Although the article in Healthcare Informatics is titled “Intervening on Preventable Infections with IT,” it’s a whole lot more than IT. The article addresses using an EMR system to either remind a nurse to check if a urinary catheter should still be in place, or to place an automatic stop order by default. The clinician can only override the stop order when the patient meets specific criteria to leave the catheter in place.
Dr. Jennifer Meddings of the University of Michigan Health System digs deeper and describes the solution more broadly. In addition to alerts and automatic stop orders, the solution requires the political empowerment of nurses to issue stop orders, strong considerations for usability and workflow in the system, and understanding the root causes for clinicians to place urinary catheters in the first place.
One problem area is with regards to who receives alerts. Sometimes, alerts are produced in an EMR system and not delivered to appropriate decision makers or those responsible for catheter placement. The article also mentions combining high-tech solutions with low-tech, such as attaching a sticker to a catheter bag requiring the person placing the bag to indicate the specific reason for placing the catheter.
These issues serve as a great reminder that technology is never a panacea and that whole solutions for infection prevention need to take into consideration people, process, and technology.
Healthcare Informatics: Intervening on Preventable Infections with IT