How Data Leads to Better Nursing: Improving Workflows and Patient Care

How Data Leads to Better Nursing: Improving Workflows and Patient Care

Whether nurses think their job includes data informatics or not, it does in one way or another. For almost any nurse, data is a touch point in their day, whether they work at the bedside, in an independent office, or a boardroom.ow-data-leads-to-better-nursing-improving-workflows-and-patient-care

“Data is critical,” says Andrew Awoniyi, ND, RN, NI-BC, education director and board member of the American Nursing Informatics Association (ANIA). “It underlies everything we do.” When a fellowship experience revealed the way technology could have a positive and significant impact on healthcare, Awoniyi says he developed a new understanding of how nurses can use it. “It opened my eyes to how you deliver the best healthcare,” he says. 

Many nurses hear informatics and think it does not apply to their jobs, but the opposite is true, says Awoniyi. “There’s a school of thought that all nurses are nurse informaticists,” he says. “Everyone is using data whether they fully understand it or not.”

Often, a nurse’s day includes responsibilities unrelated to numbers or patterns in data. Still, those responsibilities and the equipment or directions they rely on are a direct result of information that has been collected and analyzed. 

It’s All About Data

“When a new initiative comes out, or there is a new process or new product, that is all because of data,” says Kathleen Ulanday, MBA, MHA, BSN, RN, NI-BC, CPHIMS, and a senior clinical informatics specialist at Texas Children’s Hospital. For example, a new process that aims to solve an identified workflow issue is often found because measurements indicate needed improvement. Once implemented, the new process will be measured as well. All the data produced during those assessments reveals patterns or other information that can influence everything from how nurses dispense medication to shift adjustments.

The most basic nursing process of identifying a problem, assessing what is being done, intervening, and evaluating all relies on some collection of information, Awoniyi says. Assessing a patient uses the data produced through vitals, lab results, and tests, so everyone from a bedside nurse to a chief nursing officer knows how to check those results to help direct patient needs. “Nursing is holistic, and everything we do around that involves data,” he says. “It is not foreign to us.”

Ideally, nurses work more efficiently when any change is implemented to improve an outcome because they gain fact-based information that can be applied broadly, says Ulanday. If a new process has a more significant positive impact on a cardiovascular patient population than a gastro one, there’s an opportunity to learn why. “Nurses might notice those patients go home quicker and ask why is that,” she says. That discrepancy can trigger a deeper investigation into new areas needing attention. 

Informatics Isn’t Just Computers

Nurses who are especially drawn to the idea of working as a nurse informaticist might be happy to know that gathering data doesn’t mean sitting in front of a computer all day. Data, Awoniyi says, has a way of helping nurses when the results are interpreted and applied. And with artificial intelligence leading to advances in medical robotics and more targeted applications, nursing informatics is advancing rapidly. It can be a significant factor in closing gaps in healthcare access. The recent expansion of telehealth shows how technology expands potential. As the population shifts and more people are living longer and with more complex conditions, data, says Awoniyi, can help close the gap in healthcare because it can offer healthcare in settings that are located far from high-tech hospitals.

While data is something that nurses can point to as proof of something working (or not), there’s another unexpected benefit to using data to help guide how nurses perform their jobs and care for patients in any setting. Compliance with a new process can improve a workflow, says Ulanday. When nurses see that improvement, their motivation and morale increase.

An In-demand Career Path

As data output grows, the industry needs nurses who use data efficiently and know how to interpret and apply the data to different nursing scenarios. “There’s a lot of data that is generated,” Awoniyi says, “and we must understand that.”

Whether they want to switch careers or not, Awoniyi recommends that nurses understand how and why technology is incorporated into healthcare processes and settings. “Be willing to contribute,” he says. Partner with other nurses, look at how new systems impact nursing workflows and offer feedback on what might improve the process or quality.

Informatics opens up nursing jobs for everything from a nursing informatics specialist or clinical informatics specialist to that of a professor or educator. According to the Healthcare Information and Management Systems Society (HIMSS) 2022 Nursing Informatics Workforce Survey, 60 percent of the 1,118 respondents reported annual salaries of at least $100,000. The survey also showed how nursing informatics roles are positioned in organizations, with 34% of respondents reporting to information systems/technology, 33% to informatics, and 30% to nursing. Reflecting on this kind of role’s medical and technical aspects, most respondents said they report to two departments more often than just one.

How Data and Healthcare Work Together

Even as informatics helps nurses and patients, it does require time and investment, so backing from leadership is critical, say Awoniyi and Ulanday. At Texas Children’s Hospital, Ulanday says the Magnet® status of the hospital requires that the perspective and experiences of bedside nurses, who give hands-on patient care and know how a workflow is helping or not, are included in leadership’s decision-making.

