By Suzi Birz, principal, HiQ Analytics, LLC
Last month, the Technology Report focused on the five rights
of medication administration. Today’s column addresses plans of care using the
right information at the right time in the right form. Zynx Health does the
research and hospitals use the content to build nursing plans of care.
By providing more than 100 interdisciplinary plans of care
including nursing orders, ZynxCare enables care teams to put evidence-based
health care content into practice. Plans of care feature rigorously developed
evidence-based content, easy customizability and the capability for seamless
integration into the interdisciplinary team’s workflow—either in paper-based
form or by exporting them into a clinical information system.
Patricia S. Button, Ed.D., RN, director of nursing content at
Los Angeles, California-based Zynx Health, explained that the company employs a
rigorous research methodology to track the latest research results, best
practices and guidelines from peer-reviewed literature. Zynx physicians, nurses
and pharmacists synthesize the evidence into actionable plans of care designed
to help measurably improve the quality, safety and efficiency of patient care.
All clinical recommendations also include links to specific references to ensure
clinicians have the latest findings.
Health care organizations purchase this “content,” customize
it and embed it in paper forms or an electronic health record.
“The power of the experience of customizing the content and
seeing the links to the evidence improves care planning and clinical
documentation,” Button said.
She also noted that care team, including nurses, has a
significant body of research on which to base practice. ZynxCare provides an
efficient and cost-effective way to get that information to the bedside. Nurses
get new or forgotten information at their fingertips—information that may be
otherwise unavailable or time-consuming to obtain. This leads to the three
rights of information gathering:
The right information: Provides
comprehensive, evidence-based interdisciplinary plans of care and supporting
The right time: Brings
evidence-based knowledge to nurses and care team where they need it, when they
need it most: at the point of decision making at the bedside.
The right form: Structured for
seamless integration into a clinical information system or paper-based forms.
Sheri Matter, RN, BSN, MS, chief nursing officer and vice
president of nursing at Pinnacle Health, in Harrisburg, Pennsylvania, described
the facility’s relationship with Zynx as a partnership.
“We trust that the content is based on good evidence,” Matter
Pinnacle Health uses the ZynxCare content to build nursing
care plans. The software tools allow a streamlined approach to customize the
care plans prior to incorporating the content into an automated documentation
“Once embedded in the documentation system, nurses do not have
to leave the documentation tool, open a separate window or do independent
searches,” she added.
Pinnacle Health involves staff nurses in the development of
the care plans. The research is stratified already. Becoming familiar with the
research and being involved in the process has a positive effect on the
acceptance of the care plans.
Matter tied the development of the care plans and the use of
the care plans on the unit together.
“Every unit has a staff nurse involved in developing the plans
of care,” she explained. “Bedside nurses are the best people to develop what
will be used at the bedside, and putting the research in staff nurse hands feeds
the critical thinking for which nurses are trained, helping to ensure the best,
The key, she said, is “embedding the evidence and the nursing
knowledge into the daily routine.”
Although it is too early to measure, based on other
experiences using clinical data, Matter knows there has been a positive effect
on patient falls. She even cited a specific example in use at Pinnacle Health:
Embedded on the clinical documentation screen is a note that the longer a
patient remains in the hospital the higher the risk of a fall. Falls with
serious injuries have decreased since implementing the changes.
Take Away Messages
“For a long time, nursing was dependent on medical evidence,”
Matter asserted. “People now value nursing evidence, although it is still in the
early stages. The time is right for nurses to evaluate their practice, research
their practice, study their practice and continue to move their practice to the
safest most appropriate care for their patients.”
© 2006. AMN Healthcare, Inc. All Rights Reserved.