Module 2

What is one way you could become involved in designing, selecting, evaluating, or implementing an information system in your workplace?

I would implement a way to evaluate the time each MA or RN spent with each patient during check-in and the time the patient waits to see a health care provider and then the time the patient waited for treatment.  This evaluation will determine where the slow down is for moving patients in and out of the urgent care and where we can better focus our attention and resources to provide quicker, yet quality care to more people.  Also,  we need to collaborate between the University Hospital and the clinics for patient records.  This is essential and I believe it is in process however has not happened yet.  Another way to better provide care is to reconcile patient medications between hospital networks.  We do not have access to Intermountain Health Care's patient records and therefore a patient essentially could be double dosed with the same medication.  We would need an information system to better reconcile medications and patient histories.

Humbling

At the clinic, I have become quite frustrated with patients that come in just for a pregnancy test.  You can buy the $4 stick to pee on in the comfort of your own home instead of coming to the urgent care, paying the $15 copay, and then charging Medicaid for the visit and "lab" test and provider fee. So we tax payers are funding the urgent care visit for a completely unnecessary test.  I take this personally and can go off ranting about the US administration of Medicaid for a long time.  But in this instance, I asked the patient if she took a home pregnancy test and she said that yes, it was negative.  I left the room (with a very fake smile because half of health care is customer service) to check the results from the lab and it was positive!  It questioned my confidence in the specificity and sensitivity of home pregnancy tests.  I freaked out that I may be pregnant even though my April Fools day home preg test said negative :)  Yes, I assume there was user error in the patient's administration of the home pregnancy test, but still I am reminded that not all tests are accurate.  Humbled, my rantings on unnecessary urgent care visits that I, as a tax payer, end up paying for, were subdued that day. 

Big day: the girls go outside!

I kicked the girls out last night right before I went to work. Well, not exactly kicked, but I did drop them once and banged the tub against the door (all three doors.)  When I got home, it was in the 50's  and my mam-hen heart was torn.  Should I bring them back inside where it was warm and free of drafts? Pros: 1) Warmth; Cons:  1) Clean the brooder cause it stank something fierce 2) Be mad at the dust for another day 3) Feel the tension in the house from Ms. Claus's imminent death and constant squawking...I left them outside, but I did get the heat lamp and clip it inside their brand spanking new home.  They seemed to like that.  With our bathroom window open, I fell asleep to Ms. Claus's squawking. Sorry Neighbors.
When I woke, Eddie came home and gave me the news...Ms. Claus passed on.  I'm not sure if I should have rejoiced or cried.  I did neither.  Thankful, I guess, that I didn't have to take her for a drive in the country.  Maybe I should have done that just to remind myself that these are birds (pets, yes) but part of the food chain.  But, well, I'm emotionally invested.  So on with the day.  It didn't rain like the weather person said it was supposed to (surprise!); instead it was beautifully sunny.  So, Eddie in a drunk-like sleep deprived state from working all night, worked all morning on the run while I finished painting.  I put the straw in the coop and he put the wheels on the run.  Then it was warm enough to put the birds in the run and see what they do.  They were scared at first and clumped together in a corner, but soon gained courage to explore.  It was so cute to see our girls in their new home with plenty of space to roam and forage and sun bathe!  Next step, hope they are all girls and then get that permit.

Garden is a growing!

Blue potato seedlings sprouted!

Eddie made a compost bin and it has been churning for 4 months

Greens at 2 weeks (Snap peas, kale, chard, lettuce)

Onions at 3 weeks

Squash holes at 1 day between 2 boxes (zucchini, spaghetti, and cucumber)

Chicks at 6 weeks: Still inside

The girls crowded together. from left to right (Redbud, Shithead, MLK, Koenig, and the name of the week for this last one on the right is La-a (Ladasha).  Ms. Claus is not pictured here but still is holding on. We're not sure how she's made it this long, but she's still chirping away.

Shithead, MLK, and Ms. Claus

Redbud in her practice roost

We had to add the screen a couple weeks ago to minimize the dust and make sure they don't jump out.

Eddie building the coop.

Eddie wishes he was a chicken with a coop this nice.

This is the area where the coop will go.

Eddie is carefully studying the blue prints

Module 1

My name is Josie Decker. I graduated from Indiana University with a BSN and have been a nurse for 9 years.  I have mostly worked in labor and delivery but have some experience with international healthcare relief and education, teaching LPNs in clinicals and classroom, managing a skills lab and computer simulations, and camp nursing.  I currently work PRN in an urgent care in West Valley and am learning tons.  I am also in my 1st year of the DNP program in family nurse practitioner.  My husband is also a nurse.  We met in Austin, TX, then moved to North Carolina where he got his nursing degree from UNC.  Then we moved here to Salt Lake for the DNP program, got married in October, and seemingly dedicated our lives to the U.  He works on the intermediate care unit at the U, I go to school at the U, I work for the U at the Redwood Clinic, our church meets at the Post Chapel at the U, and I just got a cavity filled today at the U's dental clinic.

Information management is essential to nursing practice at a graduate level.  Healthcare is developing and with it information management must be progressively developing.  As a leader in the field, I will need to be able to synthesize health information in order to compile statistics about the population that I'm serving and adjust my practice to meet their needs.  I will need to be able to search scholarly articles and databases to  implement current research.  I will need to be able to share information securely for interdisciplinary coordination of care.  I will need to apply information technology to ensure quality and efficiency in my practice.  I will need to know about information management in order to communicate effectively and teach health care to consumers and staff. 

IT is used routinely at the Redwood Center urgent care.  We use computer prompts to ask questions of patients related to their chief complaint.  We use computer links to the lab, pharmacy, and xray for orders.  Nurses use Vocera for communication during emergencies.  We use computer codes for billing.  We use Epic for documentation.  We use a computer system for referrals and for internal staff emails.  I do not have one, but I know that patients can access their personal health information through their handheld data devices or iphones.  We all use passwords to secure computer access.  IT is necessary to making the clinic efficiently functional in serving our patients.