NUR 3472-Deliverable 1-The Influences of Technology on Our Decisions
Technology in the health field is forever changing and evolving, requiring nurses to stay updated on new equipment and systems. Those standard surgical procedures that we as nurses have encountered multiple times are changing, making our nursing interventions change. In health, you will always meet new tools or equipment you have never heard of or used before. As nurses, we have become accustomed to adapting to these recent changes. A leadless pacemaker is one of the latest technologies I have encountered in the medical field. Technology has changed how we chart and document patient encounters and made diagnostic testing and biomedical monitoring a massive role in patient outcomes and at the forefront of healthcare. We have gone from electrocardiograph to implantable pacemakers to now using leadless pacemakers that are the size of a dime (Van der Zee & Doshi, 2016).
My first encounter with a leadless pacemaker affected my decision-making as a nurse and the interventions I provided to the patient. Most patients undergoing pacemaker placement have a surgical incision closed with sutures, staples, or derma bond; depending on physician preference, the affected sidearm will be in a sling. As a nurse, we are usually monitoring for those complications that generally come with the placement of a traditional pacemaker, such as pneumothorax/hemothorax, cardiac perforation, endocarditis, lead dislodgement, skin integrity issues, pocket infections, hematomas, and tricuspid regurgitation (Reynolds et al., 2016 and Bhatia & El-Chami, 2018). However, with a leadless pacemaker such as Micra, which received FDA approval in 2016, nursing interventions are similar to a patient who undergoes a cardiac catheterization (Bhatia & El-Chami, 2018). Post-insertion of the leadless pacemaker, the patient must lie flat and keep the insertion leg straight for approximately six hours to prevent bleeding from the insertion site. The nurse would monitor for a hematoma, and a sterile pressure dressing would be placed on the affected groin post-procedure. The patient would spend the night in the hospital and be discharged once the device was checked and a chest x-ray was completed. As a nurse first encountering this new advancing technology, I couldn’t help but have my eyes glued to the heart monitor. With this new technology, the care I delivered exceptionally depended on the pacemaker’s response. While the patient was recovering and hooked up to the heart monitor, the pacemaker spikes on the monitor assured me that the pacemaker was effectively pacing the heart. Also, with the Medtronic programmer, the nurse and doctor can change the pacemaker settings initially and post-procedure or at any follow-up appointment to ensure that your pacemaker continues to operate correctly. With this computerized system, doctors and nurses can read the information collected and stored from the pacemaker and ensure the pacemaker is set at the appropriate therapy setting to be most effective (Reynolds et al., 2016 Bha; Tia & El-Chami, 2018).
NUR 3472-Deliverable 1-The Influences of Technology on Our Decisions
The evolution of cardiac monitoring and pacing has evolved dramatically. From the late 1800s to the early 1900s, the electrocardiograph was a huge breakthrough that significantly affected the understanding of cardiac rhythms and arrhythmias (Aquilina Oscar. 2006). With the electrocardiograph development and pacing therapy implementation, John Hopps invented the first cardiac pacemaker in 1950 (Aquilina Oscar. 2006). “For over fifty years, cardiac pacing systems have been surgically implanted for symptomatic bradycardia” (Reynolds et al., 2016). To improve patient outcomes and decrease complications, pacemaker technology is rapidly growing and seeking new, improved ways to provide a safe alternative for cardiac pacing. Now we have the Micra, a miniature leadless pacing system officially FDA-approved in 2016. This dime-sized pacemaker is inserted through the femoral artery. The Micra is embedded into the right ventricle, and the procedure takes less than 30 minutes to complete (van der Zee & Doshi, 2016). The downside to the Micra is that it can only be used in patients needing single-chamber pacing. However, the future is bright, and the talk of developing a pacemaker that is fueled by transforming kinetic energy from cardiac motion is one of many new technologies that we may see soon (van der Zee & Doshi, 2016 and Bhatia & El-Chami, 2018).
References
Bhatia, N., & El-Chami, M. (2018). Leadless pacemakers: a contemporary review. Journal of Geriatric Cardiology, 15, 249-253. DOI:10.11909/j.issn.1671-5411.2018.04.002
Reynolds, D., Duray, G., Omar, R., Soejima, K., Neuzil, P., Zhang, S., Ritter, P. (2016). A Leadless intracardiac transcatheter pacing system. New England Journal of Medicine,374,533541. doi: full/10.1056/NEJMoa1511643
Van der Zee, Sarina., & Doshi, Shephal. (2016, May 23). Permanent leadless cardiac pacing. Retrieved from American College of Cardiology https://www.acc.org/latest-in-cardiology/articles/2016/03/23/08/09/permanent-leadless-cardiac-pacing
Aquilina Oscar. (2006). A brief history of cardiac pacing. Images in pediatric cardiology, 8(2), 17– 81. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232561/
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NUR 3472-Deliverable 1-The Influences of Technology on Our Decisions
Explain technologies that lead to enhanced decision-making strategies utilizing the technology life cycle.
As a BSN student, you are shadowing a Nurse Informaticist to understand better their role and impact in making healthcare decisions. You have one day in this immersion and will be exposed to several Health Information Technologies and their impact on healthcare decision-making. As part of the preclinical paperwork, you have been asked to write a professional reflection in preparation for the next day’s shadowing experience. Instructions
Provide detailed responses to each question on a Word document, including:
Explain one technology you have used in healthcare. Explain the impact of the technology using referenced support with in-text citation
Describe how you used this type of technology to support a healthcare decision. Describe an example illustrating how the use of the technology affected your decision making.
Research the evolution of your identified technology using the technology life cycle.
How has the technology evolved: past, present, future? How has this evolution improved healthcare decision making