A Nurse’s Dedication to Improving Health Care

In nursing, there is a wide variety of specializations and career paths, and nurses often wear many hats. Charisse Skinner, MS, RN, is a perfect example.

Charisse, who earned her BSN from Duquesne University in 2014, works at the Greater Baltimore Medical Center (GBMC) as a full-time clinical informatics specialist and is an ICU nurse. She’s also about to become a student again.

A Closer Look at the Work of a Clinical Informaticist

Clinical informatics professionals use data and information technology to improve human health and the delivery of health care services. “We work on things like system designs to improve clinician workflow, clinical decision alerts for patient safety/quality of care, provider order entry systems and device integration,” explains Charisse. “Put simply, I design systems and implement workflows within GMBC’s Electronic Health Record (EHR) system to positively impact clinicians and patients.” 

In her role as a clinical informatics specialist, Charisse engages nursing EHR end users and works with nursing leaders and educators to help develop and improve clinical workflows within the EHR system. “I examine existing clinical workflows in search of opportunities where technology can be leveraged to lighten the nursing staff’s workload,” Charisse says. “For instance, device integration is a hot topic right now. I am able to integrate devices like ventilators, infusion pumps and vital sign machines to communicate with the EHR. This saves nursing staff a substantial amount of time on documenting and ultimately gives them more time for patient care.”

Charisse says that end users who are invited to participate and contribute their thoughts to changes and initiatives made to their organization’s EHR are more likely to feel comfortable with the system and see value in their work.

“I hope to continue to engage bedside nurses and look to improve nursing practice and patient safety using technology.”

Clinical Informatics during a Pandemic

Using clinical informatics was advantageous — and continues to be — in the management of the COVID-19 pandemic. 

At the start of the pandemic, Charisse and her colleagues built clinical decision alerts within the EHR. These alerts notified staff of patients coming into the hospital who had possibly been exposed to COVID-19. They also developed a bed tracking system so bed coordinators could place patients who tested positive in appropriate nursing units and locations without compromising other patients.

According to Charisse, many organizations across the country are now using clinical informatics to develop workflows to safely order and administer vaccines now that patients can receive them while admitted to the hospital.

“Unlike administering the flu vaccine, the COVID-19 vaccines have a short time limit for when they can be administered once the vial is punctured,” explains Charisse. “On the informatics side, we must build rules within the system that lets nurses know the patient meets criteria for the vaccine and trigger a questionnaire for nursing staff to complete. Data is looked at daily to see how many patients are eligible to receive the vaccine and when can we successfully batch doses without wasting any.”

A Passion for Critical Care

Even though Charisse works full time as a clinical informaticist, she still loves critical care. In addition to working in ICUs, including a COVID ICU, she has assisted at a COVID vaccine clinic.

“I met many patients who were overcome with emotion and grateful to be able to receive a vaccine,” Charisse says. “As I am going through the screening form with them, I hear their stories about losing a loved to COVID or even contracting the virus themselves previously.”

A Lifelong Learner

Charisse says her education at Duquesne has helped mold her into a great nurse and taught her to always keep learning. The rigorous coursework helped prepare her for working full time and when she completed her master’s degree.

“The skill sessions and simulations taught me a lot that I did not realize at the time. It was when I started working bedside that I was able to remember what I learned in those moments.”

She also found great support from faculty.

“Thank you, Duquesne faculty. I would not be where I am today without what I learned from all of you.”

This upcoming fall, Charisse will be starting the Post-Master’s Doctor of Nursing program at the University of Maryland School of Nursing.

“I think pursuing higher education is important. The nursing profession continues to grow, and nurses must grow with it,” says Charisse. “I have gone to dozens of conferences and seminars and have spoken with nurses who have their doctorate. I see the impact they are making in health care. I hope to one day be in the same position making an impact — and I know higher education will get me there.”

Charisse’s goal is to achieve a high-level nursing leadership position and hopes that this program will help prepare her for such a role.

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