QSEN Competency #5: Informatics

The Organization for Associate Degree Nursing (OADN) understands that the future of healthcare hinges on a workforce that is prepared to meet the needs of an ever-changing industry. This requires learners to develop knowledge, skills and attitudes related to technology that empower them to meet the quality and safety needs of their patients.

Acknowledging that developing these competencies must start early in the students’ academic career, OADN supports the integration of technology at all levels of nursing education. Informatics is the use of technology to address the healthcare needs of the patient. Emphasis is placed on improving outcomes for the patient.

Definition: Use information and technology to communicate, manage knowledge, mitigate error, and support decision-making. (http://qsen.org/competencies/pre-licensure-ksas/) The use of technology should first and foremost be considered a function of enhancing safety in patient care.

It is important that students and faculty understand the power of informatics to this end. Simultaneously, when developing a lesson plan in the education of pre-licensure nursing students, consider the importance of making critical thinking and clinical reasoning the center of the learning and not the technology. It is for this reason that faculty are encouraged to integrate technology tools that will be useful in multiple learning environments at various levels throughout the curriculum.

 

Classroom

• Record notes in class in the Electronic Health Record (EHR)

Ask students to open their academic EHR during class and respond or record notes. For instance, if the faculty is discussing the drug classification of beta blockers, instead of telling students what will happen when the patient takes the medication (e.g. atenolol) ask students to document teaching needing to be done about the medication’s expected side effects in the patient’s care plan.

1. Students document a current pulse and blood pressure on the patient (found in a case study at the end of a chapter in the text book).
2. Students document administration of atenolol 50mg orally.
3. Create and document the pulse and blood pressure at 3 hours post medication administration.

This activity allows the students to immediately apply learning in a realistic clinical environment.

 

Clinical

• Client safety monitoring in the EHR.

Too often nurses and students are not carefully considering the information entered by others in the EHR. They often are quickly moving from screen to screen checking boxes and quickly entering data. This activity is designed to help them consider the potential for safety and the lack thereof in the EHR.

1. Students review their patient’s EHR.
2. Students identify three areas in the patient’s EHR where they feel a mistake or errant documentation is likely. Encourage your students to look for acts of omission or failure to recognize, escalate and rescue.
3. The students explain their finding to another student and discuss the possible outcomes if this safety issue were to materialize.

Students will do well to start to consider where safety concerns could arise. This activity helps them explore how informatics can interface with safety in the clinical setting. Just-In-Time Learning: Encourage use of apps to help guide patient care such as one that gives normal lab values, foreign language apps such as one for medical Spanish, drug information and calculation apps.

1. Students load 3 apps that are designed to help registered nurses onto their phones or small portable tablet.
2. Students have to use an app at least twice during their shift and report how they used the app to give safer care to their patients in post-conference.

 

Simulation/Lab

• Evidence-based practice in action.
• Students often are challenged with developing habits that will help them build positive attitudes for practice. This includes the use of the evidence-base in providing patient care. When providing patient care, the clinical environment is often chaotic with the nurse experiencing many conflicting demands. Therefore, habits related to using the evidence-base are crucial to help avoid resource neglect.

1. Students in a simulation or laboratory learning experience need to have a smartphone or tablet equipped with clinical decision support tools (CDST) such as clinical companion manual, drug guide, and lab manual.

2. Make part of the learning / assessment experiences a challenge to the students to quickly and effectively review three parts of the CDST.

3. Students must reflect on whether or not they chose priority information / resources or if they would have done better to review other resources or parts of resources.

Developing habits of using the evidence-base practice immediately is an important part of developing professionally. Too often the business of clinical allows for resource neglect and this puts the patient at risk.

• Avoiding the Work-Around: Nurses often perform dangerous work-arounds to circumvent the medication bar code scanner when administering meds. Set up work-around bar code scanning scenarios and have students discuss what safety feature is disabled, what could go wrong and in addition, generate ideas on which system processes may have resulted in the work-around. In addition engage students to generate ideas on repairing the process breakdown scenarios.

 

Reference

http://qsen.org/competencies/pre-licensure-ksas/