Health analysis – Best Essay Writers

Resuscitation: Case Study

Part 1: Code Blue educational video from the Regina Qu’Appelle Health Region.

Time sequence	Issue noted	code	comments
0-22 seconds	Breach of Australian Resuscitation Council Guidelines:	BARCG- Guideline 2 priorities in an emergency	Finds Mr. Smith unresponsive. Fails to follow the Guide 2 BLS algorithm because she failed to assess danger, but she assessed the airway, as she is seen checking for the escape of air from the patients mouth or nose as recommended by guide 5. Implications: Delay in resuscitation processes increases the risk of reduced cardiac output to the brain due to poor compressions.
Time 3.26	Poor technical skills	PTS – BARCG Guide 6 & 8	Chest compressions inadequate as recommended by Guide 6. The recommended chest compressions are 30 chest compressions followed by two breaths. The chest compressions are slow than required by Guide 8. “A good CPR should deliver chest compressions over the lower half of the sternum at a depth of 5 cm” (ARC guide 8). Long pauses in CPR before shock delivery. Guide 6 discourages long pauses and distractions during a CPR Implications: Long pauses, distractions, slow and inadequate chest compressions lower the chance of patient’s survival
Poor Non-Technical skills PNTS
Time 0.30	Situation awareness	PNTS- SA	The nurse did not press the emergency push button system to call for help immediately and instead used the overturn Implications: Delayed response by the code blue team
Time 0.30 secs Time 2.26 minutes	Decision making	PNTS- DM	Delay in full code response. The team arrived 2 minutes later after the call alert Implications: This led to delay important activities such as defibrillation. However, the rest of the decisions such as medication, hyperventilation and defibrillation activities went on well once the code blue captain arrived.
Time 3.36	Task management	PNTS-TM	Compressors for more than five cycles. One compressor was working for almost 5 minutes which is too long for a compressor. According to Guide 5, “the compressor roles approximately after 2 minutes or after five cycles of compressions and ventilations at a ratio of 30:2 so as to maintain the quality of compressions” (ARC guide 5). However, other task management processes such as airway positioning, nasopharyngeal airway placement, bag-valve mask ventilation were correctly performed.
Time 5.28 Time 12.55	Communication	PNTS- comm	Occasionally fails to use the closed up communication which leads to miscommunications. For instance, at minute 12.55, the recorder had missed recording the endotracheal tube particulars due to poor communication strategy. The team used the SBAR technique to report the patient’s medical history to the code blue team leader. All the information was recorded including all the medication administered and other CPR outcomes such as cardiac rhythm before a shock was delivered. This is vital for future references.
	Teamwork	PNTS-Team	No introduction was done by the team members, but they delegated the resuscitation duties appropriately. The team consisted of a coordinator, compressor nurse, airway manager, nurse in charge of defibrillator, captain/leader and crash cart manager.
	Leadership	PNTS- Leadership	The leader failed to evaluate the BLS on arrival. However, Mr. Sellinger (the code captain) performed his tasks effectively including identification of cardiac rhythm, initiation of ACLS protocol, and evaluation of the protocol reviewed the code blue documentation form and signed the code blue form after completing the code blue.

PART 2: Analysis of the issues covered

Code blue should be contacted immediately for all unresponsive patients. Calling for help and initiation for help should be done simultaneously. One of the issues identified in this case study is delayed in the response of code blue code due to poor call out systems. The code team member should call out loudly for help through the facility-wide response system. In this technology, the nurse should have pressed the Blue code push button to ensure that the code blue team were notified accordingly (Bayramoglu et al., 2013).

As the nurse in charge waits for code blue team, he or she should initiate CPR (Clarke, Apesoa-Varano, & Barton, 2016). The code team are expected to introduce themselves as they arrive as well as and their roles statements such as “Am Mr. J. and will take document” or “I’ll take the airway” which helps in ensuring there is clear role differentiation. The service user physician should be contacted immediately.

According to Price, Applegarth & Price (2012), the healthcare provider should first assess the patient dangers and risks before they start the air management. This was not done in the case study and violated the ARC guide four which states that the patient’s mouth should be opened and head slightly turned downwards to remove the airways (Australian Resuscitation Council, 2008).

