Today’s Read: 4.5 minutes

Communication is the bedrock of health care. Today we look at the future of EHRs and the confusion around DNR orders. Plus, we look at the school nurse situation in Washington State and the increase in cyberattacks on the U.S. healthcare system.

And, we also give you something to dance to.

MORNING BRIEF

Yesterday…

We reported that the U.K. was considering changing vaccine protocol and that there were calls to do so in the U.S. On Monday night, the F.D.A. released a statement stating that the coronavirus vaccine protocol will not change to extend limited supplies. So, there’s that. Now, we just need to figure out how to get the doses we do have in arms.

The next generation of EHRs

EHR is an integral part of your day. And like most technology, EHRs continue to evolve as the needs of health care require. To find out what changes may occur in EHRs during the coming year, Becker’s Hospital Review asked the four largest EHR companies—Epic, Cerner, Allscripts, and Meditech—what to expect from their technology in the future. Here are some takeaways:

• Natural language processing and voice assistant capabilities will continue to evolve
• Design will evolve to make EHRs more accessible and more efficient to use, saving time per patient and increasing documentation accuracy
• EHR data will become more liquid between care venues
• EHRs will embrace more apps and technologies across the healthcare industry and ease into the natural workflows of patients and providers
• The large EHR companies are advancing cloud-based initiatives with tech companies such as Amazon, Microsoft, and possibly Google

EHRs haven’t been user-friendly to-date, so hopefully, these improvements will make your lives easier soon.

What do Do-Not-Resuscitate orders really mean?

Do-Not-Resuscitate orders, or a DNR, might seem clear enough, but too often, there can be multiple interpretations—the patient, the family, the nurse. Some may interpret it to mean “do not treat” or associating it with less or suboptimal care. Research published in the American Journal of Nursing explored nurses’ perspectives on the meaning and interpretation of DNR orders for hospitalized adults.

After surveying 35 direct care nurses on three units in a large urban hospital, researchers found that varying interpretations of DNR orders among nurses, other care team members, patients, and family members were common, resulting in unintended consequences. The differing interpretations led to shifts in care, varying responses to deteriorating status, and differences in expectations.

Nurses have opportunities to address misconceptions about care for patients with DNR orders through practice, education, advocacy, policy, and research. A few ways to make sure that unintended consequences do not occur are to:

• Define DNR among the care team. Is it “do not perform CPR” or “do not provide additional lifesaving care”? If it is the latter, explain what those measures are. Everyone on the care team should know what the DNR order does or doesn’t mean.
• Explain what the DNR means to family members. They can misconstrue a DNR order to mean that the health care team has given up on the patient.
• Do not substitute DNR orders for plans of care. “The plan of care for a patient with a DNR order should reflect a multidisciplinary approach, with defined treatment objectives that honor the patient’s and family’s wishes and values,” the authors write.

Washington State needs more school nurses

Just as Washington school districts are opening up to more students, a new study from the University of Washington suggests that many districts are short of school nurses. Statewide there are 2,000 public schools and there are an estimated 978 full-time nurses, reports the Seattle Times. The American Academy of Pediatrics recommends one nurse per school. In Washington, that would work out to a ratio of one full-time nurse per 482 students, but right now, each Washington school nurse serves 1,173 students.

Making matters worse, the school nursing shortfall overlaps in communities and rural areas in Washington that already have primary care shortages.

Interested in working as a school nurse, checkout job listings here.

Navigating the changing costs of health care

Sponsored by SingleCare

Exactly what will happen to healthcare costs in 2021 isn’t known, but SingleCare’s coronavirus survey revealed that Americans are worried about affording medical treatment (29%) and medication (24%). In response, many have delayed non-essential healthcare.

For medical professionals looking to engage and empower patients, cost is no longer an afterthought but an immediate barrier to delivering potential value. Find out how to help your patients with the changing costs of health care, here.

ONE BIG NUMBER

45%

The percentage that healthcare cyberattacks have spiked since November 1, Healthcare Dive reports. In comparison, other industries saw only a 22% increase in cyberattacks during the same period.

DAILY DIVERSION

Pure dancing joy.