Nursing Informatics

Nursing Informatics Annotated bibliography: Nursing informatics Shaw, Ryan & Jeffrey Ferranti. (2011). Patient-provided internet portals: Patient outcomes and use. CIN: Computers, Informatics, Nursing, 29 (12): 714 -- 718. Keeping accurate electronic records on patients has become an important goal of our nation's health system. Electronic records encourage the free flow of information between providers, enhancing accuracy and efficiency of medical care. However, the Internet can also be used to improve patient care by enhancing the flow of information between patients and healthcare providers.

This article studies patient-provider Internet portals, interactive Web sites where patients can transmit information to healthcare providers as well as access their own records and services. The article specifically studies the impact of the use of such a portal on patients with diabetes. Portal use was a statistically significant predictor of glycosylated hemoglobin (HbA1c) (P G .001). However, portal use was not a significant predictor of LDL and total cholesterol levels.

Still, the article's authors believe that these portals deserve further research in terms of how they can improve the dissemination of information on patient care and enable patients to be more proactively involved in monitoring their health. Rantz, Marilyn, Gregg Alexander, Collen Galambos, Marcia K. Flesner, Amy Vogelsmeier, Lanis Hicks, Jill Scott-Caweizell, Mary Zygart-Stauffacher, Leslie Greenwald. (2011). The use of bedside electronic medical record to improve quality of care in nursing facilities: A qualitative analysis. CIN: Computers, Informatics, Nursing, 29 (3) 149 -- 156.

Nursing homes historically have been criticized for providing substandard care to patients who are often not able to act as advocates for themselves. Ensuring accuracy of information can be substantially enhanced by having electronic bedside medical records. This article provides a case study analysis of one facility that implemented the use of such electronic records, which were periodically updated during the day by healthcare providers.

However, to use such systems accurately required an investment in the training of the staff to enable the healthcare workers to access such records and to record information correctly. There was substantial 'change resistance' reported at many facilities, which often kept paper as well as electronic records. This generated confusion when the two records contradicted on another and many staff members found the need to update records using an iButton to be cumbersome.

The article demonstrates the positive benefits of electronic record-keeping but also its challenges in terms of changing the organizational culture of the staff. Cooke, Catherine E., Brian J. Isetts, Thomas E. Sullivan, Maren Fustgaard, & Daniel A Belletti. (2010). Potential value of electronic prescribing in health. economic and outcomes research. Patient outcome measures.