Wonderful Technology

Through this semester I have blogged about technology as objects. My career in nursing is affected by all the technologies such as technology as knowledge, as activities, as social technical systems, and as a process. I chose to write about technology as objects because I am surrounded by equipment that I feel is amazing and helps me get through my day. I talked about my floor being a surgical floor and how we need certain equipment to meet the needs of our patients. I blogged about patient controlled analgesic pumps that help patients control their own pain and save me from having to medicate them every hour. Technology comes in many forms and for my field of practice it also comes in the form of medications. I talked about continuous passive motion machines that keep post operative joints (knees) in continuous range of motion to prevent stiffness. I blogged about how difficult my job can become when all these technological elements aren’t properly functioning. I’ve always known how important the equipment I use to perform my job is. Blogging about it has made me realize how much more significant it is when attempting to get through an eight-hour shift. I understand technology is not perfect but it sure is vital many times. In other blogs I read technology keeps people alive, breathes for them and even performs surgery. Technology makes my job easier, more convenient for both the nursing staff and patient. Efficiency is key in keeping employees and patients as well as a budget happy and balanced. I could not imagine not being able to use the technologies we have at the moment. I can envision our floor becoming even more technologically advanced. We are constantly being introduced to new technology, some good and some not so good. The point is that we will continue to require technology and continue to advance with it and through it. As we get closer to having the new hospital built we will be introduced to a better facility with even more technology that will only persist to advance our care and our staff.

A Barcode on Life and Money

On my last blog I talked about how difficult it was to get through my eight hour shift because I did not have the proper equipment to get my job done. Our computers on wheels (COWs) were no longer keeping a charge and kept turning off or locking all its drawers in leaving us without access to them. Come to find out the life expectancy of these computer units is only 3 years. The computers are exactly three years old. They do show much wear and tear yet our hospital is still attempting to get the computers serviced. It will cost a substantial amount to replace them all but they have also shown to help keep costs down. It is actually well worth the investment for these COW's because they help the user keep a more efficient pace when administering medications. This cuts down on time because the nurse keeps all patient medications in the COW drawers and can go room to room passing their meds. These computer systems have also shown to decrease medication errors because the bar coding system that is in place. Bar coding the patient ensures that they are properly identified and bar coding their medications ensures that they are receiving the correct medications and dosages at the appropriate times. According to an article I came across regarding barcode medication administration : “Medication errors are a serious public health threat. According to a landmark 1999 Institute of Medicine report, between 44,000 and 98,000 Americans die annually due to medical mistakes.1 As part of its ongoing efforts to improve patient safety, the U.S. Food and Drug Administration (FDA) ruled on April 4, 2004, to make barcodes mandatory on the labels of thousands of human medications and biological products by the year 2006.2 The FDA has predicted that the ruling will prevent nearly 500,000 adverse events and transfusion errors over the 20 years that follow, at a cost savings of $93 billion”. Not only will the hospital save money in the long run, they will also continue to improve patient safety which should be the number one goal.

Works Cited

Wideman, Mary V., Michael E. Whittler, and Timothy M. Anderson. "Barcode
Medication Administration: Lessons Learned from an Intensive Care Unit
Implementation." Agency for Healthcare Research and Quality. U.S. Department of
Health and Human, 03 May 2005. Web. 15 Nov. 2009. .

Technology and Efficiency

This week I was reminded yet again on how much we rely on technology to accomplish everyday tasks. For me it came in the form of lacking the tools to get my job done in a timely manner. Our floor holds 23 single beds which may not sound at all like a significant number but you must consider the types of patients that our floor cares for. Orthopedic patients can be a handful because of all the equipment they need, the constant pain control, and maximum mobility assistance that is required. This week our floor was completely full, as soon as we discharged a patient there were others on a waiting list ready to replace them. I am sure the rest of my coworkers will agree that anything to help us get through the day in a timely manner is really appreciated, especially during a time when we are so busy. Our equipment is old and is need of desperate replacement or repair. We use what we call COW’s (computers on wheels) to pass out our medications. With the COW’s we are able to carry large amounts of medications in drawers, scan our patients to correctly identify them, and scan in their medications. This portable computer also can be taken to a patient’s room for the admission process. This type of equipment really makes medication administration faster and safer and cuts down on the time it takes to admit a patient. This week we had two that were working with six nurses all needing a COW. We were having to wait and take turns passing out our medications which really prolonged the process. At the end of the shift we were all behind having to stay longer than our intended eight hour shift. Besides making us late we all stayed over about 1-2 hours longer. This meant not only were we being affected but also the hospital as a whole. They had to pay for more hours because the equipment provided was not working. Patients also complained on how long it was taking for them to receive their medications. Overall, not having the right equipment to get the task done affected all aspects of my work. It affected my coworkers, the patients, cost to the hospital, and myself.

Imperfect Technology

We use many objects of technology to make our jobs much easier. They help by allowing us to be more efficient when completing tasks. We appreciate technology and sometimes rely on it a little too much. In many cases I have noticed that relying on technology excessively can sometimes be detrimental to nurses. Some nurses tend to rely on monitors and readings from machines that may be reading incorrectly due to flawed use or faulty equipment. This provides an incorrect assessment of the patient and with the nurse relying on that assessment; the patient may be placed in danger.
We have vital sign machines that take blood pressure, heart rate and oxygenation readings. If the readings are out of normal range we are to retake these measurements manually if possible. Many times the readings are close to the same but we have had a machine or two that had given us low readings which resulted in nurses holding blood pressure medications when they were actually needed. When the next shift would come on, they would use a different machine and get elevated readings. Needless to say we eventually realized we had old faulty equipment that was giving us incorrect readings as much of a difference of 40 or more compared to working machines and manual readings. We cannot entirely rely on medical equipment to do what a nurse has been trained to do and that is assessing a patient.
Faulty equipment can cause serious injuries, misdiagnosis and even death. The error can be caused by those using the equipment or the actual object itself. Damage can occur to equipment via misuse or incorrect maintenance or eventually the item just being worn out. The point being is regardless of the cause for equipment not functioning properly, the fact is no technology is completely reliable. We must rely on ourselves to use our skills to properly care for patients and not rely on a machine to tell us whether a patient is stable or not. Relying on technology to do a nurses job becomes abuse by that person and those believing that technology is always dependable do not fully understand its use.

