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Reply by author Weldon to Harris to Electronic Health Record: Evidence-Based Catheter-Associated Urinary Tract Infections Care Practices

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October 30, 2014

Reply by author to John Michael Harris on “Electronic Health Record: Evidence-Based Catheter-Associated Urinary Tract Infections Care Practices” by Lois Weldon, MSN, RN (August 6, 2013)

Dear John Michael Harris,

I thank you for your letter to the OJIN Editor regarding the 2013 August article “Electronic Health Record: Evidence-Based Catheter-Associated Urinary Tract Infections Care Practices.” It was a delight to read.  Sharing your experience with the nursing community is important for two reasons: taking control of your own nursing practice and generating ideas of improvement within the electronic health record (EHR) to promote efficiency in care delivery practices and patient safety.

Professional practice nursing entails autonomous nursing – taking control of your practice and environment. This involves nursing taking ownership and accountability for the care provided their respective unit and organization. It appears your unit practice council assessed a unit problem with catheter-associated urinary tract infections (CAUTIs); developed a plan of action requiring collaboration with the informatics department; implemented the plan; and then evaluated the effects of the process improvement. Wow!  This is called the Nursing Process and your story is an example of how nurses use their education, their critical inquiry and innovation, and authority from their respective state Nurse Practice Act to advocate and promote patient safety. Frontline nurses that are empowered to take the lead in process improvement will make a difference in patient outcomes.

In this current healthcare environment, the EHR is here to stay and nurses at all levels must become savvy with the EHR use it to advance their workflow and for improvement in patient safety.  Nurses are extremely creative and will benefit by taking the lead in facilitating efficiency in documentation, care delivery and coordination, and collaboration with the Interprofessional team – including the clinical informatics team.

Since the above article was written, we now can generate automatic compliance reports that provide the evidence-based rationale for continuation of the catheter and other CAUTI-related information.  Nursing also collaborated with the infection control and technology department to pull information needed to ascertain a CAUTI.  There are many other areas of improvement to the EHR that have resulted due to an engaged nursing workforce that desires the best for staff and patients.  

Thank you for sharing your story.

Lois M. Stallings-Weldon