1)  

We all have experienced a system failure in our nursing careers. I can’t begin to describe the feeling of coming in to work only to be told “systems down”. Every time I heard those sweet words, I wanted to use a personal day. But this also the time that I am reminded that nurses rely on technology about 90% of the work day. I’ve worked at two different hospitals and each of them do things differently prior to the system going down. Both hospitals use downtime slips when the computers are not work. Nurses are still able to request lab work, use of prescription pads, and order, administer medication. I guess paper charting will never be a thing of the past. One of the hospitals did something a little different, it requires that nurses use paper charting daily alongside EMR. I thought this was a great idea, it keeps the nurses familiar with paper charting so when computers are not assessable patients can still be cared for without much delay. Also, those nurses wouldn’t be scrambling to gather information. My current organization uses downtime slips, this can hectic for some new nurses who are not familiar with paper charting. Although the hospital has backup generators, downtime slips are required to continue care until systems are back up operating. Patients can always be taken care of via paper charting. This practice went on for years before computer charting. For some of the older nurses this is a well-known and preferred method. Caring for the patient is still the number one priority, information can still be obtained and updated by the patient daily and each department is responsible for keeping charts on patients with services provided so that quality care is given until computer systems are up and running.  I think the recommendation would be first to Start by creating an outline that delegates workflow in such an event, including selecting an individual whose main job is to inform staff that the system is down and what patients are most affected by it. It’s great if you have a backup plan in place, but it won’t do you any good if the plan itself doesn’t work. Like a fire drill, have trial runs every so often to ensure that your backup plan will, in fact, pull through for you if your EMR happens to fail.

 Suggest staff keep paper charting on most recent task performed regarding patients. Information such as recent vitals and current medications with administration times, and allergies should be readily available. In case of an emergency this type of documentation must be known to avoid further harm. I think in the end working together in this stressful time will be the key in maintaining patient safety.

 2) 

Natural disasters happen all the time across the country of the United States and beyond the borders such as floods, tornadoes, hurricanes, and earthquakes.  Hospital administrators need to have emergency plans in place to help counteract the chaos, and all staff needs training on how to react in such weather conditions. According to Horahan, Morchel, Raheem, and Stevens (2014), the National Planning Framework mentions there are five mission areas of preparedness: prevention, protection, mitigation, response, and recovery.  As indicated by Memorial Hermann Hospital System (2017), several policies and procedures are listed on their website about the action plan of the failure of utility systems, the problem I have found is that many of our medical-surgical units at my campus have never received any training on how to complete the downtime forms and it expected of us.  The access to electronic health records would not be available during such conditions and staff will need to know what steps to take.

 Power outages can cause the staff to have meltdowns if not correctly prepared on what to do in such emergencies without access to computers. Clinicians need to be careful when taking the patient’s medical history, recording allergies, medications, and any recent procedures they may have had that cannot be accessed online.  Pharmacy orders, diagnostic tests, and lab orders will need to be called in, or hand delivered because of no electricity.

The staff needs to have training on what to do in case of such disasters because they too will need to stay calm themselves to keep patients and families calm during an emergency event.  My unit has an emergency kit filled with downtime forms, batteries, and flashlights.  I think adding a two-way radio would be beneficial to keep in touch with the house supervisor for updates and information.  I have requested the need for training to my manager and director, and they both said they would try to incorporate training at our next staff meeting for everyone to understand how to use the downtime forms and what to do in an emergency. My campus has backup generators that will turn on after ten seconds of no power is detected, and according to the maintenance personnel, they are checked every six months.  There are red outlets throughout the patient care areas that critical medical equipment can be plugged into during power outages for continuous patient care. Quarterly emergency or downtime drills should be conducted regularly to keep staff trained on what to do and how to fill out the downtime forms and be aware of what to do for continuous patient care. Improvising with portable trailers or mobile satellite systems in the parking lot of hospital or somewhere safe may be an option.  

Horahan, K., Morchel, H., Raheem, M., & Stevens, L. (2014). Electronic health records access during a disaster. Online Journal of Public Health Informatics, 5(3).  Retrieved from doi:10.5210/ojphi.v5i3.4826

Memorial Hermann. (2017).  Failure of utility systems.  Memorial Hermann Hospital System.  Retrieved from https://policytech.mhhs.org/dotNet/documents/?docid=32268

200 words each

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 1)

For my final assignment I have chosen to talk about how hackers have gained access to hospital computer software and manipulated systems. This trend has the ability to place patients at harm.   The best way to prevent these kind of attacks is to educate our healthcare professionals on what to look for.