Ugly Side of Technology

I keep praising how great technology is, especially technology as objects because these are the things that make my job so much easier. I am able to care for my patients in a safer more efficient way by the use of equipment and medications. I am able to document faster with electronic charting and pass medications safely with a barcode system that minimizes the chance of committing medication errors. Patients make faster recoveries with fewer complications which allows for shorter hospital stays. I have looked at many positive sides to technology but have not yet entered into the disadvantages. In this blog I wanted to elaborate on the ugly side of the technology that affects my job.
With the good there is the bad. Just yesterday maintenance at the hospital I work at decided to shut down the electricity throughout the whole place and run it on generators. They needed to do a test run on the generators in case for some reason the hospital electricity ever went out. It was close to midnight, had already had a crazy day and I was trying to finish charting when my computer along with all the electricity went out. The generators kicked back on seconds later but my computer did not. About three computers turned back on and needless to say I lost the charting I was working on at the time, plus had to wait until one of the working computers became available, (greedy co-workers). I was so disappointed that I lost my charting and after having such a hectic day I just wanted to be done. We even had patient family members complain about not being able to watch television because the important equipment was plugged into the generator-supplied plugs. It is obvious that not all technology is reliable and sometimes we cannot count on it.
Besides equipment being faulty at times, we get medications that are made to prevent complications or treat medical problems but instead create greater issues like allergies, severe adverse reactions, and further or worse complications. According to the article Medication Complications & Side Effects from the website drugcomplications.com it is estimated that every year approximately 200,000 Americans die from prescription drug adverse reactions and side effects. The website goes on and states that it is widely believed that more Americans die as a result of prescription drug interactions or side effects than from using illegal drugs.
Technology has provided my field of work with many necessary items that have enhanced the medical field as well as caused problems for it. Even then, for the improvement and efficiency of healthcare, we will continue to use computers, medications, and equipment taking in the chances of failing even if it is the only way to get closer to excellence.
MEDICATION COMPLICATIONS & SIDE EFFECTS. Accessed October 4, 2009 from
http://drugcomplications.com

Importance of Medications

I chose technology as objects in my previous blog and I was thinking of the fact that medications fall into this same category as well. I believe that medications have become very important as part of the care and health of people that they cannot go unmentioned. Medications are technology because they have in many cases improved and prolonged the life of humans in countless ways by keeping us healthy.
Medications are used in prevention of thousands of ailments. For example one medication that we use extensively on our floor is Lovenox. It is a blood thinner that helps prevent blood clots and it is the primary choice doctors on my floor use after surgery. We are an Orthopedic and Neurology department and we use it on our post surgical patients as well as those who have had a stroke. Technology has provided us with a great medication that has many uses. Comparing it to other anticoagulants such as Heparin it is much easier to administer and more convenient. As stated by Doctor Joseph Caprini, "Overall, this compound is certainly as effective as standard heparin, plus it has the distinct advantage of once-daily dosing and eliminates the need for frequent laboratory testing.". So unlike Heparin which you have to draw up, Lovenox comes in prefilled syringes in sets of milligrams, each one for a different purpose. We use high doses for stroke victims and low doses after surgery and for maintenance thereafter.
We are living in a world of innovation that is constantly changing and attempting to make it more convenient for us all. In the field of medicine the millions of drugs out there are improving the quality and quantity of life for many. Medications are a part of the technology that my field uses as an object of grand importance.

Works Cited
Doctors Guide Global Edition
www.pslgroup.com

Technology As Objects

One of the mayor types of technology I feel has affected my field of work is technology as objects, although all the other technologies apply just as well. I work on the Orthopedic and Neurology floor and much of the equipment we use has been created to properly care for the type of patients on my floor as well as make it easier on the nursing staff. We use equipment everyday to make my job more efficient and safer for the patients and staff. We are primarily a surgical floor that takes care of elective joint replacement surgeries as well as any type of fracture to any bone and therefore a lot of therapy and pain is involved. In order to keep joints from getting stiff, we have machines that keep those joints in constant range of motion. We have traction devices that keep bones from rubbing, keeping the patient more comfortable and preventing muscle spasms. We have pain medication pumps that deliver dosages of pain medication to the patient without the nurse having to physically be in the room every time the patient needs pain medication. We have a lot of equipment that has a certain purpose and it was all invented to improve the care of patients as well as make nurses more efficient in their work. I feel it was technological determinism that pushed individuals to make such technologies. We are always finding new ways to improve or change technology to better fit our needs. Out of need, safety has become a primary issue for both the medical staff and the patients. We have needleless systems that allow for intravenous administration of medications in order to decrease needle stick incidents. This has decreased the risk of nurses contracting blood borne diseases from patients or vise versa. In the nursing field there is always a new and improved gadget that replaces the old. Technology has improved my field of work in many ways even before I entered nursing and will continue to affect it in many positive ways.