The Right Technology at the Right Time

Posted by Susan Niemeier, RN BSN MHA on Jul 28, 2014 @ 10:46 AM

I find myself spending large amounts of time in airports, arriving early to get through strict security, or passing time in terminals due to weather or mechanical delays. During those periods, I seek refuge at a quiet boarding gate that has a high concentration of power outlets or Internet access. Finding these spots is often a challenge, as I peer under seats, circle support columns and poke around vending machines. Occasionally, if I'm lucky, I run across a re-charging station to at least take care of my power needs.

These recharging stations are becoming more and more popular as business travelers flock to them to charge a plethora of devices. There you can find the latest "must have" or "cool" device / gadget on the market. But as I glance at the array of devices, I wonder, "Is cool always smart?" As a nurse, what really matters to me is the impact a device has on workflow or how I do my job, not necessarily its "coolness."

By many estimates, the typical nurse spends approximately 2 hours a shift simply keeping numbers current in patient medical records. By the time the doctors and multidisciplinary care team actually receive the information, it's often already outdated. To me, "smart" gadgets should help me decrease the time I spend inputting data and increase the time I spend directly caring for my patients.

Mobile devices, such as tablets and smart phones, may be the latest technology, and what many hospitals are considering incorporating into every part of nursing workflow. But I'm not so sure these devices will help a nurse achieve what he/she intends. In my experience, adding to nurses' tool belts (which can include as many as 15 other devices) can sometimes weigh us down rather than increase the time directly interacting with patients. We should be "hands on" with our patients, not with another device.

As nurses, our focus should always be on delivering safe, competent, and compassionate care. We should take caution with becoming the first to use an innovative new technology. So, before moving ahead with the introduction of the latest and greatest mobile technologies, perhaps a hospital should consider the following items:

  • Is it easy to use? Has it been thoroughly tested in the care environment?

  • How many steps must the nurse complete in order to get data to its end location? Is it intuitive? Simple? Fast?

  • Does it need to be put down for best data input? Where do we put the device if the patient needs our immediate attention? Then what about the transmission of infectious properties as we go from room to room?

As with any technology purchase, good research and asking the right questions are musts to help assure the tools acquired are more than "cool," but actually useful. When it comes to nursing and patient care, that usefulness equates to quality care, so we must be aware of the shiny new gadget and be confident that we are implementing the right technology, for the right people, at the right point in time.

(Originally posted on www.advanceweb.com)

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Tags: Nurses, Healthcare Technology

Batched Vitals

Posted by Halley Cooksey, RN on Jul 16, 2014 @ 09:00 AM

doctor-stethoscope-patientNursing school…

Just hearing those words can make many of us cringe and flood us with a multitude of memories, whether it was studying the Krebs Cycle until 3 a.m. only to have to show up for clinicals at 7 a.m., or being convinced that you were going to be diagnosed with whatever disease process you were currently learning. All fond memories aside, nursing school was just that: school.

It gave me a foundation, but it didn’t give me the experience I was going to need to survive in the real world. We all talk about real world vs. textbook nursing. But it isn’t until you are on the floor – by yourself – that you really learn what being a nurse is all about and how to manage your time.

Time management is a critical component for any nurse to master. We must figure out how to be in six to eight patient rooms at nearly the same time and ensure we are providing personal, high quality, safe care. So, to “clone” ourselves, we learn to create shortcuts. Some of them are OK, but they often go against established hospital policy. One of the shortcuts I developed was “batched vitals”.

Batched vitals is a process I used when I would have a patient return from a procedure or who would require frequent vital signs monitoring. Knowing that I could not be in the room every 15 minutes, I would program the vitals machine to take measurements according to the doctor’s order and would promise myself to return and check on the patient, peek at the vitals, and then go on my way and repeat the process. Once I could steal away 15 uninterrupted minutes, I would wheel my computer in and manually enter the vitals in to the flow sheet from the vitals machine.

Is this shortcut safe? Have you ever “batched” your vitals?

I ask because I am truly curious as to what other nurses are doing. What is their real world practice as compared to textbook nursing? As a vendor who is out in the field, I get a lot of feedback from nurses and I have found that batched vitals seem to be a general practice. I am not saying that it is right or wrong (although I’m slightly comforted that I am not on an island of my own). But what I am asking is do we need to look at what the impact is on patient care by following this process?

