Have you really ever thought about what goes on when a nurse administers a medication? Let’s think of something even simpler. What workflow occurs when you want toast for breakfast?

If you said, “put the bread in the toaster,” you’d be mostly right. However, you do much more than that. You might have to take out your toaster, find your bread (unless you forgot that you ran out), and you’ll probably think about what you want on your toast for a topping.

What does this have to do with administering medications, or any other process, for that matter? Let’s take our earlier example of administering a medication.

Medication administration starts with an order. So the workflow needs to be started at the order level. From there, think about any processes that may occur in parallel, or those that may fall before or after one another.

After defining your workflow, you can really start to see potential points of failure where improvements can be made. You might come to realize that the original problem that you were trying to solve isn’t the problem at all.

Visualizations are an important part of explaining and presenting workflows. Creating a visualization of your workflow can help someone who is not involved in your process understand the issue that you are trying to solve. These visualizations are not always simple, and in fact are often very complex.

Think about getting down to basics with your visualization. Don’t be afraid to break out the pencils, pens, crayons, markers, and paper. Maybe you would do better to go small-scale; why not try sticky notes up on a wall?

Give yourself time to think about the process and lay it out in front of you. When you feel like you have what you need, you can then transfer this knowledge to an electronic medium and refine it further from there. This tool can be valuable for all, from creating a new screen during software development to creating or updating policies.

All things have a workflow, whether simple or complex. If you can understand the workflow, you will add a new tool to your arsenal to help make improvements, from medication administration to making toast.

Click on graphic below for larger view.

It’s that holiday time again. In holiday cheer, let’s explore how to prepare an informaticist.

(Side Note: As healthcare informatics can be very broad, I will be exploring nursing informatics specifically for this. The information can be used for other paths as well.)

Recipe for preparing an informaticist:

Ingredients:

• one motivated nurse
• dash of technology
• pinch of information
• bowl full of patience

Preparation:
Wait, you mean there’s preparation involved?!! I just fell into this role! Choose a way or many ways for your prep:

• Sign up for daily/weekly blogs
• Join a group
  • Join an organization like ANIA-CARING, American Medication Informatics Association (AMIA), Healthcare Information and Management Systems Society (HIMSS)
  • Or a local/regional group such as the Minnesota Nursing Informatics Group (MINING) or the Delaware Valley Nursing Computer Network (DVNCN).
• Explore a master’s program in informatics
  • There are many schools out there with emphasis in nursing informatics, healthcare informatics or medical informatics.
  • Many schools offer part-time programs or online-only programs for the working student.
• Go to a WINI (weekend immersion in nursing informatics)
  • These are held throughout the country.
  • The WINI provides an opportunity to have guided discussion and education in a variety of informatics topics including the systems life cycle, theories used in nursing informatics and professional practice trends and issues. (WINI, 2011)
• Take a 10x10 course
  • These courses are offered through the AMIA. They utilize curriculum content from various informatics programs. These 10-week courses provide a framework for understanding details such as electronic and personal health records, health information exchange, standards and terminology, and healthcare quality and error prevention. (AMIA 10x10 Courses, 2011)

Directions:
1. Mix the individual with technology, information and patience.
2. Come up with a good way to explain to friends, family and colleagues what it is that you do.
3. Find a role or career path you love.
4. Repeat preparation as often as needed.

Works Cited

AMIA 10x10 Courses (2011). Retrieved 11-14-2011 from AMIA: http://www.amia.org/education/10x10-courses

WINI (2011, 11-11). Retrieved 11-14-2011 from Weekend Immersion in Nursing Informatics: http://icce.us/

Galaxy Tab, iPads, Transformer, Playbook, G-Slate – what do these all have in common? They are all tablets and are the new hot thing right now. Everyone wants an iPad or a smart device. Angry Birds dominates with a combined (smartphones and tablets) 300 million downloads! What does this have to with healthcare… and nursing specifically? It means your nurses are most likely comfortable using tablet technology. They either use it on their phones or via an actual tablet.

Many use this technology as an alternate to laptops for their home computing. Tablets are easy to use and intuitive. Flick up, flick down, point to click… it’s easy. Compared to a full computer or laptop the learning curve is small and often less intimidating.

I get it, but how will this impact nursing? Think about the day when nurses carry a tablet to the bedside. They will pull up documentation and images quickly. At this point, you are probably saying, “But we have laptops for that.”

Sure you do.

But can a nurse easily transition from a leisurely chat with a patient while charting to running down the hall for a code blue? At this point a decision must be made --- finish the documentation quickly, lug a big piece of equipment down the hall, or potentially lose any information not yet saved. With a tablet in hand, the decisions are similar. However, you have the option to press save, run down the hall, and confirm the information is saved.

Lugging around a COW/WOW (computer on wheels/workstation on wheels) is difficult. Finding one that is not in use is even more difficult. Is the workstation powered? How much charge is left? Will it cut out on me half way through my charting? Having a tablet available at all times eases workflow and the information is in hand when needed. Privacy is less likely an issue. Just like paper charts, turn the tablet over and keep it out of view from others.

(Our customers are currently using our applications on tablet laptops, and our applications also are available to iPad users via a Citrix connection at this time. Future HMS product development will include more tablet options.)

If you are considering a tablet, consider additional nursing-specific apps to benefit those using the tablet. Great apps I’ve come across include the Lexi-comp Medical or Nursing Central App (includes: Davis Drug Guide, Davis Lab & Diagnostic Guide). Quick access to reference material enhances the practice of nursing and patient care overall. There are positives and negatives to each argument regarding technology. For nurses, it’s always about the patient and it’s always about how best to serve them.