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The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies

Nicole L Rosser

Walden University

NURS 6051

June 16, 2019

The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies

According to Agha (2014) “Information technology has been linked to productivity growth in a wide variety of sectors, and health information technology (HIT) is a leading example of an innovation with the potential to transform industry-wide productivity.” Due to evidence-based practice research with informatics in the healthcare setting has proven to be a well-known, much needed entity. Studies have shown the efficiency of technology in healthcare improved documentation for healthcare providers and nurses. Healthcare technology also provides a means for organizations to communicate with each other without even picking up a phone. Another, aspect of technology in healthcare allows the healthcare team to monitor trends and changes in a patient’s status. For example, a critical patient on a cardiac monitor would alarm to quickly notify the nurse that a critical change has occurred for timely interventions to take place. With stroke being the fifth leading cause of death in the U.S. adopting Stroke Telemedicine into practice would be innovative for any organization. Much research has shown that healthcare facilities remain untrained and unprepared for stroke care and management.

Proposed Project

The project proposed to better equip my organization with treating stroke patients is Telestroke. According to the Mayo Clinic (2019) “In telestroke, also called stroke telemedicine, doctors who have advanced training in treating strokes can use technology to treat people who have had strokes in another location.” The use of this system is said to reduce wait time for an onsite neurologist and to increase one’s chances of receiving prompt treatment for a desirable outcome. This service will also save money by preventing Medicare and Medicaid from having to pay rehabilitation cost due to disabilities and long-term care. Telestroke will also provide efficient time for Tissue Plasminogen Activator (tPA). The drug tPA is an FDA-approved medication also known as a clot buster use in treating strokes to dissolve that which may be causing an ischemic stroke. However, it is contraindicated with a hemorrhagic stroke which may cause an excessive amount of bleeding if given due to the broken vessels that may have caused the stroke. This service has brought together neurologist and emergency physicians that feel using Telestroke will reduce geographical disparities and prevent increased cost from misuse of other medical facilities.

Stakeholder Impacted by This Project

One of the main stakeholders that would be affected in this project would be Dr. Buehler who is the regional director of all the Urgent Cares and Clinical Decision-Making units within my organization. The other stakeholders that would be involved is the president of the company and CEO. This will accommodate the company with a unique service that can aid the community in having high tech amenities that could make the UC/CDU be the preferred choice over other establishments. Stakeholders also impacted by this project would be the healthcare providers within the organization because in their benefit they will have a 24-hr specialist to aid them in providing cost effective care that will yield them more of a financial kickback because of the savings in treatment cost. Other stakeholders that could benefit from this are the medical software companies, medical supply, and medical equipment companies that contract with the facility. Lastly, the nurses benefit from this project as well because it grants them the benefit of obtaining stroke certification and to work for a stroke certified facility.

Patient Outcomes or Patient Care Efficiencies

The outcome of the proposal would be to better manage stroke patient’s that present to the Urgent Care with stroke like symptoms to arrangement proper treatment services as needed. According to the American Heart Association (2015) “Compared to no telestroke network, a

telestroke system can result in more use of tPA and stroke therapies, more patients discharged home independently, and overall cost-savings for the network of hospitals.” When a stroke occurs, time is of the essence also referred to as “time is tissue.” Therefore, initiating prompt treatment in stroke care will reduce the percentage of deficits and mortality. In the event of a stroke patients can feel confident that choosing a facility that has 24-hr stroke care will give them the best possible outcome for recovery. Even though a neurologist may not be present at the time someone checks in having a stroke, however, having this service is the next best thing to guiding stroke management.

Project Team and Technology Needed

The technology needed for Stroke Telemedicine is video conferencing software, a mobile network monitor for communication or a telemedicine robot. Also, access for Neurology to view the patient’s medical records and radiology reports should be in place. If the space permits, there could also be a designated area where stroke telemedicine and stoke management can be set up.

The project team needed to implement this service would be the informatics specialist. According to Health Information and Management Society (2012) “Informatics nurses working at a healthcare facility may be involved in evaluating and selecting the technology; determining end-user requirements and customizing functionality; and designing and delivering training.” Another team member would be the emergency room doctor that would initiate orders on the patient and consult the neurologist for specified stroke management, and to determine which stroke care modalities to start. Other important team members would be the nursing staff to transcribe and perform that which is ordered by the physician such as starting an IV line, medications, and preparation for any procedures. According to Macieira et al. (2017) “Nurses are responsible 24 hours each day for continuously identifying care issues, implementing and adjusting care prescribed by themselves and other providers to achieve desired patient outcomes.” The nursing staff will also monitor the patient and facilitate any transfer that needs to take place. Lastly, the most critical entity required for the project to be successful is a neurologist. Their role would be to promptly respond to the consult request, assess the patient, check the patient’s chart, and radiology studies to determine the level of treatment.

Summary

Stoke Telemedicine is a valuable resource that is being adopted by facilities all over the country and others outside the U.S. Neurologist, emergency room providers, nurses and nursing informaticist are all becoming more involved with providing adequate stroke care in reducing door to needle time while initiating stroke treatment within 90 mins or less. Continue efforts across the U.S. to improve stroke care and prevention along with rapid assessment, and tPA management has improved in most facilities that have elected to utilize Telestroke. The main objective of this service is to improve patient outcomes and reduce medical cost.

References

Agha, L. (2014) The effects of health information technology on the costs and quality of medical

care. Journal of Health Economics Volume 34, March 2014, Pages 19.

Retrieved from: https://www.sciencedirect.com/science/article/pii/S0167629613001720?via%3Dihub

American Heath Association (2015) Telestroke: Connecting Patients to Quality Treatment