tmylen 486 Views
Joined: Apr 5, '04;
Posts: 4 (0% Liked)
I went in the room to check the IVF (icu) and noticed the amound on the pressors was different and lower than the previous amount. The daughter of the pt stated she changed it because she felt it was not needed at that rate any longer. She is a nurse and worked on one of the floors in the hospital. I took her in the hallway and basically had to counsel her. I was shocked any RN would do this.
Well, I didn't and don't read everything word for word. I focus in on problem areas and scan the rest. I read the doc's plan, look at labs related to the diagnosis, lytes and CBC, the first part of the H&P to make sure I have all the co-morbid diagnoses, verify that the meds I am going to give have current/active orders, and check for new orders/nows and such. Then I'm off to do my assessments. I constantly refer back to the chart as necessary. Invariably, I find orders undone, meds not delivered, etc. That's what takes up to much time. Sometimes I think we could handle more patients if the ancillary services kept up with the pace. But one patient having problems can chew up a lot of time.
Hello to all! At the hospital where I work, the glucometer or accucheck machine is a modified palm. It has a barcode scanner and test strip insertion port built into a case that encloses the palm. When we do an accucheck we scan the patients wrist band, scan our ID badges then proceed to do the accucheck. It's a nice little setup. There is a hotsync cradle attached to a modem that transmits the info to the lab. The lab ensures the machines get their daily QA routines done.
My hobbies are electronics and computers. I can program palms using NSBasic or CodeWarrior. I also do embedded computer programming. Zilog has a nice chip that has an IR port and ethernet link built into the chip. It would be very easy to use generic palms to capture clinical information for transfer to the hospital's system using the IR port. Hospitals could buy generic palms, load a program onto them, attach a barcode scanner to the serial or usb hotsync port and have a tool that could capture bedside information. Using barcodes decreases errors and the software on the palm could mask and encrypt the data to conform with HIPAA. Instead of using the IR port or hotsync to transfer info you can also get palms with wireless elthernet capabilities including Bluetooth. But if you stick with the hotsync/IR method, then clinicians could use their own palms with hospital supplied software a barcode attachments. It could even be used with medication administration to reduce errors.
This technology is already out their. I can use it as an amateur so you know that it can be used by the professional system developers. I don't know why it isn't more widespread. Especially now with the HIPAA, hospital error rates in the news, and JACHO zeroing in on process improvement and tracer methodology. Maybe hospitals consider it to be an escalation of technological complexity that they don't see an easy way to manage. They would have to add IS staff that had the additional skills in this area which may not be an overly populated manpower resource at this time.
Just my two cents. I have looked at the other sites listed here and it is coming along. It just seems that a company would introduce a middleware capability that could talk with any hospital system. Maybe I'm naieve (sp?) in this area.
A definition of "medical care" would be that under the direction of a physician, so wouldn't that be any care that the physician has written orders for? Can you give an example of something which a physician has written an order for that a nurse is more qualified as an expert in? I guess I can't see what patient care, that is not under a physician's orders, would be needing a nurse to testify as an expert in that nonphysician domain of expertise.
Of course, psychosocial cause and effect is completely foreign as it is barely mentioned in a physician's training, as far as I know. Since it's not part of a physician's expertise they have no business in overseeing it, or presenting as an expert to testimony about it.
The incidents that I can see in a court of law would be things like medication errors. In a case where the order was written incorrectly, dispensed in the wrong dosage or form or administered in error. In the foodchain from doctor to pharmicist to nurse administering it, who is the expert? Wouldn't a physician be testifying as to the validity of the order, correct mixture, route and timing of administration? If we are talking about what a nurse should be held accountable for in regards to this medical care, wouldn't an expert in phamacological inteventions be indicated?
I know this is only one example, so it certainly is not the whole argument, but shouldn't physicians be so called 'experts' in patient care? I believe I know what the overwhelming response on this board would be to that question but I think it needs to be pondered with more than just the typical knee-jerk reaction to expand the nursing empire at all costs.
At any rate, nurses seem to think that it's a good thing. I'm wondering why.
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