Seclusion and restraint are often associated with increased rates of staff and patient injuries in addition to coercive and traumatizing intervention (Wale, Belkin & Moon, 2011). Therefore, to address discharge issues, there is the need to introduce a change to the organization that will also decrease seclusion hours and restraint. There is the need to introduce a change that would reduce seclusion hours and restraint. Informatics has been argued to be an appropriate strategy to reduce restraint and seclusion since it can help to facilitate the introduction of change to the mental health care that might help decrease seclusion hours of the people with a mental health condition ( HIMSS , 2015). The quality improvement project that the paper seeks to analyze is restraint, and seclusion in mental health facilities and the primary goal is to reduce seclusion and restraint by 50% by July 2018.
Information technology systems to gather data
The qualitative research design was used collect information for the study. In using qualitative design, secondary data from online works of other authors were used to respond to the research topic. In gathering data, a systematic literature review was used. Four articles were selected from online sources as related to the objective of the study. Secondary data was thus gathered using a descriptive cross-sectional design to determine the importance of informatics and technology in reducing restraint and seclusion in mental health facilities.
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A- Nursing informatics and quality improvement initiative
Nursing informatics will actively support nursing in the reduction of restraint and seclusion in mental health facilities by providing a standard language, decision support, databases, technology assessments and readily accessible research results (Darkins et al, 2008). Therefore, through the normalized dataset spanning the entire mental health institution, nursing informatics tools would help to improve overall healthcare through responding to questions on patient outcome and the quality improvement in addition to strategic planning that would overall reduce restraint and seclusion of mental health patients ( HIMSS , 2015). Nursing informatics tools would thus offer a suitable and highly advanced nursing practice at the mental health institution to critically scrutinize their practice and possible impact of their action on the patient outcome concerning restraint and seclusion in mental health facilities. Therefore, the analysis of the patient outcome at this facility would result in core initiatives critical to quality improvement ( HIMSS , 2015). In a general view, through the support of the nursing informatics tools, advanced practice nursing will be able to leverage quality strategic improvement initiative against the mental health institution premeditated strategy to obtain leadership support and resources which will help to reduce restraint and seclusion in this facility.
b- Influence of information technology on patient care
B1- patient care improvement
Research has established that information technology within the health sector plays a critical role in improving patient care. At first hand, information technology has the potential to promote a patient-centered health care improve the quality of care and educate the mental health professionals and patients (Darkins et al, 2008). Information technology is typically attributed to reliability and timeliness which are critical to a good-patient care. For instance, real-time accessibility, exchange and even the receipt of data reduces potential replication of patient care services in addition to improvement of patient care quality. Utilization of computer-based system would help to create an opportunity for the nurses to reduce possible charting time in addition to nursing over time hence increasing the time of carrying out patient care ( HIMSS , 2015). Further, the day-to-day time requirement for the care activities in physically entering the patient information including the vital sign laboratory result and the order prescriptions have been reported to have potentially reduced through the use of Hospital Information System. As a consequence of this, it creates more time to be spent in the provision of nursing care which is a critical factor in increasing the quality of nursing practices and at the same time improve patient care.
B2- nursing time that technology takes away from patient care
Technology has greatly expanded in the healthcare; however, it has led to several downsides where it takes away nursing time from patient care. Technology helps to make nursing run efficient, but it takes these nurses away from the bedside. According to Charters (2003), the use of technology such as electronic medical record systems to document patient’s charts digitally will help nurses to look up information by clicking a button; however, charts makes the interaction between the nurses and patients less personable. Previously nurses used to visit the patient’s room and establish a working relationship, complete their patient assessment, provide medication and help the patients with their needs but this has changed drastically with the introduction of technology. Today, nurses seem to spend most of their time on the computer rather than tending to the patients. Technology has enabled the nurses to chart their patient’s blood pressure, height and even weight by putting the patient’s arm in a cuff or having them stand under a machine and then data is recorded electronically (Darkins et al, 2008). Despite the fact that most patients prefer an improved technology since it makes them safer, they still want human aspect provided by nurses. A therapeutic relationship clearly between the patients and nurses is important since patients should be able to trust and at the same feel respected by the nurses to enhance their stay in the hospital and quick recovery, but this has been affected by technology ( HIMSS , 2015). Hospitals are continuing to adopt more technologies to improve medical care, but this brings about less face-to-face care.
