Sample Answer for NURS 6501 THE APPLICATION OF DATA TO PROBLEM-SOLVING Included After Question
NURS 6501 THE APPLICATION OF DATA TO PROBLEM-SOLVING
THE APPLICATION OF DATA TO PROBLEM-SOLVING
In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.
Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.
In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.
RESOURCES
NURS 6501 THE APPLICATION OF DATA TO PROBLEM-SOLVING
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Reflect on the concepts of informatics and knowledge work as presented in the Resources.
Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.
BY DAY 3 OF WEEK 1
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
BY DAY 6 OF WEEK 1
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.
*Note: Throughout this program, your fellow students are referred to as colleagues.
A Sample Answer For the Assignment: NURS 6501 THE APPLICATION OF DATA TO PROBLEM-SOLVING
Title: NURS 6501 THE APPLICATION OF DATA TO PROBLEM-SOLVING
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Deanna Linn Howe
Nov 17, 2022Nov 17, 2022 at 11:21am
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TIPS for Success in Discussion Posts!
Every semester I have students who do not meet the posting requirements. It is important to read the grading rubric so that you understand the expectations.
The main post is always due by midnight on Wednesdays.
Peer posts are due no later than Saturday at midnight.
There must be three (3) total posts in one week.
The main post must include a minimum of three (3) scholarly sources as an in-text citation and as references. Each reference must have a matching in text citation and every citation a matching reference. They both should match.
Peer posts must include a minimum of two (2) scholarly sources as an in-text citation and as references. Each reference must have a matching in text citation and every citation a matching reference. They both should match.
APA 7th edition formatting guide has been used for a year now. The expectation is that you use this appropriately. I will give feedback but please read each discussion week to ensure you are improving.
Write in a substantive way. Participation is important in online courses, and I am assessing what you are learning. Just a few sentences are not adequate and result in lower scores.
I am looking forward to working with each of you this semester. Dr. Howe
Collapse SubdiscussionShanea Trevino
Shanea Trevino
Nov 29, 2022Nov 29, 2022 at 10:43am
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Telephone triage
The phone rings on a busy Saturday afternoon and the pleasant voice of a registered nurse answers professionally, greeting the caller seeking advice and care. This could be a day for a typical for an ambulatory telephone triage nurse. The concept of telephone triage and consultation can be one of a registered nurse using evidence-based algorithms from electronic databases. The nurses, like most nurses, working in a progressive health care industry are using technology to counsel patients. According to McGonigue & Mastrian, (2022), “For information to be valuable, it must be accessible, accurate, timely, complete, cost-effective, flexible, reliable, relevant, simple, verifiable, and secure.” p.9.
This information could be valuable to many leaders in the healthcare team. Accessibility would be easiest in form of electronic records and telephone recordings. McGonigue & Mastrian (2022), argue, “Computer science offers extremely valuable tools that when used skillfully, can facilitate the acquisition and manipulation of data and information by nurses, who then can synthesize the data into an evolving knowledge and wisdom base ”p. 35). Accurate and timely information could be an interest in nursing quality and control. One argument on how telephone triage could be cost-effective is that paying nurses to man the phone lines is cheaper than using inappropriate resources such as the emergency room to care that can be directed elsewhere. Flexibility, reliability, simple, verifiable and secure would require a more in-depth look into the nature of telephone triage and program development within a system, but the concept of triage nursing seems to be malleable to the interest of how the data would be used.
An additional source of centralized evidence-based algorithm software program could also be used and from my research is being used in assisting the nurses to effectively triage the caller and ensure best practice standards. Documentation done by triage nurses would have data from the callers that are subjective and objective, the nursing assessment, and recommendations based on the call.
From this data collection, multiple departments within healthcare could use this or would have an interest in this data collection. Intradisciplinary teams have an opportunity to look at how to retrieve data from electronic retrieval of health records or from recorded lines if those are being used. An ambulatory nurse manager might be interested in using the data as a system educator of staff development and improvement strategy to support the training needs within their triage staff. A quality nurse might want to use this data to help in creating of protocol development and safety improvements for effective triage and outcomes. Ambulatory providers could use data to see the patient population’s interests and barriers to care and from there use it to modify their practices. Health information technology departments within health care organizations could be supportive of this nursing department in implementing programs in making documentation more time efficient and detailed. Nursing leadership could use this as a cost-effective strategy.
All departments could build off one another and become temporary team members to gain knowledge and benefit in patient care and satisfaction. Emerging roles could be created as, “Teams are working across boundaries of organizations and will be organized around a particular patient.” (Nagale et al, 2017, p. 215). Within most healthcare systems the mission and visions of these organizations are built on patient outcomes and patient centered care. An informatics nurse specialist could support patients, nurses, providers, and leaders with the interpretation of data analytics and therefore participate in applying new knowledge from data to wisdom. (Nauright et al., 1999)
This hypothetical scenario of a nurse working at a telephone triage call center would benefit immensely from data access, problem-solving and the process of knowledge formation. In a real-time, scenario, I could see how this could impact patient care and outcomes on a global level and be a perfect role for a nurse informatics specialist to pilot.
References
Nauright,L.P.,Moneyham,L.& Williamson,J.1999. Telephone triage and consultation: An emerging role
for nurses,Nursing Outlook, 47(5) , 219-226.https://doi.org/10.1016/S0029-6554(99)90054-4.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist Links to an external site. Links to an external site.. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221).
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Tinuola Olaniyan
Tinuola Olaniyan
Dec 3, 2022Dec 3, 2022 at 5:37pm
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Response week 1 . Telemedicine
It was great going through your post. Telehealth is a crucial part of our healthcare system, especially with technological advancement in the recent past. I agree with the benefits of telehealth, as your post indicated.It allows access to healthcare information in a swift manner. Technology helped telemedicine reduce congestion in hospitals as patients can easily access information via teleconference. It has also expanded the opportunities for the nurses who interact closely with the patients.
Telemedicine is a sustainable type of healthcare and can open several doors for treatment for patients and practitioners. It saves time, and treatment is convenient and affordable for people who dread visiting the doctor and avoid going to the hospital. In addition, telehealth is helpful in diagnosis, administrative work, and professional and patient education.
A study assessing the effectiveness of telehealth consultations discovered they could improve patient outcomes in certain areas. Telehealth may not help and completely replace traditional office visits — after all, many services and procedures can only be done in person — but it can reduce the need for them. Telehealth effectively reduces the spread of infectious diseases, especially in this Coronavirus (COVID-19) warfare. When other patients have an infectious disease, they can stay home and call their healthcare provider to get treatment. By staying at home, patients do not expose their illnesses to healthcare professionals and other patients. Patients also reduce the chances of contracting an infectious disease from another person or transmitting and spreading their own while using telehealth services.
References
Aggarwal, A. (2017). Telepyschiatry: Current outcomes and future directions. International Journal of Clinical Psychiatry and Mental Health, 5. https://doi.org/10.12970/2310-8231.2017.05.07Links to an external site.
Menage, J. (2020). Why telemedicine diminishes the doctor-patient relationship. BMJ, m4348. https://doi.org/10.1136/bmj.m4348Links to an external site.
Stokel-Walker, C. (2020). Why telemedicine is here to stay. BMJ, m3603. https://doi.org/10.1136/bmj.m3603Links to an external site.
Collapse SubdiscussionAnupa Mukundram Mehta
Anupa Mukundram Mehta
Nov 29, 2022Nov 29, 2022 at 4:50pm
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Scenario:
A nursing home trach to vent patient comes in to the ER. Their vital signs are a Temperature of 101 F, heart rate of 110, respiratory rate of 24, BP of 85/60. He complains of pain in his back and upon assessment we see a large amount of discharge from his stage 4 sacral wound. Blood work is drawn and white blood cells are greater than 16,000/mm3, with a lactic level of 3. The vital signs are inputted into my charting system, Epic, by the nurse. With Epic, we get an automatic pop-up that due to this patients vital signs, this patient meets sepsis criteria and should be worked up appropriately. When the lab results come back, they are automatically added to epic, which also triggers the sepsis warning. The nurse and provider document their physical assessment, including the stage 4 wound, which along with the sepsis warning pop-up, help us think this may be the source of their infection.
Data collection, Knowledge Derived, Clinical Reasoning:
As you can see from the description of the scenario, data like vital signs, blood work, and a physical assessment are collected and assessed. Knowledge can be derived from that data from our medical knowledge, but as a reminder, the charting system can remind us that a patient meets sepsis criteria. Based on the physical assessment, the nurse can use clinical reasoning and judgement to find the cause of the abnormal vital signs and blood work. The likely diagnosis is sepsis due to a sacral wound. These criteria in the EHR are developed based on evidence-based studies, such as the International Guidelines for Management of Severe Sepsis and Septic Shock (Dellinger et al., 2012). I see this scenario very often when I worked as a medical step-down nurse, where many chronically ill, bed-bound, chronically vented nursing home patients came in.
Supporting Data:
As described by Walden University, very soon artificial intelligence is going to be a great support to medical professionals, where when a patient comes in with a certain complaint, asking a certain set of questions will help diagnose or rule out the most common possible conditions (Walden University, 2018). This does not replace the nurse or physician but certainly supports us in our decision-making, just like how the Epic Sepsis warning helps remind us to keep this diagnosis in mind if the patient meets the initial criteria.
Public Health Informatics professionals are the ones who make it so that an EHR like Epic works between different hospitals, outpatient offices, and more (Public Health Informatics Institute, 2017). For example, I would be able to see that the above patient in my scenario had a recent primary care office visit for a fever 1 week prior, and was discharged on antibiotics. When the provider enters the billing code for sepsis, it is thanks to the work of Informatics professionals that that code can be translated from ICD-10 to another medical billing language, so that everyone including insurance companies are receiving the correct information (Public Health Informatics Institute, 2017).
References:
Walden University, LLC. (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
Public Health Informatics Institute. (2017). Public Health Informatics: “translating” knowledge for health Links to an external site. [Video file]. Retrieved from https://www.youtube.com/watch?v=fLUygA8Hpfo
Dellinger, Levy, Rhodes, Annane, Gerlach, & Opal. (2012). Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012. Guideline Central. Retrieved 2022, from http://content.guidelinecentral.com/guideline/get/pdf/3525.
Collapse SubdiscussionShanea Trevino
Shanea Trevino
Nov 30, 2022Nov 30, 2022 at 2:17pm
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Greetings Anupa,
Thank you for your example of how nursing informatics can be beneficial to provide treatment plans and medical coding. This sounds like an essential feature that technology is providing for both information and safety in the realm of patient care. I like what Ohno-Machado, 2018, states “Although media attention occasionally concentrates on what can go wrong when information systems are employed in practice, there is also much to say on what might go wrong if information systems were not employed” p.773. This pop-up feature you mention seems to be in alignment with technology use as a benefit. In your experience, how do you see this in time management? Do you agree or disagree with the argument this enables the nurses to focus on analyzing the data rather than obtaining it? Did an informatics specialist train you on the usage of this application?
In my experience, when new technology was added to my practice, I lacked the education on new programs and found new integrations to take time. I feel that could be minimized by having supportive education in assuming new roles and use of new products. There were only a few trainers available during the rollout period of new styles and most of us were “figuring it out” solo. This was frustrating and gave the staff residence to the technology intended to be helpful.
According to Nagle et al, 2017, nursing informatics specialists will be supporting and assuming new roles within data analytics and applying this knowledge. As the scope of practice of nurses changes, nursing informaticians have such an opportunity to support the profession. As healthcare is already vastly integrating new uses of technology there is a growing demand for this specialty to support it.
In hindsight to my experience, I would have advocated more for training to be supportive rather than resistant. Thank you for your scenario to highlight some of my own inner biases based on a negative experience.
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist Links to an external site. Links to an external site. Links to an external site.. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221).
Ohno-Machado, L. (2018). The role of informatics in promoting patient safety. Journal of the American Medical Informatics Association, 25(7), 773–773. https://doi.org/10.1093/jamia/ocy079
Fatmata Mansaray
Fatmata Mansaray
Dec 2, 2022Dec 2, 2022 at 2:41am
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I have come to respect that computer and electronic mediums are here to stay with regard to taking care of patients in the clinical settings as well as remote areas as we all witnessed with the Covid-19 pandemic. Nursing informatics helps with integrating nursing sciences, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice (Sheridan, et al., 2016). This definition of informatics is needed in this age and time. The informatics side of technology is what I believe I will need more as I transition into the clinical nurse specialist role. I want to be comfortable with the use of computers, data gathering, and the means to disseminate materials as they help to safeguard patients by preventing errors and harm to patients.
Reference
Sheridan, P., Watzlaf, V., Fox, L., (2016). Health Information Management Leaders and the Practice of Leadership through the Lens of Bowen Theory. Retrieved June 9, 2022, from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832128/
Kristi Lynn Woodall
Kristi Lynn Woodall
Dec 1, 2022Dec 1, 2022 at 9:53pm
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Anupa,
I enjoyed reading your post, and I agree that health informatics plays a huge role in gathering medical information and making sure it gets communicated to all areas of the integrated public health arena such as other hospitals, outpatient offices, and even urgent care clinics. This however can be our downfall if we rely too heavily on computer systems. We still as healthcare professionals need to know how to utilize communication when technology fails. Some of the negative aspects of EPIC include the cost of EPIC (Pow, 2021). Not all healthcare providers can afford that type of EMR. There was not a current article on the outage that occurred this last month, but EPIC was down for two weeks in some areas, in my area all EPIC access was down for 3 days which included all our local hospitals and clinics, it slowed our usual pace down. According to McCann, something similar happened back in 2014 in Florida and patient safety becomes a top priority in these scenarios ( 2014). Overall, healthcare professionals must be prepared and not rely solely on health informatics.
