The Use of Bedside Electronic Medical Record to Improve Quality of Care in Nursing Facilities (original) (raw)
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Computers Informatics Nursing Cin, 2010
Nursing homes have a long history of quality problems, 1 as well as a long regulatory history attempting to correct these problems. 2,3 For the past several years, the Centers for Medicare & Medicaid Services (CMS) has invested heavily in quality improvement efforts in nursing homes through quality improvement organizations 2,4 and cooperative groups such as Advancing Excellence. 5 Despite these initiatives, marked improvement in quality of care has not been realized on a national level, and other options are being pursued. One option appears to be the implementation of clinical information systems to enhance quality of care in nursing homes.
Use of Electronic Information Systems in Nursing Homes: United States, 2004
Journal of the American Medical Informatics Association, 2009
Objectives: This study sought to define the extent of utilization of 12 types of electronic information system (EIS) function in U.S. nursing homes (NH), to relate EIS utilization to selected facility characteristics and to contrast these findings to previous estimates of EIS use in NH.
2014
This is dedicated to my incredible husband Rich for his patience, understanding, editing, and emotional guidance throughout this process. To my parents for teaching me I could achieve anything I set my mind to. Lastly, this is dedicated to my three office mates: Wallace and Barky who taught me statistics made more sense after taking a walk and Kevin who dictated when the laptop was hers and when it was mine. Carol Urban who kept me positive and provided much needed therapy during my struggles. A special thank you to Dr. Thomas Prohaska who provided valuable insight and mentorship. Thank you to Dr. Meiners who assisted me in finding my initial stride. Finally, I would like to offer my sincerest appreciation to Dr. Robin Remsburg. She saw something special in me and offered me countless opportunities to grow as a person. I would also like to thank my devoted husband Rich. Without his emotional support, editing services, and ability to keep me focused I might not have completed this process. You are my better half.
Quality Improvement in Nursing Homes
Journal of Nursing Care Quality, 2014
Falls are the most common cause of injury deaths and nonfatal injuries in older adults. In an effort to detect a resident's movement, many nursing homes use bed or chair alarms to alert staff that the resident may get up and possibly fall. However, there is little evidence that bed or chair alarms prevent falls, and mounting evidence that alarms can impede the functional status and negatively impact feelings of dignity among older adults in nursing homes. The purpose of this article was to describe the development and pilot testing of an alarm elimination program for nursing homes. A program aimed at decreasing or eliminating the use of alarms may enhance quality of life of older adults in nursing homes.
Technology implementation and workarounds in the nursing home
2008
This study sought to explore the relationship of workarounds related to the implementation of an electronic medication administration record and medication safety practices in five Midwestern nursing homes. Design: As a part of a larger study, this qualitative evaluation was conducted to identify workarounds associated with the implementation of an electronic medication administration record. Data were collected using multimethods including direct observation, process mapping, key informant interviews, and review of field notes from medication safety team meetings. Measurements: Open and axial coding techniques were used to identify and categorize types of workarounds in relation to work flow blocks. Results: Workarounds presented in two distinct patterns, those related to work flow blocks introduced by technology and those related to organizational processes not reengineered to effectively integrate with the technology. Workarounds such as safety alert overrides and shortcuts to documentation resulted from first-order problem solving of immediate blocks. Nursing home staff as individuals frequently used first-order problem solving instead of the more sophisticated second-order problem solving approach used by the medication safety team. Conclusion: This study provides important practical examples of how nursing home staff work around work flow blocks encountered during the implementation of technology. Understanding these workarounds as a means of first-order problem solving is an important consideration to understanding risk to medication safety.
Cost, Staffing and Quality Impact of Bedside Electronic Medical Record (EMR) in Nursing Homes
Journal of the American Medical Directors Association, 2010
Objective: There is growing political pressure for nursing homes to implement the electronic medical record (EMR) but there is little evidence of its impact on resident care. The purpose of this study was to test the unique and combined contributions of EMR at the bedside and on-site clinical consultation by gerontological expert nurses on cost, staffing, and quality of care in nursing homes.