A clinical information system is an umbrella term for different systems that can increase the productiveness of health care. heighten patient safety and lessening wellness attention related cost. By seting together different tools we create a clinical information system. In today’s universe with the addition in poly-pharmacy. chronic conditions and co-morbidities taking into history people are populating longer it is the clip that a engineering inspection and repair is due. The integrating of different systems will help in supplying effectual quality attention. Clinical information systems provide legion benefits and will revolutionise the manner nursing attention is delivered. Introduction

The usage of clinical information systems is going of all time more popular since it was mandated that all Americans will hold an electronic wellness record by 2014. Having experience in computerized and non – computerized installations it is apparent of the pros and cons of each. The U. S. health care system has been given a scheme to cut down medical mistakes. addition quality of attention and salvage the health care system one million millions of dollars. The scheme to carry through this is through the execution of clinical information systems. The first tool discussed is the electronic medicine disposal record and barcode engineering. Koshy ( 2005 ) gave the undermentioned statistic sing medicine mistakes. “Medication mistakes cause 7. 000 deceases each twelvemonth. with the cost of morbidity and mortality at 77 billion dollars per year” ( Koshy. 2005 ) . Therefore demoing the demand for an improved system sing medicines.

The 2nd tool discussed is the electronic wellness record. The debut of this system non merely increases continuity of attention but will besides assist with follow up attention after infirmary discharge and that will diminish the sum of hospital readmissions. “EMR’s lead to be and clip resource benefits for wellness attention suppliers. but their usage has besides led to an estimated cost nest eggs of 23 billion dollars for Medicare and 31 billion dollars for private remunerators annually” ( Follen et al. 2007 ) . The concluding system that is discussed is the chronic disease direction system. The execution of this tool AIDSs health care suppliers with evidenced based informations to care for patients with one or more chronic diseases. The execution of all these systems will assist nurses supply more efficient patient attention. It will besides diminish the clip spent on excess paperwork that is taking valuable clip off from the proper bedside attention. Clinical information systems assortment and reappraisal

Ms. C a nurse on the medical surgical unit walks into Mr. J’s room. Ms. C asks him what his name and birthdate are and cheques what he says against his designation watchband. After corroborating that she has the right patient Ms. C begins giving him his medicines stating him what each medicine is for. She comes to the medicine Jantoven and being that Mr. J merely had surgery something did non look right to her. She gave Mr. J the medicines with the exclusion of the Jantoven and went to look into the order. The order was ill written and looks merely similar Jantoven but called the doctor to voice her concerns. Upon talking with the doctor it is discovered that the medicine that was truly ordered was Januvia.

This was a close medicine mistake. but since Ms. C was critically believing and called to clear up the order the mistake was averted. “Baxter International reported that 39 % of mistakes originate with prescribers. 23 % occur during transcribing or intensifying by druggists. and 38 % occur during disposal by nurses” ( Caesar & A ; Hutchinson. 2006 ) . This information increased the execution of the eMAR. which is the electronic medicine disposal record. An eMAR is “technology that automatically paperss the disposal of medicine into certified EHR engineering utilizing electronic trailing detectors ( for illustration. wireless frequence designation ( RFID ) ) or electronically clear labeling such as saloon cryptography ) ” ( Center for Medicare and Medicaid Services. 2012 ) . As stated above. upon implementing the eMAR a type of bedside medicine confirmation system ( BMV ) is besides applied. The largest benefit of utilizing the two systems in concurrence is increased patient safety by diminishing the sum of medicine mistakes. Hunter ( 2011 ) provinces. “Through execution of the eMAR and BMV. the 5 rights of medicine disposal are maintained ( right patient. right dosage. right clip. right medicine. right path ) . notification’s are at the nurses fingertips. mistakes and warnings are readily available. allergic reaction checking is automatically performed. dose checking and other relevant clinical informations are accessible” ( Hunter. 2011 ) .

The five rights are maintained by scanning the patient’s designation watchband guaranting that it is the right patient. Clinical information that is needed before giving certain medicines are provided by an qui vive. A few illustrations of this include before giving insulin a text box will look to input the blood glucose degree. A blood force per unit area must be provided before giving a blood force per unit area medicine. Upon giving Coumadin an qui vive comes up onto the screen demoing the latest PT/INR consequences. All of these qui vives provide the excess cautiousness to give the medicine safely. By utilizing these systems it was proven that there was a direct lessening in patient medicine mistakes.