Resources:
McCann, E. (2014, January 28). Network glitch brings Down Epic EMR. Healthcare IT News. Retrieved December 1, 2022, from https://www.healthcareitnews.com/news/network-glitch-brings-down-epic-emr
Pow, A. (2021, April 23). Epic EMR cost – in 2022. The Pricer. Retrieved December 1, 2022, from https://www.thepricer.org/epic-emr-cost/#:~:text=The%20Epic%20EMR%20software%20from%20Epic
Sarah Gloria Alebesun
Sarah Gloria Alebesun
Dec 1, 2022Dec 1, 2022 at 10:37pm
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Hi Anupa,
Your scenario was excellent! Technology systems such as EPIC, serve more than 250 healthcare organizations nationwide and store approximately 45 percent of the US population’s health records (Jo Ann Day, 2016) Although the utilization of EHR such as EPIC has greatly impacted overall patient outcomes, there is the human error factor that poses a constraint. In this case, documentation of vital signs and other pertinent assessments was extremely important for the sepsis alerts. For this reason, appropriate treatment was implemented based on set guidelines such as those of the International Guidelines for Management of Severe Sepsis and Septic Shock. According to Ruppel & Liu (2019), ”Sepsis is a global health priority of staggering impact, resulting in at least 6 million deaths worldwide each year and contributing to as many one-half of all hospital deaths in the US”. A drawback to the appropriate utilization of information technology such as the sepsis alert trigger is that sometimes, healthcare professionals do not input data in real-time, and end up delaying timely notifications. In my experience years ago as a medical surgical nurse, Nursing Assistants who were responsible for recording vital signs were sometimes unable to record vitals on time and end up documenting vitals at the end of the shift. Although they would verbally notify nurses of abnormal blood glucose and blood pressure, other pertinent information such as respiratory rate and temperature is sometimes overlooked. Uploading an abnormal respiratory rate and low body temperature to a system that already has records of an elevated white blood cell count, will trigger a sepsis alert. If the information was inputted earlier in the day, the appropriate treatment would be initiated in a timely manner. To effectively utilize EHR, I believe that healthcare leaders need to allocate resources to units with higher patient-to-nurse or nurse-assistant ratios. An example will be investing in vital sign machines that automatically upload EHR to the patient chart to avoid delay.
Reference
Jo Ann Day. (2016, September 23). Why Epic | Johns Hopkins Medicine. Hopkinsmedicine.org. https://www.hopkinsmedicine.org/epic/why_epic/Links to an external site.
Ruppel H, Liu V. To catch a killer: electronic sepsis alert tools reaching a fever pitch? BMJ Qual Saf. 2019 Sep;28(9):693-696. doi: 10.1136/bmjqs-2019-009463. Epub 2019 Apr 23. PMID: 31015377; PMCID: PMC6702042.
Beveine Rodney
Beveine Rodney
Dec 2, 2022Dec 2, 2022 at 12:41am
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Reply#1
Anupa Mukundram Mehta, Greetings to you. Your post was on point and informative.
Technology has added so greatly to the effectiveness of our care. The work that has gone into vital signs and other assessment findings to create alerts when out of range is impressive. In paper forms, essential data can sometimes be missed or even go unnoticed, but having a system that connects the dots help health providers to see the bigger picture. “Advances in technology have been made available to aid nurses perform their jobs and care for patients more efficiently and safely. Nursing today is not the same as it was 30 years ago”(Pepito & Locsin, 2019).
As wonderful as technology is, it requires the working knowledge to derive or identify what is happening with the patients to offer the proper treatment. One cannot overlook the many lives technology has saved. Even the most prudent nurse can make a mistake. We have seen many things that improved in the area of medication administration. “On average, roughly 7,000 patients in the United States die each year from adverse drug events. To help curb these incidents, electronic medication administration has become commonplace”(Impact of Technology in Nursing | Nursing & Technology | Queens, 2020). Technology advancements are happening daily and will continue to revolutionize how we care for our patients. It is such a wonderful thing.
References
Impact of Technology in Nursing | Nursing & Technology | Queens. (2020, December 10). Qnstux; Queen University. https://online.queens.edu/resources/article/impact-technology-nursing/
Pepito, J. A., & Locsin, R. (2019). Can nurses remain relevant in a technologically advanced future? International Journal of Nursing Sciences, 6(1), 106–110. https://doi.org/10.1016/j.ijnss.2018.09.013
Victavian Jackson
Victavian Jackson
Dec 2, 2022Dec 2, 2022 at 9:33am
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Great Post Anupa,
I use EPIC at my facility as well and very familiar with pop-up alerts for vital signs. There is a rapid response nurse (RRN) and rapid response team (RRT) at my facility who address sepsis alerts, hypovolemic shock and cardiac arrest. In 2020, my hospital added another alert to the RRN role called DI alert. DI alert is an artificial Intelligence (AI) program that use data from vital signs and laboratory values to improve early recognition of patient deterioration. In addition to DI alerts, my hospital adopted another AI program called deep learning-based artificial intelligence (DLBAI), it demonstrated a high performance in predicting cardiac arrest using a single ECG lead (Kwon et al., 2020). I agree, AI have already began to support medical professionals by capturing a tremendous amount of data using innovations and algorithms to store information in the electric health record (EHR) (Cato et al., 2020). AI have made it imperative for nurse leaders to develop clinical reasoning and judgement around assessing data and improving patient quality of care.
References:
Cato, K. D., McGrow, K., & Rossetti, S. C. (2020). Transforming clinical data into wisdom. Nursing Management, 51(11), 24–30. https://doi.org/10.1097/01.numa.0000719396.83518.d6Links to an external site.
Kwon, J. M., Kim, K. H., Jeon, K. H., Lee, S. Y., Park, J., & Oh, B. H. (2020). Artificial intelligence algorithm for predicting cardiac arrest using electrocardiography. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 28(1). https://doi.org/10.1186/s13049-020-00791-0Links to an external site.
Chisom Judith Okogbue
Chisom Judith Okogbue
Dec 2, 2022Dec 2, 2022 at 3:34pm
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WEEK 1 RESPONDE 2
Hi Anupa,
Thank you for a great post, I really enjoyed reading and going through it. Like you rightly said, ”very soon artificial intelligence is going to be a great support to medical professionals, where when a patient comes in with a certain complaint, asking a certain set of questions will help diagnose or rule out the most common possible conditions (Walden University, 2018). This does not replace the nurse or physician but certainly supports us in our decision-making, just like how the Epic Sepsis warning helps remind us to keep this diagnosis in mind if the patient meets the initial criteria”. I just want to add that with staff stretched thin by the pandemic, reducing clinician burden is vital. Artificial intelligence can help improve the accuracy of information that clinicians receive so they can better prioritize their time, empowering them to focus on patient care. Artificial intelligence has the potential to help solve some of the biggest challenges facing healthcare today, such as managing costs, physician burnout, and health equity.
REFERENCES
Radtke A, Ousdigian K, Haddad T, et al. Artificial intelligence enables dramatic reduction of false atrial fibrillation alerts from insertable cardiac monitors. Heart Rhythm, 2021-08-01, Volume 18, Issue 8, Pages S47-S47
Walden University, LLC. (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
Oluremilekun Taylor
Oluremilekun Taylor
Dec 2, 2022Dec 2, 2022 at 11:58pm
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Hello Anupa, thanks for sharing.
I agree that technology is and will magically help improve efficiency in the health care setting. Many a times, i refer to the QSEN competencies whenever i think about technology and health care. For instance, at the moment technologies such as tele-health, tele-nursing, and tele-medicine as well as remote health monitoring are already in use and are impacting health sciences immensely. For example, as opposed to the traditional use of home-visits to offer ongoing patient education, remote health education and follow-up technologies can be used. In addition, remote health monitors including wearable technologies such as wrist watches can monitor a myriad of physiological variables and relay that information to a care provider in the event of an emergency care need. These are just examples of the current changes in health sciences’ practice that have been orchestrated by the technologies we have. However, can this match up to patient-centered care for example? The rapport, the patient-provider relationship, etc may all be compromised? According to a study, there was reported high quality care with technology.
References
Nwosisi, E., Carl, L. and Nwosisi, C. (2012) “A meta-analysis summary of information technology lack of connectivity and usability in Patient Centered Care,” International Journal of Engineering and Technology, 4(5), pp. 512–517. Available at: https://doi.org/10.7763/ijet.2012.v4.422.
“Weekly assessment of patient symptoms using simple technology translates to higher-quality, patient-centered care” (2021) Default Digital Object Group [Preprint]. Available at: https://doi.org/10.1200/adn.21.200749.
Shirley Moreta
Shirley Moreta
Dec 3, 2022Dec 3, 2022 at 9:02pm
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hello Anupa
I like your senario and would to emphasize the need for health care staf to learn how to navigate health informatics like EPIC. It is like an acquisition, storage, retrieval and use of health information. Health informatics promotes efficient and effective patient care through the fluid transmittance and retrieval of health care information. The use of technology such as computer systems, software and other technologies promote informatics. A good and simple example of the efficiency and importance of informatics can be seen when considering mail via the post office and emails via computer systems and network. The delivery of mail using email transmittance allows for the quick, efficient and certain delivery of information. Sending information through the post office takes time, vulnerable to be lost as well as being damaged. The same efficiency is needed in addressing patient Care as patients lives at times will be dependent on the efficient transmittal of information. A patient, for example, that meets in a car accident and requires emergency surgery, would benefit from health informatics as the patient’s medical history is readily retrievable from a health care informatics system that links providers to each other. Imagine calling around for patient information or worst yet, writing letters to request patient information. Antiquated systems can jeopardize patient care and patient safety (Alotaibi and Frederico, 2017).
As the main health care personnel, nurses are charged with the responsibility of operating systems that utilize informatics. In addition, nurses should be able to efficiently and fluently use those systems. It is therefore important that nurses understand the full purpose of informatics as well as to navigate any system in their network that utilizes informatics. This is a critical part of nursing care as it promotes proper nursing care for patients as well as to increase positive outcome for the patients as well. Informatics should also be part of the core curriculum in nursing school because it teaches student nurses how to better care for their patients (Leung et. al., 2015). In addition, this core curriculum should again be reinforced in the clinical setting, as there are nuances to different informatics network systems. The nurse should be familiar with these nuances so that they can best utilize the system when dealing with health informatics. Nurses understanding and use of informatics should be greater than any other personnel in the clinical setting as the nurse is the main point of contact for patient care. A nurse, for example, may alert the doctor or others of a patient’s pre-existing conditions or allergies thereby preventing any type of accident. The nurse should also be able to properly train other personnel in using health informatics. In training a new on how to use health informatics, it is also important that the nurse possess basic technology skills such as computer skills and understanding how software works. Health informatics is the wave of the future and the nurse should also be at the forefront of this wave as it directly impacts patient care and patient outcome. It has also been shown that hospitals that uses health informatics efficiently, has more positive patient outcomes (Snyder et. al., 2011).
References:
Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on
patient safety. Saudi medical journal, 38(12), 1173–1180.
Snyder, C. F., Wu, A. W., Miller, R. S., Jensen, R. E., Bantug, E. T., & Wolff, A. C.
(2011). The role of informatics in promoting patient-centered care. Cancer journal (Sudbury, Mass.), 17(4), 211–218.
Leung AA, Denham CR, Gandhi TK, Bane A, Churchill WW, Bates DW, et al. A safe
practice standard for barcode technology. J Patient Saf. 2015;11:89–99.
Collapse SubdiscussionChisom Judith Okogbue
Chisom Judith Okogbue
Nov 30, 2022Nov 30, 2022 at 2:55pm
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Health Informatics
Health informatics improves the application and management of patient data, clinical evidence, population data, and community environment information (Kim, 2019). Informatics relates clinical science, computing, and information science to provide better medical resources for quality patient care. The concept of informatics is applying reusable evidence-based methods standards in medical institutions. According to (Kim, 2019), informatics uses automation to organize, analyze, manage, and apply information in health systems. Knowledge is a concept of health informatics that explains data progression to usable information.
A hypothetical case of a patient who reports to the hospital with a chief complaint of shortness of breath on exertion might be diagnosed with asthma, Chronic Obstructive Pulmonary Disease, cystic fibrosis, or low hemoglobin (Kosmala et al., 2019). Although the patient remembers visiting the hospital in the past, she has no memory of medical assessments or interventions. Health informatics carefully maintains patient information for future reference (Rahimi et al., 2018). The medical records show the patient has a PMH of hypertension and a PSH of Cholecystectomy. The patient records indicate the need for diagnostic tests to finalize the growing list of differential diagnoses which now include viral pneumonia, mediastinal cysts, and lung tumors (Kosmala et al., 2019).
Patient information is essential in referencing follow-up visits and similar condition cases. Medical documentation collects all essential information that can be later stored on computing devices (Rahimi et al., 2018). Nurse leaders use clinical reasoning to determine the connection between previous diagnoses and present symptoms. Documentation of successful nursing interventions provides usable treatments for similar cases in different patients. Access to data has to be restricted for patient confidentiality (Rahimi et al., 2018).
