Nursing 6004 Module 6 Blog Entry

This module was a good reminder of ethical issues related to information technology and how to steer clear of ethical problems. I think it is important to review things like not looking at electronic chart files that you don't have a need to look at and also maintaining privacy laws and HIPPA when using technology. It is easy when there is the world at your fingertips to look at something that you really don't need to look at, or to cut and paste something, but one needs to always be aware of the ethical issues of doing this. I think that plagiarism is a good topic to review, as it can happen to anyone, even if they did not intend for it to happen.  I think that for many students who are coming back to graduate school after being out of the school setting for a while, they may forget the rules for citing sources and how to summarize something without copying it. It is always good to have a refresher course on this, but I usually "over-cite" things just because I am paranoid about it! I also think it was good to review maintaining HIPPA and patient privacy when working on computers, such things as keeping your passwords private and locking your computer if you are going to walk away. These things are simple and can be forgotten about but are important in keeping information private. As nurses, it is our job to always keep these type of things in mind, to ensure that we are making ethical choices and maintaining pt confidentiality. 

Nursing 6004 Module 5 Blog Entry

Reviewing the readings for this week did make me thing about how I make decisions as a nurse. I had actually never heard of the CDS software and found it really interesting. I reviewed the DXplain software and wish that I worked at a place that used it, as I think that it would be extremely helpful, especially as a student. I think that for medical practice, having electronic databases and CDS software can help the practitioner to make informed decisions and help them to consider other options that they may have otherwise missed.

One thing that I have used that related to this module's readings is a DSM psychiatric database that we have available at the state hospital. It is a website that has links to research articles on various psych disorders and I've used it to look up evidence based practice guidelines for certain disorders. However, it is not as detailed as the DXplain software and does not give you a diagnosis based on symptoms.

Where I work in psychiatry, I don't think that the CDS software would be as helpful. A lot of times, psych diagnoses don't fit into a prepackaged box of symptoms. Even the DSM IV has a hard time categorizing certain disorders, and there is a lot of overlap. There also is so much subjectivity in psych, there is not a lab or diagnostic test to confirm diagnoses. The practitioner sometimes has to make the best guess possible, as far as what is going on clinically with the patient, and many times the patient isn't able to tell them the problem (for example, an acutely psychotic patient).  I found myself trying to think how a CDS software program could help us in psych, perhaps it could be used with medication selection or to help when there are several diagnoses that the practitioner is considering. Ultimately though, psych seems to be more a mix of art and science, requiring the practitioner to think outside the box at times, and make the best guess possible on limited information.

Nursing 6004 Module 4 Blog Entry

I think that a big part of the nursing profession is teaching. Almost all nurses provide teaching as part of their job. As a psychiatric nurse, I do teaching all the time with patients. This could be teaching regarding the medications that have been prescribed to them, teaching about their diagnosis, teaching about diet and exercise and teaching about stress management. We also do teaching on medical issues such as diabetic teaching and various other disease management. We also do teaching in the way of groups that are run at the state hospital where I work. Nurses run several of the groups. These groups can be things such as skills training, wellness groups, smoking cessation groups or psychoeducational groups. While usually the clinicians run the therapy groups, the nurses are sometimes asked to fill-in this role also. While it is not officially "teaching" the nurses are also the front-line staff that are around when we have patients that are escalating or needing to talk to a staff when they are having a hard time. It is often the nursing staff that sit and problem-solve with patients and help them to use their coping skills that they are learning in their therapy groups. I think this is also an important "teaching" role in that we provide support and care for patients by role-modeling good coping and appropriate interactions with others. I do not think that there is a health care professional role that does not involve teaching in some aspect. Just the nature of being a healthcare professional means being around the patients and be helping them when they are sick or needing assistance in some way.  There are endless teaching moments that happen day to day, even if they are small ones. 

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Nursing 6004 Module 3 Blog Entry

In this module, I was searching for information on the pharmacological treatment of depression. I used the CINAHL database, Google search engine, and also looked at the National Guideline Clearinghouse website to investigate this topic. I found a plethora of information between the three. By far, Google turned up the most information, with thousands upon thousands of websites coming up. I found Google very easy to use, and was able to narrow down the search by putting in more specific keywords when searching. Although there were a lot of results that came up, many of them were not evidence-based sites and were based on people's personal experiences with depression. While that is interesting, I did not find it as helpful for what I was searching for. However, I think Google can be a good tool when searching general topics to get an overview.

I also found some relevant information on the national guidelines clearinghouse website. I was not familiar with this website, and did have to search around for a while to find what I was looking for. I was looking for specific information on what type of antidepressant medication would be most helpful for a new diagnosis of depression, and while this website did have information on the treatment of depression, it did not give me specific information regarding what medications to choose first. I did bookmark this website though and will keep it mind to use in the future.

Finally, I used the CINAHL database through the university library homepage. I found the CINAHL database to be easy to use and liked that I could put specifiers on the search, to only bring up peer reviewed articles. I also had many results with CINAHL, with some results being more applicable than others. It did bring up specific articles on antidepressant medications. I think that CINAHL would be my choice out of the three when looking for evidence based information. The Cochrane Library would also have been a good choice, although I tried not to use this one, since I am familiar with it. Overall, this module was a good reminder of all the different places that we can look for information and how technology and databases can help us to find information on evidence-based practice.

Nursing 6004 Module 2 Blog Entry

What is one way you could become involved in designing, selecting, evaluating, or implementing an information system in your workplace?

We already have a computerized charting system and computerized medication system where I work. However, we do have work-groups that look at the current note options, templates and overall flow of the system and look for ways to improve it. This includes adding new notes as we have a need, eliminating notes that are redundant or not being used and revising notes that are confusing or not user-friendly. Also, there still are a few paper forms that we are trying to change over to the computer system and the work-groups focus on that as well. I could be more involved by participating in the work-groups. I do use many of the notes and templates, so I could provide feedback for what does and does not work. I think that nurses often get overlooked for these work-groups, although we probably do the most charting out of any discipline in the hospital. I think the nurses feel they are too busy to be involved in the work-groups, but really it is the only way that we will get our voices heard, so I should be more involved. One way that I am involved however, is that I am one of the "super-users" of the computer charting system at the hospital. The "super-users" have had additional training for trouble-shooting the system and can help other staff members if they encounter a problem. This was needed more when the system first changed over, as now most the staff are comfortable with it, but it was nice to be able to help others with the system in the beginning. I think it helped to ease some of the stress of change.

Nursing 6004 Module 1 Blog Entry

Hi! I am Stephanie Clark. I am in my last year of the Psychiatric Nurse Practitioner Program. I am a distance student and live in Pocatello, ID. I have been a nurse for four years, almost all of my experience is psych nursing. I currently work at the state hospital here in Idaho.
We have experienced a lot of IT changes at my place of work in the last few years. We went from a 100% paper charting system to a 100% computer charting system. We also changed from a paper medication system to an electronic, scanning medication program. All of these changes have been for the better. I would much rather use computer charting and computer medication programs. It has reduced medication errors and made the whole charting process much more streamlined.