How does nursing data quality relate to decision support?
The quality of nursing data in relationship to decision support is critical. As Mollie Poynton related in her Captivate presentation much of the data that is collected by nurses ends up on notes in the pockets of their scrubs. Nurses need to have a place that they can import data as well as extract it in a timely manner. According to the chapter 10 reading by Androwich and Kraft, when making critical clinical decisions, clinicians depend on the reliability, accuracy, and timeliness of the information. I see that one of the area that would be a benefit for the quality of nursing care would be an interdisciplinary support in medication orders. Medication errors are a major problem. When a nurse has several patients, who each have multiple medications, it can be very time consuming to make sure all of the medications are the right dosage and often the original orders by the physicians are terribly written. I know when I worked as a floor nurse, medications were checked against several paper check lists: the cardex, the pharmacy printout, the physicians orders. A med would be added, one would be discontinued, a subtle dosage change would take place. Having a CDSS that was used by physicians, pharmacy, nursing etc. would help track changes, alert to any problems, and possible medication discrepancies. According to Androwich and Kraft, "Nurses need access to current knowledge at the point-of-care delivery where it is useful: in clinics, at the bedside, in homes, offices, and in research that makes contribution to evidence based practice." Having access to a CDSS for medications alone would help in all these areas. I know that larger health care facilities probably are already doing this, but it needs to be something that any nurse in any location can have access to when caring for patients.
Subscribe to:
Post Comments (Atom)
Leslie,
ReplyDeleteOur facility where I work currently uses a CDSS that has CPOE or computer physicain order entry. Currently we only have one PA that uses the system. Several of our other staff physicians have tried it and they always seem to find an excuse not to use it (too time consuming etc.). Also, our system performs drug calculations and checks for drug interactions when medications are ordered. But, alas, we have another problem. Our pharmacist has not taken the time to utilize this feature so the screen is glanced at and skipped over by nurses. Some day we are going to pay for this. CDSS are a great tool but you have to have hospital user "buy-in" to make it work, you also need to have an administration that will not be tolerant of such shenanigans such as not utilizing patient safety features. We have had this system for the past 7 years and we still have not fully recognized all of its capabilities.