References
Kim, H. N. (2019). A conceptual framework for interdisciplinary education in engineering and nursing health informatics. Nurse Education Today, 74, 91–93. https://doi.org/10.1016/j.nedt.2018.12.010
Kosmala, W., Przewlocka-Kosmala, M., Rojek, A., & Marwick, T. H. (2019). Comparison of the Diastolic Stress Test With a Combined Resting Echocardiography and Biomarker Approach to Patients With Exertional Dyspnea. JACC: Cardiovascular Imaging, 12(5), 771–780. https://doi.org/10.1016/j.jcmg.2017.10.008
Rahimi, B., Nadri, H., Lotfnezhad Afshar, H., & Timpka, T. (2018). A Systematic Review of the Technology Acceptance Model in Health Informatics. Applied Clinical Informatics, 09(03), 604–634. https://doi.org/10.1055/s-0038-1668091
Shanea Trevino
Shanea Trevino
Dec 1, 2022Dec 1, 2022 at 12am
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Hello Chisom,
Thank you for sharing a scenario that could be used by nursing leaders. I’m fascinated by the ever-changing cognitive load the nursing profession requires and how in the past years with the integration of technology it continues to be changing. “Nurse leaders have a responsibility to recognize signs of cognitive overload among nurses and take active measures to reduce the cognitive burden and its consequences”(Collins, 2020, p. 44).
Electronic documentation in this scenario seems appropriate. If the nurse leaders are determining the connection between previous diagnoses and present, how would that be measured? If the staff nurses are documenting successful interventions, would it contribute to lowering or adding to the cognitive load of their staff? According to McGonigle & Mastrian, 2022, information can be overlapping phases. Would the staff be knowledge workers and nursing leaders be acquirers of the information? I found your example to be a good case scenario to practice how to formulate knowledge processing with informatics. I asked questions because I liked your example. I wanted to see if how I rationalized the working parts would be similar to yours in examining the aspects of the Foundation of Knowledge model in improving patient outcomes and productivity within your scenario. Thank you for your post.
References
Collins, R. (2020). Clinician cognitive overload and its implications for nurse leaders. Nurse Leader, 18(1), 44–47. https://doi.org/10.1016/j.mnl.2019.11.007
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning
Victavian Jackson
Victavian Jackson
Dec 1, 2022Dec 1, 2022 at 7:40am
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Great Post Chirsom!
Health Informatics (HI) have improved the management of patient data throughout different health care facilities. Data tracking on the
electric health record (EHR) have tremendously help identify patients with drug seeking behaviors. Patients would visit many emergency room
(ER) departments among different cities and ask for opioid prescriptions. Many healthcare providers have been approached by these patients
with multiple narcotics request and alleged allergies with the intent to pressure the practitioner into ordering an opioid. As a response to this
scenario, the local health department (LHD) addressed this opioid situation by using a data analysis surveillance system on the electric health
record (EHR) to flag the particular patients who have been prescribed narcotics from two different ER’s (Nguyen et al., 2020). HI have open up
opportunities for the LDH to access data and use the received information to explain how drug seekers navigate through the ER’s. I agree, it is
important to analyze patient information and locate data patterns. Identifying data patterns have open up opportunities for nurse leaders to
integrate prescription drug monitoring programs (PDMP) into EHR to improve opioid prescribing practices (Hussain et al., 2020). Accessing
healthcare data has huge benefits for patient care and the ability of nurse leaders to improve their clinical reasoning and judgements.
References:
Nguyen, T. H., Shah, G. H., Khurshid, A., & Olivas, M. I. (2020). Local Health Departments’ Engagement in Activities to Address Opioid Use and Abuse. Journal of Public Health Management and Practice, Publish Ahead of Print. https://doi.org/10.1097/phh.0000000000001180Links to an external site.
Hussain, M. I., Nelson, A. M., Yeung, B. G., Sukumar, L., & Zheng, K. (2020). How the presentation of patient information and decision-support advisories influences opioid prescribing behavior: A simulation study. Journal of the American Medical Informatics Association, 27(4), 613–620. https://doi.org/10.1093/jamia/ocz213Links to an external site.
Shirley Moreta
Shirley Moreta
Dec 2, 2022Dec 2, 2022 at 8:58pm
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Hi Chisom
Hi agree with you and would like to add, Health informatics is very useful in patient safety and patient care (Feldman et. al., 2018). The ability to access and efficiently use data is very important in patient care, especially for nurses. It is therefore important that nurses and other medical personnel understand how to use technology to retrieve important medical data in an effort to optimize patient care. Data created by medical informatics is useless if nurses and others cannot properly retrieve and put it to good use in order to facilitate patient safety (McCullough et. al., 2010). Information and technology skills are essential before the nurse can take advantage of medical informatics. Without these skills, nurses will be ineffective in leveraging medical informatics to increase patient safety and outcome.
Us nurse represents the ideal personnel that would be the best champion for information and technology skills to increase patient safety and outcome. Nurses are the main advocate for the patient as the nurse cares for the patient from day one of the patient’s entry into the hospital. In addition, nurse has the educational background and training that would allow valuable insight of patient data and information
References:
Feldman, S. S., Buchalter, S., & Hayes, L. W. (2018). Health Information Technology in
Healthcare Quality and Patient Safety: Literature Review. JMIR medical informatics, 6(2), e10264.
McCullough JS, Casey M, Moscovice I, Prasad S. The effect of health information
technology on quality in U.S. hospitals. Health Aff (Millwood) 2010 Apr;29(4):647–54.
Oluremilekun Taylor
Oluremilekun Taylor
Dec 3, 2022Dec 3, 2022 at 12:04am
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Hello Chisom, thanks for sharing,
I like the scenario you have shared. The EMRs have been very helpful to refer to past medical histories and even drugs histories. Nursing practices are continually evolving to pursue and process new knowledge. (Nagle et al., 2017). Technology, analysis methodologies, ethics, decision support tools, patient care, human-computer interfaces, information systems, imaging informatics, e-learning, electronic medical records, and telecare are all integrated with this discipline. This has created a field of informatics for contemporary nurses (Pramanik et al., 2020). Technology is crucial to providing quality patient care, and its importance, relevance, and participation are increasing. According to the Healthcare Information and Management Systems Society (HIMMS), electronic recording allows nurses to get information quickly and efficiently, which they may then utilize to improve their everyday workflows. All care team members, including doctors and other healthcare providers and a group of personnel at other healthcare institutions that patients may visit, have greater access to information stored electronically.
Reference
Nagle, L. M., Sermeus, W., Junger, A., & Bloomberg, L. S. (2017). Evolving role of the nursing informatics specialist. Stud Health Technol Inform, 232, 212-22.
Pramanik, M. I., Lau, R. Y., Azad, M. A. K., Hossain, M. S., Chowdhury, M. K. H., & Karmaker,
K. (2020). Healthcare informatics and analytics in big data. Expert Systems with Applications, 152, 113388.
Beveine Rodney
Beveine Rodney
Dec 3, 2022Dec 3, 2022 at 12:44am
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Reply #2
Hello Chrisom,
Great post, and thank you for sharing.
Information is critical in healthcare. When healthcare professionals cannot retrieve data directly from their subjects, it can interfere with patient outcomes. Not having a complete history of a patient can cause harm to the patient, putting them in a compromising position.
Thankfully, technology has changed that. With technology, doctors can follow the medical blueprint of patient history, treatment, doctor’s visits, and hospitalization. “When health care providers have access to complete and accurate information, patients receive better medical care. Electronic health records (EHRs) can improve the ability to diagnose diseases and reduce—even prevent—medical errors, improving patient outcomes”(Healthit.gov, 2019).
Retrieving a patient’s information saves time, money, and lives. Doctors can initiate treatment, and the patient stresses less. “Through the use of EMRs, nurses and other medical professionals can quickly access critical patient information and reduce or eliminate the need for paperwork” (Bailey, 2020).
References
Bailey, S. (2020, June 3). How Technology Has Changed the Role of Nursing. NurseJournal. https://nursejournal.org/articles/technology-changing-nursing-roles/
Healthit.gov. (2019). Improved diagnostics & patient outcomes. Healthit.gov. https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/improved-diagnostics-patient-outcomes
Sarah Gloria Alebesun
Sarah Gloria Alebesun
Dec 3, 2022Dec 3, 2022 at 9:44pm
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Hi Chisom,
As you rightly indicated, health informatics has contributed greatly to the effective application of patient data. Data must be applied correctly to improve overall patient outcomes. As stated explained by Walden University, artificial intelligence (AI) will be an added value to the healthcare industry because of its diagnostic capabilities (Walden University, 2018). A systematic review conducted by Choudhury & Asan (2020), highlighted the pivotal role of healthcare professionals in the safe application of AI. Proper utilization of AI will require dedicated professionals to carry out the human activities that are necessary for this software to operate. There will be a better outcome of diagnosing diseases in a timely manner because providers will have the luxury of diagnosing patients by documenting patient assessment, medical history, symptoms, etc. Overall, I believe that real-life scenarios will be needed to support the effectiveness and safety of AI.
Reference
Walden University, LLC. (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
Choudhury, A., & Asan, O. (2020). Role of Artificial Intelligence in Patient Safety Outcomes: Systematic Literature Review. JMIR Medical Informatics, 8(7), e18599. https://doi.org/10.2196/18599
Collapse SubdiscussionSyreeta Doucet
Syreeta Doucet
Nov 30, 2022Nov 30, 2022 at 8:33pm
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Discussion 1 Response
In this modern era, almost all professions, including the nursing profession, depend on data for their Day-to-day operations and to perform efficiently. Collecting data not only assists in solving problems but is vital to the practitioner’s and the discipline’s body of knowledge. Data is part of the first step in the nursing process. Problems but adds to the practitioner’s and the discipline’s body of knowledge. The field of nursing informatics aims to ensure nurses have access to the appropriate data to solve healthcare problems, make decisions in the interest of patients, and add to knowledge (Walden University, 2018). According to McGonigle and Mastrian (2021), “Nurses must possess the technical skills to manage equipment and perform procedures, the interpersonal skills to interact appropriately with people, and the cognitive skills to observe, recognize, and collect data; analyze and interpret data, and reach a reasonable conclusion that forms the basis of a decision”.
Scenario
The scenario that would rely on informatics within the healthcare system involves patient care management. The scenario involves a patient on the postpartum patient unit who delivered vaginally 10 hours ago on admission, suddenly complained of sharp chest pain and rates the pain as 10 out of 10 on a scale of 1-10, with 10 being the highest pain. The patient also complained of shortness of breath (SOB) and heart palpitation. The rapid Response Team (RT) called. While waiting for the RT to arrive, the patient is connected to a continuous pulse oximeter machine to check his oxygen level. The MD was also made aware by the charge nurse. The pulse oximeter machine showed oxygen of 83% on room air and a heart rate of 140 bpm.
The nurse immediately administered oxygen at 3 L/min via nasal cannula and elevated the head of the bed. The nurse also used the EKG machine to confirm the patient’s heart rhythm. The RT arrived and connected the patient to a defibrillator machine to check for heart rhythm, which will guide the treatment plan. The machine shows sinus tachycardia with a heart rate of 120, Blood Pressure of 175/92, and Respiration of 30. A physical exam shows the patient is distressed due to SOB, rapid heartbeat, and hyperventilation. The patient states she is very anxious. The nurse administered morphine 4mg IV, and STAT labs were drawn to check cardiac markers to rule out heart disease. The patient felt relieved after 15mins of morphine administration, and vitals became stable. The patient was connected to a continuous heart monitor. The data used in the scenario include objective data from the nurse, subjective data from
The patient has data from a continuous pulse ox, EKG, defibrillator machine, and continuous heart monitor. Objective data enabled the nurse to know that the patient may need oxygen due to distress from an SOB. Subjective data informs the nurse that the patient’s symptoms might be due to anxiety. Data from the pulse ox machine confirms that the patient has anxiety and SOB and needs oxygen. The EKG and defibrillator machine confirm the patient’s sinus tachycardia. The heart monitor provides continuous heart rhythm that directs the nurse on the appropriate intervention based on changes in rhythm. The cardiac markers lab results will inform the nurse if the patient chest pain is related to a heart problem or not. All patient information is documented in the patient’s electronic health record (EH) for continuity of care by other providers. A nurse leader in the above scenario will rely on clinical reasoning and judgment by collecting and processing information regarding the patient’s condition before implementing any treatment plan. The managerial level requires the interpretation and modification of information and data for better decision-making processes within the information system(Sweeney, 2017). Virtual health services are becoming a trend globally (Nagle et al., 2017). These efforts will ensure the patient in the above scenario gets the proper diagnoses and treatment and thus obtain the best health outcomes based on evidence-based practice.
References
McGonigle, D., & Mastrian, K. G. (2021). Nursing informatics and the foundation of knowledge (5th ed.).
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Competencies for Nurses in the Future of Connected Health, 212–221. Retrieved November 29, 2022, from https://doi.org/doi:10.3233/978-1-61499-738-2-212Links to an external site.
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.
Walden University. (2018). Health Informatics and Population Health: Trends in Population Health [Video].
Karla Pineda
Karla Pineda
Dec 3, 2022Dec 3, 2022 at 10:28am
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Peer response #2
Hello Syreeta
I like the scenario you have shared. Thank you for your example of how nursing informatics can be beneficial to provide critical information and guide our nursing interventions. Which goes in contrast with Sweeney, 2017, “Health informatics and Nursing Informatics are very relevant in evolving health systems. New technology and initiatives are constantly being developed.”
