Working as a nurse takes extraordinary effort, focus, selflessness and energy to contribute to the health care community. The growing demands of today's health care industry alongside COVID-19 has made a nurses’ role even more indispensable.
According to the World Health Organization, nurses and midwives make up 20.7 million of the 43.5 million health workers worldwide – nearly 50 percent. And yet about 25 percent of WHO member states report having fewer than one nurse per 1,000 people in the population, according to a 2017 Global Health Observatory. This brings in a better understanding of the challenges before us.
Thinking of all the complexities revolving around the health care system worldwide and the challenges of coping with a decreased nurse-to-patient ratio makes it even harder to apply concepts that elevate the standards and quality of patient care across the globe. Working in the Middle East indicates a whole new level of patient experience, supported by the Government’s strategic direction toward achieving world-class health care by the year 2021. Nurses in this region are practicing on elevated standards and are supported by leadership and informaticians to perform at highest levels.
In response to COVID-19, nurses are finding creative ways to better communicate with patients. Technologies and health information systems support clinicians as they serve the patient community, and Cerner strives to design creative workflows and processes that can be easily adopted by clinicians without having to change the system they have become accustomed to over the years.
Numerous creative initiatives have recently emerged to accommodate patients' needs without physically visiting health care facilities. These initiatives still require nursing support and an additional focus on patient education. This has inspired the concept of the e-clinic nurse education service, which allows patients to speak to a nurse and have their educational needs covered, including picking up where the patient left off on their last visit and specialized education tailored to a patient’s needs.
The UAE Ministry of Health and Prevention (MOHAP) in partnership with Cerner worked to create a workflow that enables clinicians to identify patients' educational needs and make appropriate referrals within the system. This ultimately goes to a queue, allowing registration clerks to schedule those as e-clinic appointments.
Following this process, the identified team of e-clinic nurse educators use the Ambulatory Organizer, allowing them to view the list of patients with confirmed appointments pertaining to their specialty. The nurse educator would call the patient and deliver the education session with guided documentation once they are logged into a patient’s electronic health record.
Not only can nurse educators document education topics but they can also take a learning needs assessment prior to each session, which is also available on their education tool. The embedded learning needs assessment on the form helps keep education practice in line with patient and family education (PFE) guidelines provided by Joint Commission International (JCI).
Realizing its potential value, MOHAP and Cerner team collaboratively started with a pilot group of five nurses and a registration clerk. The education specialties within this team, such as diabetes and wound care, were applicable to the needs of the local population. Furthermore, high-risk populations like antenatal, postnatal and lactation–which could really make use of education more than any other service–were considered at this point. Additionally, Cerner has included general education topics covering various queries and areas of patient care not accommodated or covered during patient visits, such as using medications or devices at home, self-monitoring or risk prevention measures. Nurse educators were trained on the new workflow and system utilization to initiate this service, with the entire process being completed in less than a week.
It was rather refreshing to hear the excitement and eagerness from nurse educators to kickstart this project. Given the opportunity, the team was pleased they can now reach out to their patients and help the community using simple tools. To support the team, Cerner had a practice conference call and walked the MOHAP team through a scenario and showcased entire functionality.
Cerner also created special reference guides for the registration clerk and nurse educator workflows. Both were shared with the team along with support personnel. The MOHAP head office marked the launch of the project and sent out communications to all clinicians, to start using the referrals built for this service to better satisfy their patients’ educational needs.
Throughout the planning, design and implementation phases, the enthusiasm was palpable amongst team members. From the ministry’s head office to Cerner’s team to the nurse educators, I don’t know who was more thrilled to make this available for patients as soon as possible. Personally, the rush of executing and delivering a simple yet smart solution that can reach out to numerous patients during a time of definite crisis has made my year already!
MoHAP and Cerner are now working on further promoting this service among other health professionals. Given the current COVID-19 pandemic, both entities have ensured all teams and nurse informaticians are aligned with their shared vision and supporting physicians and nurses to use this opportunity for optimum patient service.
Nursing expertise is invaluable, especially during a pandemic. We must continue supporting our communities and reach out to patients who need professional support, while also finding ways to reduce the strain on nurses.
Using new documentation tools can be an added burden for nurses, especially during times of fear and uncertainty. Designing simple yet beneficial solutions is crucial. As an informatician and a nurse, I will strive to collaborate with my fellow nursing colleagues and think of innovative ways and tools needed to keep the community safe during these critical times.
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