Improving IT Enabled Continuity of Care Across Pre- Hospital and Hospital Settings

Pre-hospital Emergency Medical Services (EMS) are often the patients’ first contact with the health care system. These services are a collaborative effort between several organizations providing different levels of care. These services are also multi-organizational, process oriented, and information dependent. As a result, a significant challenge exists in these fastpaced environments in terms of collecting and handing-off accurate and timely patient information from one care provider to the next. Consequently, there is a significant need for technology-enabled process improvement initiatives and guiding frameworks for streamlining information hand-offs across pre-hospital and hospital settings. This multi-method study explores the current state and potential improvements of technology-enabled pre-hospital to hospital information hand-offs in the State of California (CA). A questionnaire was administered to EMS leaders across the State. Qualitative interviews and focus group discussions were then conducted on two CA county EMS systems to explore potential improvements and to construct a set of principles to guide system development to support emergency care processes. A set of design principles, guidelines, themes, and end-user needs are presented and future research directions discussed

A pragmatics' view of patient identification.

Patient identification is a central safety critical aspect of healthcare work. Most healthcare activities require identification of patients by healthcare staff, often in connection with the use of patient records. Indeed, the increasing reliance on electronic systems makes the correct matching of patients with their records a keystone for patient safety. Most research on patient identification has been carried out in hospital settings. The aim was to investigate the process of identification of patients and their records in the context of a primary healthcare clinic

Usefulness of Medication Scanners in Clinical Practice: A Systematic Review

Thousands of people die each year due to preventable medication errors. Barcode medication administration (BCMA) systems can reduce medication errors at the point of care, thus increasing patient safety. The purpose of the project was to gather evidence regarding BCMA usefulness in reducing medication errors. Kurt Lewin\u27s 3-step change theory was used to guide this project. The nature of this project was a systematic review of the literature pertaining to the effectiveness of using BCMA systems to reduce medication errors in at the point of care in the hospital setting. The Johns Hopkins nursing evidence-based practice model and tool kit was used to evaluate each article. The review comprised one systematic review, one integrative review, and 6 before-and-after observational studies. The results of each study indicated that the use of a BCMA system could reduce medication errors but not completely eliminate them. The findings of this project contribute evidence that BCMA systems can assist the clinician in safely administering medication. Dissemination of the evidence will contribute to a positive change by promoting greater understanding of the effectiveness of using BCMA systems in all areas that administer medication

Overcoming: A Theory of Accelerated Second-Degree Baccalaureate Graduate Nurse Transition to Professional Nursing Practice.

A plethora of stressors are known to be related to the process of transition to professional nursing practice as the neophyte registered nurse (RN) transitions from student to professional nurse. Although not new, accelerated second-degree baccalaureate nursing (ASDBN) programs have opened in record numbers in recent years in the wake of the current nursing shortage. Little is known about the experience of professional practice for accelerated second-degree baccalaureate graduate nurses (ASDBGNs). The stressful graduate nurse transition, current nursing shortage, and lack of an empirical base for ASDBN programs illustrate the significance of the research problem. This modified grounded theory study generated a substantive Theory of Overcoming: ASDBGN Transition to Professional Nursing Practice. Constant comparative method of joint data collection, analysis, theoretical sampling, and memoing was used. Data were collected through semistructured interviews using open-ended questions that were conducted over the telephone or in person. The identified basic social process (BSP), overcoming, encompasses 5 stages: reality check, goaling, getting started, coming out on top, and mastering. Study findings provide a beginning evidence-base for nursing education, policy, and clinical practice related to this growing student population