According to McGonigle and Mastrian, 2022, “The data that are processed into information must be of high quality and integrity to create meaning to inform assessments and decision making.” However, nurses are required to have the technical skills necessary to manage equipment and carry out procedures, the interpersonal skills necessary to interact with people in an appropriate manner, and the cognitive skills necessary to observe, recognize, and collect data; analyze and interpret data; and come to a conclusion that is reasonable and serves as the basis for a decision.
The concept of informatics and knowledge is introduced because the nursing profession depends heavily on using information, and the foundation of nursing practice science is the stages of using information, applying knowledge to a situation, and responding with wisdom. On the other hand, the Information is made up of data that is turned into interventions by using knowledge. (McGonigle and Mastrian, 2022)
References
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Sweeney, J. (2017). Healthcare informatics Links to an external site.. Online Journal of Nursing Informatics, 21(1).
Collapse SubdiscussionSarah Gloria Alebesun
Sarah Gloria Alebesun
Nov 30, 2022Nov 30, 2022 at 9:16pm
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Scenario
A 68yr old African American male is admitted to the Intensive Care Unit with a diagnosis of sepsis. He requires vasopressors, fluids resuscitation, and antibiotics. The patient is from a nursing home and recently became bedbound due to a recent Stroke. Past medical history includes diabetes mellitus type 2, hypertension, coronary artery disease, recurrent urinary tract infection, and cerebral vascular accident. The ICU Nurse completed an admission assessment which required documentation of a Braden Scale. The Braden scale is a tool used in predicting pressure score risk to improve the early identification of patients at risk for developing sores (Bergstrom et al., 1987).
Data Collection and Application of Evidence-Based Practice
The Braden scale uses six areas to assess the risk for ulcers. These categories include moisture, activity, mobility, nutrition, perception, and friction/shear. Data collected based on this information populates a score for this patient. This score is then used to determine if patients are at risk for developing ulcers. This Patient’s Braden scale resulted in a very low score after data was inputted into the computer. For this reason, the patient was at very high risk for acquiring pressure injury. The nurse then implemented appropriate measures based on evidence-based practice to prevent skin breakdown. Preventative actions included repositioning this patient every 2 hours, applying pressure-reducing devices to bony prominences, consulting the dietician for adequate nutrition, controlling moisture such as padding on the bed, avoiding the use of diapers according to unit/hospital policy, etc.
Conclusion
The application of evidence-based practices resulted from the collection of data from studies that were successful. As stated in the video presented by Walden University, the utilization of information technology by healthcare professionals will lead to better patient outcomes and reduce costs for consumers (Walden University, 2018). In this situation, proper application of data from the Braden Scale reduces this patient’s risk of acquiring hospital-acquired pressure injury (HAPI). According to the Center for Medicare and Medicaid Services, HAPI rates were reduced from 40.3 to 30.9 per 1,000 discharges between 2010 and 2014. This is due to efforts made by healthcare leaders to properly collect data on patients at risk for HAPI and ensure the implementation of preventative measures (Rondinelli et al.,)
Reference
Bergstrom, N., Braden, B. J., Laguzza, A., & Holman, V. (1987). The Braden Scale for Predicting Pressure Sore Risk. Nursing Research, 36(4), 205–210. https://pubmed.ncbi.nlm.nih.gov/3299278/Links to an external site.
Walden University, LLC. (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
Rondinelli J, Zuniga S, Kipnis P, Kawar LN, Liu V, Escobar GJ. Hospital-Acquired Pressure Injury: Risk-Adjusted Comparisons in an Integrated Healthcare Delivery System. Nurs Res. 2018 Jan/Feb;67(1):16-25. doi: 10.1097/NNR.0000000000000258. PMID: 29240656; PMCID: PMC6013055.
Chisom Judith Okogbue
Chisom Judith Okogbue
Dec 1, 2022Dec 1, 2022 at 6:31pm
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WEEK 1 RESPONSE 1
Hi Sarah,
I really enjoyed reading your post and you did a great job explaining evidence-based practice and data collection. I just want to add that evidence-based practice has been used in helping healthcare workers to meet the needs of their patients and it uses two different approaches: Infusing research and data collection which empirically supports interventions in nursing practice. The process of implementing evidence-based practice interventions include the process of assessing patients’ needs, selecting the interventions and monitoring the progress by data collection. And like you rightly said proper application of data from the Braden Scale reduces this patient’s risk of acquiring hospital-acquired pressure injury (HAPI). According to the Center for Medicare and Medicaid Services, HAPI rates were reduced from 40.3 to 30.9 per 1,000 discharges between 2010 and 2014. This is due to efforts made by healthcare leaders to properly collect data on patients at risk for HAPI and ensure the implementation of preventative measures (Rondinelli et al.,)
REFERENCE
Walden University, LLC. (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
Rondinelli J, Zuniga S, Kipnis P, Kawar LN, Liu V, Escobar GJ. Hospital-Acquired Pressure Injury: Risk-Adjusted Comparisons in an Integrated Healthcare Delivery System. Nurs Res. 2018 Jan/Feb;67(1):16-25. doi: 10.1097/NNR.0000000000000258. PMID: 29240656; PMCID: PMC6013055.
Karla Pineda
Karla Pineda
Dec 1, 2022Dec 1, 2022 at 9:58pm
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Peer Response #1
Hi Sara
Your post was very interesting!! The primacy of data in the healthcare industry is directly correlated to the significance of nursing informatics. Nurse informaticists manage, interpret, and communicate data with the primary goal of improving both the quality of patient care and the outcomes of that care using the various electronic medical record systems that are now standard fare in the healthcare industry for the collection of health information across an organization. (How Nursing Informatics Benefits Quality Outcomes, 2021). However, today’s nurses have access to more technology than nurses in the history of nursing, and there are a number of different ways in which health informatics can be used to improve patient care.
The concept of informatics and knowledge is introduced because the nursing profession depends heavily on using information, and the foundation of nursing practice science is the stages of using information, applying knowledge to a situation, and responding with wisdom. On the other hand, the Information is made up of data that is turned into interventions by using knowledge. (McGonigle and Mastrian, 2022)
References
How Nursing Informatics Benefits Quality Outcomes. (2021). Healthstream. Retrieved December 1, 2022, from https://www.healthstream.com/resource/blog/how-nursing-informatics-benefits-quality-outcomesLinks to an external site.
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Amandeep Kaur Deol
Amandeep Kaur Deol
Dec 2, 2022Dec 2, 2022 at 8:22pm
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Hello Sarah,
Thank you for a great post. I enjoyed reading and going through it. The Braden scale is a standardized, evidence-based assessment tool commonly used in healthcare tools to assess and document patients’ risk for developing pressure injuries. Your scenario proves how important it is to have up-to-date data on your patients and a streamlined way of assessing patient information. Nursing informatics is essential for nurses to provide high-quality care for their patients. Nurses are often required to help coordinate their patient care, which means they must relay information to multiple team members. (How nursing informatics benefits quality outcomes, n.d.). Providers rely on available data and information to solve patients’ healthcare problems (Sweeney, 2017).
References:
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1).
How Nursing Informatics Benefits Quality Outcomes. (n.d.). Default.
https://www.healthcarestream.com/resource/blog/how-nursing-informatics-benefits-quality-outcomesLinks to an external site.
Ambria Boutan
Ambria Boutan
Dec 4, 2022Dec 4, 2022 at 10:20am
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Hi Sarah,
Thank you for your discussion on the topic of pressure sore prevention. Evidence Based Practice is also essential in the active prevention of pressures sores as this will help to effectively evaluate patient needs and requirements for prevention.
Pressure sores can be devastating for a patient’s recovery, and even with the use of the Braden Scale, they are still seen in many hospitalized patients. Immobility poses a large risk for pressure sore development (Bedsores (Pressure Ulcers) – Symptoms and Causes, 2022). There are many forms of EBP that can be used to prevent pressure sores and nurses should be consistently evaluating the best ways to prevent these sores. When patients are bed bound, turning them is one of the most important ways to prevent pressure ulcers (Discover Our Tips on How to Prevent Pressure Ulcers or Bed Sores, 2022).
In my own experience, I have seen many nurses who are overwhelmed forget to consistently turn and reposition their patients which can lead to the development or furthering of pressure sores. One effective way that I have seen used to ensure bed sores
are prevented is by placing a turn clock outside of the patients room and writing down when the patient was turned last / when the next turn is due. This allows everyone to see when the patient has been turned and when they should be turned again which allows teamwork within the clinical setting to be utilized in order to ensure bed sores are being prevented.
Thanks for sharing about the importance of using EBP in the prevention of bedsores in patients!
References
Bedsores (pressure ulcers) – Symptoms and causes. (2022, April 19). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bed-sores/symptoms-causes/syc-20355893
Discover Our Tips on How to Prevent Pressure Ulcers or Bed Sores. (2022, October 18). Verywell Health.
https://www.verywellhealth.com/tips-to-prevent-pressure-ulcers-or-bed-sores-1131985
Collapse SubdiscussionAndrea White
Andrea White
Dec 1, 2022Dec 1, 2022 at 12:19am
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Andrea White
The Benefits of Health Informatics
Health informatics provides important data that can prevent errors. While allowing nurses to assist with coordination of care and improving patient outcomes. Nurses are often on the front lines of ensuring that their patients are kept safe and preventing medication errors, misdiagnoses, falls, and other problems. Health informatics provides important data that can prevent these errors; for example, an electronic record can provide information about a possible dangerous medication interaction or allergy that might not otherwise be immediately apparent. Armed with data, nurses can make quick decisions that keep their patients safe.” (Harness , 2021)
Scenario
I work in the rural area, and we are the only hospital in the county that offers Labor and Delivery services. I had an active high risk labor patient show up in active labor. She was seen by our providers in clinic and was told to establish care with a Level three facility due to a fetal cardiac anomaly noted on ultrasound. She was a poor historian and had a history of methamphetamine use. Our hospital uses Cerner for charting and the providers use Athena for outpatient clinical care. At one time we did not have access to the patients’ medical records. We voiced our concerns of not having access to their computer system and having the need to duplicate procedures without having access to the patient’s history and physical. Access to Athena allowed us to transport this patient to the correct facility in a timely manner. This allowed the patient to have continuity care with the perinatologist that managed her care during her pregnancy.
Leadership
“The healthcare environment is fast-paced, and nurses must be prepared to inspire, innovate, and lead healthcare transformation as the healthcare sector continues to evolve in the application use and support of delivery of care”. (Garcia-Dia, 2021)
References
Harness , J. (2021, April 1). How nursing informatics benefits quality outcomes. Default. Retrieved November 30, 2022, from https://www.healthstream.com/resource/blog/how-nursing-informatics-benefits-quality-outcomes
Garcia-Dia, M. J. (2021). Nursing informatics. Nursing Management, 52(5), 56–56. https://doi.org/10.1097/01.numa.0000743444.08164.b4
Sensmeier , J. (2021, June). Realizing nurse-led Innovation : Nursing Management. LWW. Retrieved November 30, 2022, from https://journals.lww.com/nursingmanagement/Fulltext/2021/06000/Realizing_nurse_led_innovation.5.aspx
Anupa Mukundram Mehta
Anupa Mukundram Mehta
Dec 1, 2022Dec 1, 2022 at 8:40pm
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It is very unfortunate that scenarios like that exist, but it’s great that nurses like yourself are stepping up to advocate and make changes in informatics to do better for our patients. Public Health Informatics professionals are the ones who make it so that an electronic health record works between different hospitals, outpatient offices, and more (Public Health Informatics Institute, 2017). As seen in your scenario, their work is essential for patient safety.
I was surprised to read that more than one-half of rural counties in the United States lack adequate maternity services (Hostetter & Klein, 2021). These areas are called maternity deserts and lead to women driving hundreds of miles to seek care, which is part of the rise in maternal mortality in America (Hostetter & Klein, 2021).
References:
Public Health Informatics Institute. (2017). Public Health Informatics: “translating” knowledge for health Links to an external site. [Video file]. Retrieved from https://www.youtube.com/watch?v=fLUygA8Hpfo
Hostetter, & Klein. (2021, September 30). Restoring access to Maternity Care in rural America. Commonwealth Fund. Retrieved December 1, 2022, from https://www.commonwealthfund.org/publications/2021/sep/restoring-access-maternity-care-rural-america
Isabelle Compere-Louis
Isabelle Compere-Louis
Dec 1, 2022Dec 1, 2022 at 8:56pm
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Hello Andrea,
I enjoyed reading your post!
Medication errors are among the most common health-threatening mistakes that affect patient care. According to the US Food and Drug Administration, more than 100,000 US reports are annually associated with a suspected medication error (Ross, 2019). Such mistakes are considered a global problem that increases mortality rates, length of hospital stay, and related costs (Cheragi et al., 2013). Although all healthcare team members can potentially cause medication errors, nursing medication errors are the most common. The reason is that nurses execute most medical orders and spend about 40% of their time in the hospital administering medications (Cheragi et al., 2013). Prevention of medication errors has become a high priority worldwide. There is plenty of evidence that systems that use information technology (IT), such as computerized physician order entry, automated dispensing cabinets, bedside bar-coded medication administration, and electronic medication reconciliation, are critical components of strategies to prevent medication errors (Agrawal, 2009).
