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NURS 6051 Discussion The Application of Data to Problem-Solving Sample

NURS 6051 Discussion The Application of Data to Problem-Solving Sample

Discussion 1, N.I.

In nursing, there are many times we rely on data.  The American Nurses Informatics Association’s mission statement is “to advance nursing informatics through education, research, and practice in all roles and settings.”  Without crucial data such as vital signs, lab work, radiographic readings, and other useful technology, how can healthcare professionals perform their jobs effectively and treat patients?  How does staff communicate pertinent data?  Electronic medical records such as Meditech and Epic keep staff up to date on patients and their status.  Poor patient outcomes would be the result of incomplete and incompetent data.

There is a scenario that comes to mind when a patient’s life depended on how I interpreted the data after his surgical procedure (kidney stone removal).  After the patient arrived from recovery, he started shivering uncontrollably.  Yes, that can be a common side effect of anesthesia, but that is usually immediately post-operatively.  Noticing the intense shivering, I took his temperature, and it read 106 degrees Fahrenheit.  I then rechecked it due to the insanely high number.  Heart rate was in the 110s to 115s, and blood pressure was dangerously low in the 60s over 30s.  With my knowledge and nursing background, I immediately thought of urosepsis.  I notified the rapid response team, and ancillary departments arrived at our unit to assess and gather the appropriate diagnostics tests.  We increased his fluids and started antibiotics. NURS 6051 Discussion The Application of Data to Problem-Solving Sample

Without noticing his shivering and taking his temperature, urosepsis would have taken over his body, and this patient could have quickly perished.  His lactate level was an eight, which indicates organ failure.  This patient did end up in the ICU but soon recovered due to my quick actions and responding to his vital signs.  In nursing, we rely on various machines and devices to provide feedback on a patient’s condition.  This feedback then interprets the appropriate care needed and plan of action for this patient.

Before this class, I did not know Nursing Informatics was an actual concept that pertained to me. However, now that I have learned the concepts of informatics in nursing practice, I realize that I integrate informatics every day.  Nagle, Sermeus, and Junger (2017) stated that a wide array of emerging technologies and increases in data analytics make the integration of informatics imperative into every area of nursing.  While working in the field of nursing, new technology is always emerging. Therefore, it is critical to keep up on the latest research and grow our knowledge.  This scenario is where we, as nurses, integrate informatics into our practice. NURS 6051 Discussion The Application of Data to Problem-Solving Sample

According to our readings, McGonigle and Mastrian (2017) described knowledge as an awareness and understanding of a set of information and ways that information is useful to support a specific task or arrive at a decision.  My patient above, I went by what his vitals were telling me, and I quickly made an action plan gained from knowledge with past experiences.

References

American Nurses Informatics Association. (2020). https://www.ania.org/about-us

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Nagle, L., Sermeous, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Evolving Role of the Nursing Informatics Specialist, 212–221.

The Application of Data to Problem-Solving

At first, I thought nursing informatics pertained to data collection and management such as surveys and research studies. However, McGonigle and Mastrian (2017) explains knowledge as an awareness and understanding of a set of information and how it is utilized to support or make a decision. Once I read this, I realized it is something I do every day at work.

As an ICU nurse, our patients are connected to monitors constantly. Our patient’s data is continuously recorded and displayed on monitors and flows into their electronic chart records. So not only can the nurse look at the monitor and assess if the patient’s vitals are within normal limits or not and what that might mean but the data recorded flows over into their electronic charts. From there, some of the data is inputted into an algorithm. Some of the algorithms create warnings such as a sepsis warning. NURS 6051 Discussion The Application of Data to Problem-Solving Sample

For example, I received a patient from the ER who was in critical condition. I was in the room admitting that patient while my other patient’s monitor alarmed noting irregular heart rhythm. I ran to my alarming patient’s room to find my patient diaphoretic, short of breath and anxious. Since my patient was already connected to the heart monitor, I was able to see the irregular heart rhythm was ventricular tachycardia. I was able to call for help, start the appropriate care and the patient was later stabilized.

That patient had been stable my whole shift and his family members had left for the evening. The monitor and the alarms became my eyes and ears while I was admitting my new patient. If he had not been monitored, he could have died. And if I, as the nurse, did not pay attention to the alarm or accurately assess my patient and the monitor, he could have died.

