Innovative use of electronic health record reports by clinical nurse specialists.

PURPOSE The purpose of the study was to demonstrate how clinical nurse specialists (CNSs) can use information pulled from the electronic health record (EHR) in innovative ways to improve nursing care of vulnerable older adults. BACKGROUND As the number of older adults increases, the need will grow for easier access to evidence-based practice nursing interventions for the older population. Clinical nurse specialists are the experts in evaluating research and will also need to find innovative ways to bring the evidence-based practice pertinent to the care of older adults to the bedside nurse. DESCRIPTION OF THE PROJECT/INNOVATION Clinical information from various parts of the EHR is pulled into computer-generated reports that focus on identifying older adult patients with specific high-risk indicators. The specific clinical information pulled into the reports and examples of how the reports are used will be presented. Four reports are described including new hospital admissions of patients older than 65 years, current hospitalized patients with dementia/delirium, current hospitalized patients on cholinesterase inhibitors, and a comprehensive report of all current hospitalized patients older than 65 years focusing on specific geriatric indicators identified in the literature. OUTCOMES/IMPLICATIONS Computerized reports can be used to facilitate the use of nursing practice guidelines and evidence-based clinical tools such as the confusion assessment method and to increase use of nursing plans of care. The reports can also provide real-time key indicators that can be used to facilitate identification of older adult patients in need of CNS and/or geriatric team consultation. More research still needs to be done regarding the impact of the EHR on nursing indicators such as number of falls, delirium, and use of restraints.