In one installation it was reported that there was a 37. 8 % overall lessening in medicine mistakes ( Caesar & A ; Hutchinson. 2006 ) . Statisticss provided by Caesar & A ; Hutchinson ( 2006 ) illustrate “wrong medicine mistakes showed greatest betterment. dropping from nine mistakes to one mistake ( 89 % lessening ) with eMAR” ( Caesar & A ; Hutchinson. 2006 ) . A 2nd installation that surveyed their nurses identified that 62 % of the nurses stated that the system had really prevented them from doing a medicine mistake ( Hunter. 2011 ) . In add-on to implementing the eMAR and the BMV system one installation besides discussed the plus of “smart pumps” . These specialised IV pumps include multiple benefits that besides aid in medicine disposal safety. Troester ( 2007 ) supports this statement by explicating characteristics of the IV pumps. “Our infirmary besides invested in I. V. pumps and sets that prevent free-flow. every bit good as pumps that provide package and dose parametric quantities. which meets the JCAHO PSG for guaranting free-flow protection on all general usage and PCA endovenous extract. These pumps alert the nurse at the clip of disposal if the does is outside set parametric quantities. It besides provides studies that identify fluctuations from these standards” ( Troester. 2007 ) .

Another wellness information system that is being utilized is the electronic wellness record ( EHR ) . The EHR is “an electronic version of a patients medical history. that is maintained by the supplier over clip. and may include all of the cardinal administrative clinical informations relevant to that individuals care under a peculiar supplier. including demographics. advancement notes. jobs. medicines. critical marks. past medical history. immunisations. research lab informations and radiology reports” ( Center for Medicare and Medicaid Services. 2012 ) . One of the largest benefits to holding an EHR is the continuity of attention the EHR provides. Since the record is invariably updated conditions in the infirmary or at the wellness attention suppliers office all information will be updated.

Follen et Al. ( 2007 ) states “The bulk of medical information is still recorded on paper. doing it disputing to expeditiously organize attention. efficaciously step quality. or cut down medical mistakes in a mode that is non labour intensive” ( Follen et al. 2007 ) . From personal experience. there are a batch of patients that get admitted to the infirmary upon executing the admittance assessment a inquiry asked to every patient is what medicines do you take at place? The reply to this inquiry is non ever easily. There are some patients that do non cognize any medicines they are on. Some patients have their medicines written down but do non cognize what the dose or how many times per twenty-four hours the medicine is taken. The last reply that is the most common is. “I take a xanthous unit of ammunition pill one time a twenty-four hours and I take a white unit of ammunition pill twice a day…” This makes the passage between place and the infirmary a batch more hard.

This is one premier illustration of the benefit to an EHR. all of the medicines the patients are taking will be updated in the EHR. Follen et at. ( 2007 ) states “the EMR provides entree to real-time patient-level medical information. frequently through a web-based interface” ( Follen et al. 2007 ) . By holding this type of record makes it easier to entree patient’s informations. which is particularly utile if the patient is non-verbal and there is no historian to reply any inquiries. The Centers for Medicare and Medicaid Services besides had this to state sing the benefit to EHR’s. “The EHR can better patient attention by doing the wellness information available. cut downing duplicate of trials. cut downing holds in intervention. and patients good informed to take better decisions” ( Center for Medicare and Medicaid Services. 2012 ) . Another type of system that can be implemented is called the chronic disease direction system ( CDMS ) . These tools were developed to heighten how wellness attention suppliers can pull off patient’s holding one or more chronic conditions. This system “includes tools for disease hazard stratification accompanied by disease-specific guidelines and protocols for effectual attention management” ( Follen et al. 2007 ) .

