Health Information Pre-class Questions

Question One:
Why do you think Health Information Technology is important to the current practice of
healthcare? Upon what do you base your answer?
Technology is an ever evolving aspect of healthcare that impacts patient on a daily basis. In the
current time, there are more options than ever for patients. From the choice of providers &
institutions, to medications, and treatment options. As nurses, we are taught that the most
important part of providing care is getting a detailed assessment. More imprrtanly, I think, is to
have an even more detailed history on the patient you are treating. Getting previous records from
other locations is now easier than ever and it benefits both the patient and the provider.
Do you think that tele-technology is superior to, inferior to, or much the same as non-technology
options for healthcare documentation? What is the basis for your answer?
Tele-technology is the use of is the use of electronic information and telecommunications
technologies to support long-distance clinical health care, patient and professional health-related
education, public health and health administration. Based on the definition alone, I believe that it
is neither superior nor inferior, but instead more of an adjunct element to the healthcare
documentation process. While it is true tele-technology is the new thing, the future of
medicine, we must always remember that technology has its drawbacks. Just as in non
technology documentation, errors can and will be made. Whether it be in the input process, the
information attained by the provider, or even the data provided by the patient, there will always
be room for error. To further elaborate on the necessity for both, when technology fails, the go to
option is paper documentation. When paper charts are lost misplaced or inaccurate, technology is
there to provide necessary data. While it may be a pain for nurses to deal with double charting, I
feel it should be thought of more as an additional safety measure for both the provider and the
patient.

Question Two:
What do you see as the strengths and weaknesses of the electronic health record? What do you
base your answers on?
Electronic records are quickly becoming a common practice in most areas of healthcare. Of
course the best part is the great ease for healthcare providers to attain & share patient records
between providers. However, that is also a major weakness as more and more major corporations
fall victims to hackers. Although patients medical records are not a much of an interest to
hackers as, say a credit card company or banks, the potential for data such as social security still
puts EHRs at risk.

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Having records electronically provides providers with a more accurate data. For example,
patients who are on several medications may not accurately remember names or dosages for each
Rx. In addition, healthcare is becoming more and more specialized. There is a specialist for
every part of the human body. While your cardiologist who has you on Cardene, may be an EHR
participant, your podiatrist with a small practice, may not be aware that his new Rx for
Itraconazole has a major drug interaction with Cardene. Making HER universal for all providers
allows for a safer treatment pathway for patients
Who benefits most from the electronic health record platform, patients or clinicians? Can you
explain the rationale for your answer?
As explained before, both patietns and providers benefit from EHR. At one point, manual
charting was unusual and most likely, initially rejected. I believe that just as we have accepted
the documentation aspect of our jobs, we will eventually all accept that EHR is the way to go for
the good of all. It is as basic as thinking about the following: as of now kids in school are more
technology centered than ever. Some schools have even gone as far as no longer teaching
cursive! To think that a provider, 10yrs from now will not be able to read the orders written by a
60yr old surgeon is silly to think about, yet very much a reality. Stop to think how many doctors
you know that write in that amazing Dr cursive that are putting up a fight to input electronic
orders. Yes, like any new practice, there will be a learning curve for everyone impacted.
However, I believe once everyone jumps on board patient will benefit from healthcare in a way
formerly not available.
Question Three:
Do you think that point of care (POC) testing adds to the quality of patient care? How?
Yes.I believe POC testing is a huge asset to a nurses ability to provide quality care. In a world
where the focus in healthcare is positive patient outcomes, its safe to say that a major contributor
to achieving this is assuring mistakes are avoided at every point of the patients visit. As with teletechnology and documentation, CDSs should be used as a assistive tool rather than a primary
decision tool.
What do you see as the strengths and weaknesses of clinical decision support systems? How can
you verify or disapprove your assumption?
As previously stated, the technology these CDSs offer is extremely helpful and beneficial to both
patient and provider. Tools such as bar coded medications allows even the newest of nurses to
avoid medication errors. Most hospitals programs now have a drug interaction alert which lets
the nurse know that giving scanned drug will interact with meds pt is currently on. The weakness
of the systems obviously then applies when the system fails, ie downtime, and the provider who
constantly depends on the technology is likely make a mistake when those reminders are not in
place or available. In other words while its convenient to have the assistance of the system it is

still vital that providers actually learn the information. Strengths of these tools are evident in
tools such as glucose monitors. They have been redesigned to give quicker results with less
blood. To be honest, without further research, I have no idea how BGLs were checked prior to
the technology of monitors. Furthermore, tools such as the OraQuick Advance Rapid HIV-1/2
Antibody Test now provide results in approximately 20mins. Treatment plans can be made
quicker and with less risk of harm to the patient based on results from these tools.

Question Four:
Alarm fatigue occurs when hospital staff become desensitized to alarm alerts causing missed
alarms or delayed response.
What do you think are the primary reasons alarm fatigue occurs?
Alarm fatigue basically occurs when a nurse becomes desensitized to all the different types of
alarms from the various number of monitoring devices used on patients. As nurses, especially on
the floors and units, they are responsible for carrying out many tasks for several different patients
at once all while planning and thinking of interventions. The mind of a nurse is never at rest.
What measures would you recommend to counteract alarm fatigue?
Knowing when to intervene, delegate, assess, and still manage to remain calm and think clearly
almost sounds impossible. Stressors for one person may be completey different than that of
another. Prioritization is defintately a learned skill as a nurse, and like any skill, not every one
will be as good as it. Learning to assess which patient will need extra attention on your shift,
learning all the different machine alarms, as well learning how to manage stress all at once is not
something every nurse will conquer. Measures to counteract fatigue would include avoiding
silencing alarms, monitor only those that need to be monitored, and taking advantage of the
settings options on each machine. In addition to this I think that including the patient as well as
the physician, could possibly assist in the issue. For example, if the patient has an IVP that is
constantly going off due to an occlusion in line it would be important to teach the patient to
keep the arm still or straight. Perhaps if the problems persisted, it would benefit both the patient
and the nurse to change the IV location site. Alarms affect the patient as well, interfering with
sleep. Bed alarms, chair alarms, vent alarms, are all required to have an up to date maintenance.
If the nurse has done all she can do to fix the problem perhaps the machine itself needs to be put
out of service.

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