An ineffective cough indicates a severe obstruction. In this case, if the patient is responsive, the healthcare provider should give about five back blows, and if still, it is ineffective, they should give at least five chest thrusts (McInnes et al., 2012). This article states that for all unresponsive patients, the healthcare should send for help and start CPR immediately. Similarly, guideline 5 recommends that all patients who are breathing abnormally or are unresponsive require being resuscitated.

The first thing when assessing breathing, the rescuers should check for movement around the chest (lower part) and abdomen (upper part). They should check for the exhalation through the patient’s oral cavity or nose, and feel the movement of air in the patient’s mouth or nose. The guide recommends a ratio of compressions to rescue breaths as 30:2 (Australian Resuscitation Council, 2008).

According to this article, the first nurse to respond should start saving the patient’s life by performing chest compressions immediately (100 compressions per minute). Although important, the nurse should not wait for backboard , they should start chest compressions as it can be put in place later when the code team arrives. The switching the compressor roles in the case study is present but it took quite a long time than that recommended by ARC guide 6 which is approximately after 2 minutes.

To maintain the quality, the ventilations ratio should be maintained at 30:2 (Castelao et al., 2013). This is supported by Guide 6 which recommends that interruptions to chest compressions should be minimized. The best location to perform the compressions is the sternum- the lower half part of it. The healthcare provider’s heel is placed at the central part of the chest and put the other hand on top it. The recommended rates of compressions are 100 to 120 compressions per minute which are about two compressions per second.

The guide also outlines on the quality of compressions ( which is identified as poor in the case study) where it suggests that depth of compressions should be “at least 2 inches (5cm) with complete chest recoil after every compression” this helps the heart to re-fill completely by the next round of compressions. The number of interruptions should be minimized to ensure maintain the quantity and quality of compressions (Eroglu et al., 2014).

According to the article, the patient should be given 2 ventilations for every 30 seconds of oxygen-bag-mask device assisted ventilation. The oxygen level should be set to the flow meter 15 L/min, and where applicable, the reservoir should be fully open ensure that the patient gets 100% oxygen for each breath. One strength observed in the study is the fact that bag-mask device is best done by two blue code team members where one open the airway to fasten the mask on whereas the second one squeezes the oxygen bag.

Also, the article states that defibrillation is very critical and that the use of placement hands-free defibrillation pads is a safer option than hands held defibrillation paddles (Girotra et al., 2012; Prince et al., 2014). The article states that the deployment of automated external defibrillators (AED) should be used as soon as possible as it reduces mortality and morbidity associated with cardiac arrest caused by either ventricular fibrillation or ventricular tachycardia (Australian Resuscitation Council, 2008).

The compressions should resume immediately after delivering shock even with a normal heart rhythm as it will not provide enough cardiac output that will ensure adequate perfusion. It is recommended that 2 minutes the cardiac rhythm should be assessed after 5 cycles of a CPR (Merchant et al., 2014). The use of vasopressors in cardiac arrest is recommended only when there are no high-quality CPR. It is important to be extra cautious when administering a drug. This is because miscommunication is a common issue which often leads in the administration of incorrect drug doses or medications.

This can be prevented by using “closed loop” method of communication (Segon et al., 2014; William et al., 2016). For instance, when a nurse receives an order to inject some medicine, they should repeat the information of drug prescribed out loud, inject it and then announce it again after administration (Price et al., 2012). This method was used in some instances, but in the instance that it was absent, the recorder was prone to miss out some key aspects; for example, in this code blue simulation, the recorder had missed recording the endotracheal tube measurements.

The article suggests that an effective code blue team should have leader who controls the all the procedures and efforts of resuscitation. They communicate with the staff involved and evaluate the cardiac rhythm of a patient. Mr. Sellinger is the team captain of the case study and was standing in a position such that he could effectively see all of the resuscitation procedures and efforts. If the organization allows, the family member can be allowed into the room. It is also important to ensure that the information is well recorded.

In the case study, the recorder is shown documenting all the resuscitation process. However, it is important to understand that documentation process is done according the healthcare facility’s policy (McEvoy et al., 2014; Sahin et al., 2016). The recorder should remind the code team when time for a specific task has elapsed and must record all the activities taking place including the medicines prescribed. The article also suggests that all clinical areas should grant quick access to equipment such as blood glucose, blood pressure, and equipment of pulse oximetry and other equipment so as to effectively manage a deteriorating patient (Clarke, Carolina Apesoa-Varano, & Barton, 2016).

