Questions to Help Clarify Scenario and Application of Data

Respond to two of your colleagues asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.

Peer 1

Jordan Mckaley Boney

Collecting and analyzing data on Hospital-acquired infections can benefit any organization. I’m sure that my current organization already collects data related to Catheter-associated urinary tract infections (CAUTIs), but I would like to make it more specific to my department. I am a travel nurse and specialize in emergency nursing. With that being said, I have worked for many different organizations. One of the organizations I worked for had a unit-based council that focused on the concept of having a “foley-free ED.” This means the emergency department (ED) staff refrained from unnecessary urinary catheter placements. We would still place catheters for things such as retention or other urinary emergencies, but we would leave catheter placement up to the units the patients were going to. This reduced CAUTIs associated with my specific department. I will consider this hypothetical scenario for this discussion at my new organization.

First, ED staff must create and utilize a specific criterion for foley placement. Each foley placed in the ED must be accounted for and audited. The Agency for Healthcare Research and Quality (2015) reports that outcomes can be measured by collecting the CAUTI rate and calculating the days since the last CAUTI on the unit. Other data to collect are age, population, and how often foley care is done on the unit. Data can be collected and assessed using auditing forms, but a more modern approach is utilizing electronic medical records (EMRs). Computer science is a valuable tool that can collect data, synthesize data, and facilitate professional development and the ability to apply evidence-based decisions to nursing practice (McGonigle & Mastrian, 2022, pp. 35-36).

The knowledge that will be delivered includes the number of CAUTIs associated with the department, the date since the last CAUTI in the department, the age of the patient who experienced the CAUTI, etc. Nurse leaders can take this information and determine if the “foley-free ED” concept is a success. They can also compare it to previous months to determine the factors associated with a rise or decline in the number of CAUTIs. It improves patient safety and quality of care. “Nurse informaticists analyze big data to look for patterns, trends, and commonalities among patient populations and communities. Then they use those insights to prevent disease, encourage patients (and clinicians) to change behaviors, and improve health” (Northeastern State University, 2019).

Resources

Agency for Healthcare Research and Quality. (2015). Toolkit for Reducing Catheter-Associated Urinary Tract Infections in Hospital Units: Implementation Guide. https://www.ahrq.gov/hai/cauti-tools/guides/implguide-pt4.htmlLinks to an external site.

McGonigle, D., & Mastrian, K. G. (2022). Computer Science and the Foundation of Knowledge Model. Nursing informatics and the foundation of knowledge (5th ed., pp.35-36). Jones & Bartlett Learning

Northeastern State University. (2019). Take on Big Data as a Nurse Informaticist.  https://nursingonline.nsuok.edu/degrees/msn/nursing-informatics-program/take-on-big-data-in-healthcare/

PEER 2

Laura Ferretti

The nursing world is advancing with technology and efficient ways to capture and utilize data. Hospitals constantly filter through patients, employees, and changes within the workplace and need information technology tools to keep their vast systems afloat. Nagle and Junger note that nurses work in temporary teams that need clear goals to coordinate and communicate appropriately to provide quality care (2017). Data collection and analysis are essential in assessing the workplace and using the information to make hospitals a better work environment. Incident reports have always been necessary documentation throughout all the hospitals I have worked in. Incident reports are crucial to document to increase safety in the workplace, both for patients and employees. These incidents are meant to be recorded, whether it be a patient leaving against medical advice, a needle stick, a patient fall, or a workplace injury.

Kodate et al. found that incident data helped to improve the implementation of safety management in health care (2022). Healthcare organizations are complex environments with plenty of room for human error. With adequate reporting of incidents, matters can be addressed promptly to improve the workplace for staff and the quality of care for patients. Oweidat et al.’s study showed that approximately 60% of the surveyed nurses had filed an incident report at least once in their practice (2023). With over half of the study confirming they have used incident reports, it is evident that data collection for events like this is prevalent and helpful in the medical setting. In the event of a patient fall, data collection would include several details. Some of the data would include a brief description of the incident, the patient’s orientation and safety, any equipment involved during or after the fall, any medications used during or after the fall, and whether the fall was witnessed or not.

In assessing data from an incident report, a nurse leader would use clinical reasoning and judgment to evaluate each situation to see what could have been prevented and what could be done to reduce the risk of reoccurrence. For example, if a nurse leader noted that multiple patient falls occurred while a patient was getting up from a chair with no chair alarm, action could be taken to educate healthcare workers on implementing these alarms. They could also look at data to see if the unit was appropriately staffed that day, if chair alarms were available, and other factors. When data such as this is adequately captured and analyzed, it can be proactively used to better the unit, making a safer environment for both the patient and the staff.

REFERENCES

Kodate, N., Taneda, K., Yumoto, A., & Kawakami, N. (2022). How do healthcare practitioners use incident data to improve patient safety in Japan? A qualitative study. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-07631-0Links to an external site.

Nagle, L., Sermeus, W., & Junger, A. (2017). Forecasting informatics competencies for nurses in the future of connected health. Evolving Role of the Nursing Informatics Specialist. https://doi.org/10.3233/978-1-61499-738-2-212

Oweidat, I. A., Khalid Al-Mugheed, Samira Ahmed Alsenany, Mohammed, S., & Alzoubi, M. M. (2023). Awareness of reporting practices and barriers to incident reporting among nurses. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01376-9

Peer 1:

Jordan, your focus on reducing Catheter-associated urinary tract infections (CAUTIs) in the emergency department (ED) through a “foley-free ED” initiative is commendable. Here are some questions and suggestions to further clarify and enhance your approach:

1. How would you ensure that the criteria for foley placement are consistently followed by ED staff? Are there any specific training or protocols in place to support this?
2. You mentioned utilizing electronic medical records (EMRs) for data collection. Could you elaborate on the specific data points and variables you would capture in EMRs to evaluate the success of the “foley-free ED” concept?
3. Beyond CAUTI rates and the time since the last CAUTI, have you considered collecting patient satisfaction data or feedback from ED staff regarding the initiative’s impact on workflow and patient care?
4. In terms of data analysis, will you use any statistical tools or software to identify patterns and trends in CAUTI rates and factors influencing them?
5. How do you plan to disseminate the knowledge gained from this initiative among ED staff to ensure continuous improvement in patient safety and care quality?

Peer 2:

Laura, your emphasis on incident reporting and its role in improving patient safety and workplace conditions is crucial. Here are some questions and additional ideas for the application of nursing informatics principles:

1. In your experience, have you noticed any challenges or barriers in the incident reporting process that might hinder data collection or analysis? How can these challenges be addressed to encourage more comprehensive reporting?
2. Could you elaborate on the role of informatics tools or software in incident reporting and data analysis within healthcare organizations? How can technology streamline this process?
3. Besides patient falls, what other types of incidents do you think should be closely monitored and reported to enhance patient safety and quality of care?
4. How do you envision nurse leaders using incident data to implement proactive measures to prevent similar incidents in the future? Are there any specific strategies or interventions that have proven effective in your experience?
5. Considering the increasing importance of interoperability in healthcare, do you think there is potential for incident data sharing and collaboration among different healthcare organizations to learn from each other’s experiences and improve overall patient safety?

Thank you both for sharing your insights and ideas on how nursing informatics can be applied to enhance patient care and safety.