The role of nursing informatics in health care
The Role of Nursing Informatics at Cleveland Clinic Foundation
The Informatics system at the Cleveland Clinic Foundation (CCF) plays an essential role in supporting the delivery of quality patient care and to improve patient satisfaction, features that are very important to maintain the "Magnet Status" achieved by the Clinic. As the CCF mission statement highlights, the goal of the Clinic is to support nursing care and achieve good outcomes along with patient satisfaction. This goal was reached by creating an informatics system that allows an easy access to data information, ensures easy communication between health care providers and promotes nursing and patient education. The mission of CCF is "to support evidence-based nursing practice and improved patient outcomes with technology solutions that enhance nursing communication, documentation and efficiency" ( Nursing Informatics: Nursing past, present and future section, para. 1).
Cleveland Clinics Nursing Informatics implemented an electronic medical record system, called Epic System that is using high technology and considers professional and clinical experience to manage the patient's information, to improve work, and to deliver higher quality health care for its clients. Nurses and Physicians have easy access to the system, being able to view data and collect necessary information, provide quality client care and document the patient's condition. health care professionals can document through the electronic medical record system the medical care that was provided to the patients and the patient's responses to the care given. The Epic System is used not only by nursing professionals, but by a large variety of allied health care departments, too. For example respiratory therapists can document aerosol treatments administered to their patients, adjustments in ventilator settings and the patient's response to these interventions. The pharmacy department uses the information system to access patient's data such as medical reconciliation, medications profile, including current and home medications , demographics, health history and medical diagnosis. In this way it will be
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reducing significantly medication errors. The physicians consider Epic System to be very useful for them, because allows them to easily find their patients file in the system, allowing access to the patient's prior doctor's visits and health information, laboratory results, radiology test results as well as interdisciplinary consult results and recommendations. The physician's orders for medications and treatments can be easily entered into the system through the computerized physician order entry feature of the system (CPOE). This has high significance in reducing medication errors and in delivering care in a timely manner. The CCF website presents a clear explanation about the Informatics system's role in obtaining and maintaining the high standard achieved by the clinic:
Nursing Informatics, in collaboration with the Information Technology Division, is
Implementing an electronic medical records system from Epic Systems of Madison,
WI.Â Electronic documentation of the patient's medical record is transforming
clinical practice for nursing, allied health and medical practitioners at the Cleveland
Clinic. After using Epic Care successfully in ambulatory outpatient services for two
years, the Clinic is currently undergoing a phased implementation of the Epic
system in the inpatient setting-enabling health care providers to examine any
patient record across the entire continuum of care in all Cleveland Clinic facilities
(Nursing Informatics: More information about the Nursing Informatics specialty
section, para. 4).
Another important aspect of the Informatics system in the nursing care provided at CCF is that it contributed significantly to the improvement of communication between medical professionals by improving the accuracy and the speed of communication. It comes very convenient for the physicians to access the computer system from any location, either inpatient or outpatient locations, or either "from the comfort of his or her home or office or even while on the golf course or at the mall" (Hebda, Czar& Mascara, 2005, p.126), to enter orders for the patient. By doing so, the system alerts all departments to carry out physician orders. For example when ordering a chest X-ray for the patient, the radiology department will automatically place a transportation order for the patient, to be transported from the nursing floor to the radiology department. Through the nursing communication tool, the physician can communicate to the nursing staff about withholding diet or medications as preparation for specific tests or even surgery. The same way, the physician, can interpret radiological results in a timely manner, by checking the radiography evaluation report placed in the computer system, without the need to walk to the radiology department to read the film. In this way it could be saved precious time that could save another patient's life.
A different feature of the Informatics System used at the CCF is that provides a large variety of choices for patient and nursing education, offering multiple educational resources at different levels. For patient education purposes, the CCF intranet has a link called "patient education" that consists of information edited in a simple language, easily comprehensible for non-healthcare personal. This site provides information about specific medications, including their side effects, indications and contraindications; also gives information about diseases or home going discharge instructions, regarding activity, diet, signs and symptoms of complications and many other subjects. The CCF television channel has information about diabetes, advice for smoking cessation, anti-coagulation administration, or techniques to reduce and manage stress, etc. This
way patients can be easily educated towards a better understanding of the healing process and can actively participate to their care. At the same time, the CCF Intranet provides valuable information for physicians and nurses that improve their knowledge related to medical diagnoses, policies and procedures as well as giving them the chance of updating themselves with the newest technologies used. The CCF's Alumni Library has commonly used medical sites like Up to Date, Medline that are handy to use when more information are needed about a healthcare related issue. The COMET helps nurses and nursing aids to maintain an updated level of nursing education, reinforcing policies and standards required by the clinic.
According to its definition, the Nursing Informatics has a primary role in delivering high quality nursing care,
Nursing Informatics is a specialty that integrates nursing science, computer science,
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and information science to manage and communicate data, information, and
knowledge in nursing practice.Â Nursing informatics facilitates the integration of
data, information and knowledge to support patients, nurses and other providers in
their decision-making in all roles and settings. This support had been accomplished through
the use of information structures, information processes, and information
technology ("ANA Scope and Standards of Nursing Informatics Practice", 2001, pg
The convenience of the Informatics system of the Cleveland Clinic Foundation is represented, by easy access to patient data, and resources for patient and nursing education. The valuable communication tool between health care providers, contributed tremendously in attaining high standards in patient care and their satisfaction. All these features are essential factors that helped the Cleveland Clinic to achieve the great award of "Magnet Hospital".
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