Through this case study, it is evident code training programs using simulation is beneficial and has been recommended by various healthcare institution organizations since 1999. This training will help the learners to improve cardiac resuscitation outcomes as it offers an opportunity for regular hands-on practice within the hospitals. This also helps the team to understand the various roles and responsibilities expected during a full code. Along with continuing education and mock codes, the team members become confident in their responsibilities (Gutwirth, Williams, Boyle, & Allen, 2012).

References

Australian Resuscitation Council. (2008). Standards for Resuscitation: Clinical Practice and Education. Retrieved from http://www.resus.org.au/clinical_standards_for_resuscitation_march08.pdf

Bayramoglu, A., Cakir, Z. G., Akoz, A., Ozogul, B., Aslan, S., & Saritemur, M. (2013). Patient-Staff Safety Applications: The Evaluation of Blue Code Reports. The Eurasian Journal of Medicine, 45(3), 163–166. http://doi.org/10.5152/eajm.2013.34

Castelao, E. F., Russo, S. G., Riethmüller, M., & Boos, M. (2013). Effects of team coordination during cardiopulmonary resuscitation: A systematic review of the literature. Journal of critical care, 28(4), 504-521.

Clarke, S., Apesoa-Varano, E. C., & Barton, J. (2016). Code Blue: Methodology for a qualitative study of teamwork during simulated cardiac arrest. BMJ open, 6(1), e009259.

Eroglu, S. E., Onur, O., Urgan, O., Denizbasi, A., & Akoglu, H. (2014). Blue code: Is it a real emergency? World Journal of Emergency Medicine, 5(1), 20–23. http://doi.org/10.5847/wjem.j.issn.1920-8642.2014.01.003

Girotra, S., Nallamothu, B. K., Spertus, J. A., Li, Y., Krumholz, H. M., & Chan, P. S. (2012). Trends in Survival after In-Hospital Cardiac Arrest. The New England Journal of Medicine, 367(20), 1912–1920. http://doi.org/10.1056/NEJMoa1109148

Gutwirth, H., Williams, B., Boyle, M., & Allen, T. (2012). CPR compression depth and rate about physical exertion in paramedic students. Journal of Paramedic Practice, 4(2).

McEvoy, M. D., Field, L. C., Moore, H. E., Smalley, J. C., Nietert, P. J., & Scarbrough, S. (2014). The Effect of Adherence to ACLS Protocols on Survival of Event in the Setting of In-Hospital Cardiac Arrest. Resuscitation, 85(1), 10.1016/j.resuscitation.2013.09.019. http://doi.org/10.1016/j.resuscitation.2013.09.019

Merchant, R. M., Berg, R. A., Yang, L., Becker, L. B., Groeneveld, P. W., & Chan, P. S. (2014). Hospital Variation in Survival After In‐hospital Cardiac Arrest. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 3(1), e000400. http://doi.org/10.1161/JAHA.113.000400

McInnes, A. D., Sutton, R. M., Nishisaki, A., Niles, D., Leffelman, J., Boyle, L., … Nadkarni, V. M. (2012). The ability of code leaders to recall CPR quality errors during the resuscitation of older children and adolescents. Resuscitation, 83(12), 1462–1466. http://doi.org/10.1016/j.resuscitation.2012.05.010

Price, J. W., Applegarth, O., Vu, M., & Price, J. R. (2012). Code Blue Emergencies: A Team Task Analysis and Educational Initiative. Canadian Medical Education Journal, 3(1), e4–e20.

Prince, C. R., Hines, E. J., Chyou, P.-H., & Heegeman, D. J. (2014). Finding the Key to a Better Code: Code Team Restructure to Improve Performance and Outcomes. Clinical Medicine & Research, 12(1-2), 47–57. http://doi.org/10.3121/cmr.2014.1201

Segon, A., Ahmad, S., Segon, Y., Kumar, V., Friedman, H., & Ali, M. (2014). Effect of a Rapid Response Team on Patient Outcomes in a Community-Based Teaching Hospital. Journal of Graduate Medical Education, 6(1), 61–64. http://doi.org/10.4300/JGME-D-13-00165.1

Sahin, K. E., Ozdinc, O. Z., Yoldas, S., Goktay, A., & Dorak, S. (2016). Code Blue evaluation in children’s hospital. World Journal of Emergency Medicine, 7(3), 208–212. http://doi.org/10.5847/wjem.j.1920-8642.2016.03.008

Williams, K.-L., Rideout, J., Pritchett-Kelly, S., McDonald, M., Mullins-Richards, P., & Dubrowski, A. (2016). Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses. Cureus, 8(12), e938. http://doi.org/10.7759/cureus.938

Want help to write your Essay or Assignments? Click here

Nursing care: Concept Analysis Critique

Introduction

The concept analyzed in this article is nursing care. Evidently, nursing scholars, theorists, and healthcare professions have varying interpretations of the concept. However, in the middle of these disparities, nursing care is a vital aspect of nursing practice and a beneficial factor for both patients and nurses.