References
Agrawal, A. (2009). Medication errors: prevention using information technology systems. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723209/
Cheragi, M, et al. (2013). Types and causes of medication errors from the nurse’s viewpoint.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748543/
Ross, Michael. (2019). 6 Medication Error Stories that Made Headlines.
https://www.blog.cureatr.com/6-medication-error-stories-that-made-headlines
Shaquilla Williams
Shaquilla Williams
Dec 2, 2022Dec 2, 2022 at 6:07pm
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Hello Andrea,
Thank you for your insightful dive into health informatics and its benefits. Notably, you have underpinned the frontline role that nurses usually play in the multidisciplinary approach to a patient-centered care approach. Due to this stature, nurses usually would require precision, and the role of health informatics and reliable data comes out well in your insights. You have also highlighted the role that accurate and easily retrievable data plays in reducing medical errors through the precision of health informatics systems. Obstetrics reliability is a helpful measure of the quality of care in most centers (Ameh et al., 2019). Your choice of experiences in an obstetric unit that was improved through positive leadership that takes feedback well into consideration and acts on it serves well to highlight the role.
Health informatics would further benefit from integration and collaboration. In the case of a care facility not being able to take care of a complicated obstetric case, such complications can be easily anticipated. Ways in which this goal can be achieved through a widespread and safe sharing of trends and epidemiological data that nurses can thereafter use to guide their role in patient care (Rahimi et al., 2018). It is easy to chart whether there exists an improvement in the management of patients in any facility once such systems are instituted while ensuring perpetual access to medical records stored in ways that respect patients’ right to privacy. In most cases following a reliable system that supports solid health informatics, continuity care becomes one of the basic benefits along with faster referrals, decision making, and management.
References
Ameh, C. A., Mdegela, M., White, S., & van den Broek, N. (2019). The effectiveness of training in emergency obstetric care: A systematic literature review. Health Policy and Planning, 34(4), 257–270. https://doi.org/10.1093/heapol/czz028
Rahimi, B., Nadri, H., Lotfnezhad Afshar, H., & Timpka, T. (2018). A systematic review of the Technology Acceptance Model in health informatics. Applied Clinical Informatics, 09(03), 604–634. https://doi.org/10.1055/s-0038-1668091
Ambria Boutan
Ambria Boutan
Dec 2, 2022Dec 2, 2022 at 7:39pm
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Hi Andrea,
Thanks for sharing about your experience and about this scenario. Your scenario proves how important it is to have up to date data on your patients and a streamlined way of accessing patient information.
Nursing informatics is essential for nurses to provide high quality care for their patients. Nurses are often required to help coordinate their patients care, which means the nurse must relay information to multiple members of the healthcare team (How Nursing Informatics Benefits Quality Outcomes, n.d.). If nurses do not have the necessary information, individual patient care can suffer which can result in poor patient outcomes (How Nursing Informatics Benefits Quality Outcomes, n.d.).
Healthcare informatics also creates the ability for patient records to be stored electronically which allows for a more seamless process of care (Pharmapproach, 2020) There is less stress put onto the medical staff by utilizing this process of storing patient data (Pharmapproach, 2020). As you stated, when you had the patients medical data it gave you the ability to properly care for the patient which allowed her to get the care that she needed in a timely fashion rather than waiting for her care process to be determined later due to the need for further assessment.
Thanks for sharing about your experiences and the need for healthcare informatics in the nursing world.
References
How Nursing Informatics Benefits Quality Outcomes. (n.d.). Default. https://www.healthstream.com/resource/blog/how-nursing-informatics-benefits-quality-outcomes
Pharmapproach. (2020, September 30). 6 Benefits of Health Informatics. Pharmapproach.com. https://www.pharmapproach.com/6-benefits-of-health-informatics/
Mackenzie Hudnall-Ellington
Mackenzie Hudnall-Ellington
Dec 2, 2022Dec 2, 2022 at 10:31pm
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Andrea,
That is great that you all were able to voice your concerns about not having access and now you are able to have that continuity of care. The hospital that I work at has allowed nurses to be very involved in the charting design process and it has led to so many improvements “Nurses have the most communication with patients, and interact with technology more frequently. Using technology should create a positive attitude in nursing productivity.” (Darvish, et al, 2014). There have also been improvements between providers and nursing staff once we were able to be more involved in the development aspect of charting “relationships between health care teams and family members cannot bring value to a patient unless they are easily discoverable within a healthcare system.” (Kasthurirathne, 2018). Informatics can make such an impact on patient care and services!
References
Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and
the need for appropriate education. Global journal of health science, 6(6), 11–18. https://doi.org/10.5539/gjhs.v6n6p11Links to an external site.
Kasthurirathne, S. N., Mamlin, B. W., Purkayastha, S., & Cullen, T. (2018). Overcoming the Maternal Care Crisis: How Can Lessons Learnt in Global
Health Informatics Address US Maternal Health Outcomes?. AMIA … Annual Symposium proceedings. AMIA Symposium, 2017, 1034–1043.
Atem Orock
Atem Orock
Dec 2, 2022Dec 2, 2022 at 11:19pm
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Hello Andrea,
Thanks for sharing. I agree with you one hundred percent on informatics helping nurses reduce errors. This enables nurses to better perform the job they were trained for in a timely manner, without having to worry about spending time making sure errors were avoided. Safe and quality care is at the top of healthcare and this helps us provide just that. (Harness , 2021)
Due to the fact that you were able to have access to the patient’s previous data, a safer care was provided to the patient. In as much as technology, informatics, and all the new innovations are becoming popular, they cannot replace the nurse . But we do need them to maximize time and provide better care to our patients. (Garcia-Dia, 2021) As you mentioned, nurses must be prepared for these innovations as the profession is not only fast paced but also fast growing.
References
Harness , J. (2021, April 1). How nursing informatics benefits quality outcomes. Default. Retrieved November 30, 2022, from https://www.healthstream.com/resource/blog/how-nursing-informatics-benefits-quality-outcomes
Garcia-Dia, M. J. (2021). Nursing informatics. Nursing Management, 52(5), 56–56. https://doi.org/10.1097/01.numa.0000743444.08164.b4
Fernando Davila
Fernando Davila
Dec 4, 2022Dec 4, 2022 at 6:59pm
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Hello Andrea, one of my goals is to help provide primary care in the rural setting. Your scenario depicts a situation where continuity of care is of high importance. Being able to follow up with a primary care practitioner or specialist in this patient’s case would provide her with the tools she needs to be successful in her pregnancy. According to the cdc, there is a very large gap between rural and urban America when it comes to healthcare (About Rural Health, 2022)
Continuity of care is very important in healthcare today more than ever. With ever changing treatments and medications, conditions which require monitoring cannot fall through the cracks for our patients (Gulliford et al., 2006)We need a more seamless approach to healthcare and health informatics will be at the forefront of this endeavor.
References
About Rural Health. (2022, January 1). cdc.gov. Retrieved December 4, 2022, from https://www.cdc.gov/ruralhealth/about.htmlLinks to an external site.
Gulliford, M., Naithani, S., & Morgan, M. (2006). What is ‘continuity of care’? Journal of Health Services Research & Policy, 11(4), 248–250. Retrieved December 4, 2022, from https://doi.org/10.1258/135581906778476490Links to an external site.
Collapse SubdiscussionAmbria Boutan
Ambria Boutan
Nov 28, 2022Nov 28, 2022 at 9:31pm
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Patient Scenario
In the hospital, there are many scenarios that may benefit from the collection and application of data. For example, falls are always a high risk in the hospital and can be a cause for major disruption in the patient’s recovery. I work on an oncology unit which involves patients who are receiving high amounts of pain medications and are almost always attached to an IV pole. This poses a high risk for falls for any patient, but especially patients undergoing intense chemotherapy regimens. We had a patient who had gone through a month of chemotherapy treatment and was ready to go home, but then had a fall which caused them to stay in the hospital for much longer. This was very discouraging for the patient as they had already been in the hospital setting for so long, and staying longer was very discouraging to them. In the hospital setting up to 20% of patients fall at some point of their stay (Hospital-Based Fall Program Measurement and Improvement in High Reliability Organizations | OJIN: The Online Journal of Issues in Nursing, n.d.). Falls are the leading adverse event seen in hospitals, and these falls can even lead to death in some scenarios (Hospital-Based Fall Program Measurement and Improvement in High Reliability Organizations | OJIN: The Online Journal of Issues in Nursing, n.d.).
Data Collection
Data can be easily collected within the hospital setting. There are multiple opportunities to continually change how charting and patients assessments are done in relation to fall risks and procedures. Within the hospital, different units could try different policies and procedures in order to determine what may have the best outcomes in relation to patient falls. When a fall does occur, nurses may hold briefings to determine why the fall occurred and what could have been done to prevent the fall. When these briefings occur, data can be collected on sheets that does not contain any PHI which could allow a fall committee to review the falls and create policies and procedures that may help to prevent similar falls from occurring hospital-wide.
If multiple similar falls occur on the same unit that seem to have similar origins, a fall committee could conduct observation to determine why these similar falls keep occurring. This may provide a different point of view for the nurses and staff that may help to keep patients safe and prevent falls from occurring. This data will provide knowledge on the origination of patient falls and the best prevention measures when it comes to different patient populations.
Leadership
One of the best ways that nurse leaders can help this change is by adapting a proactive approach when it comes to patient falls (Tops Health Info, 2022). Challenges are going to occur in the healthcare setting, and a leader shows their skills by adapting to those challenges and collecting data and knowledge on how to overcome those obstacles. In the same sense, leadership positions are significantly linked to patient mortality (Teecycle Editorial Staff, 2022). Leaders must be supportive of their staff in order to help their nurses provide the best care and prevent burn-out. By nurse leaders gaining knowledge on the prevention of falls, they can better support their staff with the resources needed, which will ultimately result in better patient outcomes and less patient falls.
A nurse leader must be proactive in gaining knowledge on different areas of patient care. A proactive nurse leader would be observant of what is going on around them and would then assume knowledge from those circumstances. It would also be beneficial for a nurse leader to be involved in data collection and review in order to determine what methods will be best to promote patient safety. Nurse leaders are the beginning of patient safety and the start of new methods and procedures which is why their involvement and knowledge is vital for patient care.
References
Hospital-Based Fall Program Measurement and Improvement in High Reliability Organizations | OJIN: The Online Journal of Issues in Nursing. (n.d.). https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Fall-Program-Measurement.html
Teecycle Editorial Staff. (2022, March 15). 6 Ways Efficient Nurse Leaders Can Improve Patient Outcomes. Teecycle. https://teecycle.org/health/6-ways-efficient-nurse-leaders-can-improve-patient-outcomes/
Tops Health Info. (2022, November 4). Seven Ways Nurse Leaders Can Influence Positive Change in Healthcare. https://topshealthinfo.com/seven-ways-nurse-leaders-can-influence-positive/
Collapse SubdiscussionDeanna Linn Howe
Deanna Linn Howe
Nov 29, 2022Nov 29, 2022 at 9:05am
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Hi Ambria and all,
Thanks for your comments here. There is such a great potential of computerized collection of data and patient tracking! I love that we can track and compile data regarding our patients and outcomes. This data can inform us to practices we need to give attention to and those we can celebrate. The nursing profession should use evidence-based data to implement new practices. Tracking of patient data is important to determine if there is a potential practice issue that can be addressed. And, because reimbursement rates are affected by outcomes, understanding the root cause is very important. How is your workplace currently using collected data? And is this data in a shareable form at this time? If not, how could you advocate for this important need? Thanks, Dr. Howe
Shanea Trevino
Shanea Trevino
Nov 30, 2022Nov 30, 2022 at 1:32pm
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Thank you Professor Howe for this inquiry,
Nurses are responsible for advocacy. In this situation, data is not sharable to my knowledge with staff nurses at my current workplace. In the effort to advocate for this need for shared data, I would approach this by using my chain of command and bringing this up at a staff meeting. As an incentive to make an argument on the importance, I would use the same platform as McGonigle & Mastrian, 2022, on the importance of how computer science is valuable and contributes to a knowledge base. To facilitate professional development sharable data could benefit the nursing practice as a whole. In my personal experience, I lacked the understanding of why sharable data would be important, but with education and knowledge, I have changed my view on the significance to practice decisions and care. Collaboration with leadership and the health information technology department could be a starting point for getting involved in informatics and knowledge management.
References
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Kristi Lynn Woodall
Kristi Lynn Woodall
Dec 2, 2022Dec 2, 2022 at 4:32pm
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Professor Howe,
My current workplace is utilizing a third-party company to send random surveys to patients to collect data. There are questions that involve patient satisfaction as well as outcome measures. They may ask the patient if the nurse did certain tasks adequately. There are several areas of questions. Each survey can be linked with individual clinicians allowing for a better focus on quality improvement, and it gives the ability to see real-time trends (2021). We know that the rates of reimbursement are going to be highly affected by patient experience and patient outcomes, based on the data taken from CMS (2022). Each of these surveys is put into the CMS national database in which we are ranked by a percentage. If we fall below a certain percentage, we have the education to each clinician and focus on how we can intervene to make those specific numbers go up. I feel very fortunate to have the opportunity to see how interventions can impact data in this way.
References:
HHCAHPS. Strategic Healthcare Programs. (2006). Retrieved December 1, 2022, from https://www.shpdata.com/home-health/hhcahps-surveys/Links to an external site.
