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IT Systems Help Facilities Achieve Magnet Recognition

Monday September 7, 2009
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Magnet recognition and informatics is “a little bit like the chicken and the egg,” says Mary Kennedy, RN, MS, director of clinical informatics at The Miriam Hospital in Providence, R.I. “There is so much alignment between Magnet and informatics that one naturally drives the other.”

Miriam first received the American Nurses Credentialing Center’s Magnet Recognition in 1994; it’s now working on its third redesignation.

New Magnet Model
The new Magnet model encompasses transformational leadership, structural empowerment, exemplary professional practice, and new knowledge. “Informatics sits in every one of them,” says Marisa Wilson, RN, MHSc, DNSc, assistant professor, University of Maryland School of Nursing, who teaches a course on how IT can transform healthcare and maintains clinical hours in acute care.

Commitment to IT starts at the top. “Technology can either wreak havoc or can be managed for effective change,” says Wilson. “The chief nursing information officer needs to be able to speak at the C suite and stand for what nurses need.”
IT “is the vehicle that enabled the evidence [for Magnet Recognition] to be collected,” says Kimberly Caruso, RN, MSN, Magnet program director and clinical nurse educator at Geisinger Medical Center, Danville, Pa.

Geisinger developed a Magnet Web site for nurses. “We use the Web site during the application process to let people know where we are and what deadlines are coming up,” says Caruso. Employees can submit “Magnet Moments” — examples of employees living Magnet principles — and submit comments and suggestions.

IT facilitates interdisciplinary collaboration. At The Miriam Hospital, Kennedy says nurses, physicians, and other healthcare professionals work together to create electronic order sets. Electronic nursing protocols, such as one that addresses skin care and mobility in the elderly, are easy to access, easy to refine, and encourage nurse autonomy.

“We’re one of the few hospitals that has both inpatient and outpatient electronic health records,” says Terry Bickert, MSN, RN, NE-BC, associate vice president of nursing services for Geisinger. “They help us unite all the caregivers.”

Any innovation requires fine-tuning, and IT can help with that, too, says Kennedy. In the past, The Miriam Hospital would use meetings to gain feedback on different projects but now the hospital turns to a variety of online forums, such as those geared toward clinical practice and ones for unit-based best practices. Feedback is just a mouse click away.

Consumers benefit from innovation, too. With “My Geisinger,” patients can view their medical record online, access health and fitness information, and communicate directly with their physicians’ offices for needs such as appointments. Patients in the hospital can connect to friends and family by laptop computers with wireless access.

Empirical Outcomes
“IT is the vehicle that enables us to link the evidence with outcome,” says Caruso. “It enhances our data collection, eliminates redundancy of chart writing, increases accuracy of documentation, and gives us more automatic data collection.”

Wilson says data can be used to create dashboards for nursing leaders to use in tracking nursing-sensitive indicators that affect patient outcomes. “It’s taking the data and creating a graphic format in real time,” she says. For example, by tracking the number of days a urinary catheter is in place, nurses can be sure to take appropriate action to prevent infection.

Good outcomes require good information retrieval. Geisinger supplies employees with a comprehensive, online health science library, where they can run literature searches and quickly access information, such as drug dosages. They also have access to policies, procedures, education programs — including those to determine knowledge competencies — and patient education material. “All this supports evidence-based practice,” says Bickert.

“If you put technology in the hands of nurses, you can transform the way bedside care occurs,” says Wilson.

Cynthia Saver, RN, MS, is president of CLS Development Inc., in Columbia, Md.

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