarantee amenableness with the hospital procedure. All system doings will be trailed in the inspection trials and this take account of comprehensive listings of content, length and the operator, the audit will be able to generate day and time for all admissions and records for all alterations to EHR. In a case scenario where there is unsuitable admittance to a medical file, the system will be able to harvest data about the title of the individual gaining entree, the interval and time, the records retrieved and the period of the analysis. This is very important information when defining whether the entree was flawed or intentional unauthorised view.

Consideration to make in EHR Implementation

System operations of many EHR projects are always unsuccessful normally because they undervalue the prominence of one or more clinicians to attend as judgement frontrunners for workers in the clinic. It is significant that clinicians direct co-workers in understanding their functions in the execution and registering of their connection in undertaking as EHR assortment workflow design and worth enhancement (McAlearney et al., 2015). Clinical workers often have diminutive awareness of the clinic’s workflow and the functions that others play in provision of care. This unsighted predicament consequences in insufficient scheduling for positive execution without recognizing a consistent best exercise technique to do the task, every user ends up struggling.

When two schemes are joined, a boundary is formed, that is the border between the operator and the computer structure. These boundaries are important to the whole success of the application course (Houston-Raasikh, 2014). Boundary issues are the utmost system dangers because these let-downs can be imperceptible at the start. Lack of orderly deliberation of operators and errands, constantly consequence in poor boundaries, poorly calculated user boundary account for unintentional adverse result leading to lessened time proficiency, poor value of upkeep and augmented menace to patient safety. A boundary that is poorly calculated fails to convey the much needed eminence of care which clues to user displeasure (Houston-Raasikh, 2014). The defective user boundary which was minor at the beginning ends up increasing over time which ends up leading to EHR program abandonment.

Benefit of EHR for the organization

 A new EHR program in this case AdvancedMD, is effective and beneficial because it will allow the organization to advance workflow competence while it is being customizable and supple all at the same time. With the EHR program, it is easy for the organization to agenda schedules, manage dissolutions, and confirm insurance analysis, registrations and even assess transfer data completed in just one screen (McAlearney et al., 2015). It is easy to have activities computerized and appointment appeals for patients can effortlessly be accomplished through a portal designed for patients.

Doctors have the choice to design records in the manner in which they desire and they can use both speech and transcriptional tools which allows them to view patient records in the format that best suits them.  It is easy to configure patient charts according to the preference of the physician; it is easy for one to look at family history, allergies and other important details, all in one screen (McAlearney et al., 2015). Another important aspect of this HER program is that clinicians and the patients can easily be sent medical advice and reminders which ensures effective medical care. The users can issue digital prescriptions and have controlled substances monitored and prescriptions can also be signed and sent directly to the pharmacy which greatly enhances patient experience through this program (McAlearney et al., 2015).

 

 

 

 

 

 

 

 

 

References

Dolansky, M. A., & Moore, S. M. (2013). Quality and Safety Education for Nurses (QSEN):

The Key is Systems Thinking. Online Journal of Issues in Nursing, 18(3), 1–12. https://doi.org/10.3912/OJIN.Vol18No03Man01

Houston-Raasikh, C. (2014). What the Others Haven’t Told You: Lessons Learned To Avoid

Disputes and Risks in EHR Implementation. Nursing Economic$, 32(2), 101–103. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=95580667&site=ehost-live

McAlearney, A. S., Hefner, J. L., Sieck, C. J., & Huerta, T. R. (2015). The Journey through

Grief: Insights from a Qualitative Study of Electronic Health Record Implementation. Health Services Research, 50(2), 462–488. https://doi.org/10.1111/1475-6773.12227

Papoutsi, C., Reed, J. E., Marston, C., Lewis, R., Majeed, A., & Bell, D. (2015). Patient and

public views about the security and privacy of Electronic Health Records (EHRs) in the UK: results from a mixed methods study. BMC Medical Informatics & Decision Making, 15, 1–15. https://doi.org/10.1186/s12911-015-0202-2

Skiba, D. J. (2011). Informatics and the Learning Healthcare System. Nursing Education

Perspectives (National League for Nursing), 32(5), 334–336. https://doi.org/10.5480/1536-5026-32.5.334