Baltimore, MD. (2022). Centers for Medicare & Medicaid Services. Retrieved December 1, 2022, from https://www.hcahpsonline.org/Links to an external site.
Ambria Boutan
Ambria Boutan
Dec 2, 2022Dec 2, 2022 at 7:27pm
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Hi Dr. Howe,
Currently my workplace utilizes the data collected from falls and reports them to the fall committee which then determines if there are ways that falls can be prevented in the future. In my experience, I have not seen much information come from the fall committee, which makes me wonder how it can be improved on for patient care. The data that is sharable to floor staff consist of a binder that contains a review of falls that have occurred, which when reviewed can help nurses understand how to prevent falls for future patients. There is definitely a need for further advocacy for fall prevention in patients which may include advocating for a better fall prevention committee and better floor standards that are maintained by all staff.
Thanks for the response!
Ambria
Careen Lynette Sisk
Careen Lynette Sisk
Nov 30, 2022Nov 30, 2022 at 8:53am
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Week 1 Response 1
Hi Ambria! Your post was very interesting. I think the issue of falls in the hospital is always at the forefront of our attention, as the extra cost and prolonged inpatient stays can be significant. Melin (2018) said, “It has been estimated that approximately 30–35% of falls in healthcare facilities result in injury. These injuries can cost over $14,000 per incident and add an average of 6.3 days to an individual’s length of stay.” The article also said that CMS limits how much they will reimburse a hospital for a fall that occurs while a patient is admitted there. This helps to outline why tracking falls so essential. I work in a behavioral health hospital, and we have a special psychiatric fall risk assessment done every shift on every patient. It considers the person’s mental state, physical abilities, and prescription and illicit drugs they have been using recently/currently. I agree that data on falls can easily be collected and that a committee that focuses on reducing the fall rate would be great to have in the hospital setting. McGonigle and Mastrian (2022) said, “for information to be valuable, it must be accessible, accurate, timely, complete, cost-effective, flexible, reliable, relevant, simple, verifiable, and secure.” Suppose the fall committee and nurse leaders can use knowledge to interpret the data collected regarding patient falls. In that case, they can investigate trends in the origins of falls and work to implement prevention strategies to eliminate risk factors.
Resources:
McGonigle, D., & Mastrian, K. (2022). Nursing Informatics and the Foundation of Knowledge (5th edition). Jones & Bartlett Learning.
Melin, C. (2018). Reducing falls in the inpatient hospital setting. International Journal of Evidence-Based Healthcare, Volume 16, 25-31. DOI: 10.1097/XEB.0000000000000115
Tinuola Olaniyan
Tinuola Olaniyan
Dec 2, 2022Dec 2, 2022 at 5:33pm
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Hello Ambria,
Great Post. Patient fall prevention is still a challenge in the medical field. Falls can cause up to 30% of victims to sustain fractures, soft tissue injuries, or even fatalities (Titler, 2016). In addition, falls in the hospital can lengthen a patient’s stay, raise hospital expenses, and delay the patient’s transfer from home to a long-term care facility. Utilizing interventions that have been proven as an evidence-based practice is the most popular strategy to minimize falls in hospitals. These fall bundle tools would help execute the best therapies to prevent patients from falling again by identifying the patients’ risk factors, such as medications, toileting habits, cognition, mobility, and environment.
One standard tool used in elderly patients is the morse fall tool. The data input predicts the risk of falling based on personal fall history, gait, mental status, Secondary diagnosis (2 or more medical diagnoses in chart), use of ambulatory aid, and presence of intravenous IV access. This information creates a score that predicts the risk of falling. The numbers ranging from below twenty-five are considered very low risk, and nursing continues primary care; numbers ranging from twenty-five to forty-five are regarded as moderate risk, and fall prevention intervention should be initiated. Scores higher than forty-five are very high risk for falls. Therefore, prevention should not only be in place but should to strictly adhered to by all staff.
References:
Titler, M. C. (2016). The effect of translating research into practice intervention to promote use in evidence – based fall prevention interventions in hospitalized adults: A Prospective pre-post implementation study in the U.S. Applied Nursing Research, 31, 52-59.
Tool 3h: Morse fall scale for identifying fall risk factors. (n.d.). https://www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/morse-fall-scale.htm
Andrea White
Andrea White
Dec 2, 2022Dec 2, 2022 at 11:19pm
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HI, Ambria,
I enjoyed reading your discussion post. It was quite informative and stressed the importance of monitoring fall. According to the CDC, one in four adults age 65 and older, report falling each year. This equates an estimate of thirty-six million falls each year. (Older Adult Falls reported by State, 2020) Data Collection is imperative if we want innovation to occur in healthcare. Your discussion stresses the importance of health informatics and nursing informatics. And it key for one to understand data collection storage and extraction. Nursing informatics is essential for bridging the gap between data abstraction, collection, and implementation of policies. For change to occur, and hospitals to remain sustainable. Leadership must understand the importance creating a solid product and realize new technology and initiatives are constantly being developed. (Julianne Sweeney, 2021)
References
Julianne Sweeney, B. S. N. (2021, May 11). Healthcare Informatics. HIMSS. Retrieved December 2, 2022, from https://www.himss.org/resources/healthcare-informatics
Centers for Disease Control and Prevention. (2020, July 9). Older Adult Falls reported by State. Centers for Disease Control and Prevention. Retrieved December 2, 2022, from https://www.cdc.gov/falls/data/falls-by-state.html
Esther O Adeyemo
Esther O Adeyemo
Dec 3, 2022Dec 3, 2022 at 9pm
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Hello Ambria,
We’ve had a few falls on our unit, so I can relate to your post. Data shos that the elderly are disproportionately likely to sustain injuries from trips and falls, and that this is particularly true when the individual is attempting to rise from a sitting or lying position (Mastrian & McGonigle, 2017). We don’t record details either, but we do document falls by taking notes and filling out forms. My workplace, a hospital, has found that older people on painkillers are more likely to fall. In our experience, we have seen a decrease in the number of reported falls when we situate patients at high risk for falling near the nursing station and activate their bed alarms. As a bedside nurse who spends the majority of their time with the patient, you collect and analyze data to provide new insights that improve healthcare for your patients (Mastrian & McGonigle, 2017). I completely agree with you that using EPIC software, which I have always used in hospitals, would help immensely in tracing the exact demographic factors that contribute to poor outcomes for patients. Providing our patients with treatment that is both safe and effective is a top priority (Sweeney, 2017). Currently, we document the patient’s fall in detail, including potential causes and how the patient fell.
References
Mastrian, K., & McGonigle, D. (2017). The theoretical and empirical underpinnings of nursing practice. Understanding the Role of Nursing Informatics in the Progression of Care (4th ed., pp. 7–19). Jones and Bartlett Learning.
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1. University of Illinois. https://healthinformatics.uic.edu/blog/4-uses-for-patient-care-data/
Collapse SubdiscussionCareen Lynette Sisk
Careen Lynette Sisk
Nov 29, 2022Nov 29, 2022 at 12:42pm
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Discussion Post Week 1: The Application of Data to Problem Solving
Nursing is a profession that relies on data collection and interpretation. Subjective and objective data are obtained and analyzed consistently during a nurse’s shift. Nurses must be able to receive the data and then be able to know what to do with it to treat the patients they care for. “The steps of using information, applying knowledge to a problem, and acting with wisdom form the basis of nursing science practice (McGonigle & Mastrian, 2022).”
The nurse who is caring for patients who are detoxing from drugs and alcohol must be able to analyze the data that is collected on their patients. This is especially true with those withdrawing from alcohol, as it could cause a fatal seizure. I work in a behavioral health hospital, and our facility has protocols that direct the collection of data on these patients and assessment of its severity so nurses can intervene. At least every four hours and as needed, behavioral health specialists obtain patient vital signs. They scan their ID badge and the patient’s armband; the information goes directly from the vitals machine to our electronic health record (EHR) system. This information is used as a portion of the withdrawal assessment along with what the patient reports they are experiencing and what the nurse observes. The nurse enters this information into the protocol in the computer, which then assigns a severity score for the symptoms and vital signs. Based on that score, the nurse knows if there is a medication that can be given and how much to give according to parameters that have been outlined by the physicians when the protocol is ordered. These assessment scores are part of the EHR and can easily be accessed to monitor trends in the presentation of the patient’s detox symptoms. From there, the doctor may order additional medications or increase doses to keep the patient safe and comfortable during their detox or decrease them if the patient is improving. Electronic protocols and health records add an extra measure of safety for the patient. The vital signs immediately go into the chart, eliminating data entry errors. Medications are given with a computerized scanning system and charted in the EHR. Utilizing these information systems requires support at the bedside to ensure data is entered correctly so that accurate assessments and interventions can be performed.
Nursing informatics is “a specialty that integrates nursing, science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice (Sweeney, 2017).” At my hospital, there is a Clinical Informatics nurse on site. Whenever changes are made in the EHR system, she makes her rounds. She completes education with all the staff to ensure everyone understands the rationale and the new way to collect data and document information. There was a recent change from a previously used detox protocol to the CIWA protocol, a widely used, evidence-based tool to assess alcohol withdrawal symptoms. Our informatics nurse was crucial in helping the nurses transition into this new data collection and analysis system. A challenge for nurses in the clinical informatics role is to stay abreast of technological advances, which are always changing and progressing at record speed. “The only way forward is to integrate and embed the new knowledge in electronic patient records using algorithms and decision support systems so that practice remains aligned with new knowledge and insights (Nagle, Sermeus, & Junger, 2017).”
A nurse leader could use clinical reasoning and judgment to form knowledge from this experience regarding staffing assignments. “Knowledge is the awareness and understanding of a set of information and ways that this information can be made useful to support a specific task or arrive at a decision (McGonigle & Mastrian, 2022).” My facility utilizes charge nurses, who take information from the current shift and use it to assign staff for the oncoming shift. The hospital assigns staff based on acuity, so every patient is given a score based on the number of interventions required to be safe and cared for appropriately with their unique needs. With the example of the patient detoxing from alcohol, the charge nurse looks at the EHR and talks to the primary nurse about how severe the withdrawal symptoms are, how many times they needed to be medicated, and how much time was spent on the interventions that are required to be performed for that patient, and then takes that into account when assigning the staff member to care for that patient for the next shift. The charge nurse needs to be sure the oncoming nurse has a balanced workload and can meet the needs of all their patients. Assigning the withdrawing patient to a nurse who is well-versed in the special care these people need would also be advantageous. Nurses are constantly taking in data, interpreting it, and gaining new knowledge, continually changing and evolving as nursing science becomes. It is a great responsibility and necessity to manage this knowledge efficiently.
Resources:
McGonigle, D. & Mastrian, K. (2022). Nursing Informatics and the Foundation of Knowledge (5th edition). Jones & Bartlett Learning.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. In Murphy, J. et al. (Eds). Forecasting Informatics Competencies for Nurses in the Future of Connected Health. (2017). IMIA & IOS Press, p. 212-221. https://doi.org/ 10.3233/978-1-61499-738-2-212
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1).
Collapse SubdiscussionDeanna Linn Howe
Deanna Linn Howe
Nov 30, 2022Nov 30, 2022 at 8:29am
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Hi Careen and all,
I appreciate your comments in this post. In today’s world of healthcare, things change on an almost daily basis. Therefore, it is increasingly important for healthcare professionals to remain as up to date as possible. This makes continuing education an absolute must. Because of technology, furthering one’s education is so much easier now than ever in the past. In fact, many professionals prefer internet-based learning due to busy schedules, time constraints, and travel costs. There are many methods available to help update technical education and informatics skills in nurses. How are nurses updating their informatics skills in your work area? Thanks, Dr. Howe
Collapse SubdiscussionShanea Trevino
Shanea Trevino
Nov 30, 2022Nov 30, 2022 at 1:07pm
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Hello Professor Howe,
Nurses are updating their informatics skills in my work area in Northwest Montana partnered with a Healthcare Compliance education program called HealthStream. I personally like the pre-assessment and post-assessment exercises, interactive videos, and easy-to-navigate software. Their micro-learning content has been well received by myself and my colleagues in the workplace. Their mobile app feature makes it accessible on the go which is convenient. I agree with the benefits of internet-based learning for the reasons you have mentioned. I have found their content customized to my specialty of acute care and applicable. I would recommend this system.
References
How nursing informatics benefits quality outcomes. Default. (n.d.). https://www.healthstream.com/resource/blog/how-nursing-informatics-benefits-quality-outcomes
Deanna Linn Howe
Deanna Linn Howe
Dec 1, 2022Dec 1, 2022 at 2:16pm
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Thank you for responding. Dr. Howe
Collapse SubdiscussionCareen Lynette Sisk
Careen Lynette Sisk
Nov 30, 2022Nov 30, 2022 at 2:18pm
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Hello Dr. Howe and thank you for your insights. I agree that nurses must be constantly aware of changes that are happening so we can stay on top of what is the most relevant and current evidence-based material out there. I appreciate that I have the ability to further my education online. I can access the resources I need at a time that works with my busy schedule. At my facility, nurses further their informatics skills with annual modules that are part of our mandatory education. We have to complete training on changes in our EHR and spend time with our clinical informatics nurse to be sure that we are documenting and entering data correctly, as audits are completed in our EHR system. There have been times where I have gone on PTO and come back and there has been an update to the system, so things are definitely progressing quicker than ever!
