Devices & Technology

Nursing Plans of Care


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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.

Evidence-Based Content

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 evidence.

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.

Use

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 said.

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 system.

“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, safest care.”

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.”

Resources

Zynx

Pinnacle Health

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