Several studies have explored the meaning of the concept (from both nurses and patients perspective) with the aim of identifying the relationship between nursing caring and patient satisfaction. Most textbooks, scientific articles, ethical codes and legal documents use the term nursing as a synonym to caring which are characterized as a nurse’s main ethical obligation (Dalpezzo, 2009).

Therefore, the aim of this concept analysis critique is to help clarify the vague concepts such that every person using it speaks the same thing. This is important in healthcare discipline because it helps people to develop knowledge related nursing concepts.

The overall intention of this analysis to provide a meaningful nursing care concept that can be used by nurse researchers and theorists to get its deeper insights and to identify better means that can be used to assess this complex nursing concept. The specific aims for this concept analysis article critique is; a) to clarify the nursing care concepts, b) identify the strengths of this article in clarifying the nursing concepts and c) to identify the weakness and d) to highlight its implication for practice.

Strengths

The concept analysis criterion background and purpose is clearly described which is to explore the concepts of nursing care and its essence with the aim of developing an operational definition of nursing care (Dalpezzo, 2009, p. 256). Also, the article analyzes the relevant literature to determine the definitions of the nursing care concept terms and in arriving at the core defining attributes of the nursing concept.

For instance, the researcher uses Dictionary.com Unabridged v 1.1, 2006a and the American Heritage Dictionary of the English to define the term ‘care’ and ‘nursing.’ The article also explores the basic definitions of the words ‘caring’ and ‘nursing’ in major nursing models and nursing theories (Dalpezzo, 2009, p. 259).

The author also explores the definition of the concept nursing care from the allied health literature; where he reviewed 16 randomly selected peer-reviewed articles. This research ensured that the analysis of the concept is done extensively, making it clear, distinct and is unambiguously differentiated from the other nursing concepts.

The author develops the definition of the nursing concept in logically, and the discussions of the empirical referents and antecedents are clear. For instance, the author begins by identifying the purpose of the study. This is followed by a brief description of Walker and Avant’s concept analysis method. To start with, the rationale for the selection of the concept nursing care is well outlined which is the lack of clear definition within the nursing literature (Dalpezzo, 2009).

The article describes the purpose of the analysis and clearly identifies the uses of the nursing care concepts in different disciplines. The author also determines concepts defining attributes which include a) nursing care procedures- those needed by patients, b) nature of nursing care – including the high quality of care, nursing skills, safe, holistic and evidence-based, and c) the core functions of nursing care including listening, assessing, preventing, advocating.

The concept is further developed by reviewing additional cases to identify the antecedents and the consequences and to define the concepts empirical referents. This extensive research to define nursing care concept ensures that the analysis of the concept is accurately developed and illuminated (Dalpezzo, 2009).

Weakness

Nursing discipline has set forth an explicit desire to serve the public and commitment to the overall well-being of the society. Therefore, concept analysis is performed to refine the definition of nursing care, with the aim of differentiating it from other similar or dissimilar concepts. The concept analysis of nursing care outlines the focus and boundaries of nursing discipline and also highlights the aspects of the concept that are significant to nursing practice, and can be traced back to the nursing field fundamental concepts(Dalpezzo, 2009).

The terms, meanings, usages, definition and attributes are derived from the nursing care concept analysis is derived from dictionaries, thesauruses, Walker and Avant (2005) method and the current literature. The term nursing care is used throughout the disciplines allied to health, but its meaning is not clear. There are varied themes of nursing care concepts in the literature which present the world’s views and perceptions about nursing care.

However, the concept analysis is limited in that the definition of nursing care concept is a context- based activity; however, the activities differ between the operational environments and the measures or methods used to assess the nursing care outcomes (Koy, Yunibhand, Angsuroch, 2015).

