I have been on the nursing and vendor side of patient surveillance for more years than I would like to admit in print. In providing clinical surveillance, we nurses have the potential to minimize negative outcomes by preventing adverse events or deterioration in the patient’s status. As a vendor, it is our job to enable health systems to take enormous amounts of data from multiple sources to gain insight that drive decisions and actions. These actions can ultimately improve patient outcomes on a much larger scale. This large scale effect is one of the reasons I can be so passionate about a job that isn’t at the bedside helping patients. I am frequently asked “do you miss direct patient care?” At this point, I honestly can say I do not. I can help exponentially more patients by helping facilities understand their own data and use it to improve outcomes across all of their patient populations. And if I can make the job of collecting and using data less “painful” and more beneficial for my fellow nurses, then even better.
When I refer to Clinical Surveillance, I am specifically referring to the collection and analysis of health data about a clinical syndrome/condition that has a significant impact on the health of the population. This data is then used to drive decisions and actions.
It wasn’t until a recent experience from the patient side did I really take a look at what all of this surveillance data meant to me personally. In the days leading up to my surgery, in typical nurse fashion, I began to run through every worst case scenario in my mind. Suddenly hospital acquired conditions and infections (HACs) were no longer just statistics and numbers. Drug resistant wound infections, blood clots, air embolisms or a catheter associated infection, were all conditions that could now happen to me. I thought of the phrase “ignorance is bliss.” Wouldn’t it be better if I didn’t know all of the things that could happen to me?
I was determined that I would dictate a great deal of my care to help ensure I escaped the inpatient experience unscathed by any HAC or other negative outcome. While my intentions were strong willed, once I was post op and medicated, preventing a negative event never again crossed my mind during my stay. Most of my cognitive exercise was spent trying to locate the button for the wonderful machine that delivered the elixir of pain relief or making the long eight foot trek across the floor to the rest room.
It wasn’t until after I was home that I realized that despite my good intentions, we must rely heavily upon the care teams and facilities to keep us as safe from these conditions. It was clear that they were using past surveillance data and studies to keep me safe. Because my surgery (per historic data) did contribute a risk factor for Deep Vein Thrombosis (blood clots), they put the SCD (Sequential Compression Device) on my lower legs from post op to discharge. I was given the proper pre-op and post-op antibiotics to ensure my risk of surgical site infection was minimal. They also kept all devices that came in contact with me – such as blood pressure cuffs and stethoscopes – in my room, thus cutting down on my chance of getting a drug resistant infection from other patients.
I have no doubt that my inpatient experience was influenced by clinical surveillance data collected and studied. While it is always very important to be an informed patient engaged in our own care, I do now realize that clinicians and vendors who collect and study this data are the ones who are able to get insight and drive actions for our positive outcomes.