NR 360 Week 7 Edapt; Improving the Quality of Care and Outcomes Using Informatics

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