By Megan M. Krischke, contributor
August 27, 2010 - New technologies are constantly being developed and refined to increase the efficiency and safety of medical care, and many institutions and individuals are embracing these new technologies. The days are numbered for pen and paper systems as the stimulus package’s Health Information Technology—Meaningful Use and Standards legislation is offering, first, incentives for the adoption of electronic health records in physician’s offices and hospitals and then after four years, penalizations for the lack of adoption of this technology.
Lara Key, BSN, RN, Director of Clinical Informatics at Kootenai Health.
In July, H&HN (Hospitals & Health Networks) Magazine published its list of the 30 Most Wired Hospitals, which includes Northern New Jersey’s Atlantic Health and Kootenai Health in Coeur D’Alene, Idaho. Linda Reed, RN, MBA, Atlantic Health’s Vice President-Chief Information Officer, and Michelle Downing, RN, MPA Nursing Informatics Coordinator at Morristown Memorial Hospital, part of Atlantic Health, along with Lara Key, BSN, RN, Director of Clinical Informatics from Kootenai Health offered their insights on medical technology trends, benefits to nurses and patients and helping nursing staff to adopt new technologies.
Michelle Downing, RN, MPA, Nursing Informatics Coordinator at Morristown Memorial Hospital.
One of the technologies which all three specialists see becoming a standard is a barcoded system for ordering and dispensing medications. With this system the physician’s digital prescription goes directly to the pharmacist, avoiding transcription errors. The medication is labeled with a barcode, which the nurse must scan, along with the patient’s barcoded identification bracelet to ensure that the correct patient is receiving the correct dosage of the correct medicine before the medication is administered.
“Nurses love this technology because the order is visible immediately, it is clear which physician made the order and it is legible,” Downing remarked.
“With a pen and paper system, if something was unclear it would take hours to determine which physician made the order and to track him or her down, time better spent at the bedside. Not only does this system increase safety for our patients, it decreases the time it takes for them to receive their medications,” said Reed.
This technology’s other features include: immediate physician notification if a prescribed medicine is contraindicated, reminders, for example, to check blood pressure if administering a blood pressure medication, and alerts if the medication is being administered too early, too late or in the wrong amount. The system also offers details on the correct injection site and reminders for high-risk medications that require a double signature or a witness. Another feature that is a great benefit to nurses is that the system will create a schedule for each nurse to follow to ensure that each patient is receiving their medications at the appropriate time.
Reed and Downing both see predictive technologies as the wave of the future. These types of systems can analyze information like past patterns in ED wait times to help create better staffing schedules or even look at a patient’s health history and symptoms to offer a suggested care plan.
Linda Reed, RN, MBA, Vice President Chief Information Officer for Atlantic Health.
The plans for many new hospitals are beginning to experiment with the nurses’ station and even eliminate the station all together.
“This decentralization and move to clinicians communicating in cyber space is going to create substantial changes in the way we think about our professional interactions and relationships,” Reed noted.
One change that has been made at Morrison’s nursing station is the introduction of visibility boards. These digital screens display each patient, their location and condition so everyone working on the floor can see it at a glance.
“Before this technology it would have been necessary to open each patient’s chart to get this information. Now, although it is coded with icons for the sake of privacy, you have a view of the whole floor,” Downing explained.
A favorite technology among nurses at Kootenai is a program that automatically downloads a patient’s vital signs to the electronic medical record after the nurse has made an assessment.
“Nurses appreciate this technology because it is efficient, reducing charting time; it is accurate, there are no transcription errors because the equipment monitoring vital signs is connected directly to the computer; and because it makes the information immediately available to everyone working on the health care team,” commented Key.
“Even though change is always met with some resistance, I’ve found that nurses readily adopt new technologies exactly because of those benefits: efficiency, accuracy and immediacy,” Key continued.
“Often when implementing a new technology, we don’t activate all the bells and whistles up front, but wait until the nurses see the need and come asking for it,” Downing stated.
Both Kootenai and Atlantic Health include their clinical staff in new technology and equipment decisions. Not only does this create a sense of ownership among the clinicians, Key said it has led to better decision-making because clinicians know what they really need and which features might actually detract from patient care.
“The technology is always getting better and easier to use and that leads to safer delivery of patient care. It is an evolution. Sometimes we think, ‘Ok, we are done; this is as good as it gets.’ But, it does evolve,” Key remarked. “For nurses who are feeling discouraged or overwhelmed by new technologies, I’d encourage them to keep working with their IT departments and it will get better.”
“It is worth noting that there is a correlation between the most wired hospitals and improved patient outcomes,” Reed stated. “That is good for everybody.”
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