Nurses who are interested in learning more can start by reaching out to their organization’s technical team to ask questions and gain insight into how technology impacts healthcare, says Ulanday. She says to join a professional organization like ANIA to hear about the latest developments and bring those back to leadership.

Ulanday says nurses know it takes time to learn and adapt to new technology, but they also find it will save them time in the long run. It also has a significant safety impact, as data can improve how something is done. Implementing a new workflow based on those findings can eliminate outdated processes and improve patient safety and outcomes.

“As we look to the future, data needs to be a critical part of that,” says Awoniyi. “Understand how data is collected, analyzed, and interpreted. It’s then about how to leverage that data to bring about change.”

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How Can Your HR Department Help You?

How Can Your HR Department Help You?

Nurses help people all day long. Whether it’s a colleague who needs a hand or a patient who needs support, a nurse will evaluate what’s needed and find a way to make that happen.

But when nurses need something, they are frequently reluctant to ask for help. But a nurse’s human resources (HR) department can help with professional help and often has extensive assistance available. One of the most important tasks a nurse can complete professionally is to have a thorough awareness and understanding of what an HR department offers. a stethoscope over a face mask and with a graphic heartbeat image for HR week

Here are a few things to consider when you need help from HR:

Know Your Benefits
Benefits are much more than health insurance and vacation time. Benefits encompass everything from short- and long-term disability to wellness reimbursements to parental leave policies. The HR benefits manual or explanations your organization has on file are worth reading and understanding. There could be hidden discounts that you aren’t aware of or nuances to emergency time off that you should familiarize yourself with. Your benefits can help you pay for additional education and might have excellent professional development resources you weren’t aware of.

Understand What Happens in an Emergency
Nurses know that life can change in a second. So if something happens in your own life that can impact your job attendance or performance, you shouldn’t have to scramble to find out what you need to do. Does your company have a waiting policy before you take any kind of disability? What happens if you need time to recover from a health emergency? If a family member needs your care, does your organization have any time available for you to take off to help? You’ll want to know about bereavement time as well.

Determine the Complaint Process
No one likes to have problems at work, and it’s a frequent reason that employees leave companies. Whether it’s a problem with a colleague, a supervisor, an annual review process, salary questions, or a scheduling issue, resolving it to your satisfaction is important. It might not always be possible, but understanding how your HR department deals with complaints is good information to have.  Is there an ombudsperson or a neutral mediator in your organization who can help?

Figure Out Retirement Options
Good retirement options are a key part of any benefits package, but it’s up to you to know what it includes and how it can best apply to your own situation. No matter how close to or far away from retirement you are, having a good understanding of what is offered will pay off in the long term. Does your company offer a retirement plan? Is there a retirement match and is there a minimum employee contribution required? What happens if you need help with making decisions? All of these are questions you can pose to HR to find out how any of the offered benefits can increase your own retirement savings. And if you are close to retirement age, it helps to understand the process for when you want to retire. If there are timelines involved or steps you will need to take as you ready for retirement, you will need to work with HR for a smooth transition.

HR departments offer so much information that employees might not be aware of. Take the time to find out what might be available for you.

Patient Safety Is a Nurse’s Top Priority

Patient Safety Is a Nurse’s Top Priority

Nurses put a priority on keeping their patients safe and Patient Safety Awareness Week, which takes place March 10-16 this year, helps focus attention on this important part of any healthcare provider’s job. No matter how much attention nurses give to patient safety, there is always room to make improvements. swirl logo for the Center for Patient Safety

But there’s more to patient safety than knowing and following procedures and protocols, says Kathy Wire, JD, MBA, CPPS, CPHRM, FASHRM, executive director of the Center for Patient Safety. The complexities of patient safety and how it is incorporated, monitored, and managed in any healthcare organization are real. Patient safety isn’t just limited to healthcare providers–it also involves the patient and the patient’s loved ones, too.

The overall organizational culture often sets the tone around patient safety. “A culture develops as a result of attitudes and related behaviors,” says Wire. “The underlying components of safety culture are well known. Some require action from senior leadership; others fit nicely in unit-based efforts. For example, supervisors can encourage non-punitive responses to errors, focusing on addressing underlying system issues and acknowledging human fallibility.”

