Using informatics in the treatment of patients with signs of Malignant Hyperthermia

There is need for perioperative nurses as well as nurse leaders to understand the application of nursing informatics concepts as well as nursing informatics framework so as to have enough strength of data interpretation, patient engagement, and also care transactions. All these requirements are mainly to the patients who have signs of malignant hyperthermia and their family members (Flick et al, 2016). The outcomes of the patients are improved when the solutions offered by the informatics are capable of facilitating risk identification, decisions made in hospitals when there are crisis, looking for prioritized information during care transitions, as well as patients involvement when doing care plans. Informatics solutions should be inclusive into the patient’s quality improvement procedures so as to facilitate knowledge evaluation and readiness which is related in managing care for the patients who are diagnosed with malignant hyperthermia. Additionally, informatics solutions are important in assisting in situations of interoperability enhancement as they evaluate the workflow which is related to care transitions. There is need for the nurse leaders and he perioperative nurses to sponsor for diligence when succumbing patient intelligences of MH suspected proceedings to the catalogues. With better data gathering and allotment, there is enhancement in aggregated and standardized data set-ups which further improve research as well as increasing the evidence quality which is availed for guiding nursing practices. The purpose of this paper is to offer the learners a knowledge platform which is specified for improving the patients care suspected to have malignant hyperthermia through nursing informatics.

Malignant hyperthermia is a condition that happens where there is susceptible genetics in persons who have acquired some triggered agents that causes a line of chain reactions mostly in muscles and thus leading to an increased ion concentration of intracellular calcium and muscle tissue use increments. Nowadays, the incidence of MH is low the conditions being considered to be low-occurrence but high risk events. The clinical officers are now better prepared when I comes to recognizing MH in nowadays than they could recognize it four decades ago as the condition was initially identified. Improvements such as pulse oximetry hat were being used as monitoring techniques when put together with understanding of pharmacologic factors have played a significant role in decreasing the mortality rate related to MH. Through careful preoperative interviews, there has been observed careful improvements in the screening of MH patients. Additionally, screening has been facilitated by a means of increased family awareness about MH conditions affecting various family members having undergone a testing referred to as caffeine-halothane contracture. The clinicians are now allowed to avoid using triggering agents due to an established pharmacologic basis for MH. This is when the clinicians are performing diagnosis of identifying patients suspected with MH conditions and when they what to make an immediate administration of IV dentrolene sodium in treating MH patients (Flick et al, 2016). The family members are said to be susceptible to opposing events when they experience anesthesia for an invasive practice. The patients MH vulnerability is also vulnerable to extension and also heat exposures as well as exhortation when there is pharmacologic triggers.

Health informatics and the knowledge- wisdom framework data information

Intersection with the upkeep of patients vulnerable to MH is done by the health informatics as well as their members of the family in various ways that are used for influencing care quality provided to them. The nurse leaders and the perioperative nurses are supposed to be aware on how to apply the nursing informatics data-information –knowledge-wisdom framework. Further, the said practitioners are required to have informatics concepts so as to have strong data interpretation, care transitions as well as engagements with patient with the members of their families. The other concepts that are put together with the health care informatics are ethical issues, data security as well as confidentiality and all these should be well addressed during care planning for the said population. Despite this, the concepts are said to be beyond the discussion scope (Denholm, et al, 2016). The framework (DIKW) is described to be a metastructure that supports informatics and nursing practice. Applying the framework to the susceptible MH population is capable of facilitating perioperative nurses understanding and patient care improvement.

Data

The two most important points of data include measuring patients’ temperatures and their weight. Standardization of the methods that are used in documenting the said data points is necessary. They are further required to be easily retrieved when there is need for their use and this is made possible if they are contained in electronic health records. The electronic health records are supposed to be inclusive of accurate electronic conversion in between the metric as well as the US customary units used for measurements. There are identifications by researchers about the challenges that relate to the accuracy in measurements of core temperatures that are further said to influence hyperthermia early detection. This mainly occurs where there is invasive monitoring by lowly appropriate. As a result of accurate documenting of the patients’ weight, it is said to be of significance to clinicians as they administer dantrolene sodium basing on a weight medication as well as calculations of their weight.

Information

This is the next level of DIKW framework that involves interpretations, data structuring as well as data organization. Retrospective reviews that are said to quantify as well as interpret statistics for expressive research or routine improvements projects are said to offer information during this stage of the outline. Data organization into the evidence is inclusive of sorting it into various arrangements like the MH clinical categorizing scale that is used for ranking the qualitative likelihood with a contrary anesthetic event representing the MH condition.

Knowledge

The nurse leaders and the perioperative nurses are supposed to advocate for informatics solutions that are capable for providing immediate workflow access to patient’s temperature tends and weight trends. In addition, they are supposed to make proper laboratory results as they facilitate the MH event potential management. The MH and knowledge intersection mainly occurs as the clinicians make proper interpretations of data as they monitor devices which further recognize symptoms that are associated with MH. The perioperative nurses and the nurse leaders also make interventions provisions as they treat events of MH suspicion. While making decisions, the practitioners should use EHRs, which is the routine use core temperature monitoring as well as the updated formularies that include the most recent approved dantrolene suspensions of sodium (Denholm, et al, 2016). The practitioners are further required to raise alarms which monitors the clinicians’ alert of the signs of increased heart rates, end-tidal carbon dioxide values and also temperature rise.