Also, the concept analysis is limited because the attributes gathered from the literature are the only ones used to define nursing care concepts. For instance, the description of nursing care concept from the literature ranges from general conceptions of just being helpful to include divine oriented interventions.

Therefore, the lack of clear definition of nursing care concept in the context of socio-cultural and religious aspects is the greatest dilemma associated with quality nursing practice because it hinders nurse’s efforts to meet patient’s socio-cultural needs. Therefore, future nursing care concepts should put into consideration the cultural contexts (Koy, Yunibhand, Angsuroch, 2015).

Implication for practice

Caring is a complex universal phenomenon and is deeply rooted in the primitive society. For instance, women care for their children and other dependent members of the family. Women involvement in all aspects of care is common in many cultures (Sarpetsa, Tousidou, & Chatzi, 2013). Also, the word ‘nursing’ is highly connected to the term ‘care.’

Nurses deliver nursing care to other people with the aim of maintaining and promoting their health during illness, ordeal or disability. Care is an important element of nursing; and that the conception of the term ‘care’ in nursing affects the way it is delivered. Therefore, people’s perception, experiential, and socio-political aspects of nursing influence provision of care (Schrijvers et al., 2012).

Nursing care is a continuous phenomenon that follows human existence since the time they are born to death. According to Institute of Medicine (IOM) study, nursing care is patient-centric and is directly linked to quality and safety. Nurses have the potential to foster a quality healthcare environment through various ways (Kvist et al., 2014). Nursing care starts with non-verbal communication between the nurses and patients.

It has been found that emotions expressed by nurses towards their patient have an effect on their outcomes, with positive emotions improving their recovery rate. Also, it is through emotional empathy, a respectful, and trusting relationship with the patients is established. Patient-centric care provides a distinct advantage of consistent daily assessment of the patient’s health condition which allows the nurses to detect slightest changes in patients health that require them to proactively make some modifications to the patient care plan when needed (Cheung et al., 2008).

Addressing the variance in nursing care perception is important when interpreting inconsistencies of the concept in nursing literature because it affects patient care outcomes. Nursing care also influences the quality of interaction by the healthcare team (Samina et al., 2008).

While caring is vital between patients and nurses, it is equally important for the healthcare staff because it helps the team to adapt and work together and to understand each person’s individual responsibilities and to provide constructive feedback. Every nurse is a leader because they are in a unique position to make a difference in patient’s recovery. The concept of nursing care facilitates communication, especially when implementing care plans for the patients (Sarpetsa, Tousidou, & Chatzi, 2013).

At administration level, nurses utilize their hands on experience (nursing care) to identify the most effective strategies to delegate the available healthcare recourses to ensure positive patients outcome. Therefore, this concept analysis ensures that one gain the knowledge and technical know-how so that they car skilfully integrate their knowledge into practice (Sarpetsa, Tousidou, & Chatzi, 2013).

Understanding the concepts of nursing care helps one understand the nursing discipline, its culture and the changes needed to make changes that positively impact on the patient’s health outcomes. Tapping into the sufficient knowledge developed by the nursing care concepts analysis, nurses can foster a combination of personal skills, evidence-based practice to collaboratively improve patient outcomes (Schrijvers et al., 2012).

References

Cheung, R. B., Aiken, L. H., Clarke, S. P., & Sloane, D. M. (2008). Nursing care and patient outcomes: international evidence. Enfermeria Clinica, 18(1), 35–40.

Dalpezzo, N.K. (2009). Nursing Care: A concept analysis. Nursing Forum 44(4); 256- 264

Koy, V., Yunibhand, J., Angsuroch, Y. (2015). Nursing care quality: a concept analysis. International Journal of Research in Medical Sciences 3(8): 1832- 1838 DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150289

Kvist, T., Voutilainen, A., Mäntynen, R., & Vehviläinen-Julkunen, K. (2014). The relationship between patients’ perceptions of care quality and three factors: nursing staff job satisfaction, organizational characteristics, and patient age. BMC health services research, 14(1), 466.

Samina, M., GJ, Q., Tabish, S., Samiya, M., & Riyaz, R. (2008). Patient’s Perception of Nursing Care at a Large Teaching Hospital in India. International Journal of Health Sciences, 2(2), 92–100.

Sarpetsa, S., Tousidou, E., & Chatzi, M. (2013). The Concept of” Care” as Perceived by Greek Nursing Students: a Focus Group Approach. International Journal of Caring Sciences, 6(3), 392.

