Module 3 Entry

In this module, I learned a lot about information retrieval.  First, I used CINAHL, which is an index to research my clinical problem.  I found it very user friendly, and found it intuitive to search using Boolean phrases.  It was easy to focus my search using PICO as my guide (Patient/Problem, Intervention, Comparison, and Outcome.)  I was comfortable with this source, because CINAHL is highly recommended, and I found references from academic, peer reviewed journal articles.  I next referenced the National Guideline Clearing House, and found various guideline syntheses of research regarding my clinical problem.  Two areas I found especially helpful were area of agreement and difference; and comparison of recommendations.  I was comfortable utilizing this source because it is sponsored by the U.S. Department of Health and Human Services.  Lastly, I conducted searches using the web search engines, Google Scholar and Google.  On Google Scholar, I found scholarly articles, but most of them were too old to be considered relevant.  My Google search identified newer information, but most of the sources were questionable, and I would not feel comfortable using them in my practice.  In my future practice, I will include electronic indices, such as PubMed, CINAHL, and other scholarly indices, along with the National Guideline Clearing House so that I can include evidence based guidelines when treating my patients.

Module 2 Entry

Now that I am learning how to blog, the applications I can dream up are limitless!  In my free time, I love to think about ways I can use the blog to contribute to health promotion and disease prevention in my community.  I am new to almost every form of technology (and a little bit afraid, as well).  As a distance student, I have been forced to embrace technology.  I realize that it is the only way to be a competent practitioner.

            As I mentioned earlier, I am on a leave of absence from a free-standing infusion center and pharmacy that also administers IV infusions in the home.  Nursing uses paper charting exclusively.  I could discuss the virtues of a paperless documentation system with my director of nursing.  Since nurses work on-site, and in the patients' homes, I think that a secure web-based program would work well for nursing documentation.  While at the patients' homes, nurses could enter information via a laptop computer.  I think that the program should be able to communicate with the pharmacy in order to streamline the patients' medication reconciliation, which has to be completed with every patient visit (per Joint Commission mandate).  The pharmacist would also have access to the nursing assessment, in order to complete pharmacy documentation.  The program should be able to communicate with the billing department.  With correct coding, billing would not have to be completed by numerous office staff, and billing would not have to wait until the end of the month.  Lastly, the program should be able to communicate with hospitals in order to streamline lab results, discharge summaries and discharge instructions.  Currently, lab results are faxed, and nursing transcribes lab results into a separate program, line by line, requiring nursing time, and the possibility of transcription errors.

            Well fellow colleagues, it is nice to read your posts, and get to know you better.  Keep up the good work!