Nurses often look to leadership to implement processes in which questioning a decision or a process is supported. If nurses push back on something that appears unsafe, they need to know they will have a manager’s support, she says. And this kind of transparency is in the best interests of any organization as patient safety is often tied to nurse safety. “A lack of patient safety can lead to errors and near misses that any conscientious nurse will find disturbing,” says Wire. “Even minor events can trigger this ‘second victim’ phenomenon. Many provider organizations have developed programs to address this trauma in their staff, but isn’t it better to prevent the issue in the first place?” And in the high-stress situations when loved ones are concerned about the care being given, anger and fear can spark threats to nurses, so open communication is essential, she says.

A patient’s family and loved ones contribute immensely to patient safety, says Wire. As nurses need to feel comfortable about being vocal about safety, loved ones also need to be heard and feel they can raise questions safely. Nurses also can trust that those closest to the patient can be advocates and have information the nurse might not. “Helping them understand planned nursing interventions and treatments while encouraging them to ask questions will establish that relationship,” says Wire. “We must let them know that an additional, dedicated set of eyes and ears can help busy nurses provide the best care. For example, family members can often recognize subtle changes in the patient’s condition that may be more difficult for a nurse to see.”

Even the best environment can’t prevent all errors. “Good safety culture tells us that people make mistakes and can drift from the ‘standard,'” says Wire. “Reporting mistakes and errors helps the organization learn about gaps in policy and how well it is supporting its nurses, and it also helps all nurses benefit from the learning that a reported event can generate.”

The highly tuned ability that nurses have in assessing a situation and evaluating the needs in the current moment can also help reveal problems, even problems that were never there before. “It can also bring mistakes and near misses to light, avoiding unnecessary injury to patients,” says Wire. “They must know that safety is not a condition or a statistic. Patient safety is an ongoing set of activities, and a state of mind focused on recognizing risk and generating improvement. It doesn’t care what you did last week.”

A CRNA Career Path: Meet Bijal Chaturvedi

A CRNA Career Path: Meet Bijal Chaturvedi

Nurses considering a career in nurse anesthesiology know the role is complex and demands a high level of critical thinking and commitment. The career path, in which many certified registered nurse anesthetists (CRNAs) obtain a doctor of nursing practice degree, also offers a high salary and an upward projection of job openings. With a dynamic mix of clinical practice and the capability to work in many settings, nurse anesthetists find a rewarding career.CRNA Bijal Chaturvedi headshot in a black top

Bijal Chaturvedi, DNP, CRNA, GHLC is a member of the American Association of Nurse Anesthesiology (AANA) and gave Minority Nurse some insight into this career path.

How did your career path lead to nursing and becoming a CRNA?
During my final year in college, I battled severe bronchitis and sought help at the health clinic. The provider who attended to me was not a doctor but a nurse practitioner, displaying both kindness and extensive knowledge. This encounter sparked a conversation about her nursing career, introducing me to the world of advanced practice nursing. This pivotal moment inspired me to explore nursing as a career path.

Upon college graduation, despite my Indian parents’ desire for me to pursue medical school, I knew I wanted a profession that combined science, pharmacology, and interpersonal interactions. Armed with a bachelor’s degree in cellular biology, I promptly earned another Bachelor of Nursing within a year. Upon graduation, I entered the field of critical care nursing, working in the most acute critical care unit settings such as burn, cardiac, and transplant ICUs.  It was during my time at Northwestern Memorial Hospital’s Neurospine ICU that I witnessed the role of CRNAs. This experience solidified my decision to pursue a career as a CRNA.

I earned my Master of Science in Anesthesia Nursing from Rush University in Chicago in 2005. In 2021, I received my Doctorate of Nursing from University of North Florida, and in 2022 I received my Global Health Leadership Certification from Northwestern University. I have participated in numerous global mission trips and currently co-chair the AANA’s Diversity Equity and Inclusion (DEI) Committee. I am also the chair of the Illinois Association of Nurse Anesthesiology’s DEI committee. I am passionate about healthcare equity and access and have my own nonprofit called Citizens For Humanity which addresses social determinants of health.

Do you specialize in a certain area or population?
Numerous healthcare environments rely on anesthesia services, encompassing fields such as dentistry, podiatry, surgery, obstetrics, and pain management. In my professional journey as a CRNA, I have experienced diverse settings, including community hospitals, ambulatory surgical centers, and plastic surgery centers, and participation in large teaching hospitals as part of an Anesthesia Care Team. The degree of autonomy varies across these settings, ranging from those with no supervision to those adopting a more interdependent model. I have experience working with diverse patient populations, including pediatric, low-income, and critically ill individuals.