Schrijvers, G., van Hoorn, A., & Huiskes, N. (2012). The care pathway: concepts and theories: an introduction. International Journal of Integrated Care, 12(Special Edition Integrated Care Pathways), e192.

Want help to write your Essay or Assignments? Click here

Healthcare Delivery: Case Study

The Impact of Electronic Health Record (EHR) Systems on Healthcare Delivery in Australian Hospitals

Abstract

Variations in healthcare needs of today’s population compel modern healthcare organizations to change the manner in which they deliver healthcare. A good number of contemporary healthcare organizations have taken advantage of advancements in information technologies, and they increasingly integrate electronic health record (EHR) systems into healthcare delivery.

The current study aims at finding the impact of electronic health record systems on healthcare delivery in Australian healthcare organizations. The study will utilize a theoretical research approach that involves a review of records of selected companies in order to obtain relevant data. Findings obtained from this study will be used to advise modern healthcare organizations on some of the reasons why they should either adopt or avoid implementation of electronic health record systems.

The Impact of Electronic Health Record (EHR) Systems on Healthcare Delivery in Australian Hospitals

1.0 INTRODUCTION

With the rapid rate of advancements in information communication technologies, contemporary healthcare organizations have integrated electronic health record system into healthcare delivery to match healthcare needs of the current population (Zeng, 2016). An electronic health record (EHR) system is a computerized version of a patient’s health data, including past medical history, laboratory reports, vital symptoms, demographics, medications, and progress notes, that can be shared among healthcare practitioners within a healthcare organization (Bowman, 2013).

According to Gao, Sorwar, and Croll (2013), Australian healthcare industry began to consider electronic health record systems in 2000. Since then, many hospitals in the country have made an effort to develop and implement electronic health record systems. As opposed to the traditional paper records system, it is anticipated that electronic health record systems will enhance the quality of care, minimize medical errors, improve patient satisfaction, and reduce healthcare costs in Australian healthcare organizations (Gao, Sorwar, and Croll, 2013).

This proposal will direct a study on the impact of electronic health record systems on healthcare delivery in Australian hospitals. It provides a detailed analysis of existing body of literature on the study topic. Additionally, the paper outlines the procedures and processes that will be followed to gather data to answer the research question. It also highlights the relevance of the study approach as well as the implications of study findings.

1.1 Problem Identification

Traditionally, hospitals used to rely on paper records to keep important medical information of patients. Although clinicians used well-organized templates to document their patient’s health data, retrieving this information was sometimes difficult due to illegible handwriting. Furthermore, the handwritten information could not be shared among healthcare providers through computer systems.

Paper records were also easy to destroy, thereby resulting in loss of patient’s data. Advancements in information technology systems allow contemporary healthcare organizations to store patients’ medical data electronically to allow easy sharing and analysis. The number of hospitals which are implementing electronic health record systems is on the rise in today’s society due to the anticipated benefits of this new technological advancement.

In order to help Australian hospitals to evaluate the financial feasibility of implementing electronic health record systems, it is important to investigate and reveal the nature of impact that an electronic health record system has on healthcare delivery.

1.2 Significance of the Problem

An electronic health record system makes it much easier to track and retrieve patient data as compared to paper reviews. Availability of these systems in hospitals makes patient information available to authorized healthcare practitioners who may need it within the organization. For this reason, healthcare organizations that use electronic health record systems are highly likely to have a form of healthcare delivery that is different from those organizations that use paper records (Bowman, 2013).

1.3 Research Question

Have electronic health record systems improved healthcare delivery in Australian Hospitals?

1.4 Hypotheses

Alternate Hypothesis (H1): Electronic health record systems have improved healthcare delivery in Australian hospitals

Null Hypothesis (HO): Electronic health record systems have not improved healthcare delivery in Australian hospitals

1.5 Variables

Independent variable; an electronic health record system

Dependent variables; health care quality, medical errors, and patient safety

2.0 LITERATURE REVIEW

A number of studies have been performed with the aim of finding out the benefits of electronic health record systems as far as their influence on clinical outcomes is concerned. The main clinical outcomes that have been the center of focus in a large percentage of these studies are patient safety, healthcare quality, and medical errors (Menachemi and Collum, 2011). Healthcare quality is achieved when the healthcare provider delivers the right type of care, in the right manner, at the right time, and to the right patient, with the aim of having the best results possible.

