The shortage of registered nurses in hospitals threatens to cripple healthcare delivery in the next three to five years. The demand for nursing care has increased while the willingness of nurses to stay at the bedside in acute-care settings has decreased. The American Academy of Nursing Workforce Commission developed and tested a process called Technology Drill Down in more than 200 medical-surgical patient care units in a study supported by The Robert Wood Johnson Foundation. The process identified workflow inefficiencies that could be addressed through the deployment of technology. Findings from the study indicate the need for smart, portable, point-of-care solutions that are interoperable across devices and systems. Nurses believe that technology can reduce waste and workflow inefficiency and enable nurses to provide safe, reliable, quality patient care.
"In theory, savings in nurses' unproductive time can lead to reductions in staffing requirements or lower overtime (Case, Mowry, and Welebob 2002; Turisco and Rhoads 2008). EMR might also improve nurses' working conditions, which could lead to higher nurse satisfaction and lower turnover (Bolton, Gassert, and Cipriano 2008). Evidence that EMR improves nurse efficiency is mixed. "
[Show abstract][Hide abstract] ABSTRACT: To estimate the effects of electronic medical records (EMR) implementation on medical-surgical acute unit costs, length of stay, nurse staffing levels, nursing skill mix, nurse cost per hour, and nurse-sensitive patient outcomes.
Data on EMR implementation came from the 1998-2007 HIMSS Analytics Databases. Data on nurse staffing and patient outcomes came from the 1998-2007 Annual Financial Disclosure Reports and Patient Discharge Databases of the California Office of Statewide Health Planning and Development (OSHPD).
Longitudinal analysis of an unbalanced panel of 326 short-term, general acute care hospitals in California. Marginal effects estimated using fixed effects (within-hospital) OLS regression.
EMR implementation was associated with 6-10 percent higher cost per discharge in medical-surgical acute units. EMR stage 2 increased registered nurse hours per patient day by 15-26 percent and reduced licensed vocational nurse cost per hour by 2-4 percent. EMR stage 3 was associated with 3-4 percent lower rates of in-hospital mortality for conditions.
Our results suggest that advanced EMR applications may increase hospital costs and nurse staffing levels, as well as increase complications and decrease mortality for some conditions. Contrary to expectation, we found no support for the proposition that EMR reduced length of stay or decreased the demand for nurses.
Health Services Research 08/2010; 45(4):941-62. DOI:10.1111/j.1475-6773.2010.01110.x · 2.78 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To assess the accuracy of the EverOn™ piezoelectric sensor based contactless heart rate and respiration rate monitoring system.
Measurements of the EverOn™ and reference devices were performed in a sleep lab and an intensive care unit (ICU) setting. One minute measurements by both the reference device and the EverOn™ were averaged and compared. Accuracy was defined in accordance with industry criteria.
Respiration rate (RR) accuracy in the 41 children and 16 adults evaluated in the sleep lab was 93.1% and 90.6% respectively, and heart rate (HR) accuracy was 94.4% and 91.5% respectively. For the 42 ICU patients RR accuracy was 82.0% and 75% (versus end-tidal CO(2) and manual respectively), while accuracy of HR was 94.0%. The EverOn™ was found to be superior to the impedance technique in measuring RR.
The system described was found to be accurate in accordance with regulatory and industry criteria.
Journal of Medical Engineering & Technology 10/2010; 34(7-8):393-8. DOI:10.3109/03091902.2010.503308
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