Computers, informatics, nursing : CIN
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Comparative Study
Challenges implementing bar-coded medication administration in the emergency room in comparison to medical surgical units.
Bar-coded medication administration has been successfully implemented and utilized to decrease medication errors at a number of hospitals in recent years. The purpose of this article was to discuss the varying success in utilization of bar-coded medication administration on medical-surgical units and in the emergency department. Utilization reports were analyzed to better understand the challenges between the units. ⋯ Hardware problems affected all users. Bar-coded medication administration in its current form is more suitable for use on medical-surgical floors than in the emergency department. New solutions should be developed for bar-coded medication administration in the emergency department, keeping in mind requirements to chart medications when there is no order in the system, document medications distributed by prescribing providers, adapt to unpredictable nursing workflow, minimize steps to chart with bar-coded medication administration, limit alerts to those that are clinically meaningful, and choose reliable hardware with adequate bar-code scanning capability.
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Nursing shift report is vital for patient care. Accordingly, healthcare facilities have made great efforts to establish a standardized nurse-to-nurse shift handoff process to ensure patient care quality. The purpose of this study was to determine whether the use of a standardized mobile intershift handoff system would affect the quality of nursing documentation. ⋯ Although overall compliance rates among inpatient units varied, the statistical test showed that the pattern of changes was consistent. As more items were added to the new handoff system for reminder purposes, documentation compliance increased; however, since the new handoff system did not include nursing diagnosis, patient outcome tracking compliance was reduced. The results of the study reveal that implementing a standardized point-of-care handoff system could improve nursing documentation compliance and quality.
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Communication during patient handoffs has been widely implicated in patient safety issues. However, few studies have actually been able to quantify the relationship between handoffs and patient outcomes. ⋯ Unique network patterns were observed for different types of outcome variable (eg, safety, symptom management, self-care, and patient satisfaction). This exploratory project demonstrates the power of *ORA to identify communication patterns for large groups, such as patient care units. *ORA's network metrics can then be related to specific patient outcomes.
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Patient monitors generate alarms to signal changes in vital signs. Some research suggests these alarms can improve patient safety. Other reports caution that these systems generate false alarms and create nursing workflow interruptions. ⋯ They described learning to interpret alarm data and developing workaround strategies (eg, ignoring alarms). Paradoxically, alarms prompted nurses to regularly consider and interpret patient information. We suggest the interpretive work associated with workarounds may hold benefits mitigating the potential harms of ignoring alarms.