This week, I decided to review a few of the articles I’d written over the years. I was drawn to an article I wrote for ADVANCE on the complexity of nursing in the digital world. Although authored several years ago, the theme is as relevant today as when it was originally published.
“Today, increasingly complex and demanding workloads combined with shorter patient stays limit the valuable minutes nurses can spend with each patient. At the same time, patients who once would have been considered critical are now more rapidly moved to lower acuity areas such as med-surg. This rising patient acuity combined with shorter stays requires more energy, effort and attention from nurses, increasing their obligatory chore of documentation. While evolving financial and regulatory expectations for documentation contribute to even more time spent in charting.
In their increasingly digital environment, nurses are expected to learn new EMR applications and technologies while still providing safe, compassionate care. And while certainly not always the case, it can be an overwhelming task for a nurse to do both simultaneous and maintain high clinical standards. Meanwhile, the internal silos in which hospitals often operate (IT, nursing and other disciplines) may not align, creating needless redundancies in documentation for the nurse. The end result is a loss in direct patient care time.”
Significant benefits have been promised with the implementation of an EMR, including greater efficiency, a higher quality of care and, ultimately, patient safety. However, the advancement of the EMR exposes the need to get more data into the record as quickly and accurately as possible. And it is the skilled nurses who are charged with this responsibility of grabbing volumes of data from bedside devices including monitors, pumps, ventilator, etc. and transcribing it into the EMR.
From a clinical perspective, the value of the EMR is not only recording information, but also building insight. High quality treatment depends on the timeliness and accuracy of data. But this is restricted by how much time a nurse spends during a shift in direct care at the expense of updating the EMR. Hence, a vicious cycle ensues. The article went on to note that:
“Medical device integration automatically records vital signs data from bedside devices and sends that data to the patient's record. It removes the nurse as the "human bridge" linking the devices to the patient record and helps minimize the competing forces a nurse often encounters, i.e., they can document frequently in a timely manner or consistently assess and care for the patient. The easiest way to understand how device integration works is to think of it as a language translator with all the devices monitoring a patient speaking a different language.
Device integration takes all the data coming from these devices, translates it, filters it, normalizes it and sends it to the electronic medical record (EMR) so the clinician can review and validate the data. Or, device integration can support immediate bedside validation, thus removing the critical delay from vital sign measurement to documentation. Such integration ensures that the right data is in the right record at the right time.”
With the right medical device integration solution, nurses can reinvest their time at the bedside to focus on patients – their satisfaction and care – all without worrying about charting medical device data. After all, isn’t it all about the patient anyway?
Niemeier, Susan, MHA, BSN, RN. "Gaining Leverage: Combining modern technology with age old nursing documentation improves patient outcomes." Advance Healthcare Network for Nurses, Web. 2 June 2010.