Peer Response Instructions
After making your initial post, substantially respond to at least two other student posts that prompts further input or provides another viewpoint. Describe a situation from your professional experience that backs up your viewpoint and discuss the social, moral, political and economic factors impacting your position.
Hc informatics peers response
1st peer response
Danyka Harrison
The evidence-based practice I chose was the use of standardized order protocols in triage to assist with expediting patient care and improving patient outcomes. In most ER settings physicians are tasked with assessing every patient and at times due to high acuity may take time to perform assessments. There are universal protocols in place for Chest Pain such as EKG in less than 5 minutes or straight to CT if a patient appears to be having a stroke. In addition, adding order sets for common problems such as abdominal pain and fever which are constantly presented to the ED can assist doctors with patient flow. When a patient presents with abdominal pain or a fever the system can use informatics to order basic blood and urine samples in the case the practitioner or doctor is unavailable to enter orders in the system. This can keep the care of patients moving and assist with expediting the discharge or admission process in many hospitals.
As with any system, we should not rely 100% on the metrics triggering order sets and should utilize our critical thinking skills to perform accurate patient assessments. But trend tracking can set a great reminder or recommendation for triaging nurse staff. Obtaining a full patient history and performing a thorough assessment can help identify any contraindications in the system’s recommended treatment such as medication contraindications or allergies.
Reference:
American College of Emergency Physicians (n.d.). Standardized Protocols for Optimizing Emergency Department Care. https://www.acep.org/patient-care/policy-statements/standardized-protocols-for-optimizing-emergency-department-care/
2nd peers response
Stevie Kohns
Labeling patient lab specimens at beside is the EBP I chose this week. There are many technologies that support this practice in various ways. At my hospital, we have recently implemented a program called “MobiLab” which involves a printer in every ER room and an application on our iMobile work phones that connects to the printers. Specimens are collected at bedside, the app requires a scan of the patient label and verification of patient identifiers (Name, DOB, etc), the labels are printed at bedside and applied to the specimens, and then they are sent to the lab. The goal of this technology is to reduce time spent hand-labeling specimens, but more importantly to reduce errors where specimens are labeled with the incorrect patient’s information. According to Sandhu, et. al (2017), lab labeling errors led to over 160,000 adverse events, eleven percent of all transfusion deaths, and increases in rejected samples. The goal of MobiLab technology at bedside is to reduce (or ideally eliminate) these errors as they are connected to lab specimen labeling. The challenges we struggle with in the ER is the pace of the care we’re giving, and there are a few “glitches” yet to work out with this technology. We draw labs, then the printer has turned itself off, so we have to wait for it to turn back on. Then, we go to open the app, and it’s logged us out again, so we have to log in. Then it sends repeated prompts that “draw list has been updated” that we can’t skip, and the list of req’s is confusing and jumbled. We can verify and re-verify time and again, but sometimes it just doesn’t want to scan and verify the patient information. The benefits of the technology is that within the app we can see exactly which labs we need to draw, without having to open Meditech and search through the confusing order screen. I think reinforcing how to use the technology and trying to plan ahead before an admission by logging everything in are ways we can work around some of the issues we have.
References
Sandhu, P., Bandyopadhyay, K., Ernst, D. J., Hunt, W., Taylor, T. H., Jr, Birch, R., Krolak, J., & Geaghan, S. (2017). Effectiveness of laboratory practices to reducing patient misidentification due to specimen labeling errors at the time of specimen collection in healthcare settings: LMBP™ systematic review. The Journal of Applied Laboratory Medicine, 2(2), 244–258. https://doi.org/10.1373/jalm.2017.023762