The CDMS has evidenced based determination support built in to assist the wellness attention supplier manage patients with the most up to day of the month information. Surveies have shown that by utilizing CDMSs the tools addition improved wellness behaviours and lessening disease specific symptoms. In 2007 the CDC reported that “care for patients with chronic diseases absorbs more than 75 % of the states wellness attention dollars” ( Centers for Disease Control. 2007 ) . By utilizing the EHR and CDMS together we will non merely be able to supervise chronic disease symptoms but besides behavioural and clinical informations every bit good. Topic Availability

The subject of clinical information systems revealed 100s of consequences. This subject is really wide in nature and in order to minimise the consequences I had narrowed the subject to nursing autonomy related to clinical information systems. This yielded small to no consequences. Therefore. the subject was changed to clinical information systems in relation to specific systems. The consequences of this hunt were once more in the 100s ; In order to contract these down a specific type of system was searched along with the words Implementation or Utilization. An illustration of the hunt looked as such. electronic wellness record AND execution OR use. Another scheme that was used to seek was while utilizing an advanced hunt the subject of nursing information sciences was besides chosen to restrict the consequences specifically to nursing information sciences as a subject. Information Availability

All of the resources that were found were articles found in diaries or research documents written for professional usage. The lone resource used that would be helpful towards consumers would be the Center for Medicare and Medicaid Services. The information from the web site was geared toward wellness attention professionals but there was besides information for consumers to read sing the engineering. Personal Positions

After reading and roll uping all of the information it is clear that this will better the wellness attention field. Not merely within the infirmary scene but. within health care suppliers installations. long-run attention installations. and the homecare puting. Another positive result that can happen from the execution of clinical information systems is besides the possibility of increasing patient cognition. By holding wellness attention records be computerized this gives the patient the chance to increase their cognition of their wellness. This may besides assist these people take control of their health care and be able to do more informed determinations sing their attention. In respects to nursing. the execution of clinical information systems has multiple benefits to the nursing field. Some of these benefits include decrease in medical and medication mistakes. increased patient safety. productiveness and clip efficiency. All of this increases the sum of clip that so can be spent giving direct bedside patient attention. A concluding benefit that will be discussed is the growing in nursing liberty. This would come from the handiness and entree to attest based pattern. Decision

In decision there are legion grounds to incorporate clinical information systems into the health care puting. The primary and most of import ground for including these tools is the addition in patient safety they provide. With the debut of these systems there is besides a chance of increasing liberty within the nursing profession. Studies show that there is a direct correlativity between occupation satisfaction and nursing liberty. A quantitative survey was performed affecting 178 registered nurses. The survey showed “autonomy to be the most of import occupation constituent for registered nurses’ occupation satisfaction” ( Finn. 2001 ) . By utilizing clinical information systems algorithms. determination trees. and protocols can be developed ( Wayne & A ; Da Rosa. 2005 ) . This has been shown to diminish dependence of doctors and thereby increasing nursing liberty and nursing occupation satisfaction. With all of the benefits explained above and many others the execution of clinical information systems far outweighs the negatives. The healthcare field is of all time altering and turning. engineering merely helps this field grow to give the best patient attention available.

Mentions

Caesar. B. R. . & A ; Hutchinson. B. ( 2006 ) . Reducing medicine mistakes by utilizing applied engineering. Nursing. 36 ( 8 ) . 24-25. Center for Medicare and Medicaid Services. ( 2012. October ) . Eligible Hospital and Critical Access Hospital Meaningful Use Core Measures. Retrieved February 26. 2012. from Center for Medicare and Medicaid Services: hypertext transfer protocol: //www. centimeter. gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/Stage2_HospitalCore_16_ElectronicMedicationAdminRec_eMAR. pdf Finn. C. ( 2001 ) . Autonomy: an of import constituent for nurses’ occupation satisfaction. International Journal of Nursing Studies. 38 ( 3 ) . 349-357. Follen. M. . Castaneda. R. . Mikelson. M. . Johnson. D. . Wilson. A. . & A ; Higuchi. K. ( 2007 ) . Implementing Health Information Technology to Better the Process of Health Care Delivery: A Case Study. Disease Management. 10 ( 4 ) . 208-215. Hunter. K. M. ( 2011 ) . Execution of an Electronic Medication Administration Record and Bedside Verification System. Online Journal of Nursing Informatics. 15 ( 2 ) . Koshy. R. ( 2005 ) . Voyaging the information engineering main road: computing machine solutions to cut down mistakes and heighten patient safety. Transfusion. 45. 189-205. Troester. S. ( 2006 ) . Drive Nursing Activities to the bedside with a closed-loop system. Nursing Management. 37 ( 12 ) . 18. 20. Wayne. J. D. . & A ; Da Rosa. D. A. ( 2005. January 18 ) . American College of Surgeons. Retrieved March 1. 2013. from Advancing Nurse Autonomy: hypertext transfer protocol: //www. facs. org/education/rap/darosa. hypertext markup language