Module 6:Ethical Issues and policy issues related to info. technology

During this course I have learned several things about computers and how they are used in the real world currently in almost every aspect of life. The health care setting uses computers for charting, delivering medication via acudose system, the computer checks the dosage automatically and notifies the nurse if the dose is incorrect immediately, which decreases patient medication errors. Computers allow quick access to patient lab results and xrays before they are dictated by the professionasl.
 I was actually avoiding computers before starting school, I only used them for email and mandatory education at work in the hospital; however, I now have a whole new perspective on computers and how even the public and parents rely on them so heavily for communication and information retreival of all styles. Professional, personal, networking, sales, purchasing, medical documentation and billing reimbursement issues with insurance groups are a few examples. The computer has allowed rapid transactions in banking, medical billing, that deal with policy and health care provider's or insurance groups. computer charting helps medical personnel to prompt the needed information to bill a patient correctly for a procedure or medication and allows world-wide access to an individuals medical history with electronic health records.  This helps with accuracy of billing as well as rapid documentation that a procedure has been done. Patient care plans are computerized and pre-printed. They are easy to fill out and make the care plan specific to the patient, it is not just a "cookie-cutter" framework.
The downside to all of the information being available on computers are that information can be misused or stolen identities have been an issue. confientiality can be broken easily as medical personel use computers in the workplace and need to make sure they log out of the system or close the screen before walking away and leaving personal information open to the public. Computers are definately improving the spread information technology and research by internet. Computer systems help track births and deaths of people and cause of death that can be studied in specific areas and used by the department of health. I am truly astonished at all of the information at my fingertips that I have been so blind to for so long. This class has really opened my eyes to the virtual world and has given me an eagerness to search for information online.

Decision Support for Care Delivery

All of the reading this week made me reflect on my personal biases and assumptions when providing patient care. I work in the Newborn Intensive Care Unit (NICU) where the population- being newborns- cannot verbally tell me when they hurt, I have to rely on physical signs and sypmptoms such as high blood pressure, high heart rate, and facial grimacing or restlessness. I often try physical comfort measures first, such as holding, changing diapers, feeding, respositiong the patient prior to giving pain medication. I know that as a NICU nurse I must follow-up on the reaction of the patient to my intervention in a timely manner. It is very important to provide safe interventions to my patients. If I am not familiar with a certain pain medication, I look it up or reasearch it before administration to ensure that I know what the side effects are and what to expect from the literature. I also like the fact that in my NICU, the medical personnel work as a team to provide the best patient care, collaboration with the pharmacist, the doctor, the nurse practitioner and other team members can be priceless when providing patient care.

Teaching with technology

What sort of teaching is done in your professional role?
In my role as a Registered Nurse in the Newborn ICU, there is a multitude of information that will be taught from the admission of the neonate until the discharge of the neonate. Teaching starts from the very beginning of the admission by explaining to the parent why their neonate is in the hospital, what type of treatments, surgery, medications and special cares that neonate will need. Many topics are covered over the coarse of the hospitalization of the neonate, including sepsis, infection control measures (such as washing hands and wearing a mask if they have any signs of a cold), I teach the parents about the monitors and how they translate to the illness/wellness of their neonate. I teach parents how to interact with their ill neonate as not to increase stimulation or pain by too much touching, bright lighting, and increased noise at the bedside from just talking.
Our Unit has an actual checklist of sorts, a discharge sheet that is monitored during the hospitalization of the neonate. As the neonate nears discharge, a discharge specialty nurse is notified and equipment or supplies are ordered as needed, such as oxygen or home health monitors. The parents are taught how to use these devices and are taught CPR before going home. This discharge checklist is signed off as completed by the nurse who sends the baby home to signify that all teaching has been completed and the parents signs the sheet in agreement that they received all of the information. Handouts are sometimes given as reminders, and I often have to repeat my answers to clarify or reinforce teaching daily.

Is there any nursing/health care provider role that does not involve teaching in some manner?
I think everyone in the health care field is involved in teaching in one way or another. Not only Nurses and Doctors, but Social workers who help the family find community resources, Discharge planners who network with the family to get supplies according to their type of insurance coverage, I think even other family's teach each other when they discuss their medical issues and use one another as emotional support systems during the hospitalization period. I learn something new every day at work and in school. Teaching is a very important role, especially in a medical profession.

Module 3 Electronic Index

I have chosen to research the topic the benefits of breast milk for neonates. When searching the engine, guideline index, and electronic index I found comparisons in specific terms. Key terms or key words of neonate and breast milk were listed in all references. In contrast, benefits had to be specifically added to the key terms to get a more narrow search. This was surprising to me, as benefits of breast milk is usually part of the discussion of this topic. 
I am learning more each week how to be more specific in my searches for information.

Module 2 Healthcare Information Systems and Devices

What is one way you could be involved in designing, selecting, evaluating, or implementing an information system in your workplace?

Where I work in the Newborn Intensive Care Unit (NICU) at Primary Children's Hospital, correct information is essential and obtaining that information in a timely manner is imperative. We have council members who volunteer to take a role. An example of these roles are Developmental support, where a support persona makes sure that the staff gets emails and training or visual aids that support the most recent evidence-based information for our neonatal population. I am involved in this developmental support committee and attend meetings that also allow general non-committee staff to attend. This is one way of enhancing or coming up with new ideas or recruiting new volunteers. I have implemented a safety/precaution system at work in the past. NICU nurses handle mother's milk (which is a bodily fluid!) I noticed there were no gloves by the fridge where the milk was kept and I observed how many nurses brought their own gloves to the fridge to pour the milk. After noticing not many had brought their own, I discussed this problem with management and gloves were placed on a rack that was installed next to the fridge that next day. Newsletters and emails went out to the staff updating this new intervention. I felt that I had contributed to the evaluation, implementation, and selection of an information system. Biohazard poster also was posted next to the fridge to remind nurse that mother's milk is a bodily fluid.  Technology wise, the NICU has recently started to scan medications as they are administered to patients and I have new ideas that may make this process less painful. Currently the scan gun is wired to the wall with a stretch cord, and I knock everything off the counter every time that I scan the med-then scan the patient band at the bedside. A wireless scan gun would be more portable, less time consuming and make staff happier. These are a few examples of how I am involved in the information systems in my workplace. Technology is continually advancing at a rapid pace and it includes a large portion of the healthcare industry.

Module 1 Entry

Hello. My name is Tanjula, pronounced like Angela with a "T" in the front. My graduate area is Neonatal Nurse Practitioner in the DNP cohort. I have worked in the Newborn Intesive Care Unit (NICU) at Primary Children's Hospital (PCMC) for 11 years now. I love my job and plan to continue working in the NICU after graduation. 

As a graduate level nurse, I will be using computerized technology for many different areas of my job. I am able to look up patient labs, computerized x-rays, and access patient history information online in a timely manner (even between distant hospitals). This technology makes the process of patient care more consistent and safe.

IT in my clinical setting is used for all of the above discussed. IT also includes "vocera", which is a realtime walkie-talkie type gadget that hangs around your neck and allows immediate communication with staff. This immediate communication mode is especially important in response to patient codes or staff/patient emergency needs. Patient charting and drug administration is moving to a computerized  tracking database. In our NICU unit, we have and "Acudose" machine to dispense narcotics for each specific patient ,which helps to reduce patient medication errors and tracks narcotic waste and dosage checks with another staff member per protocol. Computerized technology is the way of the future in medicine.

My first post

My name is Tanjula,

I am in the DNP program. I am an R.N. currently at Primary Children's Hospital.

I look forward to learning with everyone this Spring Semester2011.