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Introduction to Theory in Healthcare Informatics

Juleah Baxton

Aspen University

CIS450- Informatics in Healthcare

Kim Warren, MSN-Ed, BSN, RN

8/24/19
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Introduction to Theory in Healthcare Informatics

Informatics play a very important role in healthcare today. Many people do not realize

exactly what healthcare informatics is and why it is so important to healthcare. “Healthcare

Informatics is defined as the integration of healthcare sciences, computer science, information

science, and cognitive science to assist in the management of healthcare information” (Sweeney,

2017). According to Handbook of Informatics for Nursing and Healthcare Professionals,

informatics is responsible for improving the quality of care that is delivered to all patients across

the world, reducing mortality rates, cutting costs, and collecting data to support learning (Czar,

Hebda, & Hunter).

Electronic Health Records (EHRs)

Electronic Health Records were implemented with the main objective being to improve

the quality of care given to all patients. “A basic definition of an HER is a database of an

individual’s healthcare data during healthcare encounters. Another simple definition is that an

HER is comprised of any patient data stored in electronic form” (Czar, Hebda, & Hunter).

It is said that although electronic health records are easier to read than paper charts,

providers tend to spend more time on the computer charting than actually delivering care to their

patients. One reason this may be said is due to lack of skill or training. In many instances, a nurse

may need to play “catch up” with her charting due to how she handled her time earlier in the

shift. For example, if the nurse needs to replace an IV, she would first need to gather the

appropriate supplies. If she does not remember to grab tubing for the bag she needs to hang or a

saline flush to flush the newly inserted IV, she would need to leave the patient’s room yet again

to gather the supplies. The time she had wasted will take away from the time she would have had
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to chart if she would have obtained all her supplies at once in the first place. Skill has to also be

taken into account here if she knows how to insert an IV properly. What if she was unable to start

an IV after three times of trying? She would have to call a nurse supervisor of some sort to try to

insert the IV for her. What if that nurse supervisor is busy with another patient and she will not

be there for at least another hour? This is delaying care because the unskilled and untrained nurse

had already taken out the previous IV before starting a new one, so now the patient does not have

IV access.

Poor computer design may be another reason to explore when discussing why healthcare

providers spend too much time charting on the computer than delivering care to the patients.

Sometimes electronic health records may be redundant or just flat out confusing. Sometimes

there are various places to chart the same information or their may be several places information

is located. It may also be hard for the healthcare provider to navigate through a very complex

computer charting system. Much time may be wasted from just trying to obtain lab results or

look at the last set of vital signs.

Patient care is not suffering from the implementation of electronic heath records, in fact

patient care has greatly been improved by the implementation of electronic health records.

According to healthit.gov, health care providers have access to complete and accurate

information thus allowing patients to receive better medical care. Electronic health records have

been shown to improve the ability to diagnose diseases and to reduce and even prevent medical

errors which also improve patient outcomes. Electronic health records keep a record of important

information such as the patient’s list of medications and allergies which will also alert the

physician of potential conflicts when ordering a new medication (Improved Diagnostics &

Patient Outcomes).
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With some charting systems, it is a lot of clicking boxes and completing templates which

may not be detailed enough in the event of a lawsuit. However, with the electronic health records

that I use at my facility, it allows the provider to free text whatever he or she needs to before

signing that note. We also have an option to write a narrative note instead of using a template

which allows the provider to add as much details as he or she needs to. I really appreciate this

feature because one thing we were taught in nursing school is that our documentation can either

make us or break us and that it needs to paint a perfect picture of our patient. Just clicking boxes

on a template will not give a jury or a judge the full picture of what is going on. It would not

even give the nurse the full picture if she had taken care of that patient seven years ago, she may

not remember anything about the patient. However, with adequate documentation, it may help

her to jog her memory of the time she spent caring for the particular patient in question.

Hopefully all electronic health care records would do the same by providing a narrative note for

the health care providers.

Data Being Tracked by Organizations

One type of data being tracked that is specific to my practice is pressure injuries. At the

facility where I work, we get dinged if a patient had a pressure injury during his or her stay at our

facility. This is why it is very important to do a thorough skin assessment, because if the patient

already had a pressure injury upon admission, we would not get dinged for it since the pressure

injury did not take place during the patient’s stay at our facility. Pressure injuries are important to

track in order to decrease the occurrence of them. We do not typically have a problem with

pressure injuries at my facility because we have had extensive training and education on the

topic. We received pressure relieving devices such as chairs and mattresses to reduce the risk of

pressure injuries. We do a weekly skin assessment as well. There are also measures in place that
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the nurses need to do in order to decrease the occurrence of pressure injuries. These measures

include: repositioning the patient every two hours, using a wedge to prop the patient on and

rotate sides every two hours, using a lift pad to slide the patient up while also in Trendelenburg

to decrease shearing, frequent toileting, the application of an external urinary device, applying

the appropriate size brief, ensuring the patient is clean and dry, application of ordered creams and

powders, applying a mepilex on patient’s bottom, padding all bony prominences, applying

padded boots on patient’s feet, and also floating the patient’s heels. This data is important to

track in order to assess for the need of further interventions. It also important to track because

these sorts of injuries are absolutely preventable with proper training and education. Patients

should not suffer due to lack of training on the part of the nurse. With tracking this data will

allow the facility to know whether or not more education is necessary. The inspector general of

the Department of Veterans Affairs is tracking this information. There are no ethical concerns

with an outside organization tracking this data, as far as I know.

Signature Assignment Project

My topic for the module 8 signature assignment project will be on patient falls. I want to

discuss the risk factors, causes, and interventions that all relates to patient falls. Patient falls are

one of the three items that are being tracked by organizations for the purpose of improved quality

care, which is why this topic is completely relevant to the class. This topic is important to me

because I am aware of just how important this data is. I think it is important to identify risk

factors in order to have interventions in place for them. Hospitals use this data to compare to

their own in order to come up with ways to prevent patient falls. Every time a patient falls, the

facility gets dinged for it, and if the patient sustains some sort of injury due to the fall, this may

increase their hospital stay, thus costing the facility thousands and thousands of dollars.
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Depending on the severity of the injury sustained in the fall, this may cost a patient his or her life

from something that could have potentially been avoided. I do not think a patient has to fall,

become injured, or die because of the lack of education surrounding the topic.

I think decision analysis from the management science key ideas may align with my

project. To be honest, that is the only theory that I actually understand and that may work well

with my topic. Informatics does not make the most sense to me no matter how much I read on

the topic; however, decision analysis makes the most sense to me and may give me the most

success.
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References

Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses and healthcare

professionals. NY, NY: Pearson.

Improved Diagnostics & Patient Outcomes. (2019, June 04). Retrieved August 24, 2019, from

https://www.healthit.gov/topic/health-it-and-health-information-exchange-

basics/improved-diagnostics-patient-outcomes

Sweeney, J. (2019, June 05). Healthcare Informatics. Retrieved August 24, 2019, from

https://www.himss.org/library/healthcare-informatics