Nursing Informatics: GBS Case Study, Clinical Barriers, and Solutions

This report presents a nursing informatics case study focusing on a patient diagnosed with Guillain-Barre syndrome (GBS). The student, a registered nurse, recounts the experience of encountering a patient with diverse symptoms, including weakness, high blood pressure, speech issues, and sensory impairments, leading to initial confusion in diagnosis and care planning. The report details the nurse's use of electronic medical records and internet research to understand GBS, its etiology, pathophysiology, and effective nursing management strategies. The search strategy involved using PubMed to find scholarly articles, focusing on keywords like 'nursing management,' 'etiology,' and 'nursing care' related to GBS. The nurse discusses the importance of accessing scholarly, peer-reviewed articles for reliable information, emphasizing the need for critical evaluation of research biases and the applicability of findings to patient care. The report concludes by recommending similar search strategies for patients and highlighting the value of scholarly resources in contrast to general internet searches for accurate and high-quality clinical information. The report also emphasizes the ethical considerations of patient care and the importance of evidence-based practice in nursing informatics.

Running head: NURSING INFORMATICS
NURSING INFORMATICS
Name of Student
Name of University
Author note

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As a registered nurse, I came across a patient in the intensive care unit. The name of
the name was Steven, age 35 years who came from an African American background but was
fluent in English although he spoke with a different accent. On nursing assessment, it was
found that the subject has severe weakness of both the upper limbs and one of the lower
limbs. In addition, the subject also presented with high blood pressure and tachycardia. He
had shortness of breath and extreme fatigue on activity and even at rest (Sternberg, 2018).
The x-rays of the chest did not show any abnormal chest or rather lung findings. This
confused me as a nurse as because I was not being able to clinically correlate the signs and
the symptoms to the pathophysiology and unable to make a nursing diagnosis as well and a
diverse set of medications was given to address the case that confused me further. On
examination, I found that the subject has speech issues along with dysphagia and he reported
sensations of burning and tingling which meant he had a sensory impairment as well. On
motor examinations, it was found that the reflexes in the patient are diminished that is the
subject has hypotonia but the patient did not have a history of stroke, that made me more
perplexed. He had urinary retention issues as well. With these diverse range of signs and
symptoms, it was very difficult to formulate a nursing plan and as because the subject was
unaware about the disease and I, who was attending the patient for the first time and most
importantly was attending this type of diversely manifested disease for the first time, the
nursing care that was about to be followed seemed very vague to me. Clinical reasoning,
critical thinking were the three areas where I, as a registered nurse was feeling the barriers
with and it is critical to note that these barriers extended a huge challenge to my clinical
decision making. All the senior nurses in the department had gone home for the day and I
could not consult with anybody regarding the same. I decided to check for the medical
diagnosis that has been made and it was written in the case file that the patient has been
diagnosed with Guillain-Barre syndrome. As a registered working for about more than a year

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in the intensive care and working with the multidisciplinary teams – I had no idea about the
disease condition and I faced a knowledge gap issues in managing and care for this Guillain-
Barre syndrome case. I decided to access the electronic medical records to go through the
case thoroughly but before that I wanted to access the internet in the personal computer to
learn about this disease that I was completely unaware of. Moreover, the patient wanted to
know about the disease and so were the family of patient.
I turned on the computer and decided to understand the etiology and pathophysiology
of Guillain-Barre syndrome and which nursing management strategies should be most
effective for Steven in the hospital and the ways of transitioning the hospital care gradually to
home care with the gradual involvement of the family members into the patient centered-care
process. As for search strategy, I first opened PubMed and then typed the keywords ‘nursing
management’ ‘etiology’ ‘Guillain-Barre syndrome’ ‘nursing care’ ‘Guillain-Barre syndrome
nursing interventions’ ‘pathophysiology’ ‘patient centered care’ ‘family centered care’ and
used the PubMed electronic database to search for the articles. The electronic search for
disease and nursing information was determined for scholarly, peer reviewed articles that
were in English language and only the journals that were both scholarly and only published
the articles that are written in English language were chosen (Zhang et al., 2019). I filtered
the year section to ‘2015 –present’ section and the search returned the most recent scholarly
articles that were not more than five years old. The articles that have been cited by the most
authors should be read (Brajovic et al., 2018).
The articles that I searched for accurate, of high quality and was acceptable was
determined by the fact that the articles were all published in scholarly journals that promised
the quality. The fact that the articles were published in the scholarly journals and were cited
by various other scholarly articles made me accurate, valid and reliable as well ((Weinlander
& Mian, 2019). Almost all the articles relating to Guillain-Barre disease and the nursing took

