As the old saying goes, “practice makes perfect," and in no place is that phrase more important than a profession in which it's your job to save people's lives.
So when it comes to training the next generation of nurses, an increasing number of nursing schools are looking at how an educational EHR improves can patient outcomes.
When nurses and other health care providers have access to complete and accurate information, patients receive better medical care and overall outcomes improve. Electronic health records (EHRs) can improve the ability to diagnose diseases and reduce-even prevent-medical errors. Accurate records can literally mean the difference between life or death in some cases.
With EHRs, nurses can enter, retrieve, and update individual patient records. Plus, the organizations that utilize these EHRs receive helpful tools, such as reminders and alarms, to help automate processes for improved clinical accuracy and outcomes. Electronic documentation with these systems can help decrease documentation deficiencies and errors, as well, since an EHR system's prompts remind a nurse to chart certain important aspects of the patient's case.
A national survey of doctors conducted by the National Center for Health Statistics found the following:
- 94% of health care providers report that their EHR makes records readily available at point of care.
- 88% report that their EHR produces clinical benefits for the practice.
- 75% of providers report that their EHR allows them to deliver better patient care.
And consider this case study:
Dr. Christopher Tashjian, a family medicine practitioner in Ellsworth, Wis., was visiting Estonia in 2011 when he got a call from a patient who needed a refill on blood pressure medications. Dr. Tashjian was able to access his patient's records using a mobile connection to his EHR, and called in a refill for the patient. He specifically sites the EHR's summary abilities as being extremely useful in improving patient outcomes.
“All their important health information is captured in the summary. They can take a print out of the summary to another doctor, which is also a helpful safety measure," Dr. Tashjian explained. “In addition to helping providers offer quality health care, the summaries allow patients to better remember what happened at their most recent visit and review their health data."
Plus, he added, “from a safety standpoint, one of the most obvious benefits is the computer physician order entry. There is no more confusion about the care instructions or the prescriptions I write because it is all done electronically."
Educational EHR: Train on Accurate Documentation, Improving Patient Outcomes
Many negative - and, even, deadly - patient outcomes can often be prevented with proper documentation. Some of the most common medical documentation errors can also be the most disastrous. Plus, improper documentation can open up an employer to liability and malpractice lawsuits. For nurses, who are on the front lines of defense in the medical field, being adequately trained early on proper documentation with educational EHRs can help avoid such medical errors, save lives and help protect their employers.
Here are some of the top 9 types of medical documentation errors:
- Sloppy or illegible handwriting
- Failure to date, time, and sign a medical entry
- Lack of documentation for omitted medications and/or treatments
- Incomplete or missing documentation
- Adding entries later on
- Documenting subjective data
- Not questioning incomprehensible orders
- Using the wrong abbreviations
- Entering information into the wrong chart
Also, a combination of the above common nursing and medical documentation errors can also lead to medication errors. Academic EHRs benefit nursing students in preventing medical documentation errors before entering into real-world practice.
The number of hospitals adopting EHR technology surged from fewer than 10% in 2008 to nearly 84% in 2015, according to federal data. But in order for EHRs to be efficient and effective in improving patient outcomes, practicing nurses need to be proficient in the technology. They need to know how to complete electronic care plans, collect data needed for patient education, and complete discharge planning. They also need to know how to effectively document in real-time rather than waiting until the end of the shift.
This is where nursing schools come in.
Practice Makes Perfect
Nursing schools need to employ educational EHRs to improve patient outcomes when nurses get on the job.
Nursing education programs provide nursing students with the fundamental nursing knowledge they will need to make quick, clinical decisions on the job that will be incorporated in EHRs. But nursing students also need to be taught to utilize EHRs to complete complex clinical calculations, identify potential drug interactions, and quickly scan large amounts of information if the appropriate electronic reports are accessible. The more practice they get using educational EHRs in class, the more comfortable they will be with them in a real patient setting.
Up until a few years ago, academic institutions offering nursing degrees did not typically include EHR use in curricula and nurses reported they were not prepared to use EHRs. But that has all changed. Today, nursing program faculty are working to develop curricula that includes current information technology, such as adding simulated EHRs to the assignments for the assessments and care plans completed during clinical rotation. The practice is needed to fill existing gaps between the informatics knowledge new nurses have and the skills they need to have on the job.
Educational EHRs can:
- Help nursing students become proficient in patient documentation.
- Enhance classroom learning and provide ways to introduce more patient-centered or case-based activity.
- Help nursing students fulfill their graduation requirement for EHR practice.
- Add another level of realism to patient simulation scenarios as students learn to care for patients.
- Offer the ability to customize scenarios to allow students to recognize important indicators within a patient chart that will affect patient outcomes.
- Teach students how to evaluate and document patient care within an electronic health record and prepare students for any EHR that they may encounter in practice.
Students have shared that the use of academic EHRs improved their charting performance, critical thinking skills, and preparedness for practice after graduation. Instructors benefit too, and say that using an academic EHR allowed them to provide immediate feedback to students and help students to further develop clinical reasoning skills as well as clinical skills.
Haywood Community College's School of Nursing in Clyde, NC, is just one college that has chosen Lippincott's DocuCare as their educational EHR of choice to prepare their nursing students for practice. Here's how the nursing program at Haywood deployed DocuCare:
- Instructors initially deployed it as an adjunct to clinical paperwork in a live environment. When they saw its usefulness, they used it to build case studies to support lecture material.
- Instructors use it extensively across the entire curriculum for first-year nursing students, transition nursing students, and capstone nursing students.
- First-year students use Lippincott DocuCare to get a feeling early in their education for how to document in an electronic health records environment.
- For transition students, instructors use Lippincott DocuCare to reinforce lecture material, and to teach how to use a true electronic records system in a simulated setting.
And the results? Take a look:
- Faculty creates between 48 and 50 assignments with it each semester.
- Nursing students create and submit nearly 100 care plans using it each semester.
- Between 400 and 500 students have submitted assignments in the system since Lippincott DocuCare was first introduced.
- Overall, approximately 2,000 scenarios have been run with it in the simulation lab. Haywood has added more realism to students"™ lab experiences by incorporating documentation as part of practice.
- Haywood nursing students graduate with experience that is a strong addition to a job interview because many hiring managers now consider documentation a required skill set.
- Capstone students use it extensively in case studies built as simulations.
“Nothing I've tried compares to Lippincott DocuCare," said Michael Youngwood, Lead Instruction Clinical & Simulation Coordinator at Haywood Community College's School of Nursing. “I can run simulations that are true to real-world hospital settings. It enables our students to graduate with hands-on experience with electronic health records, have better skill sets, and are more likely to find jobs when they graduate."