The Use of Clinical Systems to Improve Outcomes and Efficiencies.
Nursing Informatics and Technology Paper Sample
With advancements in technology, clinical systems have become a crucial component of healthcare quality improvement solutions. Clinical systems provide solutions to various aspects of healthcare management to enhance efficiencies and improve clinical outcomes. Electronic health record (EHR) is an example of a clinical system that has been widely adopted to improve clinical efficiencies and outcomes. EHRs’ implication to healthcare is broad, including automation of clinical documentation and support to healthcare delivery mechanisms, interactions between healthcare professionals and patients, and coordination of healthcare services (McGonigle & Mastrian, 2017). The purpose of this paper is to conduct research and provide a summary and synthesis of peer-reviewed research articles that support the application of electronic health records to improve outcomes and efficiencies in healthcare organizations.(Nursing Informatics and Technology Paper Sample)
Research Article 1: Lawrence, J. E., Cundall-Curry, D., Stewart, M. E., Fountain, D. M., & Gooding, C. R. (2019). The use of an electronic health record system reduces errors in the National Hip Fracture Database. Age and Ageing, 48(2), 285-290. https://doi.org/10.1093/ageing/afy177(Nursing Informatics and Technology Paper Sample)
Lawrence et al. (2019) sought to determine the impact of EHRs by comparing the outcome data of a level 1 trauma center in the UK and the National Hip Fracture Database (NHFD). The authors argue that EHRs can solve errors in the NHFD databases that concern their utility. The authors present NHFD as a national audit for evidence-based standards by individual hospitals against the guidelines laid out in the Blue Book for patients having fragility fractures. The authors argue that EHR facilitates real-time and standardized recording of audit data by clinicians during treatment.(Nursing Informatics and Technology Paper Sample)
The authors found out that EHRs contributed to the reduction in NHFD errors. Before EHRs implementation, about 59% of patient data were incorrect, while after EHRs implementation, 100% of the patient data were correct. Furthermore, the authors found that entries through the EHRs system were error-free compared to datasets that did not use the EHR system.(Nursing Informatics and Technology Paper Sample)
This study ascertains the potential significance of EHR systems, including automated data collection necessary for auditing nursing processes to maintain efficiency and quality of patient health outcomes. Although the study identified persistent errors, the authors argued that such errors were due to users’ failure to use the NHFD recommended template for auditing purposes. Therefore, healthcare personnel should be engaged with the EHRs system technology to prevent and reduce human errors and ensure the NHFD database integrity.(Nursing Informatics and Technology Paper Sample)
Research Article 2: Bush, R. A., Pérez, A., Baum, T., Etland, C., & Connelly, C. D. (2018). A systematic review of the use of the electronic health record for patient identification, communication, and clinical support in palliative care. JAMIA Open, 1(2), 294-303. https://doi.org/10.1093/jamiaopen/ooy028(Nursing Informatics and Technology Paper Sample)
Bush et al. (2018) examined published literature to determine the role of EHR in supporting nursing activities in a palliative care setting. The authors identify the various applications, methods, nursing outcomes, and barriers associated with the active incorporation of EHR in a palliative care clinical workflow. Bush et al.’s (2018) theoretical concepts are supported by the global use of EHR to facilitate palliative care. Equally, the adoption of EHR has been shown to promote interdisciplinary support, albeit not in palliative care that requires the use of technology to support health-oriented data management to enhance comfort-oriented care.
