4550 Critical Thinking Week 10

·         Does the use of EMR guarantee error-free patient care? If yes, why? If no, why?

I do not think that the use of an EMR guarantees error-free patient care.  I think that it can help achieve this goal but it depends on how accurately the EMR is filled out.  Since this is usually information provided by the patient there is room for human error.  Because of this I do not think that it guarantees anything.  But, if done correctly it can be a great tool that can help provide care for a patient that is safe. 

·         What types of nursing behavior regarding the use of EMRs might contribute to jeopardizing patient safety?

·         

      -Rushing the patient while filing out the EMR form

·         -Not looking closely at the names, dose amount, and dose schedule and transferring this information incorrectly to the electronic version

·         -Not clarifying with the patient information that is difficult to read, or doesn’t make sense

·         -Not including OTC medications on the list

·         What are the dangers of excessive system alerts in computer charting systems?

When there is an excessive number of system alerts in a system I think that users become desensitized and stop taking them seriously.  Also, users might stop looking at each individual alert and make assumptions of what alerts has been triggered, and assume incorrectly. 

·         How can the nurse guard against the potential effect? 

To guard against this effect nurses need to take the time to look at the alerts being triggered and see if there is common theme.  Maybe the nurse is doing something wrong that is resulting in a large number of alerts.  Changing their process could help decrease alerts and therefore allow the nurse to focus on potential problems.  

This past year I was involved in the launch of a computer charting system in our hospital.  In the beginning there were many problems, and charting took a long time compared to our old ways.  I kind of got used to alerts being triggered, and when I would read them or find a specialist they would tell me not to worry about it.  This behavior eventually became normal.  Luckily, most of those alerts were fixed.  Now when one is triggered I try and pay attention and read the information provided to fix the problem.  

In my unit we do not complete EMR since I work with newborn babies.  In fact, I have joked in the past that not having to do med recs is one of my favorite things about my job.  Prior to working in the NICU I worked in Behavioral Medicine, and medication reconciliations were very difficult, and very often incomplete...I am so glad I don't have to do them anymore :)