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Medical Device Integration Blog

Halley Cooksey, RN

Hometown: Elyria, OH Role at Capsule: Clinical Consultant Degrees & Certifications: RN First Job in Nursing: Right out of nursing school I was hired in the ER. Hospitals / Organizations Worked At: University Hospitals Elyria Medical Center Areas of the hospital you have worked: ER and Clinical Information Systems Which care environment(s) of the hospital did you most enjoy working? I loved the ER. What do you enjoy most about being a nurse on the vendor side of healthcare? I get to help other nurses take the best care possible of their patients. What is your favorite cereal? Honey Bunches of Oats.

Recent Posts

National Nurses Week: One nurse's view on technology and patient care

Posted by Halley Cooksey, RN on May 06, 2016 @ 06:00 AM

Celebrate National Nurses Week 2016!

Editor's note: In celebration of National Nurses Week we asked a variety of nurses, ranging from our team members, clients, and social followers to share their thoughts on a wide range of nursing issues. In this blog post, our own Halley Hoefs  explores the impact on technology and patient care.

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Tags: Nurses, National Nurses Week

Wish List

Posted by Halley Cooksey, RN on Nov 13, 2014 @ 10:18 AM

The holiday season seems to have officially kicked off this past weekend. It seems to happen earlier each year. Gone are all the witches, bats, and ghoul decorations. In their place are festive trees strung with lights, with only the occasional Thanksgiving turkey to break things up. Soon we’ll face the barrage of commercials advertising the countless ways we can spend our holiday budgets. Many of us will spend hours listening to our children and grandchildren describe in very finite detail all the things they have placed on their wish list and how they promise to behave so they’ll get as many of the coveted gifts as possible.

Like our children, as adults we also have wish lists for our toys and that can extend into our professional lives. As nurses we have wish lists for things that will make our work life not only easier, but also allow us to truly practice our profession – caring for patients. Do you have a wish list? What sort of things do you wish for to help you in your daily practice? Do you wish for the kind of technology that can enhance your nursing practice and not hinder or slow it down? We know that no amount of technology will ever be able to replace our assessment skills, our ability to connect with a patient or their family members. There isn’t any form of technology that can console them during a very trying time; nor can technology wipe away a tear or put a band-aid over an injection site. However, we also know that technology can help free up the time for us to give our patients the kind of attention they need and that we want to provide.

If you could create a wish list of the things technology could do for you as nurse, what would you put on it and why? Would you wish for tools that could decrease the amount of time you spend documenting in a patient’s record? Or, perhaps a technology that could help you see the subtle changes in your patients and could alert you that they are beginning to decline and are in need further intervention? We want to hear your thoughts!

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Tags: Medical Device Connectivity, Medical Device Integration, Nurses, Health IT, Healthcare Technology, Nursing Stories, Medical Device Information System, Clinical, Clinical Documentation

The Pecking Order of Device Integration

Posted by Halley Cooksey, RN on Sep 26, 2014 @ 03:16 PM

When I first became a nurse, one of my favorite questions to be asked was “What kind of nurse are you?” The fine print of this question, of course, is “where in the hospital do you work?” I would swell with pride and proudly state that I was an “ER” nurse.

As far as I was concerned (at that time) an ER nurse was the best kind of nurse anyone could be. Sure, working in the critical care area must have its challenges, but how hard is it to take care of an intubated patient who I had so kindly stabilized for you? As for the nurses on the floor, I mean, really? These patients were of the walkie-talkie population. Hang a few bags of IVs, push a little Lasix and remind your nurse tech to measure their output. Obviously nothing compares to the ER.

Fast forward many years to today and I have to tell you what an awakening I have had. After leaving the ER for a myriad of reasons, I crossed over to the dark-side of nursing … also affectionately known as “HIT”. It was during my years working as a clinical systems analyst that everything I thought I knew about med-surg floors made me realize that I had no concept of what it was to walk in their shoes and understand what their workflow was all about.

The nurses who worked on the med-surg unit were taking care of a complex, diverse group of patients with varying degrees of acuity; more times than not, without the assistance or extra set of helping hands of a patient care tech, because the patient care tech was in a room with a confused geriatric patient who couldn’t be left alone. I watched these nurses document on napkins, scrubs and sometimes bed sheets all while taking phone calls from different doctors and receiving orders. Additionally, they were working with social services, the hospice nurse and every other visitor who decided to stop them in the hall and ask about their loved ones. I remember thinking, who signs up for this gig? To say the least, I was humbled by their dedication.

The big picture of this is that “floor” nurses are the ones in need of technology to complement their workflow and not impede it. Technology should not be seen as “big brother” watching over their shoulders, but as an extra set of eyes to help them do what they do best: take care of patients.

Interestingly enough, though, med-surg units are typically that last areas to be thought of for medical device integration. Walk into any critical care area and you’ll likely see monitors feeding to a central station that, in turn, feeds directly to an EMR. Ventilators are cutting edge and their data is flowing to the EMR, as well. Conversely, walk onto a med-surg unit and you’ll likely observe nurses with tattoos of vital signs up and down their arms, or on scraps of paper that they will later transcribe. Their patients’ data is just as important as the patients sitting in the critical care unit or ER, right?

So, here’s an interesting thought to ponder: Typically, there are more med-surg beds in a facility than ER beds and critical care beds combined; therefore, there are more med-surg nurses working at any given time than there are in all the other areas put together. The med-surg areas are the backbone of the hospital. As a general cultural oddity, why is it that these areas are the last to get connected? Why are they not seen as mission critical like other areas of the hospital?

I’d like to hear your opinion as to why this is the case and how we can change this thought process.

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Tags: Medical Device Connectivity, Nurses, Nursing Stories, Clinical, Med-Surg

Safety First - Are You Automating Your Medical Device Data?

Posted by Halley Cooksey, RN on Aug 13, 2014 @ 12:59 PM


When I grew up, safety equipment like bike helmets and seat belts were few and far between. Some of the best memories from my childhood are of sitting in the back of my parent’s station wagon with my sisters untethered to either our seats… or to electronic devices. We passed the time by playing license plate bingo and trying to get truck drivers to beep their horns.

Fast forward 20 years, and the thought of allowing a child into a car without a seat belt, let alone in the “wayback” of a station wagon... err, a SUV... would land a parent on a DFACS (Department of Family and Child Services) watch list. The impetus behind these changes was research. Research found that when children are placed in the backseat of a car, and securely fastened, their chances of survival are greatly improved if they are involved in a car accident.

Nursing practice has followed suit. As a nurse, it is our duty to ensure that we provide the safest care to the patients we serve. Clinical, nursing-driven research has laid the foundation for what is considered to be “best practices” to support us in achieving that goal. But, what if those best practices aren’t enough?

I read an article last week that stated that in 2013, an estimated 440,000 patients died due to medical errors. That’s four times the population of my hometown! As nurses, what can we do to help decrease those errors? How can we be the driving force that saves one of those lives?

Sending data automatically from medical devices at a patient’s bedside into the medical record and other information systems, like clinical decision support, is a good first step in supporting the reduction of those errors.

Have you conducted any studies at your facility that have shown improvement in patient care when documentation is automated?

Let me know your thoughts! Share your story!

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

Batched Vitals

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


Nursing 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

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