Ideas for Informatics and Nursing

MagsMom · Mar 9, 2009

oh - I wanted to add that I have thought about doing a paper that would address the question - "does the use of drop down menus in electronic medical records lead to over- documentation?" BUT....I really can't find enough published research to answer the question. Thank you again for anyone who can help me!

rninformatics, DNP, RN · Mar 9, 2009

Greetings MagsMom,

Good topics usually come from issues, challenges, problems that you have encountered in your own daily practice.

Or what about looking at issues that are current in NI and Healthcare Informatics practices accross the board - such as

Patient Safety Issues:

Bar Code Medication Administration and Medication Errors

CPOE and Medication Administration Errors

Patient Quality of Care issues:

Core Measures and Electronic Documentation and Data Collection

Clinician User and Device issues:

COWS/WOWs, PDAs or Tablets

Can you take any of the above and connect them to Evidence Based Practice?

Have you looked at the Dec 11th (Issue 42) Joint Commission's Sentinel Event Alert related to safely implementing HI and converging technologies?

Good Luck with your paper and your class.

Hi All
While I am waiting to hear from nursing school admissions I am taking a class called Technology and Healthcare. I have to write a one page abstract every week about journal articles we have been assigned to read and we also have to write 2 research papers. I finished my first research paper and it was "Integration of Clinical Decision Support Software and Nursing Practices" -- I looked at whether or not the increased use of clinically based software applications would lead to increased delegation of nursing tasks to non-nursing staff.
Now I am trying to come up with a good topic for my next paper and would really appreciate ideas! I would like to stay focused on nursing - MOST of everything in the course has to do with MDs and administration which is frustrating. This is a graduate level course (not in nursing) so the paper has to be substantial - for example my first paper was 16 typed pages with 35+ references.
Does anyone have any good ideas? :typing

rninformatics, DNP, RN · Mar 9, 2009

here is another idea related to pt safety.

From iHealthbeat March 9, 2009

Study Raises Questions About Value of E-Prescribing Alerts

Clinicians bypassed more than 90% of the drug interaction alerts and 77% of the drug allergy alerts sent by their electronic prescribing systems, according to a study in the Archives of Internal Medicine, Healthcare IT News reports.

Study Details

Investigators at Boston's Dana-Farber Cancer Institute and Beth Israel Deaconess Medical Center looked at the electronic prescriptions and the related medication safety alerts produced by 2,872 clinicians at community-based outpatient practices in Massachusetts, New Jersey and Pennsylvania.

The clinicians submitted 3.5 million e-prescriptions between Jan.1 and Sept. 30, 2006.

About one in 15 prescription orders, or 6.6%, triggered an alert for a drug interaction or drug allergy. Of the 233,537 alerts, 98.6% were for a potential interaction with a drug a patient already had been prescribed.

Findings, Recommendations

According to the study, physicians typically disregarded even high-severity alerts triggered from medication combinations commonly used for specific diseases.

In addition, the study suggested that clinicians were less likely to accept an alert if the patient had previously been treated with the medication.

Based on their findings, researchers recommended:

Recategorizing the severity of alerts, particularly those that are frequently bypassed;

Offering an option that will allow physicians to ignore alerts for medications a patient already takes; and

Aligning the alerts to a physician's specialty (Merrill, Healthcare IT News, 3/9).

Comments

Saul Weingart, co-author of the study, said the study's results indicate that electronic alerts are not well tailored for all clinical circumstances, rather than suggesting that physicians are irresponsibly ignoring medication warnings.

He said, "If doctors are overriding 90% of alerts, of the 10% they're accepting, what's the chance that those led to improvement in care and in turn prevented health care utilization to save money?" (O'Reilly, American Medical News, 3/9).

MagsMom · Mar 9, 2009

Thank you so much! Since I have just finished my pre-reqs and do not work in a clinical setting I do not have much personal experience with this. My course focuses mainly on doctors and adminstrative use of technology. In fact, when I handed in my topic for my last paper my instructor asked "why do you want to research nursing?" I said believe it or not nurses do use technology!?!?!?!!! Anyway, thank you for the suggestions - they are very helpful and are going to enable me to write a great - not mediocre paper. What does "evidence based practice" mean? Thank you again - I am heading to the library in about an hour to narrow down my topic. I appreciate the help -

rninformatics, DNP, RN · Mar 9, 2009

Evidence Based Practice

In short what scientific or research based "evidence" is there to support that this way of doing something ( providing care, implementing HIS systems, changing policy, performing a procedure) is the "best" "practice".

http://en.wikipedia.org/wiki/Evidence_based_practice

http://sophia.smith.edu/~jdrisko/evidence_based_practice.htm

http://www.biomed.lib.umn.edu/learn/ebp/