Thursday, May 26, 2011

Cell Phones, Hospitals, and Social Media

Infusion phlebitis
Picture: Copyright 2011 Teresa Heithaus

Over a year ago my son was admitted to a local hospital for emergency surgery. The hospital was known for its excellent reputation and for its ANCC Magnet status. He developed some complications following surgery that extended his stay longer than expected. During the hospitalization he developed a Grade 3- 4 infusion phlebitis. I uncovered the phlebitis by examining his right arm after he complained about pain at the IV site. I pulled up the sleeve on the hospital gown and saw a long red streak that extended from his antecubital region up to his shoulder. Immediately, I called his nurse who examined his arm and discontinued the IV. After the nurse left the room, I dug through my purse and pulled out my cell phone. I wasted no time in taking a photograph of his affected arm. I was not thinking of litigation but rather, I believed this would make a good photo for the IV course that I teach at my institution. An added plus was that I could easily obtain permission for use of the picture. His nurse soon returned to tend to his arm.
Uploading pictures or videos onto a social media site from a smart phone takes only seconds.  In general, any individual with a smart phone can simply click on a social media app such as Facebook, followed by clicking on the "+" symbol and choose either a picture on file or “Take a photo/video.” In moments, a person can post the picture or video along with a “comment” on a social media site for every "friend" or "follower" to see. From my perspective, most of the pictures or videos posted by my family or friends have been positive, fun, or just plain silly. However, this does not limit individuals from posting negative, malicious, compromising, and hurtful comments, pictures, or videos on social media sites.
 A nursing colleague had once told me of a patient's family member who insisted on using his cell phone to videotape discharge education his mother was receiving in the hospital. She asked the family member not to videotape the session as she felt it was “distracting and made her uncomfortable.” I suggested that the development of “scripted,” educational, video tutorials become available on the hospital Internet site for the purpose of patient education. This way, patients and their families can be directed to the website for viewing the information while providing their full attention to the live educational session.
Disgruntled consumers have been known to write negative feedback on websites or even post disparaging videos on YouTube.  Some institutions have resorted to creating policies to combat the taking or posting of pictures and videos (on the Internet) by imposing a ban on such activities while on the hospital premises. However, do such policy statements stop anyone from taking pictures or videos with his or her cell/smart phone when such actions can be done quickly and covertly? The discovery of such posts generally occurs well after the fact.

Wednesday, May 18, 2011

Online Newsletters for Staff Development Updates

In November 2010 I went to the AAN pre-conference kicked-off where I attended a terrific presentation given by Barbara Rickabaugh RN, MSN  from UC Davis Medical Center. Her presentation was on developing online hospital newsletters. What I enjoyed about this particular short program was that the information was practical and resourceful. Barbara Rickabaugh discussed a useful way of organizing hospital-wide departmental information (generally found in e-mail distributions) by creating a monthly newsletter for the hospital’s intranet site. As I listened, I thought how this concept was a great way of consolidating important announcements in one monthly document!  
Following monthly department meetings, staff development (SD) instructors at my institution perform a variety of on-unit in-service updates. These updates include new or revised policies, procedures, products or initiatives. Based on Barbara Rickabaugh’s idea, I developed an online monthly SD newsletter that incorporated these in-service updates in an online staff development monthly newsletter complete with links and pictures. I also added an attestation link that staff can use to document that he or she reviewed the information in the newsletter.
I limit the newsletter to two sides. The links connect to “Fast Facts,” tutorials, new product information, in addition to policy and procedure documents. If a link connects to an Internet site, I request IT to “bypass the proxy” to allow access by staff who do not have Internet privileges.  Attractive Newsletter templates are available on the Microsoft Office site in Word, Publisher, and Outlook. I am fortunate to have several of my SD colleagues review and edit content.  Review and editing are necessary to ensure accuracy and readability. The newsletter has been well received and serves as a good resource, especially for those who missed the on-unit in-service.

Tuesday, May 10, 2011

Survival Tips for the Prospective Online Nursing Student

Distance learning or online education is an excellent option to consider if you are thinking of going back to school to further your degree. Some healthcare systems are now requiring a higher degree as a condition of employment. I received my MSN degree from one of the well-known distance learning programs. After graduating I participated in two online certificate programs, and I have recently begun teaching in this venue. From these experiences, I garnered valuable skills such as networking, online collaboration, computer literacy, and leadership. I recently wrote an article for offering some tips and advice to consider for the individual who is seriously thinking about pursuing this route. Read my recommendations and survival tips in "Online nursing degrees: Guide to success." When selecting a school, check the accreditation of the program, requirements, and do your homework to determine if the program is a good fit for your busy lifestyle. offers information on its "Online Nursing Degrees" including an extensive listing of online programs.

Thursday, May 5, 2011

Making Online Attestations

I use attestations to affirm that an individual has read an online posting or activity. This is similar to using a clip board with a sign in sheet for on-unit updates or a “read and sign,” except this is done electronically. Attestations can be easily made by using an online quiz maker or manager. I use the test template in my account with QUIA but I've also experimented with the quiz maker on ProProfs and Blackboard. By using an online quiz maker I can track who participated in the online activity and what unit they came from. The basic templates for most quiz makers are similar in structure. To create an online attestation by using a quiz maker, I do the following:
1.       Click on “Create a quiz”
2.       Name the quiz: For attestations I generally use the following "Attestation Form: Name of the online activity "*
3.        “Description”: Provide a brief instruction such as the following:
 Please indicate "True" or "False," attesting that you have completed reading the online activity. Enter your first and last name in the boxes provided below.
4.       Add one “True-False" question
5.       Enter the value for the one-question quiz at 100%
6.       Enter the following statement in the question box:
a.       I attest that I have fully reviewed the “Name of the Online activity”*
7.       Select “True” as the answer
8.       “Settings”
a.       Uncheck the options for” Question number” and “Point values”
9.       "Access"
a.       Logon required: with this option your student rosters should already be set up
b.      No logon required: no rosters required; however you will not be able to filter your participants by unit
10.   “Global settings”
a.       Enable the quiz
b.      Show all questions
c.       Anonymity: Require student names
d.      Feedback: Select no feedback
e.      Attempts permitted: Select “1”
f.        Security: Disable copy, paste, and printing
11.   Click “Done”

12.   The Attestation page will have a specific URL located in the address bar
a.       Copy the link
b.      Make the link available on the web page where the activity exists. I generally hyperlink an interactive button.
* In place of the words, “Name of the online activity,” add the actual name of the activity.
If your staff does not have access to the internet request by-passing the proxy from your IT department for the URL. By requesting the bypass, staff can directly access the attestation.