Deanna Linn Howe
Deanna Linn Howe
Dec 1, 2022Dec 1, 2022 at 2:16pm
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Thanks for your response! Dr. Howe
Shaquilla Williams
Shaquilla Williams
Dec 3, 2022Dec 3, 2022 at 6:36pm
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Hello Careen,
Thank you for your informative insight into health informatics, and the role it serves to shape continuity of care in the nursing profession, especially in behavioral health. you have brought out the multidisciplinary input that health informatics draws, from various fields of expertise to finalize attempts at utilizing data in achieving the highest possible care. The COVID-19 pandemic helped reveal the less mild spectra of behavioral and mental challenges that may exist but also improved how technology can be used to accelerate care through data-driven approaches (Ye, 2020). This is because behavioral health is delicate, and relatively data conscious.
A robust system focusing on providing health informatics services can focus on various aspects. Storage and retrieval of medical data in real-time take center stage, as this provides nurses with ample time to plan, make patient-centered decisions, and synthesize clinical information to the best of their ability. It is also easy to draw trends from past data, compare data and formulate epidemiological data that can then be exported, combined with data from other health centers, and ultimately strengthen public health measures (Gamache et al., 2018). Nursing protocols are numerous, just as in other health professions, and health informatics systems can help nurses keep up to date with peer-reviewed data that is used to guide protocols for care. Research plays a central role in revealing what pathways are to be explored to efficiently care for the patient, which nursing informatics benefits strongly from.
References
Gamache, R., Kharrazi, H., & Weiner, J. (2018). Public and Population Health Informatics: The bridging of big data to benefit communities. Yearbook of Medical Informatics, 27(01), 199–206. https://doi.org/10.1055/s-0038-1667081
Ye, J. (2020). Pediatric mental and behavioral health in the period of quarantine and social distancing with covid-19. JMIR Pediatrics and Parenting, 3(2): e19867. https://doi.org/10.2196/19867
Collapse SubdiscussionTinuola Olaniyan
Tinuola Olaniyan
Nov 29, 2022Nov 29, 2022 at 3:52pm
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Collapse SubdiscussionEsther O Adeyemo
Esther O Adeyemo
Dec 2, 2022Dec 2, 2022 at 3:17pm
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Hello Tinuola,
Great post! The areas of healthcare informatics and nursing informatics within medicine are expanding rapidly and making extensive use of cutting-edge technologies. Science-based nursing is predicated on the three-step process of acquiring knowledge, analyzing that data, and making an informed decision (McGonigle & Mastrian, 2027). To what extent do you believe these practices will expand to better monitor ED procedures, which in turn will lead to more patient capacity, enhanced treatment, and reduced turnaround times for disposition decisions? Do you think expansion will lead to improved results for both patients and nurses in the ED?
Reference
McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning
Esther O Adeyemo
Esther O Adeyemo
Dec 2, 2022Dec 2, 2022 at 4:36pm
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Hello Tinuola,
Great post! The areas of healthcare informatics and nursing informatics within medicine are expanding rapidly and making extensive use of cutting-edge technologies (Adane et al., 2019). Science-based nursing is predicated on the three-step process of acquiring knowledge, analyzing that data, and making an informed decision (McGonigle & Mastrian, 2027). To what extent do you believe these practices will expand to better monitor ED procedures, which in turn will lead to more patient capacity, enhanced treatment, and reduced turnaround times for disposition decisions? Do you think expansion will lead to improved results for both patients and nurses in the ED?
Reference
Adane, K., Gizachew, M., & Kendie, S. (2019). The role of medical data in efficient patient care delivery: A review. Risk Management and Healthcare Policy, 12, 67–73. https://doi.org/10.2147/RMHP.S179259
McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning
Collapse SubdiscussionVictavian Jackson
Victavian Jackson
Nov 29, 2022Nov 29, 2022 at 6:35pm
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Discussion Post Week 1: The Application of Data to Solving CAUTI
In 2020, my hospital unit experienced a 9% increased of catheter-associated urinary tract infections (CAUTI). One CAUTI can result in millions of deaths and billions of dollars added to the U.S. healthcare system (Whitaker & et al, 2022). Currently, the benchmark for CAUTI was listed under the Centers of Disease Control (CDC) website at 0 and my facility did not meet the expectation (CMS Issues Technical Update for Performance Standards Regarding Select Hospital VBP Program Measures, 2019). In order to meet the CDC standards of CAUTI prevention, the collection and assessment of electrical health record (EHR) data is the only effective means of solving the issues surrounding the CAUTI increase. The first step is to identify the data that provides the causes of CAUTI through chart audits on the appropriateness of catheter use, frequency of documented maintenance of perineal care and observation of insertions to validate aseptic technique used (Toolkit for Reducing Catheter-associated Urinary Tract Infections in Hospital Units: Implementation Guide, 2015).
After collecting the data, this knowledge retrieved will help the nurse leader such as charge nurses (CN), nurse educator (NE) or nurse manager (NM) to develop a clinical reasoning and professional judgement toward a solution. The nurse leaders collaborated with the EHR (Electric Health Record) tech team called EPIC and incorporated the CDC criteria alert for physicians before ordering a foley catheter. The Society of Healthcare Epidemiology of America estimated 69% of CAUTI can be prevented by using the evidence-based strategies (EBS) published by the CDC (Bagley & Severud, 2021). The nurse leaders will focus on establishing hospital protocols influence by EBS and CAUTI-prevention bundles. CAUTI prevention bundles consist of hand hygiene, aseptic catheter insertion procedure, proper foley catheter maintenance and surveillance.
The nurse leaders will collaborate with physicians about nurse-driven protocol orders to set in place to ensure an Indwelling Urinary Catheter (IUC) is appropriately removed promptly when no longer needed to dramatically decrease the number of CAUTI (Bagley & Severud, 2021). The data collected from the EHR identified patients with CAUTI after having the medical device for more than 4 days. There was no appropriate clinical reasoning qualified under the CDC guidelines for each incidence to maintain a foley catheter in place. EBP shows that prolonged indwelling urinary catheterizations is a predominant risk factor for urinary tract infections (UTI) (Lilley et al., 2022). The EPIC tech team set up pop alerts to remind nurses after two days to review the foley criteria to ensure it is still appropriate for their patient. In addition, nurse leaders partnered up with an organization called Purewick, to help decrease CAUTI by using an alternate medical device. Purewick is a non-invasive medical device used in replace of foley catheter to absorb urine through cloth material and suction canister. Hospital units have reduced the use of foley catheters, which directly drop the rate of CAUTI’s. Thanks to the good professional judgement by the nurse leaders, the hospital have been meeting the CDC benchmark of zero CAUTI occurrences for the past 4 months and counting.
References
Whitaker, A., Colgrove, G., Scheutzow, M., Ramic, M., Monaco, K., & Hill, J. L. (2022). Decreasing Catheter-Associated Urinary Tract Infection (CAUTI) at a community academic medical center using a multidisciplinary team employing a multi-pronged approach during the COVID-19 pandemic. American Journal of Infection Control. https://doi.org/10.1016/j.ajic.2022.08.006
Toolkit for reducing catheter-associated urinary tract infections in hospital units: Implementation guide. (2015, October). Agency for Healthcare Research and Quality. https://www.ahrq.gov/hai/cauti-tools/guides/implguide-pt4.html Links to an external site.
CMS issues technical update for performance standards regarding select hospital VBP program measures. (2019). The Centers for Medicare & Medicaid Services (CMS). https://qualitynet.cms.gov/news/5d0150021543e8002ceb1d4d
Bagley, K., & Severud, L. (2021). Preventing Catheter-Associated Urinary Tract Infections with Incontinence Management Alternatives. Nursing Clinics of North America, 56(3), 413–425. https://doi.org/10.1016/j.cnur.2021.05.002
Lilley, T., Teixeira-Poit, S., Wenner, J., Pruitt, J., & Jenkins, M. (2022). Reducing CAUTI in patients with acute urinary retention in the critical care setting: A pilot study with electronic medical record analytics. American Journal of Infection Control. https://doi.org/10.1016/j.ajic.2022.06.005
Deanna Linn Howe
Deanna Linn Howe
Nov 30, 2022Nov 30, 2022 at 8:32am
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Hi Victavian and all,
Good work on this discussion. There is definitely a need to build informatics competencies. The profession of nursing relies on rigorous research to implement and change current practices. Nurses should be able to evaluate the information relevance and quality, and organize and synthesize the information and communicate it effectively. This in turn will develop practitioners with skills to adapt research into the workplace that enhances patient care and safety. Nagel, Sermeus, and Junger (2017) states that informatics is being incorporated into many nursing programs and nurses are showing interest by advancing their career and seeking employment in this field. It is believed that the role and responsibilities of informaticists will continue to expand (Nagel, Sermeus, & Junger, 2017). Therefore, it is essential to get on board so we can provide the best care. How will nursing informatics education inform your nursing practice? Thanks, Dr. Howe
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221).
Patricia Okoye
Patricia Okoye
Dec 3, 2022Dec 3, 2022 at 3:22am
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Hi Victavian. Healthcare-associated infection control is one of the priorities of nurses and other providers in contemporary healthcare settings, necessitating greater utilization of health information technology for effective monitoring of adverse events and care coordination. Patients undergoing urinary catheterization expect registered nurses, as primary caregivers, to be technically competent and embrace health information technology for the formulation of viable decisions regarding the prevention of medical errors. Using digital health tools and data analytics, registered nurses and nurse managers obtain sufficient information to develop clinical reasoning and professional judgments toward the improvement of patient well-being in the healthcare environment. Nurse managers and senior management require data analytics and digital health tools to evaluate the progress made by the implementation of the catheter maintenance and surveillance system toward the prevention of nosocomial infections (McGonigle & Mastrian, 2022). With the accumulated technical competence, a nurse manager would ensure that the collected data from the catheter maintenance and surveillance system is transformed into a format that can facilitate collaborative decision-making, enhance care quality, and improve patient outcomes. From the clinical scenario, data analytics and digital health tools are used by nurse managers and registered nurses to ascertain the effectiveness of an evidence-based intervention in the prevention of nosocomial infections.
References
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Fernando Davila
Fernando Davila
Dec 3, 2022Dec 3, 2022 at 4:01pm
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Hello Victavian, this issue with the CAUTI-prevention was nationwide. CMS implemented the requirements as part of their hospital acquired condition reduction program (HAC). It was an attempt to encourage hospitals to improve patient safety and implement best practices to reduce infection rates associated in healthcare (Hospital Aquired Condition Reduction Program, 2022)
We also were using the epic system, it was a vast improvement over cerner. Although it has yet to bring different entities together to achieve a seamless EMR, it does go a long way in applying the technology as long as the patients different providers are associated with the hospital in question. One of the benefits of epic is its mychart option which provides realtime access to the patients medical records (with some limitations) which a pcp can access making continuity of care a little more possible (Digital Patient Experience, 2022)
Healthcare continues to evolve with the application and use of technology to support care. Technology helps in reducing errors and costs and improving the patient experience throughout the care continuum. Telemedicine and teletriage are some of the modalities which are now becoming more common place in healthcare which are in fact helping to expand the population being reached which require nursing informatics to provide the support and development in the future (Nagle et al., 2017)
References
Digital patient experience. (2022, January 1). EPIC. Retrieved December 2, 2022, from https://www.epic.com/software/digital-patient-experienceLinks to an external site.
Hospital aquired condition reduction program. (2022, January 1). CMS.gov. Retrieved December 2, 2022, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/HAC/Hospital-Acquired-ConditionsLinks to an external site.
Nagle, L. M., Sermeus, W., Junger, A., & Bloomberg, L. S. (2017, January 1). Evolving Role of the Nursing Informatics Specialist. Unil.ch. Retrieved December 2, 2022, from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REFLinks to an external site.
Collapse SubdiscussionVida Sarpong
Vida Sarpong
Nov 29, 2022Nov 29, 2022 at 6:59pm
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Nursing Informatics is a subset of informatics, specific to the field and the role of the nurse in the healthcare setting. The American Nurses
Association (ANA) identified nursing informatics as “a specialty that integrates nursing, science, computer science, and information science to
manage and communicate data, information, and knowledge in nursing practice”. (Sweeney, 2017). In my few years of working experience, I’ve
worked with two distinct facilities that both used paper charting before switching to an electronic charting system called PointClickCare. Electronic
medical records can have several advantages. This is an advantage because, with the help of medical records, you can frequently access and use
them, making it easier for patients and doctors to communicate and share information. (excel-medical.com, n.d). Nurses, doctors, and other
healthcare workers can use electronic medical records to enable information for the patients to be easily accessible such as tracking lab tests and
diagnostic tests and results. One night during the 11-7 shift, while we were short two staff nurses, unexpectedly, post one am, there arrives two
admissions in the facility that were two readmits but thanks to the electronic health records and the electronic charting system, the patient
information was quickly retrieved and accessed, allowing us to complete the admissions faster and survive the shift.
When health care providers have access to complete and accurate information, patients receive better medical care. Electronic health records
(EHRs) can improve the ability to diagnose diseases and reduce—even prevent—medical errors, improving patient outcomes. (HealthIT.gov, n.d.).