NURS 6051 Discussion The Application of Data to Problem-Solving Sample

NURS 6051 Discussion The Application of Data to Problem-Solving Sample

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While all of that was happening, my fellow nurses help admit my new patient. Once I was able to get back to my new patient and look

at her chart, I had a sepsis warning. Laureate Education (2018) states, “computer principles and information science are combined to turn data into knowledge”.  Due to the data the nurses and the monitors collected and the algorithms analyzed, the system was warning me my new patient potently could have sepsis. This was a great reminder. Even though I was interrupted by a crisis, my new patient would still get the appropriate care she deserved.

It is the goal of The American Nursing Informatics Association (2020) to utilize “informatics to improve the health of populations, communities, families and individuals by optimizing information management and communication”. In the scenario described above, the health of two patients were greatly improved by informatics along with the clinical reasoning and judgment of the medical staff.

Resources

American Nurses Informatics Association. (2020). Retrieved from  https://www.ania.org/about-us

Laureate Education (Producer). (2018). What is Informatics? [Video file]. Baltimore, MD: Author.

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

RE: Discussion – Week 1

Terra,

Great post!  Your scenario was similar to mine in the fact that we both discussed septic patients.  Just like you, I did not know much about nursing informatics; honestly, I did not even know it existed.  I thought some nurses worked in I.T. and took extra courses to become an expert in this field.  I was wrong.  Nurse informaticists integrate data, facilitate information and knowledge to better support patients, doctors, and other healthcare providers (“Nurse Journal,” 2020).

My husband works in our ICU, and their system is similar to yours.  The data from the patient’s monitors transfer into their EMR; however, it does not help him when there is a potential septic situation.  Having that system would be very helpful.  Bedside nursing is very challenging, but I believe that informatics has helped us come a very long way.   In my situation, I had my patient connected to the monitor post-operatively, and his vital taken every 15 minutes.  How I noticed he was becoming septic was that he became extremely febrile, blood pressure dropped, and became tachycardic.  If it were not for this technology, this patient would have had a very different outcome.  NURS 6051 Discussion The Application of Data to Problem-Solving Sample

Informatics plays an essential role in the care we give our patients.  Yes, my patients receive excellent care with or without technology. Still, because of informatics, we make clinical decisions based on our nursing knowledge.  Patients are more critical than they ever were, and people are living much longer, and I believe technology has a considerable part.   McGonigle and Mastrian (2017) state being a knowledge worker deals and processes information and makes it meaningful to our practice.  With our septic patients, that is what we did.  We used our knowledge to deliver proper care to the patient.  50-80 years ago, do you feel as though patients did not have better outcomes because informatics and technology have come a long way?  I know medicine plays a pivotal role in the lifespan of patients’ lives, but what about technology?

References

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Nursing Informatics Career & Salary. (2020). Retrieved from https://nursejournal.org/nursing-informatics/nursing-informatics-career-outlook/

These are great points. I would have to agree that I also have a love / hate relationship with electronic additions to the health care world especially due to the lack of nurses’ input. I remember when my hospital implemented another policy to continue the decrease in medication errors. As an ICU nurse, I give the majority of medications via IV. Due to our new policy; now I must scan the patient’s wrist band (after asking name and date of birth), scan the medication, verify which IV access will be used, and then scan the medication pump that will be used. After that, the computer will ask that all the information is correct: patient, medication, route, IV access, pump, rate, dosage along with any extra information that is needed such as vital signs. Once I confirm all of that information, I send the data from the computer to the IV pump. While I walk across the room to double check the IV pump, I pray the computer and IV pump actually communicated correctly the first time. If the data is all correct on the IV pump, then I can hit accept. The IV pump will start administering the medication at that time. But as I walk back across the room, I pray that the IV pump and the computer communicated correctly again. If so, the computer will then document that the medication has been administered and the medication is “linked”.

This is an amazing tool when everything is working correctly. However, I am sure you can begin to imagine how this process can begin to fall apart. Sometimes the scanners are not working. Sometimes the barcodes on the medications, the patient’s wrist band, or the IV pump are not working. Did I mention the scanners are NOT wireless? Sometimes there are family members or co-workers in the way. Sometimes the MD is doing a sterile procedure at bedside. Sometimes the patient is coding and IV drips get stopped and new ones are started and they have not been “linked”. Sometimes, the IV tubing is switched to another port or IV access entirely without being “linked”.

As I stated prior, this technology is great when everything works correctly. However, if it does not, it can make my job more difficult and time consuming.

When everyone (including nurses) sits at the table and is able to give their input, that is when amazing things happen.

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