In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.
Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge. NURS 6051 week 1 Discussion: The Application of Data to Problem-Solving
In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
Healthcare informatics integrates health science with computer science to communicate data, information, and knowledge (Sweeny, 2017). Working in cath lab, we use many metrics to determine procedure time, door to balloon time during STEMIs, and post-procedure care. Cath lab nurses are often stuck sitting with our STEMI patients holding waiting hours for an inpatient bed. No metrics have ever been completed as to the average time waiting for a bed from cath lab, or any negative implications the patient may have as a “boarder” patient waiting for an ICU or PCU bed within this hospital system. NURS 6051 week 1 Discussion: The Application of Data to Problem-Solving
A now chronic problem in the United States healthcare is ER boarding patients from hours to sometimes days. It has been studied and proven that ER boarding of critically ill patients was associated with worse clinical outcomes (Mohr, 2020). Can the same be said for cath lab nurses holding post-cardiac arrest or impella management for hours? In our current lab, we have nurses from the cardiac floor, ICU, and ER backgrounds. For many, they may not have the critical care training to feel proficient in impella management or post-arrest care such as cooling protocols.
As a nursing leader, data can be collected by looking at the time between when the patient enters the hospital system, the time they get to cath lab, when the procedure ends, and the final time that the patient arrives at their assigned room. Leaders can look at how critical these patients are and if and what care was delayed due to waiting for ICU care. Unfortunately for leaders, it comes down to money and Medicare funding. Currently, hospitals are only functioning on average at 65% inpatient bed capacity (The National Law Review, 2020). Hospital leaders can take this data to justify the immense need for additional staff to increase inpatient beds. Quick admission to patient bed assignments will dramatically decrease worse patient outcomes and optimize patient care and delivery. NURS 6051 week 1 Discussion: The Application of Data to Problem-Solving
Hospital and ER Overcrowding Leads to Increased Patient Risk. The National Law Review. (2020, February 13). https://www.natlawreview.com/article/hospital-and-er-overcrowding-leads-to-increased-patient-risk.
Mohr, N. M., Wessman, B. T., Bassin, B., Elie-Turenne, M.-C., Ellender, T., Emlet, L. L., Ginsberg, Z., Gunnerson, K., Jones, K. M., Kram, B., Marcolini, E., & Rudy, S. (2020). Boarding of Critically Ill Patients in the Emergency Department. Critical Care Medicine, 48(8), 1180–1187. https://doi.org/10.1097/ccm.0000000000004385
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21 (1).
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.
*Note: Throughout this program, your fellow students are referred to as colleagues. NURS 6051 week 1 Discussion: The Application of Data to Problem-Solving
I once interviewed for a cath lab position, I was qualified, but did not get the positon based on my travel time in relation to call shifts. This was an eye opening experience to the benchmarks that need to be met for certifications. Over the years, studies have analysed various aspects of cardiac catheterization planning. According to Mercuri et al., (2009) “Improving access to CATH in our center was reactive to the increasing need of the community rather than based on anticipation of need and continuity of service within RMWTs. Registry data can help monitor key indicators (e.g. RMWT). Prudent use of this information should help policy makers with future expansion in our region.”
While this study netted pertinent information related to the catheterization procedure, the vast amount of data could benefit from an informatic software program; which would optimize the application of the data. For instance, this particular study looked at basic demographics like age, gender, and total number of cases. Additional variables such as aortic stenosis, previous CABG, history of MI, and diabetes; to name a few, were also factored into the study (Mercuri, 2009). The array of topics incorporated into this study is why and how the concept of informatics could process this information with efficiency. NURS 6051 week 1 Discussion: The Application of Data to Problem-Solving
“Information systems in the managerial role often consist of interpreting information and modifying data to be utilized in decision-making processes (Sweeney, 2017). If time is a critical element in the cath lab process, it only seems logical that automation is a component that would benefit the process, thus improving patient outcomes. The use of informatics could make for a safer healthcare model. From my experience, longer procedural times results in anxiety of the patient and family. Also, mortality and the level of care needed for these patients are delicate markers
Mercuri, M., Natarajan, M. K., Holder, D. H., Xie, C., & Gafni, A. (2009). Insight into capacity planning for cardiac catheterization services: policy lessons learned from “Looking in the Mirror” over a decade. Health Policy (Amsterdam, Netherlands), 91(3), 314–320. https://doi.org/10.1016/j.healthpol.2009.01.004
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.
sample response 2
I understand how you and your fellow nurses must feel regarding holding patients while waiting on inpatient beds. As a PACU nurse this issue is daily in our unit. Not only are we holding surgical patients but surgical ICU patients. We have a process that if the patient is an ICU patient having to be recovered and held by a PACU nurse that ICU must provide an ICU nurse within 4 hours of arrival to PACU. The continuity of care not only is an issue but overloads the PACU nurse when they are responsible for other patients that are coming out of surgery. “A surge in post-op patients needing hospital beds means fewer beds for ER patients, which creates a bottleneck and leads to boarding.” (Dalton, et. al., 2019) We find in our facility that post-operative patients take priority when it comes to bed placement before ED holds. NURS 6051 week 1 Discussion: The Application of Data to Problem-Solving
I see how gathering data and trying to see if there is a better way to discharge in patients and stream line the admission process as well.
Dalton, Clayton, and Daniel Tonellato. “Opinion: Emergency Rooms Shouldn’t Be Parking Lots For Patients.” NPR, NPR, 30 Nov. 2019, www.npr.org/sections/health-shots/2019/11/30/783278033/opinion-emergency-rooms-shouldnt-be-parking-lots-for-patients. NURS 6051 week 1 Discussion: The Application of Data to Problem-Solving