Nurses are on the front line of care, and as inpatients' conditions become more complex and time-intensive, these clinicians need more help. Unfortunately, many believe that the documentation and record-keeping requirements of electronic health records systems don't help make their jobs easier.

Pushback against EHRs, then, is to be expected. However, healthcare organizations can make better use of the tools within integrated EHR systems to help nurses become more efficient.

Here are some of the key capabilities of EHR systems that can provide time gains, and operational improvements, for nurses.

Nurses collaborate on care at Texas Health Presbyterian Hospital Dallas. (Photo credit: Quynh Tran, Texas Health Resources)
Nurses collaborate on care at Texas Health Presbyterian Hospital Dallas. (Photo credit: Quynh Tran, Texas Health Resources)

Surveillance and evidence-based content
EHRs with surveillance tools can apply evidence-based practice around clinical decision support. Evidence-based algorithms search the clinical and demographic data in the EHR, take that live, actionable, real-time information, and return it to nurses in a meaningful way to improve outcomes and in turn, the patient experience.

Patients who meet certain criteria automatically populate tracking boards that indicate when quality measures are due; show signs of a potential hospital-acquired condition; and provide notifications of out-of-range values, as well as critical medication and transfusion information. A tool like this can be a real time-saver for inpatient nurses, giving them meaningful, actionable data, and helping them to know which patients need their immediate attention.

Comprehensive standard content is available with surveillance boards which already have outcome-based components and rules/algorithms incorporated to analyze data, easing the burden of having to create the content in the first place. A great surveillance solution will have a library of standard surveillance boards, which include the embedded rules needed to comply with clinical quality measures and protocols.

In addition, an organization will want to find content that provides active and predictive surveillance for early detection of sepsis, VTE, CAUTI, stroke, pneumonia and other potentially life-threatening conditions or diseases. The surveillance board should also monitor patient populations that may be vulnerable, such as patients with a high risk of readmission, patients with specific therapy consults, or patients with restraint orders. This can help improve clinical outcomes, and reduce length of stay.

Watchlists
A watchlist can automatically generate a list of patients that need immediate attention from a quality and patient safety perspective. Watchlists can be built around fall risks, restraints, sepsis or any other potential danger. This tool can save nurses a tremendous amount of time over manually reviewing information and creating lists. An electronic watchlist created in real time gives nurses the most recent patient information, and also lends itself to patient safety by having up-to-date lists of patients that nurses can monitor quickly and more completely.

Mobile documentation
An EHR that has a mobile component will enable nurses to conveniently review and document care from smartphones using modern web browsers, saving them time from having to walk back and forth between the nurses station and patients’ rooms. Nurses, LPNs, aides or other care providers can use their smartphones for performing tasks such as quick medication verification and care intervention documentation.

Critical care flow sheets
EHRs that have critical care flow sheets integrated into the technology will help nurses in these settings to better understand the patient's journey and deliver appropriate care quickly. For example, whether their patient arrived through the ED or is currently on a ventilator in the ICU, providers will have clear, accessible information on the patient’s care progress all in one place, saving them time on documenting care. Nurses can also “live” in the flow sheet and review labs, meds and notes, all while collecting information from monitors, ventilators, EKG readings and administering and titrating medications.

Case management
A solution with case management functionality helps nurses to facilitate smoother transitions of care and reduce readmissions risks by tracking data from monitoring devices, such as bluetooth-enabled scales and blood pressure cuffs, so they can quickly identify those at risk of readmission and those with changes in condition. This gives them a chance to reach out and intervene before a costly visit to the ED or an unnecessary inpatient stay.

Integrated home care
An EHR with an integrated home care solution enables nurses to share allergies, medications, problems and other information across the spectrum. Home care agencies and hospitals then can work together as a team to improve care transitions, treat chronic conditions and avoid readmissions.

This type of integration benefits both the patient and their care team. With all of the patient’s information in one place, clinicians can view any request for orders and approve them, as well as approve any care plans. Home care nurses also save precious time by not having to use fax or snail mail to communicate. Agencies can also use their own smartphones to view their schedules, aid documentation and view a patient's diagnosis, procedures, medications or other important patient information.

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