Monday, February 16, 2015

A Call to Action for Nurse Leaders

Be the Nurse Leader you would want to follow




     
     The American Organization of Nurse Executives (AONE) puts forth recommendations regarding competency standards for the nurse leader that range from being able to email to possessing knowledge on the newest technologies. This is quite the spectrum and how do you define knowledge? Is it that the Nurse Executive (NE) knows of the technology or that they are able to navigate smoothly through it? The current state shows that many Nurse Executives are not able to lead projects regarding Nursing technology (Simpson, 2013). This is a sad statistic because if the NE is not able to lead the project, many times another discipline will take over when it should be nursing at the helm.Nurses have the ability to reshape healthcare. We are not able to do so by taking a back seat or worse not even being on board the bus. Nurses are accountable to using all resources available to provide the best care to their patients and they use their knowledge and wisdom to drive change and develop new structures to enhance care delivery (AONE, 2010). Nurses make up the largest number of healthcare workers. If Nurse leaders do not push themselves to learn and become competent with the technology, the leaders and front line team following them will not take it seriously or not feel empowered/inspired to speak up and make changes.


AONE



     Nurse Executives need to be able to apply the Nursing process to all things. They need to be able to Develop, Implement, and Evaluate in all areas that need improvement (Cropley, 2014). This thought process and critical thinking needs to occur if we are to have a major contributing factor on the triple aim and improving nursing processes supported the Electronic Medical Records (EMR) and other technology. I would like to see AONE update their suggested competencies regarding technology because knowing how to email will just not cut it any longer. Nurse Leaders need to unite and advocate for more education and not wait to be educated. They must seek out these opportunities if they want to succeed. There are too many Nurses and patients depending on us and we cannot fail them.



FON
The Future of Nursing site is great as it speaks of what it will take to be successful and what initiatives are being worked on.



The Future of Nursing site is great as it speaks of what it will take to be successful and what initiatives are being worked on.
     
References

Simpson, R.L.(2013). Chief Nurse Executives need contemporary informatics competencies. Nursing Economy$, 31(6), 277-288.

AONE guiding principles for the rle of the nurse in future patient care delivery. (2010). Nurse Leader, 8(4), 21-25.

Cropley, S. (2014). Essential skills for Nurse Executives. Texas Nursing, 88(4), 18-19.



Monday, February 9, 2015

Tele-Health- Transforming Care Through Interfacing








What is Tele-medicine?

I am very proud to highlight Rochester General Hospital (RGH) when it comes to utilizing technology interfacing to achieve better patient outcomes and accessibility. In 2008, The program was started using video conferencing where patients are able to interface with the provider/specialist they need consulting from (Nelson & Staggers, 2014). Rochester General Hospital is part of Rochester Regional Health System which is an Accountable Care Organization (ACO). Currently Newark Wayne Community Hospital and United Memorial Hospital in Batavia utilize tele-medicine. Intensivists located at RGH interface with patients in the ICU at the rural hospitals to review care with Nurse, Doctor, patient, and families to make sure the best care is being provided. If you have ever worked in a rural setting, you can appreciate how overwhelming it is to drive to a big city to receive a specialty consult. Newark Wayne has a tele-medicine department that schedules patients as an out-patient to either follow up or perform initial consults. Patients in these setting are more apt to keep these appointments. The future of healthcare will be an increased need for accessibility to care. This is one proven way to do just that.


Tele-Health


Ohio passed a bill where The Centers for Medicare/Medicaid  would be required to cover tele-health. They were hesitant to cover this emerging technology but it is the wave of the future and much needed as resources are limited (Fraley, 2014). As Nurse Leaders, this is where we come in to push for legislation like this that helps support our communities and their health.


    This video amazes me and is the future. It personally touches me because my father suffered a stroke two summers ago and luckily his symptoms were identified early and he was able to receive TPA and had little residual. Not everyone is so fortunate. This emerging field will help those who should not have to suffer their lack of resources based on where they live.


References


Nelson, R. & Staggers, N. (2014) Health Informatics: An Interprofessional Approach
     Elsevier:St.Louis, Missouri



Fraley, A. (2014). Telehealth Service: Health Care from Afar. Ohio Nurses Review, 89(6), 8.



       Standardized Nursing language is designed to eliminate confusion and mitigate risks caused by errors or ambiguity. It has only been in recent years that the hospital has switched over to "plain language" when paging overhead. For example, a "code red" would be paged overhead. Now this happened to mean a fire alert but perhaps that did not mean fire in another organization which has the potential to lead to disaster. So now the overhead announcement states "fire alert on second floor....". No confusion there. That was an organizational example but the example is relevant as the standardization of nursing language means that we all talk the talk and understand the language fluently to perform our work more concisely.


Patient Care Data Set

There are two data sets that are accepted by the ANA. The first is the Nursing Minimum Data Set (NMDS) which helps to standardize how nursing data is collected. The second is the Nursing Management Minimum Data Set (NMMDS) which helps to structure for data elements that are specific to nursing (Nelson & Staggers, 2014).

NMDS- consists of required information such as patient information/demographics, Nursing assessment, patient diagnosis, expected outcomes, and nursing interventions

NMMDS- Made up of 18 nursing elements such as financial and nursing resources, environment, and decision making.

Ireland performed a study on an NMDS that was specific to mental health. The study showed that this particular NMDS showed reliability and validity so the set specific to mental health is an evidence based set. This supports that nurses increase the impact of healthcare delivery through documentation (Morris, Macneela, Scott, Treacy, Hyde, Matthew, & Byrne, 2010).




NMDS Comparison



References

Nelson, R. & Staggers, N. (2014) Health Informatics: An Interprofessional Approach
     Elsevier:St.Louis, Missouri


Morris, R., MacNeela, P., Scott, A., Treacy, M., Hyde, A., Matthews, A., & ... Byrne, A. (2010). The 
     Irish nursing minimum data set for mental health -- a valid and reliable tool for the collection of  
     standardised nursing data. Journal Of Clinical Nursing, 19(3-4), 359-367. 
     doi:10.1111/j.1365-2702.2009.02995.x