Computerized Management Systems

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Computerized management systems or electronic medical records (EMR) are computerized medical records generated in an organization that delivers care, such as in a physician's office or a hospital. The EMR stores the patient's protected health information, such as patient history, test results, current medications, and demographics in a centralized database. There are many EMR systems available on the market today, but the two most popular systems are EpicCare and NexGen. A. Increase in Quality of Care

Computer management systems facilitate “patient safety and quality improvement through use of checklists, alerts, and predictive tools; embedded clinical guidelines that promote standardized, evidence-based practices; electronic prescribing and test-ordering that reduces errors and redundancy; and discrete data fields that foster use of performance dashboards and compliance reports” (Silow-Carroll, et al, 2012). The EMR has shown to improve communication within the interdisciplinary team, reduce medication errors and other clinical errors, such as ordering duplicate tests, and improve documentation. Clinical information is easier to access with an EMR. And it has the ability to collect quality improvement data from the system to identify the occurrence of problems and errors. B. Active Nursing Involvement

Nurses should be involved in the planning, choice, and implementation of the system because they are the ones that are on the frontline of patient care and will be using the system the most. By overlooking the nurses within the organization during the implementation process, it will adversely impact the universal goal of the planning, choice, and implementation of the system. Nurses may not cooperate and this may compromise the quality of service provided to patients, when they are not consulted and communicated with. Involving nurses in the implementation process will have a final outcome that is prone to be more accessible, wholly embraced, and thus have a larger positive influence on patient care. C. Handheld Devices

The use of handheld devices such as personal digital assistants (PDAs) in nursing would enable an access to a range of evidence-based resources, however, research has shown that PDAs are not commonly used by nurses (Johnson, 2008). Nonetheless, handheld devices used by nurses could be successfully integrated into management systems for better quality of care. The benefits of integrating a handheld device into nursing practice encompass “point of care access to electronic resources, which increases efficiency and productivity, facilitates time savings, and reduces errors” (Johnson, 2008). A handheld device, like a PDA or a smart phone, offers the nurse an ample assortment of resources that are configured specifically for the device. Nurses will not have to search for manuals, paper sources, or textbooks, wasting time, as it can be delivered in an electronic format. They can look up electronic resources immediately at the bedside using a PDA, instead of waiting around for a computer. Clinical reference guides for nurses are also available and are a valuable resource for nurses who may encounter a patient with an unfamiliar medical condition. Clinical calculators to assist in the calculation of IV drip rates or weight-based dosing for medication administration are invaluable to a busy nurse. Other resources include drug reference databases, medical dictionaries, diagnostic tools, and clinical guidelines. D. Security Standards

Due to the necessity to maintain confidentiality for electronic protected health information (e-PHI), the U.S. Department of Health and Human Services has sanctioned the Security Rule under the Health Insurance Portability and Accountability Act (HIPAA). The Security Rule outlines several technical safeguards required by organizations to use to shield e-PHI from security breaches.

The first technical safeguard is access control. Access control provides “users with...
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