NR-512 Week 1 Discussion: Integration of Nursing Informatics Skills and Competencies

NR-512 Week 1 Discussion: Integration of Nursing Informatics Skills and Competencies

NR-512 Week 1 Discussion: Integration of Nursing Informatics Skills and Competencies

Within the operating room, safety is a must to prevent what we call “wrong site, wrong surgery.” Before the patient enters the operating room, they are in a holding area which my facility calls “Day Surgery.” Before we go meet the patient in day surgery, we have several “extra layers” that we use to ensure safety. The first thing I do is log into our electronic health record (which is also Epic) and I ensure that the consent matches the order. For instance, I would ensure Right Leg Amputation is the same on both the consent and the physician’s order, with emphasis on triple checking the right laterality. After this, I look at lab values. I make sure electrolytes are within normal limits, the hemoglobin and hematocrit aren’t deathly low, and if it is a female under the age of 55, I ensure she is not pregnant.

My next step is to check to see if the physician or their resident have put in an updated history and physical note within 24 hours. This ensures us that the patient has been seen by them and are still eligible for surgery. I next check the allergies and write them down to confirm with the patient when I go to interview them. After I have checked these, I walk over to day surgery and open the patients chart. Here, I make sure that the patient has signed the consent and verify if they have or have not consented for blood if needed during their operation. I get my report from the nurse and meet the patient. Upon meeting the patient, I ask them to point to me what leg they are having amputated and ensure there is a mark. This mark is used as an extra layer of safety to ensure that the surgeon does not amputate the wrong leg! Once everything matches and everything is good to go, and the patient verifies their allergies and the procedure with me, we take the patient to the operating room.

Now, there are two more vital safety layers we are required to utilize inside the actual operating room. These are known as a “time-out” and a “sign-out.” A time out, also known as the universal protocol, is done while the patient is asleep but before an incision is made. This confirms the patient, their date of birth, their allergies, the procedure, the laterality, and confirms all relevant members involved in this procedure (Lipshy, 2016).

After the procedure is completed, we then end the procedure with a “sign-out” before the surgeon leaves. In this safety layer, we confirm that the procedure on the consent is the procedure that was completed, we also confirm if there are any specimens and what the surgeon wants to do with them (leave them fresh, put them in formalin, etc).

All of these are considered safety layers that starts with informatics, and as Ashley mentioned, competency. We are not going to send a patient back to the operating room with a Hemoglobin of 5. We would utilize our competency to call the physician about ordering a blood transfusion and rescheduling the procedure.

Thank you, Ashley for your post. I enjoyed it and look forward to reading more in the future!

Hailey Whisenant

Reference:

Lipshy, K. A. (2016). Invited response to Paull et al, errors upstream and downstream to the universal protocol associated with wrong surgery events. The American Journal of Surgery,211(4), 827-829. doi:10.1016/j.amjsurg.2015.07.035

Reflect on your own practice. Discuss how informatics is … in your practice. What is your primary area where you would use informatics?

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.

Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

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APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.

I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.

As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.

It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.