       ‘To solve these problems, there are many levels of technology, such as cryptography technology, network security technology and so on.”(Ming, Chen, Guo, 2019). Cryptography is the art of writing or solving codes. Network security technology is also another way to prevent hackers from manipulating systems. Healthcare professionals also have a responsibility in detecting possible computer hackers as well. Upon employment, employers are educated on not opening suspicious emails   that maybe an attempt  for hackers to gain access into computer software. Healthcare employers who use screens and monitors in their field of work, also need to be educated on how to recognize when software has been manipulated. For example, areas of care that use monitors for diagnosing purposes need to be able to decipher  actual patient data from manipulated   data possibly shown on screens and monitors.

       Other ways to prevent software attacks are to keep computer software updated frequently. Companies and organizations should invest in the latest computer security programs. Never use open wi-fi on a computer router, always update your password frequently and create a password that does not involve birthdays or any significant events in your life that will be easy to figure out,  and do not wander on websites that are not allowed by the organization.

       Preventing computer hackers is the responsibility of everyone in an organization. On going computer education  training is  a must in order to prevent computer hackers  and software malfunctions.

2)

I selected to do my final assignment on universal electronic health records. I would say there is a lot of misconception out there regarding these records and just the terminology that a lot of caregivers use interchangeably.  Before this course I thought the electronic medical record and the electronic health record to be virtually the same. I know differently now and the way I find it easiest to remember is that the electronic medical record is basically a digital version of the paper chart. It contains basic past medical history and is held and collected in an office or medical organization. The electronic health record is an oversight of the whole health of a patient. It goes wherever the patient goes and can be shared by healthcare providers. An all-inclusive patient record has more benefits for sicker patients that will hopefully improve outcomes.

 The first part of training of electronic medical records would be the security aspect of sharing data electronically.  This would be ongoing annual training as well as training updates for employee’s that might have a breach of confidently. The Health Insurance Portability and Accountability Act  of 1996 set forth rules and regulations to protect medical records and other health information that could identify an individual. The penalties for known violation of HIPAA can be processed criminally.  A fine can be imposed up to $50.000 dollars and up to one year and jail  according to an article in Hospital Access Management (2018). This in my opinion is much worse than just losing your job.

         The actual training would be required on the version of the electronic record itself that is currently being used in the organization where you might be employed. This subject is very current with me at present due to being thirty days out from our EPIC conversion. Training on EPIC modules has been ongoing over the last five weeks. There have been zero tolerance measures for tardiness and cell phone disruption. The first day of training 7 people that were not quite in the door were turned away with two of those being physicians.  That information spread quickly across the hospital that the trainers meant what they said about being on time.

 After the completion of the modules with the trainers from EPIC ongoing practice as well as system update training will be required to stay current with the records. Super Users have been selected from all departments that will help with training as well as when new employees are hired. The use of any electronic record is a better value purchase for an organization when people are trained properly. When users are aware of the information that they can pull out for reporting purposes and use the system at a high functioning level it is beneficial for all.

200 words each

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1)

When I reviewed the assignment for this week, sheer panic took over. Then after reviewing all the tutorials on www.screencast-o-matic.com I felt a little relieved. The next tutorial reviewed from Professor Lease’s, and this one helped to pull it all together. This is one of those things that I had to get to website and navigate through a lot. I can easily record, stop, and erase after recording myself narrating. I use Microsoft online. I had a lot of trouble using PowerPoint Online, and trying to record by voice while using the slideshow view. This is impossible using the online version of PowerPoint. I had to click on “open in PowerPoint,” on the upper right hand side of my PowerPoint viewing area of the presentation. The computer asks if you want to switch apps. One must click “yes,” and it will bring you to the version used on the desktop. Before finding this out, I had a lot of trouble recording. The Screencast-O-Matic control board would completely disappear. This became very frustrating, and almost had me in tears. Finding out that PowerPoint online had to be changed to the regular PowerPoint used for the desktop was my saving grace. I was even able to record using the webcam. After saving the video, I could not find it but knew it was somewhere. On the top of the screen I clicked “for education.” This will lead to a different screen layout. There is an option for “my videos,” that is located next to your account e-mail address. After clicking on “my videos” this will bring one to all the videos saved. Downloading and installing was easy. I have a new laptop so on the upper right hand side of the screen are 3 dots. I clicked on that, then clicked on “pin this task to the toolbar.” It puts a little icon on the bottom of the computer. This icon acts as a direct link to the website. I use this for Aspen University’s Classroom, Aspen’s student portal, Microsoft online, and any other important places I need to get to quickly with a click of a button. I do have a question for you all. What does Professor Lease mean when she wrote “this can not be a voice over PPT?” My understanding is screencast is a PPT with voice recorded as a narrator, but what is voice over PPT? Does she mean we need to record our face as well? 