In order to maximize patient safety, healthcare providers must avoid injuries for their clients and ensure that services offered are able to generate the intended help (Gao, Sorwar and Croll, 2013). As Gao, Sorwar and Croll (2013) explain, medical errors are minimized during care delivery when data is entered accurately and when there is clarity of medical records. According to Menachemi and Collum (2011), electronic health record systems generally minimize medical errors, improve health care quality, and enhance patient safety.

In a survey conducted across Australian health organizations in 2015, Australian Digital Health Agency revealed that electronic health records have got numerous benefits for healthcare providers which translate into improved healthcare delivery for patients. According to the Australian Digital Health Agency (2015), electronic health record systems enable healthcare providers to spend more time with their patients as they do not have to waste time looking for clinical information.

This gives patients an opportunity to share their important health information with health care providers thereby contributing to improved health care quality. Furthermore, healthcare providers in Australian health organizations which have implemented electronic health record systems are able to closely monitor their patients’ progress, including those with chronic health problems, while at the same time offering them necessary medical support. This helps patients to have a comprehensive understanding of their health problems (Australian Digital Health Agency, 2015).

Australia is one of the industrialized countries which support the integration of electronic health record systems into healthcare delivery. The version of electronic health record system which majorly operates in Australia is the Personality Controlled Electronic Health Record (PCEHR) system (Gao, Sorwar and Croll, 2013). The Australian public has demonstrated support for PCEHR system due to a number of benefits they have experienced since its adoption.

For instance, with PCEHR systems, patients can now have immediate access to their health information, easily track their prescriptions and medications, as well as make necessary changes to their health records. Basically, PCEHR system has helped Australian healthcare organizations to keep accurate patients’ health records, deliver the right care at the right time, and to maximize patient safety (Gao, Sorwar and Croll, 2013).

Several researchers agree that electronic medical systems are associated with reductions in medical errors in healthcare organizations because they improve the accuracy with which patients’ health data is maintained (Menachemi and Collum, 2011). In a study conducted by Bates, Leap, and Cullen (1998), an electronic health record system reduces medical errors in healthcare settings by approximately 50 percent.

In a similar study, Bowman (2013) found out that computerization of patients’ health data results into an error rate reduction of approximately 10 percent. These findings indicate that clarity and accuracy of medical records are greatly enhanced with the use of electronic health record systems in healthcare organizations.

Although electronic health record systems generate numerous benefits, healthcare organizations serious negative consequences by adopting the technology due to inappropriate design choice and careless use (Bowman, 2013). For instance, poor design choice of an electronic health record system will increase medical errors instead of reducing them. Additionally, poor use of the system may interfere with the integrity of data thereby endangering patient safety and decreasing the quality of care (Zeng, 2016).

In most instances, these are unintended consequences which may make an organization to face lawsuits and pay huge legal fines. As health information technology becomes increasingly involved in the delivery of care, healthcare organizations must be prepared to manage HIT-related risks which may damage their reputations if no appropriate actions are taken. The most appropriate ways through which such risks can be avoided are; choosing appropriate electronic health record system design, and ensuring proper use of the system (Sitting and Singh, 2011).

3.0 METHODOLOGY

The study will involve a detailed analysis of the impact of electronic health record systems on healthcare delivery in Australian hospitals. The first step of the study approach will involve selecting Australian health organizations which have already adopted electronic health record system. A list of this category of hospitals will be obtained from the Australian Public Health Database. Top 30 largest hospitals which have adopted the EHR systems will be used in the study.

The Chief Executive Officers of the selected organizations will be contacted via email in order to obtain an appointment to visit their organizations. The chosen healthcare organizations will be visited physically in order to obtain consent from them and to request usage of their health records for purposes of the study. During the visit, the Chief Executive Officers will be informed about the purpose of the study, the study objectives, how research findings will be used, benefits of taking part in the study, as well as the risks involved. Only those organizations that will agree with the provided terms will be used in the study.

Under the permission of Chief Executive Officers, health records and annual reports of the selected organizations will be reviewed. Changes in a number of factors will be recorded from when the selected companies used paper-based records to the period following adoption of the electronic health record systems.

Specific items which will be extracted from the health records include changes in; patients’ waiting time, the manner in which care is delivered, clarity of medical records, the accuracy of patients’ data, recovery period, readmission rates, and death rates. Similar data will be collected across all healthcare organizations which will have agreed to take part in the study. The collected data will be analyzed using Statistical Packages for Social Sciences (SPSS) software.

