by Dr. Dee McGonigle
Editor in Chief
Bruce Nicely, RN, BSN, CPTC,
and Dawn D. Laing, BSN, RN, CCRN, CLNC
McGonigle, D., Nicely, B. & Laing, D. (June 2012). Editorial. Keeping PACED: Patient –Advocacy – Caring – Education – Dissemination. Online Journal of Nursing Informatics (OJNI), 16 (2), Available at http://ojni.org/issues/?p= 1698
In this fast PACED, information overloaded world we practice in, we must keep PACED. The patient must always come first; they must be the first consideration from the second we enter our practice arena. Next, we must be advocates for the nurses and support their professional needs and patient care activities. Finally, we must never stop learning, educating or sharing since education and dissemination will help all of us improve our practice and meet the goal of enhanced quality care for our patients.
As informatics nurse specialists (INS) continue to be integrated into practice settings, they are helping their organizations keep PACED. Often, in the clinical setting, the patient is not the first consideration but is relegated to second, third or fourth place depending on the technological concerns of the nurse and their difficulty in accessing the necessary information in order to provide care. The INS helps nurses stay focused on the patient through advocacy, caring, education and dissemination. The INS advocates for the nurses, educates them about the technologies, information and the data-information-knowledge pathway so they can refocus on their patients. Making the technology transparent and truly supportive of the nurse’s and their patient care needs, makes the INS invaluable!
We have provided two examples of the INS’s role and how they can impact and enhance patient care. The first example concerns organ transplantation and the second the importance of keeping the nurse focused on the patient, at the patient’s side, providing care.
“With the ever-increasing advances in technology, nurses from the bedside to administration have found that information systems and technology are now a standard part of the daily nursing workflow” (Mitchell, 2011, p. 11). The INS can bridge the divide between technology and patient care to expedite and improve outcomes for organ transplants. Bedside care of the brain dead organ donor is a complex and challenging medical situation (Furlow, 2012) that requires extensive testing, monitoring, reporting of data (e.g., hemodynamics, laboratory results, organ functionality, etc.), and accurate documentation of the course of events prior to surgical recovery of the donated organs. Even the way people record their decision to donate after death has become a technological event because of donor registries (Harrison et al, 2010). Everything from confirming the donor’s decision to conveying accurate results from serological assays can affect the life and health of a waiting recipient (Shafer et al, 2011). Family dynamics following devastating loss surrounding the potential organ donation require care and attention that is of higher quality when the caregiver can focus on the patient and family instead of the equipment, monitors, and other potentially distracting devices. The INS can be the catalyst and unifier to bring minimally intrusive technology to the demands of patient care, thus freeing the nurse or other provider to provide care. Technology is most helpful when it enhances, and does not impede, care.
For decades, the primary emphasis of a nurse has been to provide safe, efficient, and accurate care to the patient. The INS may not offer hands on care for the patient, but the role of the INS is a behind the scenes nurse finding ways to support and keep the bedside nurse’s focus where it should be, on the patient. Information technology provides ways for nurses to communicate more effectively with patients, families, and healthcare providers through electronic medical records. The INS can focus on techniques to make documenting electronically safer and quicker allowing the nurse more time to give one on one care, something every nurse strives to do. Also, with patient safety being a high focus, the INS incorporates methods to provide ways for safe medication administration. For example, the method of using bar code scanners for patient identification and medication administration promotes a safe, time saving environment again allowing more time with the patients and families (Halley, Sensmeier, & Brokel, 2009).
The goal of the INS is to enhance the quality of patient care by advocating for the nurses and becoming the liaison between nursing, IT personnel and administrators. The INS advocates for the nurses by promoting and supporting their patient care needs through the development of efficient information entry, access and retrieval. The INS educates and disseminates data and information to nurses, IT personnel and administrators. The INS keeps everyone PACED.
Furlow, B. (2012). Solid organ donation and transplantation. Radiologic Technology, 83(4), 371- 389. Retrieved from http://www.radiologictechnology.org
Halley, E., Sensmeier, J., & Brokel, J. Nurses exchanging information: Understanding electronic
health record standards and interoperability. Urologic Nursing, 29(5), 305-313
Harrison, T.R., Morgan, S.E., King, A.J., DiCorcia, M.J., Williams, E.A., Ivic, R., K., & Hopeck,
P. (2010). Promoting the Michigan organ donor registry: Evaluating the impact of a multifaceted intervention utilizing media priming and communication design. Health Communication, 25, 700-708. doi: 10.1080/10410236.2010.521912
Mitchell, J.K., (2011). Nursing informatics 101: Using technology to improve patient care. Oncology Nursing Society Connect, 26(4), 8-12. Retrieved from http://www.onsconnect.org/reconnect
Shafer, T., Schkade, D., Schkade, L, Geier, S.S., Orlowski, J.P., & Klintmalm, G. (2011). Zero risk tolerance costs lives: Loss of transplantable organs due to human immunodeficiency virus nucleic acid testing of potential donors. Progress in Transplantation, 21(3), 23-247. Retrieved fro http://www.natco1.org/prof_development/progress_transplantation.htm
Bruce Nicely and Dawn Laing are MSN students at Chamberlain College of Nursing completing their practicums in the Nursing Informatics track.