I have read a few studies, but nothing says in bright red letters: “you must be at the bedside every 15 minutes”. But, if this is the case, does technology need to support real nursing practice and allow for sending validated batches of vitals? Or, should we continue with business as usual and embrace the adage of “we’ve always done it this way”?

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Tags: Medical Device Connectivity, Patient Care, Medical Device Integration, Patient Safety, Nurses, Nursing Stories, Vital Signs

Multitasking Nightmares? Tame Them with A MDIS

Posted by Karen Lund, RN BSN on Jul 10, 2014 @ 12:00 PM

ID-10083882Rising patient acuity and dramatically shortened hospital stays are threatening nurses’ ability to meet the needs of their patients. We are constantly on the move, switching from activity to activity, too often finding it difficult to spend enough time with our patients.

How many times have you had to tap your super-power multitasking abilities? Daily? Take, for example, the following all too common scenario. Patient #1 is coming back from surgery. The blood bank calls to say the packed red blood cells are ready for patient #2. You’re waiting for labs in order to give medications to patient #3. Your nurse aide has just informed you that your confused patient #4 has just fallen out of bed and requires immediate help. And patient #5 is waiting for you to complete brand new procedures for discharge paperwork so he can leave the hospital. Sound eerily familiar?

Nurses have adapted to the endless demands for our attention in order to meet both patient needs and their facility’s goals. Distractions may come in many forms on top of patient care, such as new equipment, increased education for new procedures, documentation requirements, and orienting new staff. Krichbaum (2007) reported 40% or more of a nurse’s workday is outside of direct patient care. So what happens when nurses feel like they’re no longer helping the patient and that they’re overwhelmed with non-value tasks? Burn out?

A Medical Device Information System (MDIS) can help nurses gain back more time by helping improve the efficiency of patient documentation. It automatically integrates your medical device data into your hospital’s information system(s), which can save documentation time, increase communication, all while improving accuracy and timeliness. Moreover, in addition to providing connectivity with the EMR, an MDIS delivers monitoring, management and analysis of real-time patient data, enabling nurses to recognize signs of a patient’s physiological deterioration.

Why is this important? An MDIS is one of the few IT solutions that can take some of the pressure off those who give care to our loved ones, while offering real enhancements to the quality of care we are so committed to deliver.

If your facility has already deployed medical device integration capabilities, what kind of impact has it had on your daily activities? And if you haven’t, what’s holding you back?

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Tags: Patient Care, Workflow, Medical Device Information System, Clinical, Clinical Documentation

Maximizing the Benefits of Your Medical Device Integration Strategy

Posted by Michelle Grate, RN MSN CPHIMS on Jul 01, 2014 @ 10:00 AM

ID-10061774A successful strategy is crucial to helping guide decisions throughout an organization, making it critical that it be in alignment with the organizational goals that it is designed to support.  If the strategy is developed without a clear understanding of those goals, then resources, effort, and money can easily be misappropriated. 

When it comes to information technology, a strategy would not be complete without a thorough architecture covering all aspects of an enterprise. However, one of the challenges for developing that strategy is to look into the future and make plans for current infrastructures as well as potential emerging technologies.  A good enterprise architecture will assist in keeping the focus on growth and the necessary predecessors to get there.

With respect to integrating medical device data with the electronic health record (EHR), the strategy needs to look at the current and long term needs of the organization in order to maximize the investment of the medical device information system (MDIS).  Gone are the days when the ICU is considered the only location for integration of medical devices. 

The vast amount of patient data that can be collected and analyzed for real-time clinical decision support can lead to better outcomes. The more medical devices that are connected to the EHR and other information systems, the greater the amount of patient data that can be evaluated for clinical decisions.  Developing a MDIS strategy will help guide the organization's goals and plans over a long term period and keep the organization focused on their patients as they pursue expanding their use of medical device data.

 

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Tags: Medical Device Connectivity, Medical Device Integration, implementation, Medical Device Information System, CONNECT, Medical Device Infrastructure

High Reliability of Data – A Key Benefit of Device Integration

Posted by Susan Niemeier, RN BSN MHA on Jun 25, 2014 @ 10:00 AM

ID-10070663The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 incentivized the adoption of the electronic health record and fast-tracked efforts to implement electronic medical records. The program motivated hospitals to meet deadlines for achieving meaningful use and adopting a wide range of capabilities within their EMR. The benefits gained by implementing the EMR are significant and promise greater efficiency, higher quality of care and safer patients.

