NR 360 Week 7 Edapt Answers

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Contributor

Criston Cole

Category

Nursing

Course

NR 360 Information Systems in Healthcare

Institute

Chamberlain

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21

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Informatics and Quality Improvement Clinical Decision Support Tools Clinical decision support (CDS) encompasses a variety of technological tools that directly support clinical decisions across settings. Which of the following are an examples of CDS? Select all that apply. Real-time monitors and dashboards Automatic order implementation Event-driven alerts and reminders Condition-specific guidelines, order sets, care plans, and protocols Smart documentation forms and templates CDS encompasses a variety of technological tools that directly support clinical decisions across settings including: Immediate warning alerts for clients and providers Event-driven alerts and reminders Parameter guidance for providers Real-time monitors and dashboards Condition-specific guidelines, order sets, care plans, and protocols Smart documentation forms and templates CDS architectures that influence design, implementation, and adoption It provides order implementation support for a provider but not the automatic initiation of orders. Automated Medication Dispensing System The nurse retrieves medication through an automated medication dispensing system. How does an automated medication dispensing system increase the quality of care? Eliminates client misidentification Reduces intravenous (IV) pump programming errors Eliminates adverse drug reactions Decreases medication errors The use of an automated medication dispensing system decreases medication errors. It does not eliminate adverse drug reactions or identification errors, since providers still need to go through the medication administration checks at the bedside. It also does not reduce IV pump programming errors. This alert would be part of a smart pump. Culture of Safety How does technology promote a culture of safety? Electronic incident reports improve reporting rates Clinical decision support systems determine consequences Video surveillance catches perpetrators Databases track who has been involved in unsafe acts A culture of safety is where all employees are committed to being safe, whether or not someone is watching. It is not about punishing unsafe acts or catching perpetrators. Technology can be used to improve reporting rates of incidents, allowing organizations to identify issues and respond with solutions to improve quality and safety. Types of Clinical Decision Support The nurse scans bar codes of the client’s wristband and the medication. An alert comes up on the computer of a potential drug-allergy interaction. This is an example of which type of clinical decision support? Expert Systems Point-of-Care Workflow Support Order Implementation Point-of-Care alerts include drug-condition interaction reminders , drug-drug interaction , drug-allergy interactions , plan-of-care alerts , and high-risk state monitoring . Order implementation assists providers with order sets and protocols. Expert systems offer support for labs, equipment, and tools. Workflow support provides templates and documentation support. Smart Pumps The nurse is using a smart pump in the emergency room. How does a smart pump increase the quality of care? Decreases adverse drug reactions Eliminates client misidentification Reduces programming errors Eliminates medication errors The use of smart pumps reduces programming errors. It does not eliminate medication or identification errors, since providers still need to go through the medication administration checks. It also does not decrease adverse drug reactions. This alert would be part of medication administration. Alert Fatigue One study in an intensive care unit found that they had 187 alarms per bed per day, of which 72%-99% were false alarms (Drew et al., 2014). How could this unit use technology to combat alert fatigue? Changing the default alarm settings to settings based on each client’s condition Install flashing colors that correspond to each of the types of alarms Hire more staff to attend to the alarms Increase the decibels on all alarms from 70 dB to 90 dB Since all client’s are unique, tailoring alarm signals of devices to each client’s needs can reduce the number of false alarms and therefore, reducing the total number of alarms. Increasing the decibels or using flashing colors will cause more sensory overload. Hiring more staff is expensive and does not combat the alert fatigue. Reference Drew, B. J., Harris, P., Zègre-Hemsey, J. K., Mammone, T., Schindler, D., Salas-Boni, R., Bai, Y., Tinoco, A., Ding, Q., & Hu, X. (2014). Insights into the problem of alarm fatigue with physiologic monitor devices: a comprehensive observational study of consecutive intensive care unit patients. Plos One, 9(10), e110274. https://doi.org/10.1371/journal.pone.0110274 Sentinel Events Which of these sentinel events, or “never events,” could technology prevent? Staff injury associated with a burn Staff death or serious disability associated with an electric shock Surgery or other invasive procedure performed on the wrong client Significant injury of a staff member resulting from a physical assault Identification errors can be prevented using a bar code system or other technology coded system where the procedure or medication is “matched” with the correct client. It is difficult for current technology to prevent spontaneous accidents or situations. Electronic Incident Reporting A local clinic had a low rate of reported safety issues. After instituting an electronic incident reporting form, the rates went up. What is the most likely reason for the increase in incident reports? It was easier for staff to access and fill out forms. The clinical staff were more careless. The clinical staff did not understand the reporting process. It was more difficult to access safety information. Studies have shown that organizations that moved to an electronic reporting system have an increased rate of reporting frequency. It does not mean the staff were more careless. It means that reporting was easier, so staff were more likely to do it. Information is easier to access and the process is easier to understand. Decreasing Rates of Adverse Reactions A local hospital has high rates of adverse drug reactions. What technologies could be utilized to decrease these rates? Select all that apply. Bar code administration Standardized incident reports Smart pumps Electronic health records Automated medication dispensing Electronic medical records and bar code administration will decrease adverse drug reactions by alerting to drug-drug and drug-allergy reactions. Automated medication dispensing decreases medication errors at the point of dispensing. Smart pumps reduce programming errors. Standardized incident reports help identify quality issues, but the actual reports do not decrease rates. Color-Coding Call Buttons How does color-coding call buttons increase the quality of care for clients? Select all that apply. Creates severity levels Decreases false alarms Increases specificity of alarms Decreases number of emergencies Increases frequency of alarms Adding color to alarms helps distinguish between the types and severity of alarms, so staff are more prepared to answer. Making alarms user friendly also decreases false alerts as clients are more apt to select the correct one. It does not decrease the number of emergencies or increase the frequency of alarms. Color-coding is used to decrease alarm fatigue. Bypassing Safety Features What is the main reason staff and providers bypass the safety features of technology? They do not understand the safety features. The safety features are annoying. They do not care. They want to save time. The main reason safety features are bypassed is the misconc

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