As technology expands into every facet of our lives, it makes sense that we would attempt to harness it’s powers to improve patient care and, therefore, patient outcomes. I am becominging increasingly interested in this part of nursing as I am beginning to catch a vision for what it could mean for our field. I look forward to exploring the ways in which I can be an agent of change in my workplace to help usher in technology that will enable me to increase the quality of care I can deliver to the patients.

The hypothetical scenario I chose for this discussion is the use of monitors to better care for our residential level clients. Remote monitoring is already used in large part in hospitals but as technology expands and improves, we are going to see sensors and alert systems embedded in more structures such as furniture, lighting and floors (Nagle, Sermeus & Junger, 2017). In my research I found there is a monitor invented in Israel which is able to easily fit underneath the mattress of a patient to monitor heart rate and rhythm, respirations and movement. In fact, has been used heavily in hospitals during COVID-19 as a way to remotely monitor patients who are actively sick. This not only minimizes unnecessary patient interaction which decreases the spread of the disease, these monitors are able to show which client is likely to be becoming septic or which is heading toward respiratory failure within a matter of hours (Council, 2020).

Technology such as this would yield very useful data in the eating disorder population I serve. Their bodies are starved for nutrition which causes their respirations to slow and their heart rates to fall. As they begin to eat again they are at risk for refeeding syndrome which can be life threatening and result in cardiac arrest. With this technology we could see if their heart rhythm is slowing, becoming irregular or has stopped. Additionally, clients who restrict have a lower temperature. This is an issue because an infection causing a fever may not register as a normal fever range because their temperatures are lower than normal. Seeing an increase in the pulse rate over time can indicate a lurking infection we may not have caught without this monitoring. Finally, the eating disorder population tends to have difficulty staying asleep as a result of trauma and/or the sympathetic nervous system activation that happens in starvation. As they begin to eat again, we would be able to see their sleep trends increase signifying a return to health.

Council, J. (2020). Hospitals Tap AI to Help Manage Coronavirus Outbreak. Wall Street Journal Pro. Retrieved from https://webreprints.djreprints.com/57205.html

Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA5…

Nursing informatics blends technology and information (Laureate Education, 2018). The information and knowledge obtained are needed to improve efficiency, enhance communication, and improve patient care (Laureate Education, 2018). Some factors contributing to the evolution of nursing informatics roles are rising health care cost, an increase of chronic disease, the commonness of technology, the aging population, personalized medicine, mobile, and virtual healthcare applications. These are just a few of the factors that will increase the demand for nursing informatics specialists (Nagle et al., 2017).

The hypothetical scenario I chose for this discussion is an online website for the patient medication list that could be updated by the patient’s providers. This database would be seen by any provider that the patient saw from emergency room providers to specialists and their primary care physicians. I know that some pharmacy list will show medications on the Meditech computer system currently used in the hospital where I work. The online system I am proposing would not be tied to a computer system such as Meditech, Epic, or whatever system the hospital or clinic is using. The database would be a separate online database system that could be accessed from any provider and could be updated by providers during the patient visit.

A patient’s home medication list is essential and needs to be updated and checked frequently. If a patient is prescribed a medication that causes an interaction with another medication, this could cause harm to the patient and could potentially be fatal. What if a patient is prescribed the same medication by two different providers and takes both medications? What if that medication is a blood thinner and the patient takes too much? Or if the patient is prescribed more than one pain medication and overdoses from taking more than one type of pain medicine? There are so many scenarios that could happen when a patient’s home medication list is not current and can not be viewed by all providers involved in the patient’s care. Inaccurate medication lists can cause duplicate medications and contraindicated prescriptions, leading to an adverse drug event, increased morbidity, mortality, readmission to the hospital, and increased hospital costs (Pandolfe et al., 2018).

The medication data entered into the database would allow providers to see what current and past medications a patient may be on or may have tried in the past. The database will enable the providers to view what medicines have not worked for them so they could try something different that may be more beneficial for that patient and their needs. The medication database would also allow nurses to complete an accurate medication list upon patient admittance to the hospital. Correct medication lists help physicians, nurses, pharmacists, and other healthcare providers provide the best possible care.

References

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

Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health, (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF

Pandolfe, F., Wright, A., Slack, W. V., & Safran, C. (2018). Rethinking the outpatient medication list: increasing patient activation and education while architecting for centralization and improved medication reconciliation. Journal of the American Medical Informatics Association, 25(8), 1047-1053. doi: 10.1093/jamia/ocy047