B3- advantages and disadvantages of bar-coding
The mental health care can significantly benefit from the full spectrum of bar code applications resulting to reduced seclusion and restraint by 50% by July 2018. Below are the main advantages of bar-coding in mental health care. First, it facilitates fast and accurate capture of patient’s data which reduces the chances of errors. According to Charters (2003), the bar code helps to capture data accurately hence resulting in accurate diagnosis and treatment. Bar coding further results to better decision making where it allows for precise and timely data capture critical to gain better knowledge about the patient’s condition and the type of medication to provide to the patient ( HIMSS , 2015). Bar coding has further been associated with a reduced labor cost through elimination of paperwork in the documentation which saves a significant amount for the hospital which could be used in other areas to improve a quality of care. Lastly, bar-coding facilitates productivity measurement, where an accurate and timely data capture capability to track patients’ conditions and improvement results to increased productivity of nurses (Darkins et al, 2008).
Besides the advantages, a barcode is associated with several disadvantages; first, the cost of acquiring and implementing the equipment and other critical infrastructure is very high resulting in increased cost of operation. According to Charters (2003), the labeling of the location with the barcode labels in most instances is time-consuming and an expensive process. Further, there would be the need for the hospital to adopt the compliance process which is often time-consuming and costly. The adoption of bar code would require training and culture shift which would be expensive and need more time to adapt to the system complexly.
2- Systems that contribute to the management and maintenance of change
The primary objective of change management process is specifically to carry out a formal and standardized methodology when it comes to handling changes in the mental hospital. The most suitable system that would help in the management and maintenance of change for the mental health organization is the Common Web Platform (CWP) team (Darkins et al, 2008). The system will help to regularly patch and upgrade software running on the organization’s website to guard against potential vulnerability and at the same time prevent the system from becoming unsupported. It entails the operating system and the software running on the servers in addition to the shared system including caches, code repository, search and even firewalls.
3- Health and Medicine Division recommendations for integrated information systems
Cerner software
A newly integrated clinical information system that the mental health hospital should adopt is Cerner software. In the year 2008, the Ministry of Health had issued a strategic priority that required health authorities to standardize and rationalize all their information system to either Meditech or Cerner ( HIMSS , 2015). Cerner integration offers healthcare organization with a nonintrusive approach for the unification of the paper and electronic documentation. In this case, it would be important that the mental health care adopt and implement Cerner (Charters, 2003). Cerner platform has a long history of hundred of successful implementation in North America and globally. Recently, Cerner was selected by US Department of Defense to be adopted in upgrading the largest and complex clinical information system globally. Cerner is the commonly known product built for the health sector which makes it simpler to configure the adopted technology to meet the needs of the PHC, VCH, PHSA and at the same time make it much easier to upgrade as technological change ( HIMSS , 2015).
4- Applications of technology to implement the quality improvement project
Technology has been applied widely to improve healthcare and thus could be adopted in mental health care to reduce restraint and seclusion by 50% by July 2018. There are several types of application of technology that the mental health care should adopt and implement the quality improvement project which in this case is to reduce restraint and seclusion by 50% by July 2018. In addition to the electronic medical record system EMR, electronic health records (EHR), electronic medical records (EMR), robotics and 3-D printing (Charters, 2003).
Conclusion
With the adoption of informatics, the mental health organization would successfully be able to reduce seclusion and restraint of the mentally ill patients. Transformational leadership is thus an appropriate method because it facilitates the introduction of change to the mental health care that might help decrease seclusion hours of the people with a mental health condition. A reduction in the rates of seclusion hours and restraint of the mentally ill patients would mean that the intervention was successful, but increased rates would imply that the intervention was not successful.
References
Charters, K. G. (2003). Nursing informatics, outcomes, and quality improvement. AACN Advanced Critical Care , 14 (3), 282-294.
Darkins, A., Ryan, P., Kobb, R., Foster, L., Edmonson, E., Wakefield, B., & Lancaster, A. E. (2008). Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions. Telemedicine and e-Health , 14 (10), 1118-1126.
HIMSS . (2015). Impact of Heath Information Technology on the Quality of Patient Care . Retrieved from http://www.himss.org/impact-heath-information-technology-quality-patient-care
Wale, J. B., Belkin, G. S., & Moon, R. (2011). Reducing the use of seclusion and restraint in psychiatric emergency and adult inpatient services—improving patient-centered care. The Permanente Journal , 15 (2), 57.
