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Posts tagged ‘Susan McBride’

Reconceptualizing the Electronic Health Record for a new decade: A Caring Technology?

Our first featured article in ANS 42:3 is titled “Reconceptualizing the Electronic Health Record for a New Decade: A Caring Technology?” authored by Catherine Robichaux, PhD, RN; Mari Tietze, PhD, RN-BC, FHIMSS; Felicia Stokes, JD,MA, RN; and Susan McBride, PhD, RN-BC, CPHIMS, FAAN. This article examines and critiques a 2009 article published exactly 10 years ago in ANS that focused on the electronic health record and propose a virtue ethics framework for the future (see Dilemmas, Tetralemmas, Reimagining the Electronic Health Record). It is available for free download while it is featured, and we welcome your comments related to this important topic!  Here is a message from Dr. Robichaux about this work:

L to R – Felicia (Liz) Stokes, Mari Tietze, Catherine Robichaux

We are very happy to have this article published in the Critique and Innovation issue of ANS. This is our second collaborative publication and we each bring different experiences and perspectives to the complicated issues inherent in the development and use of the electronic health record (EHR). Susan and Mari are nurse informaticists, researchers and educators, Catherine’s background is ethics and education, and Liz (Felicia) is a nurse ethicist, policy expert and attorney. As with our first article, this manuscript evolved from Susan and Mari’s research exploring nurses’ experiences with the EHR in which the participants described a wide range of advantages and disadvantages.  Recognizing that it had been ten years since passage of the HITECH act in 2009, we were interested in whether some of the problems

Susan McBride

described in their research were identified ten years ago. Through our literature review, we discovered the article by Petrovskaya, McIntyre, and McDonald, Dilemmas, tetralemmas, reimagining the electronic health record.  This article beautifully analyzes advanced technologies with the ethical and philosophical constructs of caring in nursing.  Rather than viewing the use of technology and caring practice as an either/or dilemma, they suggested application of the tetralemma, a Buddhist approach which expands the range of choices.

Although positive aspects of the EHR have been realized since 2009, many problems identified by Petrovskya et al. continue. We discuss these ongoing challenges to patient safety and nursing practice and suggest integration of polarity thinking with the tetralemma as a viable approach to resolution.  Petrovskya et al. also addressed the potential negative impact of the EHR on ethical nursing practice and we explore the relevance of virtue ethics and technomoral wisdom in revisioning the EHR as a caring technology.

We believe that the roles of nursing leadership, education, research and organizational accountability are all critical in addressing the issues identified in this article.  We hope this discussion is helpful to readers and we look forward to your comments.



Preventing Hospital Readmission

The current “Post-Hospital Nursing” featured article provides a report of a study to determine hospital admission variables that might predict a risk for re-admission.  The article, titled “Can Nurses Tell the Future? Creation of a Model Predictive of 30-Day Readmissions,” is authored by Adonica Dugger, DNP; Susan McBride, PhD; and Huaxin Song, PhD.  Dr. Dugger sent this message about this work for ANS readers:

Hello, and thank you for your interest in our article published in the current issue of Advances in Nursing Science, “Can nurses predict the future? Creation of a model to predict readmissions.”   I would also like to thank Advances in Nursing Science for the privilege of having the article published. The journey to the research for this project started, as I was a director for case management and was attempting to identify patients who may have a readmission to my hospital. I Dugger-Adonica_400thought of all the factors that I, and my fellow case managers, felt, when present, would likely predict a readmission to the hospital.   I reviewed many of the predictive models available in the literature, but I couldn’t find one I felt addressed the population of patients seen at my hospital in West Texas.   At that point I wasn’t sure what to do next, but I soon started my studies toward a DNP at Texas Tech University Health Science Center.   Soon after beginning, I met Susan McBride and learned how a predictive model was created and validated. With guidance from Dr McBride and Dr Song, I was able to examine the data and create a model to predict the patients most likely to readmit to my hospital within 30 days.

Through this project, I have learned much about how a nurse with a PhD and one with a DNP can work together to solve a problem and put the solutions into practice more quickly. These partnerships allow for a nurse’s practice to be truly evidence based and help to improve the quality of care we give to our patients in the acute care setting. I also learned the value of the data that is available as the use of electronic health records grow throughout Texas and the nation. Nurses can use this data to help prove both how and why changes to current practices should and could be made.

Since this article was submitted in April of 2014, I have moved from case management back into the surgical services area of the hospital. We are looking at ways to predict our daily, weekly, and monthly case loads, which patients may be more likely to have a post operative infection, and factors that will delay our case starts. Throughout the hospital, change is also being considered with predictive modeling, as nurses examine our patients with pressure ulcers and seek to determine if a risk scoring system specific to our patient population can be created.

You can download this article for free while it is featured on the ANS web site!  Read this article, then return here and share your comments!

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