Wisdom

In the event of MH, the clinicians are required to have an understanding of the pathophysiology and protocols of treatment for MH as they apply the knowledge they have acquired to what is exhibited by the patients during the period of suspecting the MH conditions. Clinical administration incomes such as the Malignant Hyperthermia Association of the United States app (MHAUS) is used during the facilitation of clinician’s guidance from the phases of knowledge to the phase of wisdom in the DIKW framework (Workman, et al, 2015). There are considerations of the ethical uses of MH conditions at the wisdom phase as the clinicians provide the same level of care to every patient. Also, transparent information sharing and informed content obtaining during genetic and muscle-biopsy testing.

Meaningful use

Due to Health Information Technology for Economic and Clinical Health Act (HITECH), which is a branch of the American Recovery and Reinvestment Act of the year 2009, the mission of the Office of the National Coordinator for Health Information Technology is inclusive of developmental coordination of the national health information technology infrastructure. Additionally, it is responsible for supporting and promoting EHRs meaningful use (McLeod et al, 2017). The main goals for the said acts is to create an ecosystem which has safer care as well as making productions of various benefits like the reductions in administrative costs, better communication, as well as the improved clinical performance pertaining the patients and caregivers.

The three concepts that are said to be components of the meaningful use are technical, sematic and also process interoperability which are meaningful components of the meaningful use associated with EHR. The technical interoperability is used for making computer connections even if the computers are far apart from one another although there is no involvement of the information meaning that is exchanged. Sematic interoperability is used to make compatible information become meaningful while helping the data to go through an exchange between the computers having the same understanding levels. This level requires no ambiguity or errors. Using of terminologies such as the Systematic Nomenclature of Medicine- Clinical Terms is a necessity so as this can happen. The importance of sematic interoperability occurs when a patient is being transferred to various levels of health care. On the other hand, process interoperability has a relation to the work procedures as well as allowing various systems like the payroll, scheduling modules amongst others as they work together in reducing redundancies and also errors that might occur in the documentation of the manuals. The regulations by the EHR incentive program make a provision of the requirements so as to enable interoperability, capturing of the data, reusing the data as well as comparative studies effectiveness (Workman, et al, 2015). Using standardized language in the EHR and mapping a common nomenclature by researchers makes it easier for them to design comparative reports using a number of systems that are capable of facilitating nursing research amongst various settings. Additionally, it facilitates quality improvements studies in a single setting.

Transactions in patients care

Regardless of terminologies such as patient handover and transfer of care, a general agreement is made that there is vulnerability of patients during their care transitions. Additionally, another agreement reached upon is that there is a factor of poor communication as the vulnerability of the patients is raised. As result of care transitions, three studies revealed literature review that have a relation to care transactions that are usually applied to patients who are susceptible to MH. A study by Johnson came up with a definition that comprehended with various genetic set of items that used electronic formats complementing a verbal handover patient care. Contrastingly, Zheng and Hilligoss led a two-year ethnographic reading as they evaluated handovers from the emergency subdivision workforces to the inner medicine admittance personnel who focused on the rehearsal that they referred to as Chart biopsy. The chart makes an indication of the patient as well as groundwork for the hand over as well as subsequent care that mainly defend against probable biases. The two researchers made reports that the chart biopsy altered the handover of the recipients over the statement into more active participants as they planned the care because the said practice made changes in their thinking as it offered the a clear understanding of the patient. As a result, the researchers made recommendations that the EHRs should make provisions of more intelligent information retrieval algorithms (McLeod et al, 2017). This is aimed at making clusters of patient care data while highlighting allowances of better comparison of patients from a particular healthcare encounter to the other. Another study included a systematic review of 36 articles that made evaluations of handover tools between the month of February in 1983 and the month of June 2012. In his review, Abraham and the other researchers discovered an important difference in the quality and rigor of their articles and this made it much difficult while identifying a standardized strategy for handover tools. The researchers concluded that only 5 of the total 36 articles had reports of research funding support despite the importance perceived while developing electronic handover tools.

Summary and conclusion

Malignant hyperthermia is mainly a low-occurrence and a very high risk event that requires patient coordination of the care providers as well as offering accessibility to pertinent patient information. While using informatics, there is a possibility of collecting data and making appropriate interpretations of the collected data which further provides clinical guidance for the clinical care. The offered clinical care is offered to patients who have signs of MH as well as their family members who receive the best care leading to most favorable outcomes as the patients undergo process that include the use of triggering agents. When the clinicians are prepared in making the clinical decisions in such a crisis situation makes an improvement in the quality of the care offered in the healthcare organizations. Collaboration of perioperative nurses with the educators and also the clinicians is required so as to make proper evaluations of the knowledge as well as preparedness during care management of the MH patients.

References

Gleich, S. J., Strupp, K., Wilder, R. T., Kor, D. J., & Flick, R. (2016). An automated real‐time method for the detection of patients at risk for malignant hyperthermia. Pediatric Anesthesia, 26(9), 876-882.

Denholm, B. G. (2016). Using Informatics to Improve the Care of Patients Susceptible to Malignant Hyperthermia. AORN journal, 103(4), 364-379.

Ignatavicius, D. D., & Workman, M. L. (2015). Medical-Surgical Nursing-E-Book: Patient-Centered Collaborative Care. Elsevier Health Sciences.

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