In relation to patient care delivery, knowledge can give nurses greater power to take action and lack of knowledge can leave nurses powerless to provide safe or effective care. Evidence of knowledge as a source of power is that many employers during this difficult economic time prefer to recruit experienced RNs rather than incurring the expense of training new graduates.
Anderson and Willson (2009) offer a conceptual framework for nursing knowledge management that supports using technology to offer health care providers many tools to effectively use data to transform it into knowledge. Clinical decision support software such as those integrated with electronic medical records or those that clinicians access through mobile applications (apps) are examples of using data effectively to support knowledgeable clinical interventions. An example of how powerful this can be is that two nurses sharing a clinical rotation have access to texts for purchase in the books store and mobile apps that they can use on a Smartphone. One nurse feels more comfortable using the text and the other is very adept at navigating information technology including mobile apps. The nurse with the mobile product completes medication administration quicker because he finds all the drugs in his reference while the nurse with a book misses out on recent drug releases requiring an extra step to call the pharmacy or to look up drugs online.
There are many other examples and some that may have life-threatening consequences such as drug to drug interactions that information systems recognize that health professionals frequently overlook. In a time when health care quality is a mandate, organizations and professionals who use knowledge effectively will have the power to take control over costs and attain a higher rate of insurance reimbursement due to fewer complications.
Reference: Anderson, J. A., & Willson, P. (2009). Knowledge Management Organizing Nursing Care Knowledge. Critical Care Nursing Quarterly , 32 (1), 1 - 9.
By now, most of us have read about, heard about, discussed, seen the picture, etc., of the nursing student who posted a picture on Facebook of herself with a placenta. While we may have differing opinions about the ethics involved, whether HIPAA was violated, or whether the punishment of expulsion was too severe, the lessons to be learned are the same - think before sending anything out there into the realm of the world wide web, proceed cautiously before clicking that “submit” or “post” button, and consider the effects and possible repercussions of your actions.
Today, this nursing student, who was scheduled to graduate this May, will be taking action against her school and the involved faculty. I’ll be following the case, how about you?
In each issue of Nursing2010 Critical Care, Karen Innocent demonstrates the important relationship between technology and nursing. In the September issue she educates us about mobile applications and describes how easy access to current information right at the point of care can improve our practice. I’ve condensed the information from her table of free mobile apps here for our blog, but take some time to read the entire article Tech Talk: Mobile apps for nurses.
Free mobile apps:
In the recent past, mobile computing devices (formerly referred to as personal digital assistants or PDAs), were optional in the workplace and in higher education. Now the fast pace of practicing in health care is affording nurses little time to step away form the bedside to look up references.
I gave up carrying multiple print references a decade ago when I purchased my first PDA. There were fewer options, but they were adequate at the time. For one thing, the references were all text-based and I had to pay for them myself. It was worth every penny to me as I managed a busy clinical patient load, providing staff education, managing projects, and juggling my personal life. Still there are many nurses who are not using mobile technology to support their nursing practice.
I commend nurse leaders and educators who have pioneered the adoption of mobile computing to help keep current information in the nurses' hands. Examples of some universities that provide resources to students include Drexel Univesity College of Nursing and Health Professions which provided iPod Touches to 300 nursing students. At University of Virginia, all students are required to own a mobile computing device, and the library provides support and training on using mobile reference software. At Ohio State University, the BSN and graduate students are not only required to use mobile devices, they are required to install and use specific software. School is a safe and supportive place to learn how to use mobile software, so if you are going back to earn a higher degree, you may want to research the mobile computing resources and support that is available.
Numerous references include evidence-based plans of care, drug information, drug calculators, and disease information. Therefore, acquiring the skills in using mobile references will help you to manage your time better, to make better clinical decisions, and to provide safer care.