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care of the ethical considerations and the ethical parameters although there were some
research biases in some papers (Quesenberry, 2017). The validity and reliability of the
nursing and the disease information in the published articles were determined by evidences
that were all scholarly again, to the context of the research problem and most of the articles
had citations that were recent and applicable to modern researches done with respect to
Guillain-Barre syndrome (Duncan et al., 2019). About 70 percent of the articles or rather the
information was accurate and the other 30 percent had research biases, not written in patient
friendly language and were not applicable to the patient.
I found any articles that discussed about various signs, symptoms, effective care,
effective clinical management of Guillain-Barre syndrome in hospitals and nursing homes,
the role of nurses in the management of the same and how the disease presents itself and
progresses plus how the symptoms and the signs are to be managed by the nursing and the
medical team. Many articles spoke about the role of community care and interdisciplinary
team in the management of Guillain-Barre syndrome.
Following search for the internet-based nursing and clinical information about which
the patient and myself was unaware about completely, I learned that in order to find the right,
accurate and the high quality information about the clinical condition, more than the
websites, the scholarly articles that are published in the scholarly journals are more valid and
reliable. I would strongly recommend the patients that prior to accessing the articles, they can
perform a basic search on internet to understand the basic disease and the signs and
symptoms related to the same. To increase the knowledge the patient, the same search
strategies will be recommended which are - searching in the electronic databases such as
PubMed, Embase, Medline that contains that the scholarly articles published in scholarly
journals, reviewing the peer reviewed articles and the articles that are published in last five
years but not more. In addition, I would not encourage them for accessing the same. When

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they come across any difficult language in the scholarly journal, they can search for the term
with basic internet search and get the meaning.

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References
Brajovic, S., Blaser, D. A., Zisk, M., Caligtan, C., Okun, S., Hall, M., & Pamer, C. A. (2018).
Validating a framework for coding patient-reported health information to the medical
dictionary for regulatory activities terminology: An evaluative study. JMIR medical
informatics, 6(3), e42.
Duncan, L., Shen, H., Pritchard, J., Feldman, M., Ressler, K., Harris, K., & Domingue, B.
(2019). PERFORMANCE OF POLYGENIC SCORES ACROSS ANCESTRALLY
DIVERSE POPULATIONS: SCIENTIFIC AND ETHICAL
CONSIDERATIONS. European Neuropsychopharmacology, 29, S833-S834.
Quesenberry, A. C. (2017). Plain language for patient education. Journal of Consumer Health
on the Internet, 21(2), 209-215.
Sternberg, R. J. (2018). Ethical Considerations in Submitting Articles. Guide to Publishing in
Psychology Journals, 251.
Weinlander, E., & Mian, S. (2019). Re: Anderson et al.: Ethical considerations for
performing intraocular surgery on eyes with no light perception (Ophthalmology.
2019; 126: 10-12). Ophthalmology, 126(8), e60-e61.
Zhang, X., Hailu, B., Tabor, D. C., Gold, R., Sayre, M. H., Sim, I., ... & Artiles, L. (2019).
Role of health information technology in addressing health disparities: patient,
clinician, and system perspectives. Medical care, 57, S115-S120.