Busth et al. (2018) found that EHR can be applied in several aspects of palliative care clinical practice through effective incorporation and meaningful use to improve healthcare processes and outcomes. Moreover, the authors found that EHR can effectively capture data in palliative care settings and enhance multidisciplinary communication and care among different healthcare personnel and departments. Improved communication and care coordination contribute to efficiencies of nursing processes and consequent positive patient health outcomes. Moreover, the author found out that incorporating EHR with clinical decision support (CDS) can advance care-planning documentation; identify individuals who need palliative care, and increase patient-reported outcome measures that determine satisfaction with healthcare service delivery.(Nursing Informatics and Technology Paper Sample)
Although EHR is yet to be widely adopted in palliative care settings, the study the need for understanding of the significance EHR of the early identification of palliative care need among patients, patient-reporting outcomes, communication among healthcare personnel and patients. Furthermore, the authors argue that patient feedback on care delivery, including pain levels or discomfort, can help the care team adjust or escalate treatment to achieve an optimal response from eh patients. Equally, identification of patients that require palliative care can help the healthcare team determine the end-of-life stage to aid comfort and focus on the best intervention. In this regard, the implementation of EHR can facilitate an effective palliative care delivery and consequently result in improved care and positive health outcomes for patients and the wellbeing of their families.(Nursing Informatics and Technology Paper Sample)
Research Article 3: Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018). The use of electronic health records to support population health: a systematic review of the literature. Journal of medical systems, 42(11), 1-16. https://doi.org/10.1007/s10916-018-1075-6(Nursing Informatics and Technology Paper Sample)
Kruse et al. (2018) reviewed literature published on the impact of the use of EHR on population health. The authors sought to identify barriers to EHR adoption and assess whether EHR can play a crucial role in population health improvement. Furthermore, the authors posit that incorporating and utilizing EHR in care interventions and surveillance can improve the patient population’s health.(Nursing Informatics and Technology Paper Sample)
The study findings include a significant number of benefits that negative effects of EHR in population and public health. Significantly, the authors found out that the implementation of EHR improves the general productivity and efficiency of healthcare-providing institutions. EHR enhances access to healthcare, allowing comprehensive documentation of the population through surveillance. Surveillance enhances health screening and preventative healthcare interventions of public health. Furthermore, Kruse et al. (2018) ascertained that EHRs allow healthcare personnel to incorporate and share population/public health information among different healthcare services to aid evidence-based interventions. In this regard, the study proved that EHR could support a survey of chronic or infections and facilitate immediate response and sharing of patient information to aid appropriate intervention.
The study findings indicate the positive impact of EHRs on the management of population health and surveillance. The authors highlight the effects of EHR implementation, including productivity and efficiency, duality clinical data, quality care delivery, and minimal errors in patient records that aid appropriate data management. Regarding clinical productivity and efficiency, the authors posit that EHR enhances nursing capacity, clinical procedures, and nursing processes. EHR allows healthcare personnel to collect more accurate, precise, and error-free data that aids high-quality nursing outcomes regarding data collection and collation. The authors also argue that EHR facilitates seamless access and sharing of patient data among healthcare personnel to aid nursing interventions.(Nursing Informatics and Technology Paper Sample)
Furhtermore, Kruse et al. (2018) identified barriers to EHR efficiency, such as missing or incorrect data, lack of interoperability standards, and loss of productivity. However, these limitations are minor and can be avoided and mitigated to achieve an optimal outcome of the EHR system. Significantly, the authors assert that the positive aspects of EHR on nursing processes and patient outcomes outweigh the barriers to its implementation.(Nursing Informatics and Technology Paper Sample)
Research Article 4: Walker-Czyz, A. (2016). The impact of an integrated electronic health record adoption on nursing care quality. JONA: The Journal of Nursing Administration, 46(7/8), 366-372. https://doi.org/10.1097/nna.0000000000000W(Nursing Informatics and Technology Paper Sample)
Walker et al. (2016) measured the effect of an integrated EHR system implementation on nursing care improvement, including the EHR impact on hospital-acquired pressure ulcers, falls, and central-line bloodstream infections (CLABSIs). The study also measured the impact of EHR on the cost of nursing hours, ventilator-associated pneumonia, and catheter-associated urinary tract infections. These nursing aspects were measure before and after EHR implementation.(Nursing Informatics and Technology Paper Sample)