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Tags: Medical Device Connectivity, Patient Care, Medical Device Integration, Patient Data, Nurses, Medical Device Information System, CONNECT, Medical Device Data

In Good Company

Posted by Capsule on Jun 19, 2014 @ 04:26 PM

HCI_100_SealMcKesson, Philips, Siemens, Epic, GE, Allscripts, MEDITECH... You don’t have to be a gambler to know it’s a sure bet that there isn’t anyone in health IT who hasn’t heard of these companies.

Recently, we joined these leaders on the annual Healthcare Informatics 100 list, which spotlights the companies with the highest reported revenue in the year prior. It’s our first appearance on the list and after multiple years with continued double digit growth and expansion, we expect to be on the list for years to come.

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Tags: Company News

The Face of Sepsis

Posted by Cyndi Coyne, RN on Jun 07, 2014 @ 10:00 AM

Sepsis is a truly devastating condition. As an ICU nurse, I have seen first-hand how it can ravage a body. I have cared for patients that, despite the best treatment and heroic measures, did not survive. It can appear, seemingly, from out of nowhere and can strike perfectly healthy individuals.

My first encounter with someone with sepsis was many years ago, as a medical assistant in family practice, before entering nursing school. I answered one of the hundreds of phone calls that came into the office daily. It was the father of a young woman; both were long-time patients that I knew them well. He didn’t sound particularly concerned and just went on to explain that his daughter had been having flu-like symptoms throughout the weekend.

At first, I accepted his “flu” assessment and began to give the usual instructions we tended to give patients with viral infections, but something in my gut told me this was something different. Instead, I told him to bring her in to the office so the doctor could see her in between his other scheduled patients.

When they arrived I could immediately see why I felt so uneasy earlier on the phone. She looked awful….very pale, extremely weak, not to mention confused. This was definitely more than just “the flu”. We escorted her into a room and while the nurse got her vital signs, I interrupted the physician who was seeing another patient. “We need you in room three,” I told him. He immediately went in to exam her and came out of the room a few minutes later and said, “Call an ambulance and get the ED physician on the phone for me.”  

After being transported to the hospital via EMS she was admitted with the diagnosis of sepsis. She spent several days in the ICU and for a while they thought she might lose her limbs, if she didn’t lose her life.

The cause was never determined.

Luckily, due to the skill, training and dedication of an entire treatment team of physicians, nurses, physical therapists, and more, she survived and without any residual symptoms. Sadly, though, there are so many who don’t.

The numbers tell us that every year millions develop and die from sepsis. It represents someone with a family and friends who love and care about them. They are your neighbor, your pastor, your sister, or your son.

Evidence links early intervention and treatment to better outcomes. Hours, even minutes, really count and can make the difference between full recovery and death. Advancements in early detection are being made through predictive analytics with the support of regulatory actions and sepsis-awareness community efforts. Healthcare organizations, such as North Shore-Long Island Jewish Health System, are seeing success with notable results of a 16.4% reduction in sepsis related mortalities as a result of modifying complex guidelines and metrics in the emergency departments.

Even those who survive can have life-long, debilitating effects including amputation of limbs, permanent organ damage, difficulties with cognition, and memory loss.  It is critical to provide tools to clinicians that will quickly and accurately identify sepsis in its earliest stages because it truly saves lives.

 

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Tags: Nurses, Nursing Stories, clinical analytics, sepsis, Predictive Analytics

You Can Get Much, Much More Out of Your Medical Device Data

Posted by Monica Demers on May 31, 2014 @ 08:30 AM

aami_2014

 

Going beyond clinical documentation.

With the right approach, medical device data can support clinical and operational strategic initiatives to lower costs and drive towards quality-driven value based care.

Traditionally, connecting medical device data is most widely used to facilitate clinical documentation. This, in itself, creates clinical efficiencies by reducing transcription errors and providing timely data.

But, medical device data can be utilized to do so much more. Medical device integration, aided through the use of IHE profiles, can become a core requirement for other hospital strategic initiatives.

  • Clinical: enabling alarm management, clinical decision support and early identification of patients at risk, quality management initiatives, and clinical research.
  • Operational: optimizing the management of your biomedical technology infrastructure through the centralization and mobilization medical device management.

Having the tools to integrate medical devices with various systems and being able to provide accurate data, to the right place, at the right time, are critical elements to effectively enabling these initiatives.

Plan ahead for the future of your medical device infrastructure.

