Running head: THE EFFECTS OF NURSING INFORMATICS IN LONG TERM
The Effects of Nursing Informatics in Long Term Care: An Annotated Bibliography
Alana Denton
Dixie State
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THE EFFECTS OF NURSING INFORMATICS IN LONG TERM
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The Effects of Nursing Informatics in Long Term Care: An Annotated Bibliography
Alexander, G. L., & Madsen, R. (2009, Jul). IT sophistication and quality measures in nursing
homes. Journal of Gerontological Nursing, 35(7), 22-27. Retrieved from
http://search.proquest.com/docview/204206626?accountid=27045
The focus of the article was to find the relationship between information technology (IT)
sophistication and quality measures within the nursing home setting. The research was
done in 210 selected nursing homes in Missouri and seven national quality measures
pertaining to skin integrity were used. The results of the study showed that more of the
IT resources were utilized by the administrative aspects of the homes rather than the
resident care management and clinical support aspects, but it did show an increase in the
latter facets. In the study, greater IT sophistication resulted in quicker detection of the
decline of activities in daily living (ADLs) but also a higher incidence of incontinence,
due to more accessibility for documentation. The article pointed out that with increased
IT sophistication and integration, quality care in nursing homes can be improved with
higher efficiency and better planned interventions.
Breen, G., & Zhang, N. J. (2008, Apr). Introducing ehealth to nursing homes: Theoretical
analysis of improving resident care. Journal of Medical Systems, 32(2), 187-192. doi:
10.1007/s10916-007-9121-9
The purpose of the article is to enlighten the health care community of the benefits of
using ehealth services to achieve improved patient outcomes and gain a greater
knowledge base. The authors evaluated several research documents and constructed
literature reviews of their findings. The research findings showed that ehealth services,
such as WebMD.com and Medlineplus.gov, provide an easy way to maneuver through
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multi-faceted medical information, making it more accessible for medical professionals
to sift through and provide proper educational information for residents. Although the
research confirmed ehealth services benefited nursing homes as a whole, it was highly
beneficial for homes in rural locations, those with fewer staff, and those with diminished
funding, aiding in filling the deficiencies.
Dyck, M. J. (2002, Oct). Nursing informatics: Applications for long-term care. Journal of
Gerontological Nursing, 28(10), 30-39. Retrieved from
http://search.proquest.com/docview/204144520?accountid=27045
The author of this article stresses that while the healthcare field has been attempting to
utilize technology, full application of nursing informatics concepts has not been utilized
with the same fervor. Long-term care computerization does not necessarily mean
informatics is being used. In order to effectively apply informatics to its complete
potential, it should be used to maintain a legal record of care, facilitate clinical decisionmaking, manage costs, construct a database for administration and quality needs, and
enable data exchange between other facilities. By applying concepts of nursing
informatics, higher quality care can be provided for residents in long-term care.
Field, T. S., Rochon, P., Lee, M., Gavendo, L., Baril, J. L., & Gurwitz, J. H. (2009, July-Aug).
Computerized clinical decision support during medication ordering for long-term care
residents with renal insufficiency. Journal of the American Medical Informatics
Association, 16(4), 480-485. doi: 10.1197/jamia.M2981
A study was conducted to evaluate the effectiveness of the use of clinical decision
support systems (CDSSs) to assist in prescribing medications for long-term residents with
renal insufficiency. The results were obtained using a control group with their normal
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electronic health records (EHRs) but without the use of a CDSS while the intervention
group used the CDSS as well as the EHRs. The results showed that by using the CDSS,
physicians were more likely to avoid nephrotoxic drugs and order serum creatinine tests
when test results were not available. The CDSS made physicians more aware of the
medication dosages prescribed to patients with these sensitive issues, improving renal
sufficiency for long-term residents.
Rochon, P. A., Field, T. S., Bates, D. W., Lee, M., Gavendo, L., Erramuspe-Mainard, J., ...
Gurwitz, J. H. (2005, Oct). Computerized physician order entry with clinical decision
support in the long-term care setting: Insights from the Baycrest Centre for Geriatric
Care. Journal of the American Geriatric Society, 53(10), 1780-1789. doi: 10.1111/j.15325415.2005.53515.x
In many acute care settings, clinical physician order entry (CPOE) systems are used to
reduce medication errors and order contraindications, but they are rarely implemented in
long-term care (LTC) facilities. One LTC center, Baycrest Centre for Geriatric Care,
noticed the large amount of medication use and polypharmacy and decided to apply
CPOEs into practice in an effort to reduce adverse effects. By having realistic
expectations, using a CDSS in conjunction with CPOE, and providing the proper training
for physicians, Baycrest was able to integrate this system into their facility. Although it
did not necessarily reduce time, the CPOE catches mistakes that would have otherwise
been missed and enable better records to be kept.
Rantz, M. J., Skubic, M., Alexander, G., Popescu, M., & Aud, M. A. (2010, Jan). Developing a
comprehensive electronic health record to enhance nursing care coordination, use of
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technology, and research. Journal of Gerontological Nursing, 36(1), 13-17. Retrieved
from http://search.proquest.com/docview/204155409?accountid=27045
The article illustrates the use of comprehensive electronic health records (EHRs) in which
one can not only input data through text, but sensory data as well. TigerPlace, an
independent senior housing facility, studied and documented health information through
the use of multiple sensors, such as in the bed and stove, as well as general motion
sensors and cameras to obtain sensory data as well as textual information. Through the
use of this technological system, the health care team was able to obtain regular patterns
of activity and behavior, enabling them to also respond quicker to abnormal patterns and
form more effective, early intervention techniques.