What part of your job is particularly meaningful to you?
The profession of nurse anesthesiology offers a richly diverse and demanding path. In the clinical realm, you have the profound privilege of impacting individuals during their most vulnerable moments. A significant aspect of the gratification derived from administering anesthesia lies in the opportunity to support individuals through what may be the most daunting day of their lives. They grapple with fear of diagnosis, anticipation of pain, and uncertainties ahead. Your presence as a reassuring figure by their side during this critical juncture becomes paramount. While your expertise and competence in ensuring their safety throughout the procedure are undeniably vital, it is the compassion and humanity you extend that hold greater significance than any medication you administer.

Is there something or someone that helped you in your career that others thinking of this career path will find helpful?
My foremost recommendation is to shadow multiple CRNAs across various cases. This immersive experience will provide a comprehensive understanding of what lies ahead. Engage in conversations with current students to gain insights into the rigorous nature of anesthesia school. Recognize that anesthesia training demands significant dedication; therefore, it’s prudent to prepare financially by saving diligently.

Building a robust financial cushion alleviates stress and minimizes post-graduation debt, especially considering the constraints on working while in school. Enhance your academic foundation by enrolling in graduate-level courses in anatomy and physiology, pathophysiology, and pharmacology. This not only demonstrates your commitment but also strengthens your candidacy, particularly if your undergraduate GPA is subpar. While these courses may not be transferrable to most anesthesia programs, they serve to fortify your knowledge base and reacquaint you with the rigors of student life.

What would you like others to know about a being a CRNA?
I believe that aspiring RNs should possess a robust grasp of physiology, pathophysiology, and pharmacology prior to embarking on anesthesia school. Embracing challenging assignments, volunteering for cases involving the most critically ill patients, and delving deeply into the rationale behind every action are crucial steps in nurturing a profound understanding of patient care. This comprehension extends to the selection of medications and interventions, ensuring that aspiring CRNAs are well-prepared for the demanding journey ahead. The ability to think critically is paramount in the delivery of safe anesthesia.

CRNAs must excel as problem solvers and keen observers, interpreting data independently and making informed decisions that can profoundly impact patient outcomes. The weight of responsibility underscores the imperative of being both accurate and decisive, recognizing that lives hinge on the choices made in the operating room.

What is your advice for RNs considering a career as a CRNA?
Research various CRNA programs to find the one that best suits your needs. Consider factors such as clinical opportunities, cultural diversity, and program structure. Make an informed decision based on your personal preferences and goals.

Once enrolled in a program, maximize every educational opportunity, even if it seems insignificant. Graduate-level education requires proactive engagement, and your dedication will determine the quality of your learning experience. Learn from every case and practitioner, embracing the lessons they offer.

Collaborate with CRNAs who may be perceived as challenging, as they often uphold high standards and offer valuable insights. Maintain a positive attitude and remain open to feedback to maximize your learning potential. Avoid being labeled as unteachable, as it can hinder your educational progress.

Evidence-based Practice in Nursing: Why It Matters to Nurses and Their Patients

Evidence-based Practice in Nursing: Why It Matters to Nurses and Their Patients

Most nurses are familiar with evidence-based practice (EBP), using research-proven healthcare techniques to enhance patient care and the nursing environment and practices. And the benefits of EBP-led care are well documented. However, with all the positive results, EBP must consistently be taught or implemented in daily nursing practice.evidence-based-practice-in-nursing-why-it-matters-to-nurses-and-their-patients

Despite various studies that show the benefits of evidence-based practice for nurses, patients, and healthcare organizations, adopting the practice could be more widespread. Whether or not they work in an environment that supports EBP, nurses can learn more to apply EBP.

Why Use Evidence-based Practice?

What exactly is evidence-based practice? Kim M. Bissett PhD, MBA, RN, and director of the Center for Evidence-based Practice at the Johns Hopkins Institute, specializes in evidence-based practice and says, “At the most basic level, evidence-based practice (EBP) is a problem-solving approach to the decision-making process that uses the best available scientific and experiential evidence, coupled with critical thinking, to improve care.”

The method works, says Bernadette Melnyk, PhD, APRN-CNP, FAANP, FNAP, FAAN, vice president for Health Promotion and the Helene Fuld Health Trust Professor of Evidence-based Practice at The Ohio State University. “We have such a strong body of evidence that when EBP is implemented, that patient outcomes and safety is better,” she says. “We know that.”

With a patient-focused nursing priority, practicing nurses find inspiration in using innovative and successful methods. “Evidence-based practice is the most essential part of the nursing profession,” says Michael Williams, DNP, APRN, FNP-BC, a lead nurse practitioner at the Center for Health Empowerment-CHE in Austin, TX. “As a collective, organized workforce, it ensures we are keeping up with the demands of healthcare.” As healthcare delivery becomes more complex, Williams says evidence-based practice helps nurses answer their questions. “It allows us to be in a position to keep up with the demands and always be innovating.” 