Nurses are the largest group of healthcare providers in the world today. In the U.S. alone, there are 3.1 million RNs and 800,000 LPNs, all of which strive to provide the best possible care to improve patient outcomes. How do you access and utilize information and technology to improve your practice? Lippincott Williams & Wilkins and Ovid have done a great deal of market research to really understand how nurses are integrating information searches in their workflow. Nurses want two types of information, synoptic content and deep dive content. Synoptic content is quick bites of information that can be read, understood, and quickly put into practice. This information is accessed through print pocket information, smart phones, workstations on wheels, or computers at the unit station. Deep dive information is full text information that offers the nurse the depth and breadth of information often needed for continuing education, specialty clinical updates, and research. This type of information is accessed through hospital computers, library access, or through computers at the nurses' home. Google is the number one search engine used by nurses regardless of their education and experience. While nurses still love their print publications, online access to information through computers, smart phones, and other new devices is growing rapidly.
Is this information surprising? Not really. You told us you want evidence-based, best practice information delivered to you at the right time and in the right format. Information needs to be easily accessible in your workflow. Healthcare Reform will inject many new patients into the healthcare system and responding efficiently and effectively to patients needs is of primary importance. Having access to the right evidence-based, best practice information can help you improve practice and improve your patients outcomes.
For free access to the White Paper: Improving Nursing Practice with Information and Technology, just go to www.nursingcenter.com/nursinginformatics.
Social networking and social media are not new concepts. Social communication has gradually advanced from face-to-face conversations and early forms of written and print communication to using the telephone for party lines and conference calls. Now we are using computers for group email (list serv), online forums, chat rooms, instant messaging, and blogs. Interactive social networking websites like MySpace.com and Facebook.com are becoming popular for staying connected with friends, classmates, and others with similar social, political, or entertainment interests. Some examples of professional networks are LinkedIn, Tagged, and Plaxo. These sites and professional organization websites are helpful for making business contacts, finding jobs, and discussing challenging professional and business issues.
The newer features of social networking allow the users to more easily exchange documents including articles, policies, and documentation forms. Some websites allow the nursing community to mentor newer nurses; recommend great job openings; and give advice about going back to school for advanced degrees. What's also helpful is that these discussions are archived and can be searched for later use.
Professional and social networking have many benefits for nurses, but some nurses have not been very cautious about their use of these websites. Here are some examples of how to avoid making mistakes online.
- Think before you post messages, photos, and videos. You would never want to tarnish your professional image, to embarrass a colleague, or to hurt your chances of career advancement.
- To protect yourself from identity theft, you must be aware that social networking sites are not private and limit the amount and type of personal information you share.
- To avoid risk of a HIPAA violation, never publish patient information without written permission.
For those who want to share new techniques you discovered, search for cost-effective ways to deliver patient care, or to announce your recent accomplisments, there are many great websites waiting for you to post your news or to ask your questions. Happy blogging!
Technology – seems many people either love it or hate it. I must admit that I am one of the former. It amazes me that my children won’t ever have to do a paper by solely researching in textbooks or encyclopedias, or dare I even say it – using a typewriter!
In the critical care unit where I worked, we often trialed new I.V. pumps, thermometers, telemetry monitors, pulse oximeters, and the like. I never minded the required inservices – I looked forward to learning about new machines that would help us provide better care.
These days, technology goes beyond the excitement (!) of tympanic thermometers. Nurses now carry any number of personal digital assistants, or PDAs, and have information literally at their fingertips. Amazing! Getting drug information right at the bedside? Sure. Lab results delivered by text? Why not?
On our Facebook and Twitter pages, we recently posted a QTc calculation “just for fun” and the lack of response really surprised me. Was it too difficult? Were our fans and followers just not into it? Or perhaps nurses don’t have to calculate a QTc anymore because it is done for them – either directly on the telemetry monitor or 12-lead ECG machine, or perhaps the QT and R-R interval can just be plugged into their (insert device of choice here) and Voila! - the QTc appears.
All of this talk about technology reminds me of a very helpful tip though – Treat the patient, not the machine! I’ll admit I’ve been guilty of running into a room thinking a patient was in ventricular tachycardia only to find him brushing his teeth. How about you?
Also, I’m curious, when is the last time you calculated a QTc?