Walker et al.’s (2016) theoretical underpinning was founded on understanding and supporting the clinical practice environment and autonomous decision-making using computerized documentation as crucial tenets of quality care. The authors hypothesized that adopting the EHR system in a clinical setting would reduce hospital-acquired infections and associated costs, care quality, safety, and nurse satisfaction. The authors aimed to analyze the associations between the nursing the predictors of these nursing needs and the outcomes following the implementation of EHR.(Nursing Informatics and Technology Paper Sample)
Walker et al.’s (2016) found out that using EHR to incorporate evidence-based practices into workflow promotes effective decision making among the nursing team, improving quality of care and minimizing direct costs of care. The findings revealed that the number of hospital falls, CLABSIs, and CAUTIs reduced significantly following the incorporation of EHR into the nurses’ workflow. Although the number of hospital-acquired pressure ulcers and ventilator-associated pneumonia increased during EHR implementation, the number decreased substantially after the stabilization of the EHR system. Furthermore, the authors found out that the cost associated with hospital-acquired infections and patient falls increased during EHR implementation and declined following the system’s stabilization in the nursing process baseline. Lastly, turnover among nurses increased dramatically following the EHR adoption.(Nursing Informatics and Technology Paper Sample)
The study findings increase understanding of the impact of EHR adoption on the quality of care and overhead costs. Significantly, the authors attribute about 15% of fall rate reduction to implementing an EHR system. This is because the overall adoption and implementation of EHR impacted the quality of healthcare positively. Equally, other crucial areas that require nursing interventions such as CLABSIs and CAUTIs can be significantly reduced by implementing EHR. Moreover, implementing an EHR system can reduce the rate of ventilator-acquired pneumonia, hospital-acquired infections, and direct medical costs. Therefore, the study reinforces the need to adopt an EHR system to aid clinical decision-making and effective communication among healthcare teams. In this regard, the study asserts that the adoption of an EHR system can increase the ability of nurses to improve the quality of care(Nursing Informatics and Technology Paper Sample)
Conclusion
EHR is a crucial healthcare system that can aid documentation, collation, storage, and sharing of patient clinical data. In this regard, an EHR system facilitates accurate data entry and aid definitive decision-making for various nursing needs. In this paper, an EHR system has been effectively used to automate data collection necessary for auditing nursing processes to maintain efficiency and quality of patient health outcomes in NHFD. Moreover, an EHR can aid early identification of palliative care needs among patients, facilitate patient-reporting outcomes and communication among healthcare personnel and patients. EHR feedback mechanisms on care delivery, including pain levels or discomfort, can help a palliative care team adjust or escalate treatment to achieve an optimal response from a patient.(Nursing Informatics and Technology Paper Sample)
Furthermore, an EHR system can help nurses improve hospital hygiene, respond to, and reduce hygiene-related clinical issues such as CLABSIs, CAUTIs, ventilator-acquired pneumonia, hospital-acquired infections, and direct medical costs. Lastly, the chosen articles have ascertained the role of an EHR system in increasing interoperability standards through clinical processes guidelines and increasing productivity and healthcare personnel. Altogether, these findings verify the significance of an EHRs system as an effective clinical system considering its impact on various aspects of nursing care and management. Therefore, the adoption of an EHR is a crucial healthcare management decision towards quality improvement.(Nursing Informatics and Technology Paper Sample)
References
Bush, R. A., Pérez, A., Baum, T., Etland, C., & Connelly, C. D. (2018). A systematic review of the use of the electronic health record for patient identification, communication, and clinical support in palliative care. JAMIA Open, 1(2), 294-303. https://doi.org/10.1093/jamiaopen/ooy028(Nursing Informatics and Technology Paper Sample)
Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018). The use of electronic health records to support population health: a systematic review of the literature. Journal of medical systems, 42(11), 1-16. https://doi.org/10.1007/s10916-018-1075-6
Lawrence, J. E., Cundall-Curry, D., Stewart, M. E., Fountain, D. M., & Gooding, C. R. (2019). The use of an electronic health record system reduces errors in the National Hip Fracture Database. Age and Ageing, 48(2), 285-290. https://doi.org/10.1093/ageing/afy177
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.(Nursing Informatics and Technology Paper Sample)
Walker-Czyz, A. (2016). The impact of an integrated electronic health record adoption on nursing care quality. JONA: The Journal of Nursing Administration, 46(7/8), 366-372. https://doi.org/10.1097/nna.0000000000000W