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Thursday, July 23, 2015

The Quality of Your E-documentation May Actually Affect Your Salary

You've probably noticed an uptick in the blog posts this past week. That's because I'm spending the week at the National Institute for Nursing Research learning all about Big Data and it's quite inspiring. One topic that consistently comes up in how to better integrate nursing documentation data into large datasets so we can figure out how to improve patient outcomes using real bedside data.

By now you should know you're always learning something new as a nurse. This is even more true once you have a PhD when you learn about how little you really know about anything. As we've listened to really interesting speakers this past week, a few things have come up that relate directly to you, the frontline nurse.

Here's probably the most important.

That electronic health record (EHR) where you document your work may actually affect your paycheck. No, not because you have to spend so much time filling everything in that you're staying late and getting overtime (or not).

Most EHR systems are designed around billing needs. I know, you're shocked that they aren't designed for actual functionality in the clinical setting in a way that would promote human contact with patients instead of screen time!  Sad, but true.  So, how well you document basically may affect how much your employer gets reimbursed for services. That eventually translates into your annual raise (or not).

As direct care providers, we've got a challenge. We need those systems to capture what we do so we can figure out how to improve patient outcomes, but EHRs shouldn't take time away from patients any more than paper documentation did (or does). EHRs are also helpful for ensuring our practice follows the latest evidence, and that's also important for improving patient outcomes.

Frustrating isn't it? It's like being caught between a rock and a hard place and we're really stuck. So what can we do?  The good news is that research is showing that EHRs detract from the patient experience and affect health care organization's ability to meet the goals of the Triple Aim. That means that these systems will have to start changing to better meet the role-based needs of their users.

EHRs will get better quicker if more nurses choose to do their masters degrees in Informatics. Remember: There are other masters degrees besides a nurse practitioner. You can read all about it here.

Meanwhile, do you best to ensure high quality documentation. I know you get the moral, ethical, and quality reasons for this because you went to nursing school. Hopefully the salary piece will provide an added incentive as the clock ticks later into your post-shift period.

Monday, July 20, 2015

Do all those medicines you give actually work well? Maybe not.

This graphic from Nature gives nurses lots to think about.

The blue people are the ones for whom the medication actually works well for while the red represents the ones that have bad side effects.

How can we encourage adherence to medication regimens with these kinds of facts?