2)

When I found out what the discussion question was going be for this week I was shaking in my boots. I thought to myself, here we go with something else I’ve never heard of and one more thing in life I must try and figure out. But to my surprise, with a little patience and not thinking it was the end of the world I was able to look up Screencast-o-matic with very few complications. Finding the website was easy. Looking at it for the first time I thought surly its not going to be as easy as logging in, but it was. The steps to recording wasn’t as bad a thought also. I tried to do it on my own but found later that it would have been best if I took the tutorial. After watching the tutorial, I was able to record the words on my first two slides. It was nice to learn to choose the section that I wanted to be heard within the PowerPoint. I must admit, I thought I sound quite crazy. The first thing I said was “wow is this what I sound like”. Then I quickly hit stop. After regrouping, I was couldn’t figure out how to get the screencast onto the PowerPoint. After playing around with it for a while and calling for help, I was able to set things up the way it needed to be presented. I don’t think the task of getting the screencast together was hard. I just think it was one more thing new that I had to become aware of, and we all know newness can be scary. I’m still having some trouble with the upload. Sometimes it worked for me and other times it didn’t. I’m sure if I go into it again when I have more time it will be fine. In the end it turned out to be not as bad as I thought it was. I admit that I didn’t know anything about screencast. Preparing those two slides were great. It was nice to learn something different and how other things beside graphs and pictures can be added to a PowerPoint. I look forward to seeing how my final presentation will turn out.

200 words for each response

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Responding to two classmates

1) My signature assignment topic that I have chosen is how computer hackers are able to hack into computers that healthcare professionals use to diagnose and treat patients daily. I am not sure what my title will be yet I am still working on it and thinking about it. I chose  this topic because I think this very important and when I first learned about this it was pretty disturbing to me. To think that someone would interfere with possible treatment by manipulating a computer system is somewhat scary to think about.  Everyday in healthcare, computers are used to make decisions, store patients personally information, determine results and outcomes and the list is endless. So the use of the computer and computer systems are largely used in health care regardless of what kind of healthcare setting it is.   I usually choose google scholar to look up resources. So far I have not had any trouble finding articles that are related to my signature assignment.   I will say that a lot of the articles are not related to healthcare. So its just a matter of finding a relevant article that fits my assignment. A article that has enough information for me to use and to quote from.  There are many other websites that offer peer reviewed sources. To name a few of them are DOAJ, PubMed, Scienceopen, and Academic search. Every since I started with Aspen University I have used google scholar.  One article stated that “beginning in 2016, healthcare organizations in the United States have been targeted for malware attacks, a specific type of cyberattack.” (Branch, Eller, Bias, McCawley, Meyers, 2018).  Another article stated that the United States is not prepared to deal with an attack of this kind. I am hoping that the United States and any other country have expanded their technology in finding ways tp combat this problem of computer hackers. 

2)   

I am having more of a problem narrowing down my choices for sources actually more than anything. My topic is Electronic Health Records (EHRs), which is a very broad topic as EHRs encompasses many fields such as medical charting, medication administration, medical records, imaging test, real time lab test results, and Doctor’s notes. Researching and finding articles that give me the information I am looking for has always been one of my weaker points and is what consumes most of my time when it comes to writing. So far in my research process, the wording in the articles is not so difficult to comprehend compared to the textbook. The textbook for me is hard to understand and comprehend for some reason and requires me to read most sections multiple times before understanding. However, once I comprehend the information in the textbook, I find it very helpful and is usually my main source of information. I have been using the databases provided by Aspen University and Google Scholar.

“Reduce Errors with an EMR: It’s the most efficient way to keep records and improve patient care” is the first peer reviewed journal I have located. This journal advocates for using the EHRs to improve patient care by reducing errors because EHRs allow safeguards to be put into place that prevent errors. For example, medication administration errors. If a medication that the patient is allergic to is scanned before being given, a safeguard notification will pop up warning the nurse about the allergy.

“I.V. integration helps clinicians reduce medication errors” is the second academic journal I found in which EHRs have safeguard for high alert medications that provide safeguards for unfamiliar dosages and weight based dosage for pediatric patients. Basically, this means it stops the nurse from accidentally overdosing if a dose is entered into the computer that seems suspicious.

            These are just a few examples of the advantages of EHRs and the technology capabilities that they possess. I am still looking for more resources but so far these have stuck out to me most. Many people do not like how time consuming EHRs and computer charting can be, but if the patient and nurse safety are the goals, then EHRs are far more effective than paper charting. With the right prioritization and time management, there is a way to make time for patient care and computer charting.

References

Hultman, J. (2012). Reduce Errors with an EMR: It’s the most efficient way to keep records and improve patient care. Podiatry Management, 31(3), 67–69. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=108172173&site=ehost-live

Rinda, J. (2012). I.V. integration helps clinicians reduce medication errors. Health Management Technology, 33(10), 12–13. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104424094&site=ehost-live

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