Patient care is only enhanced when identified and proven practices are followed. “EBP ensures patients are receiving the most current care using the best available evidence,” says Bissett. “By implementing evidence-based interventions, nurses can enhance the quality of care patients receive. For example, implementing evidence-based guidelines and protocols minimizes errors and complications such as medication errors, risk of infections, and unnecessary procedures that could lead to complications.”

Evidence-based Practice Is Good for Nurses

As Williams notes, nurses can pause and reexamine their actions when new evidence-based practices are introduced. “It’s exciting when we have the opportunity to learn something new,” he says. “It’s easy to get caught up in the day-to-day, giving us a chance to reset. When new guidelines pop up, it appeals to that side of nurses that are innovators or creators.”

The kind of pause that Williams mentions also refreshes nurses. “Nurses can use EBP for a variety of reasons. Some include improving or validating current practice, identifying better ways to achieve patient outcomes, and answering clinical questions,” says Bissett.

Stumbling Blocks to Widespread Adaptation

Despite all the good that comes from EBP, complex factors often result in an inconsistent application. A 2021 study found that moving research findings into regular practice takes at least 15 years. Despite medical and technological advances, that number has barely shortened in the past 20 years.

Other studies show that most nurses need to be more competent in EBP. Roadblocks to more widespread adaptation of EBP include a need for a targeted curriculum, too few mentors to show EBP in everyday work, a minimal amount of EBP investment by healthcare organizations, and a fallback to traditional nursing practices.

“In some nursing units, it is not uncommon to have practices persist even after scientific evidence has proven those practices to be ineffective,” says Bissett. “The nurses continue to practice the way they have always practiced. This persists until nurses start to question their practices and start looking for better alternatives.”

Gaining EBP Understanding

Nurses can still gain the needed knowledge even in organizations with little defined EBP work. At work, they can also bring research demonstrating the efficacy of EBP to management. “People are able to negotiate better with evidence,” says Melnyk, noting it can help nurses advocate for change or increase investment.

In general, active and involved nurses will become aware of new guidelines or evidence-based practices as these new developments emerge, and they can position themselves to gain more knowledge. If EBP isn’t part of a nurse’s training, Melnyk suggests nurses take a short, free course to familiarize themselves with the 7 steps of EBP or a more intensive course for mastery of skills.

Williams says that nurses may glean excellent information from listening to two or three podcasts in their specialty. They could also subscribe to a few nursing magazines or journals to keep abreast of the latest news. Getting involved in the nursing community by joining a professional organization is excellent. Williams is an active member of DNPs of Color. Bissett says setting up a Google alert for specific topics is an easy way to discover new information. She says conferences are also an excellent source of the most current information.

There’s also a link between nurses who practice with the most proven methods and their well-being, says Melnyk. She says that even the most highly skilled nurses can’t make much progress if they are burned out and acutely stressed. “You have to tackle this in the culture,” she says.

Attaining that additional knowledge is a powerful tool in nursing practice and a professional motivator that leads to more job satisfaction and even better work for individuals and teams. Melnyk says that if nurses negotiate for change and are met with endless pushback or flat-out denial, they may want to consider moving on to a different organization.

Bissett notes that their confidence grows when nurses are equipped to make informed decisions about patient care and have the resources to consider factors such as efficacy, safety, and patient preferences. The critical thinking that comes with EBP means nurses learn something new and have the tools to analyze why it works and then apply it to their practice, she says.

EBP as Workplace Culture

The nursing community offers exceptional learning opportunities if nurses are open to different perspectives. Williams says his position as an experienced nurse means that he learns from listening to the questions and ideas of new nurses. “That’s something that isn’t talked about enough,” he says. “Student nurses will say, ‘This is what I learned.’ And it’s different from what I learned in nursing school.”

Some questions can prompt a reexamination of practices. A workplace culture that encourages information sharing and is open to all questions is one in which nurses can learn from each other in a way that is to everyone’s advantage.

A constant rotation of new nurses and information necessitates continual evaluation of practices. “It is important to understand that once an EBP project is complete and a practice change has been implemented, it does not mean that issue is closed,” says Bissett. “Nurses must continue to verify that their practices are in line with current best evidence.”

Nurses, says Bissett, need to be active consumers of evidence. “We should be constantly looking for ways to improve our practice and to use the best evidence,” she says. “We have to stay well-informed, and that requires some action on our part.”

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