As healthcare evolves so, too, do medical devices through innovations to existing devices and the introduction of completely new devices. And as the need for integrating device data from across care facilities and the home grows, the importance of having a single platform to manage all these device types is essential. But how do forward-looking providers bridge the gap between today’s environments filled with legacy devices, to ones filled with smart wireless sensors?

Let’s take a look at low acuity medical-surgical units. Here, vital signs are documented periodically and when used in conjunction with a clinical decision support system, these data can assist in the early identification of patient deterioration and help reduce the risk of costly escalations of care. Today’s approach of using a spot check monitor and some lightweight clinical documentation that is then passed through a clinical decision support application can be handled with existing solutions. However, adding more and advanced medical devices to this type of workflow will eventually encumber clinical efficiency.

An expandable, innovative new system is needed.

There is a path to the future: medical device information system (MDIS). An MDIS is an integrated connectivity, documentation, and decision support platform that is equipped to handle workflow from not only your installed monitors, but also offers a clear upgrade path to consolidate new medical device advancements into one manageable system. And it’s a system designed to meet the needs of clinicians who gather and use these data, as well as for the clinical engineers and IT personnel who support them.

 

We’re excited to be presenting just such a system this weekend at the AAMI 2014 Conference & Expo.
Stop by and see us at booth #108 to discover how you can get so much more from your medical device data with SmartLinx, healthcare’s first Medical Device Information System.
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Tags: Workflow, Medical Device Information System, CONNECT, MONITOR, ANALYZE, Medical Device Data, Clinical Documentation, Medical Device Infrastructure

Medical Device Integration: Only for the “Big Dogs”?

Posted by Jody Bregler on May 28, 2014 @ 06:26 PM

MUSE-2014-logoAs we prepare for the 2014 International MUSE Conference, I think it is appropriate to comment on the role of medical device integration (MDI) in today’s healthcare information technology infrastructure. There are some who believe that MDI is something reserved for the “big dogs” because they have hundreds of devices and beds, and dozens of departments throughout their enterprise that feed data to EMR systems. But, in reality, device integration is not only for the biggest and “baddest” dogs. It is just as suitable for the small and mighty in healthcare as well.

Small- and medium-sized hospitals can successfully take advantage of MDI solutions that will deliver important patient information to the flow sheet, while reducing the need for clinical staff to manually chart the patient data. And, of course, in addition to the clinical benefits of having these data in the EMR in near real-time, MDI allows the clinical staff to increase the amount of time to deliver more direct care to the patient. In hospitals where staffing resources may be even tighter than larger hospitals, this extra time afforded to patient care is a valuable commodity.

A true medical device information system is compatible with hundreds of medical devices and can transmit data to virtually any EMR system. Capsule, for example, has successfully integrated with EMRs at all sizes of healthcare organizations, including many MEDITECH systems with Client/Server, MAGIC, and 6.0 versions with deployments in the OR, ICU, Med-surg, PACU and many other areas of the healthcare environment.

Visit us at this year’s MUSE Conference at (Booth 205) to learn more about Capsule’s deployment setup for a MEDITECH system and to see our featured new products, Vitals Stream with Secure Association (positive patient identification) and Chart Xpress with Early Warning Scoring System in action. Stop by to see how Capsule can provide MDI solutions for “dogs” of all sizes.

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Tags: Medical Device Connectivity, Medical Device Integration, MEDITECH, Events

The Big Picture of Patient Care

Posted by Karen Lund, RN BSN on May 22, 2014 @ 02:00 PM

Nurses often talk about understanding “the big picture” in order to provide safe, competent care. As technologies move closer to the bedside, the practicing nurse naturally becomes a major user of them. As a nurse, it’s critically important that we know our patients.  That means, connecting the technologies and data together to get a clear picture about the true state of the patient.  However, with complicated patients the focus is sometimes blurry.

Knowing your patient well – having an accurate assessment of trending data and a good practice foundation – will help bring that picture into focus. But, with constantly evolving health care reform, the worsening nursing shortage and the increase in the elderly population, our workplace will demand nurses to be even more adaptable, efficient and flexible.  We will no longer be able to make slow changes in practice, but will need to predict outcomes accurately, and swiftly alter our practice to keep up with future demands. That makes research, evidence-based interventions and clinical decision support – information technology – critical to getting the “big picture” and improving patient care. 

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Tags: Patient Care, Patient Safety, Nurses, Healthcare Technology

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