Module 6 - the Final post

Congratulations to everyone for surviving another semester. To my distance cohort ONE year down. WooHoo!!
In searching the AHRQ site I discovered just how much government (tax payer) money is out there being used to develop and implement computerized healthcare records. It was amazing to me to see the list of funding opportunities on the AHRQ site.
I learned the difference between a hacker and an opportunist and a virus, trojan horse, worm, and other malicious software. Speaking of malicious software...
I learned in this module that I really like my MAC. It seems to have so much less malicious software out there against it and much better built in security. I have come to this conclusion because in January this year I bought my first PC. This week I had to take it to a computer geek to clean it up. I had picked up quite a few viruses in 11 months and my computer was acting up. I've been a MAC user since 1993 and this kind of thing has never happened with them.

Module 5

I realized heuristic thinking is a big part of nursing. As we work with people and their problems I gravitate toward the simplest answer or reason for doing what I do. I realized that often when given the same scenario I will often make 2 different decisions based on the patients.

I was excited to learn about CDS protocols used by Intermountain. The idea that there is more knowledge out there than one person can absorb and retain has always been a little terrifying to me. How am I going to keep all this new information from leaking out of my ears? The CDS is a great way to do that. My critical thinking and assessment skills coupled with software to help me is very encouraging. I do not often have the opportunity to chart for direct patient care these days, but when I do I will apply the information about the importance of quality data in the decision making process and generate that quality data.

Module 4

My professional role is as a house supervisor. I'm basically the fireman for the facility on nights weekends and holidays. I did not really expect to have to teach much when I took this position, but the opposite is true. I teach more now than every before.
As the house mouse (it's a nickname our group picked up) nurses and physicians call and request information constantly. A new nurse who's never placed and NG tube or done a central line dressing change or changed the collection container on a chest tube will call me for assistance. Physicians will call and ask about policies when they are told they can't put a patient on an insulin drip on the medical floor. Our group has become the mentor for many of our nursing staff who do not know how to find the information they need to provide evidence based care. I have also been asked questions by patients unhappy with their care. In these situations I teach them about evidence based practices and the tools we use to make sure the most appropriate care is provided to them.
Teaching occurs in every role. I see everyone from physicians to CNAs teach patients and peers.
I tried to access the Wiki from my smart phone, but could not find the underscore (_) . I'll look into this and, with luck, figure it out.
I did figure out how to post the link in the Gadgets and for that I'm kinda pleased with myself :-)

Just a little healthcare humor

Mod 3 - I forgot to mention

I really like the National Clearinghouse site. My search there resulted in an evidence based practice guideline for preventing DVT in multiple types of patients as well as research articles comparing lovenox, unfractionated heparing and sequential compression devices. It's a great resource I've bookmarked and will keep using.

Mod 3 - change might be my friend but I'm not sure yet

Searching for articles has always been daunting to me. When I’ve searched for articles during my first 2 semesters I had no guidance about how to search. Well, except for Jean LeBer’s 2 day tutorial when I and all my distance cohorts got together on campus to experience the feeling of drowning in information together.

I searched CINAHL, and www.searchmedica.com, and Johns Hopkins University through EndNote. I’ve used CINAHL often and though it lead to 3225 results before I set limits and 31 with limit I decided to use PubMed. I had only searched it through EndNote prior to this assignment. Do you hate moving outside your comfort zone as much as I do?

I can’t imagine the costs to subscribe to all the different sites if we didn’t have the universities VPN access. That thought makes me worry about access to all this information after I graduate.

PubMed had over 200 articles linked to my search for best practices for preventing DVT in trauma patients. With limits I had 22 articles to read. I did not limit the age of the research and after reviewing the results I only had 11 articles published in the last 5 years. PubMed was easy to use, but saving my search was an adventure. I discovered I had to create an NCBI account in order to save the search. I think I prefer CINAHL and searching through EBSCOhost for ease of saving searches and exporting to EndNote.

Johns Hopkins University through EndNote only had 1 article and searchmedica.com was not organized well. My search through searchmedica resulted in thousands of articles that had no relevance to my query. I will investigate it further to see if I can learn how to more effectively use it because there was a tremendous amount of information and I could sort it according to catagories like “evidence-based articles,” “practice guidelines,” and “patient education”.

MeSH terms are still a scary thing but now that I'm sailing outside my comfort zone I will dive into using them as well.

Module 2 information system

At my previous hospital, DRMC in St. George, the nurses on our floor decided to get involved in improving the system we used for charting. We discussed, in several small groups, how to improve our charting by changing and adding to the sections that automatically "popped up" in our patient assessment charting. Patient Education/Teaching was being done but not being charted. We asked for this section to be a required area every day. In order to improve our flu and pneumonia vaccination numbers we asked that vaccinations be a required area of charting. At the moment I am looking into what can be done to improve the time between the dictation of physician progress notes and their transcription to HELP 2, the EHR we use.