The history of medicine is full of lessons of object illustrating this point. Take monitoring electronic fetal heart. FSM technology become available late 1950s, and in a decade, clinicians through the United States used in the hope of spots at the beginning of the complications of pregnancy. Now, if an obstetrician does not use FSM, and there is a kind of serious complication, it is probable, that he or she will be sued for malpractice.
Unfortunately, the technology has been widely adopted before it was rigorously tested in clinical trials. Subsequent studies have shown that, in many respects, FSM is not better than the examination of a patient with a rudimentary Pinard stethoscope. The lesson here is clear enough: don't be not too rapid jump on technology "solution" before there is sufficient evidence to show it works.
While "solutions" will improve the safety of the patients and who does - or worse yet, putting patients at increased risk? We will explore some elements of evidence.
First, the bad news
When researchers recently studied how nurses and nurses and nurse managers used automated systems of distribution of medicines, computerized order entry systems and checklists to monitor medical errors, they found thatAlthough tools were effective in alerting nurses to errors, many Stam did not act on these alerts. More than half of the nurses surveyed said they had seen other clinicians take dangerous shortcuts, for example, but only 17% are discussed with colleagues. Similarly, more than 33% of the nurses saw incompetent behavior "that led to a near miss or actual harm to a patient." But only 11% of this group has taken any action.
The reason for inaction: about six in ten nurses remain silent because they were afraid to speak or could not obtain other attention. Bottom lines, according to researchers at the American Association of critical care nurses and their associates: "tools do not create security." people do. "I would it a step further. Unless create us a culture of tolerance zero in which clinicians cannot be intimidated, bullied or ignored when they see errors, patient safety is only a chimerical. And it is only steps to minimize the value of healthcare IT. It merely illustrates that it is only a factor in a complex environment.
Unfortunately, clinical inaction is not the only thing that can derail health, notes Christian M. Pettker, MD, assistant professor at the Yale School of Medicine and an expert on the safety of patients. "There are a lot of gains associated with EHR, but there are also a few sacrifices," said. "Our access to information as the previous admissions, laboratory data and care provided by other clinicians is useful because it can we prevent repeat testing and helps us come to earlier diagnosis."
However, because clinicians know that the information is so easily accessible, they tend to communicate people less frequently, Dr. Pettker said. It is easy to just assume others saw important data on patients and act on it all simply because it is in the system. "If I order a medicine to be given immediately, I can't assume that if put order into the computer and press the button STAT, the patient will have it immediately," he said. "I still speak directly to the nurse on the unit and, probably, the pharmacy so.." These health care providers are not glued to their computers. They are often take care of other patients. "And there may be a warning system that sends an urgent message to their smartphone, for example, to get their attention."
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