4.0 DISCUSSION

4.1 Relevance of the study approach

The proposed methodology is highly appropriate for this study because it will help in gathering data that will best answer the research question. A list of Australian healthcare organizations which have adopted electronic health record systems is found in country’s Public Health Database. The rationale behind selecting top 30 largest organizations in the list is the large volume of relevant data that these organizations can provide.

In addition, it is important to obtain consent from the Chief Executive Officers of the selected organizations due to high privacy concerns associated with the release of important health records. The Chief Executive Officers of the chosen health care organizations must be convinced that their health records will be used solely for purposes of research before they can allow anybody to access them.

The effectiveness of healthcare delivery in hospitals are best measured in terms of major clinical variables namely; quality of care, medical errors, and patient safety (Gao, Sorwar and Croll, 2013). The type of data collected during health records’ review can easily tell the degree of health care quality, medical errors, and patient safety in the selected hospitals. For instance, data related to changes in patients’ waiting time and the manner in which care is delivered will help the researcher to understand the quality of care in the selected organizations.

Data related to changes in clarity of medical records and accuracy of patients’ data will tell more about medical errors, while data related to changes in the recovery period, readmission rates, and death rates will inform the researcher more about patient safety in the selected hospitals. By analyzing the collected data using SPSS software, the researcher will be able to see the impact of electronic health record systems on healthcare delivery in Australian hospitals. This research approach will help the researcher to easily answer the research question.

4.2 Limitations of Methodology

The main limitation of the methodology is reviewing health records of only 30 hospitals. By limiting the data collection process to only top 30 hospitals which have already adopted electronic health record systems, the researcher may leave out other small hospitals which might have successfully adopted HER systems, and which may have better information than the organizations used.

The other limitation of the methodology is over-reliance on secondary data which is available in company records and annual reports. Conducting actual research would produce more accurate data because the validity of information available in company records might be questionable.

4.3 How the study findings may lead to further research

The proposed study focuses on how clinical factors may be impacted by the adoption of an electronic health record system. For instance, in the study, the researcher intends to evaluate how electronic health record system will impact health care quality, medical errors, and patient safety in Australian hospitals. Findings obtained from this study can guide further research on the impact of electric health record systems on organizational factors such as healthcare cost.

5.0 CONCLUSION

The number of Australian hospitals which are adopting electronic health record systems is on the rise. Australian healthcare organizations which are implementing electronic health record systems anticipate that the new technology will help them to improve the quality of care, minimize medical errors, improve patient satisfaction, and reduce healthcare costs.

Prior to spending a lot of money in the implementation of electronic health record systems, Australian healthcare organizations should be aware of the financial feasibility of implementing those systems. Making a decision of whether the approach is financially possible requires a comprehensive knowledge of the nature of impact that EHR systems will have on the quality of care, medical errors, and patient safety.

The proposed study intends to investigate whether electronic health records systems have improved healthcare delivery in Australian hospitals, by focusing on three variable; quality of care, medical errors, and patient safety. A comprehensive analysis of available literature has been conducted to show previous studies on the topic.

In addition, a methodology that will help to answer the research question has been identified. Findings obtained from this study will be used to advise modern healthcare organizations on some of the reasons why they should either adopt or avoid implementation of electronic health record systems.

References

Australian Digital Health Agency. (2015). Retrieved May 19, 2017, from https://www.digitalhealth.gov.au/get-started-with-digital-health/benefits

Bates, D., Leap, L. & Cullen, D. (1998). Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA, 280(15):1311-1316.

Bowman, S. (2013). Impact of electronic health record systems on information integrity: Quality and safety implications. Perspectives in Health Information Management, 10(Fall):1c.

Gao, J. X., Sorwar, G. & Croll, P. (2013). Implementation of E-health record systems in Australia. The International Journal Technology Management Review, 3(2):92-104.

Menachemi, N. & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Quality, 4: 47-55. Doi:10.2147/RMHP.S12985

Sitting, D. F. & Singh, H. (2011). Defining health information technology-related errors. Archives of Internal Medicine, 171:1281.

Zeng, X. (2016). The impacts of electronic health record implementation on the health care workforce. North Carolina Medical Journal, 77(2):112-114. Doi:10.18043/ncm.77.2.112

Want help to write your Essay or Assignments? Click here