Factors Influencing Clinical Decisions: HIT Accu Chek Inform II

This report examines the influence of the HIT Accu Chek Inform II system on nursing clinical decision-making. It begins by identifying factors that affect clinical decisions, such as manpower shortages, excessive workloads, and the impact of fatigue on nurses. The report then describes the Accu-Chek Inform II, a health information technology used for blood glucose monitoring, detailing its function, mechanism, and potential impact on patient assessment and decision-making. It highlights the benefits of the system, including rapid results and reduced errors, while also addressing potential drawbacks like breaches of confidentiality and the possibility of false readings due to strip sensitivity. The conclusion emphasizes the importance of effective decision-making in nursing and how the technology can facilitate it, despite potential challenges. References are also provided.

Running head: HIT ACCU CHEK INFORM II
HIT ACCU CHEK INFORM II
Name of the student:
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HIT ACCU CHEK INFORM II
Introduction:
Effective decision making has emerged as one of the most crucial factors fundamental
to nursing practices for the best possible care to the patient. In the clinical setting, nurses
usually deal with a range of incidents that impact the quality of care (Lim et al., 2018). The
effective decision making by meeting the need of the patients is considered one of those factors
that increase patient satisfaction. Considering the statistics of Singapore, approximately 36% of
the medication errors observed because of the lack of compliance with effective decision
making. Hence, in order to involve in the effective decision making, nursing professionals are
required to possess skills mandatory for clinical assessment, identification of cues and worsen of
the health of patients. Health information technology is one essential mean that can improve the
effective decision making of the nurses. The paper aims to discuss the factor that impacts the
effective decision making in part A and description of a technology in part B.
Part A:
The key factor that influenced clinical decision:
Lack of manpower in the department is one such factor that clinical decision in the
clinical setting. The underlying reason can ageing workforce, unequal distribution of the
workforce, lack of professionals with mandatory expertise and knowledge, lack of a framework
for staff recruitment, and staff incompetency (Ng et al., 2018). Consequently, existing
professionals are required to work long duty hours to meet the demand and experience distress
that impact decision making.

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Influence on clinical decision making of nurses:
Due to lack of manpower in the department, nursing professionals unusually experience
excessive workload and long shift hours that give rise to fatigue. Shorey et al. (2018), suggested
that nursing professionals who are working for 12 hours shifts tend to experience fatigue and
psychological distress that negatively impact the clinical decision making as nurses are sleepier
and stressed to make the rational decision making. Moreover, due to high nurse to patient ratio,
one nurse provide care to more than 3 to 4 patients which hinder the adequate communication,
assessment and prioritize the unique need of the patient (Haldane et al., 2019). Therefore, lack
of manpower in the department negatively influence the clinical decision making as it induces
clinical errors, low patient satisfaction and readmission of patients. Adequate distribution of
nursing professionals along with high manpower and advance technology can positively
influence nursing professionals.
Part B:
Health information technology:
In health care sectors, diverse health information technologies are installed for
facilitating the safety of the patient and improve quality of care (Haldane et al., 2019). HIT
Accu chek inform II is one such health information technology which enhances the decision
making of the nursing professionals. HIT Accu chek inform II offers a comprehensive solution
for the professional testing of the blood pressure of the patient in the hospital (Cabana, Jasmi &
Maguire, 2018). The stress-induced hyperglycemia is frequent in critically ill patients who are
suffering from diabetes. Therefore, Accu-Chek Inform II system is used to test the fresh
capillary, arterial or neonatal whole blood. It is designed to minimize the risk of cross-
contamination in the clinical setting. The common procedure of using the Accu-Chek Inform II

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system is to prick the finger with the lancet for drawing out a blood drop from the patient. After
pricking and collecting the blood, aseptic technique is used to carefully touch the blood drop
onto the green field of the testing strips. The blood glucose then read on the screen. With the
assistance of the test strips, nursing professionals can obtain a blood glucose reading within 5
seconds and it facilitates the clinical decision making. The underlying mechanism is that Accu-
Chek Inform II system uses AC as well as DC impulses detect the blood glucose level of the
blood present in the strip (Khan et al., 2019). However, the limitation of the strip used in the
technology is that it can be damaged by moisture and temperature and therefore, careful storage
of the strip is required in this case for minimizing the damage.
Potential impact on the assessment and clinical decision making:
Considering the positive impact on the assessment and clinical decision making, Garg
and Hirsch (2018), suggested that the strip based measurement of the blood glucose of the patient
provide a result within 5 seconds compared to the manual assessment. Therefore, it facilitates the
decision making by providing accurate readings within a short period of time and nursing
professionals can allocate this time to communicate with the patient and identify the unique need
of the patients. Since the communication of data directly observed on the screen of the machine,
it eliminates the possibility of committing clinical errors and improves patient safety (Khan et al.,
2019). Moreover, hardware base unit to network or wifi enable the transfer of result to the
hospital record which further positively influence future clinical decision making. It allows easy
entry of the details of the patient with patient Id and operator ID that resulted in minimizing the
documentation errors in the clinical setting. It facilitates the assessment of the patient since it
reduces the cross-contamination of the blood with the strip and requires only a small blood
sample volume of 0.6 microliters.

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Considering the negative impact on the assessment and clinical decision making, the
device may breach the confidentiality of the patients as the device mostly use Wlan or Wifi to
transfer the result into the hospital medical record (Elgart et al., 2016). Therefore, it increases
the probability of cybercrime which indirectly impact the assessment and clinical decision
making. It may impact the safety of the patient as the patient may experience bully and social
exclusion. Moreover, as discussed above, the strip used in the technology is that it can be
damaged by moisture and temperature due to high sensitivity. Damaged strip from the moisture
and temperature can give the false-negative result of the blood glucose level of patients with
diabetes (Elgart et al., 2016). Therefore, these negatively impact clinical decision making and
negatively impacted the assessment of the patient.
Conclusion:
On a concluding note it can be said that in the clinical setting, nursing professionals are
under the constant pressure of effective decision making as it is a fundamental factor of high
quality of care. However, lack of manpower in the department is one of the crucial factors that
influence the quality of care as under stress and long shift hours, nursing professionals get
limited time to assess the patient which resulted in rapid decision making. Accu-Chek Inform II
system is one such device that facilitating the decision making by reducing the time for
obtaining the results of the blood glucose within a short period of time. As wifi is used to transfer
the patient data into the medical device, it eliminates the probability of errors. Therefore, the
positive impact is that it facilitates clinical assessment and decision making. The negative impact
of technology is that it may breach confidentiality due to the possibility of cybercrime.
Moreover,

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due to sensitivity of the strip, it may provide false-positive result. It impact clinical decision
making and reduces satisfaction.
References:
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can lead to increased natural behaviours, decreased regurgitation and reingestion, and
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Elgart, J. F., González, L., Prestes, M., Rucci, E., & Gagliardino, J. J. (2016). Frequency of self-
monitoring blood glucose and attainment of HbA1c target values. Acta
diabetologica, 53(1), 57-62. https://link.springer.com/article/10.1007/s00592-015-0745-9
Garg, S. K., & Hirsch, I. B. (2018). Self-monitoring of blood glucose. Diabetes technology &
therapeutics, 20(S1), S-3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761819/
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Software and Hardware Blood Glucose Analysis as a STEM Project. In 2019 IEEE
Integrated STEM Education Conference (ISEC) (pp. 91-97). IEEE.
https://ieeexplore.ieee.org/abstract/document/8882092

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