Also, clinical reasoning is the process by which nurses observe patients status, process the information, come to an understanding of the patient
problem, plan and implement interventions, evaluate outcomes, with reflection and learning from the process. (The BMJ, 2017). The use of an
electronic charting system offers the greatest results in terms of accurate data as well as enhanced efficiency directed toward patients for better
patient care with greater outcomes.
References
Excel-medical.com. (n.d.). What Document Documents A Patient’s Admission And Hospital–
Stay
https://www.excel-medical.com/what-document-documents-a-patients-admission-and-hospital-stay-2/ Links to an external site.
HealthIT.gov. (n.d.). Improved Diagnostics & Patient Outcomes
https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/improved-diagnostics-patient-outcomesLinks to an external site.
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
https://eds.s.ebscohost.com/eds/detail/detail?vid=0&sid=00951bf4-7d8d-45a7-8635-364d9a581731%40redis&bdata=JkF1dGhUeXBlPXNoaWImc2l0ZT1lZHMtbGl2ZSZzY29wZT1zaXRl#AN=128848047&db=rzhLinks to an external site.
The BMJ. (2017). Nurses are critical thinkers.
https://www.bmj.com/content/356/bmj.j1548/rr-0Links to an external site.
Amandeep Kaur Deol
Amandeep Kaur Deol
Dec 1, 2022Dec 1, 2022 at 5:44pm
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Hello Vida ,Great discussion. I believe that growth will help the patient and nurses have better outcomes. Nursing is always changing with new evidence-based practices providing us with many options to improve our nursing skills. Healthcare and nursing informatics are vastly growing fields within the medical field and continuously incorporate new and evolving technology. (Sweeney, J.,2017). The steps of using information, applying knowledge of the data to a problem, and acting with wisdom are the basis of a nursing science practice. (McGonigle, D., & Mastrian, K. G., 2022)
References:
McGonigle, D., & Martian, K. G. (2022). NURSING informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics,21(1).
Collapse SubdiscussionFatmata Mansaray
Fatmata Mansaray
Nov 30, 2022Nov 30, 2022 at 1:19am
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Nursing informatics today has a major influence on the care that is provided to those in the health care system. Nursing informatics produces, “connectivity between care providers and patients, include a wide array of emerging technologies” (Nagle et al., 2017, p.212). It is often taken advantage of by health care providers due to the ease of use and accessibility that electronic health records have been available for approximately eleven years (Kroning, 2018). Without this long stride that was taken in health care there would be much more time spent on completion of hard copy of paperwork versus care provided to the patient. In my practice, the emergency room, we show a great amount of gratitude towards nursing informatics and the electronic health record. In this discussion, I will explain the benefits that come from these tools and its effects on nurse’s care/patient outcomes in the emergent care setting.
Data Collection
In the emergency room, many individuals come through the door with evidence of infection. Through our electronic health record, the patient answers a series of questions such as any evidence of infection and the level of temperature, heart rate, and/or respirations the sepsis score auto-populates, which then triggers a series of laboratory orders that can be drawn. The labs that are a reflux orders from this sepsis scoring is two sets of blood cultures, lactic acid, complete metabolic panel, and complete blood count. This enables the emergency room staff to draw labs before the doctor orders them.
Data Benefits and Usage
Two benefits can come from this data. The first benefit being that we can initiate treatment if the labwork shows evidence of sepsis. Rapid treatment of sepsis allows us to improve the outcomes of the patients. The second benefit being that the electronic health record will show record that the patient has a history of sepsis in the scenario that that patient is unresponsive. It is a known fact that “sepsis is a common diagnosis with a high mortality and is a leading cause of in-hospital death” (Ladha et al., 2019, p.12). This enables us to act in this situation to reduce the patients risk for mortality. As a whole, the knowledge that is gained is the patients risk for sepsis which allows for timely and accurate treatment coming from health care providers.
Conclusion
In conclusion, nursing informatics is the foundation that transforms the protocols that are made, such as sepsis protocols for those showing evidence of infection. Based on the data that has been collected it enables health care workers to provide improved treatment based on the data. In reflection of this data it allows for proper diagnosis and bettered outcomes for patients overall which is an overall health care goal we as nurses hope to reach.
Reference
Kroning, M. (2018). Nursing Informatics. 59 clicks in the EHR. Nursing Management, 49(5), 10–14. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NUMA.0000532337.74937.a1
Ladha, E., House-Kokan, M., & Gillespie, M. (2019). The ABCCs of sepsis: A framework for understanding the pathophysiology of sepsis. Canadian Journal of Critical Care Nursing, 30(4), 12–21.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212–221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF
Vida Sarpong
Vida Sarpong
Dec 2, 2022Dec 2, 2022 at 5:32pm
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Hello Fatmata,
The main discussion post you put is very fascinating. I concur that nurse informatics offers several advantages for healthcare
professionals because of the simplicity of use and accessibility of electronic health information. Electronic Health Records ( EHR s) are the
first step to transformed health care. The benefits of electronic health records include: Better health care by improving all aspects of patient
care, including safety, effectiveness, patient-centeredness, communication, education, timeliness, efficiency, and equity. (HealthIT.gov, n.d).
The Electronic Health Records make life easier and faster for healthcare providers especially in data collection and analysis. EHRs increase
productivity and efficiency while cutting down on paperwork. Patients and staff have fewer forms to fill out, leaving clinicians with more
time to see patients. Referrals and prescriptions can be sent quickly, cutting wait times for appointments and pickups. Automatic reminders
can tell patients when it’s time for annual checkups or alert them as they approach milestones that require regular screenings. With integrated
patient tracking, billing and insurance claims can be filed in a timely manner. (The University of Scranton, 2022). The utilization of
technology, it serves as a great tool for healthcare providers to give patients better care.
References
HealthIT.gov. (n.d.). Improved Diagnostics & Patient Outcomes
https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/improved-diagnostics-patient-outcomesLinks to an external site.
The University of Scranton. (2022).7 Benefits Of EHR For Hospitals | The Univ. of Scranton.
https://elearning.scranton.edu/resources/article/7-benefits-electronic-health-records/Links to an external site.
Shirley Moreta
Shirley Moreta
Dec 2, 2022Dec 2, 2022 at 8:41pm
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Hello Fatmata I strongly agree with you .
The Electronic Medical Records (EMR) transmits information to providers and patients (Smith et. al., 2006). Lab results, results of recent doctor visits, the doctor or the patient can access prescription refills and other pertinent medical information. Patient safety is increased if, for example, prescription refill or doctor’s appointments that are due is caught by the EMR. Doctor when necessary, can also review information in the system and ascertain if the patient has to come in for an urgent visit. The EMR system ensures that critical patient data is transmitted throughout the system and acted upon when necessary.
The quality of patient data is nonetheless dependent on the individual inputting the data. A wrong set of blood pressure readings transmitted in the system can lead to decreased patient safety and outcome. The effectiveness of information technology in health care is therefore dependent on the integrity of the inputted data. False or missing data can be detrimental to patient safety and patient outcome. Even though information and technology enhance medical care, responsible human use of such technology is vital. It is therefore incumbent for nurses and other medical professional to be vigilant when entering data into the system. A corrupted database can endanger patient safety and undermine patient outcome. In other words, the system is only as good as the information being put in the database. Conversely, if the integrity of the information is high then the system can be very effective when it comes to patient safety and positive patient outcome.
References:
Feldman, S. S., Buchalter, S., & Hayes, L. W. (2018). Health Information Technology in
Healthcare Quality and Patient Safety: Literature Review. JMIR medical informatics, 6(2), e10264.
McCullough JS, Casey M, Moscovice I, Prasad S. The effect of health information
technology on quality in U.S. hospitals. Health Aff (Millwood) 2010 Apr;29(4):647–54.
Smith DH, Perrin N, Feldstein A, Yang X, Kuang D, Simon SR, Sittig DF, Platt R,
Soumerai SB. The impact of prescribing safety alerts for elderly persons in an electronic medical record: an interrupted time series evaluation. Arch Intern Med. 2006 May 22;166(10):1098–104.
Collapse SubdiscussionFlavia Nagenda
Flavia Nagenda
Nov 30, 2022Nov 30, 2022 at 1:25am
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The Application of Data to Problem Solving
Information technology plays an increasingly significant role in healthcare. The invention of information systems that collect and analyze big data to produce useful information that can help improve patient care has added new dimensions to healthcare (McGonigue & Mastrian, 2022). Hence, many progressive health care providers obtain, record, analyze, and utilize patient data using technologies like electronic records, computerized disease registries, and clinical decision support. A scenario that can benefit from collection and application of data is a situation whereby hospital infection rates are higher than normal although management has implemented a best practice strategy like hand hygiene without observing the expected improvement in outcomes. Collecting and analyzing appropriate data in the above scenario will help a nurse leader make evidence-based adjustments to the implemented strategy that will improve outcomes.
Strategies for improving infection control in healthcare facilities include hand hygiene compliance. Providing the necessary materials, setting reminders, and hand hygiene training are all important techniques to improve hand hygiene. However, Ahmed et al. (2020) emphasizes the need for strict monitoring of hand hygiene compliance. Monitoring compliance helps management understand the impact of the implemented strategy and the level of adoption by the workforce which will inform possible policy changes or adjustments to the strategy. In the scenario described above, the data to be collected is hand hygiene events. This data can be efficiently collected through a hand hygiene compliance monitoring system. After collection, the data on hand hygiene events can be accessed through the system dashboard. It provides information on how employees interact with hand washing stations as well as the rate of hand hygiene compliance. An electronic data collection method has an inherent advantage over direct observation methods because not only is it more efficient and accurate, it also provides the data with the related time and place which helps decision makers identify the problem areas, departments, or individuals and act accordingly (Pong et al., 2019).
Clinical reasoning and judgment are core competencies for nurse leaders. A nurse leader can demonstrate clinical reasoning in the above scenario by using formal and informal thinking strategies to analyze the described clinical problem and find solutions that are rooted in evidence-based research. Infection control is a widely studied topic in healthcare. Therefore, there are various evidence-based studies that can be reviewed to define the problem and find solutions. To demonstrate good clinical judgment, a nurse leader must be able to determine which data is to be collected, accurately interpret such data, and then identify appropriate interventions to improve outcomes. Hence, a nurse leader with good clinical reasoning and judgment skills will be able to analyze the problem, determine the data to be collected, interpret the data collected, and develop evidence-based strategies that will improve infection control outcomes based on the interpretation of the acquired data and existing knowledge.
References
Ahmed, J., Malik, F., Memon, Z. A., Arif, T. B., Ali, A., Nasim, S., … & Khan, M. A. (2020). Compliance and knowledge of healthcare workers regarding hand hygiene and use of disinfectants: a study based in Karachi. Cureus, 12(2).
Clemett, V. J., & Raleigh, M. (2021). The validity and reliability of clinical judgement and decision-making skills assessment in nursing: a systematic literature review. Nurse Education Today, 102, 104885.
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Pong, S., Holliday, P., & Fernie, G. (2019). Secondary measures of hand hygiene performance in health care available with continuous electronic monitoring of individuals. American journal of infection control, 47(1), 38-44.
Patricia Okoye
Patricia Okoye
Dec 1, 2022Dec 1, 2022 at 3:53pm
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Hi Flavia. The transition from volume to value-based care has necessitated greater investment by healthcare providers in health information technologies to ensure seamless collection, analysis, storage, and retrieval of patient-centered data for the formulation of informed medical decisions. The adoption of health information systems by healthcare providers in hospital settings has been instrumental in the timely collection and analysis of data during the implementation of quality improvement projects targeting infection control and patient safety. The hand hygiene compliance monitoring system is highly likely to transform nursing practice by informing the need for routine training and corrective measures for minimizing patient and provider exposure to pathogenic agents. Through electronic documentation, nurse managers and the senior management of the healthcare organization would identify problematic areas characterized by non-compliance by nurses and other providers to inform workplace training and continued support for improving patient safety (McGonigle & Mastrian, 2022). In the implementation of the hand hygiene compliance monitoring system, nurse managers would review electronic data and identify barriers like the lack of desired technical competence and change resistance necessitating corrective measures to maximize patient safety. With the electronic documentation system, nurse managers inspire registered nurses and other providers to rely on digital health information technology for the provision of high-quality care.
References
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Collapse SubdiscussionIsabelle Compere-Louis
Isabelle Compere-Louis
Nov 30, 2022Nov 30, 2022 at 2:43pm
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Main Post Discussion#1
The American Nurses Association (ANA) identified nursing informatics as a “specialty that integrates nursing, science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice” (ANA, 2001, p. 17). Nursing informatics plays a vital role in the development of healthcare. It helps apply informatics concepts and theories to real-life situations to achieve better health outcomes. Home Health Care nurses rely on technology to keep our patients away from the hospital and in the comfort of their homes. Telehealth is one of the technologies we use in the house for patients with chronic illnesses such as heart failure, COPD, and hypertension who are at high risk of rehospitalization. Through telehealth, providers can deliver various diagnostic, therapeutic, and care management services and services to support families and caregivers (Quinn, 2018). Telehealth services provide many benefits to those individuals who qualify, such as reducing the burden and cost of travel, reducing the frequency of in-person office visits, lower out of pocket costs owing to fewer hospitalizations and fewer nursing homecare, increasing the ability to live at home, and reduce stress and improve well-being for family caregivers (Quinn, 2018).
The telehealth kits allow healthcare providers to connect virtually with patients to monitor vital signs, weight, and oxygen saturation daily and to see how patients go about their daily lives (Wicklund, 2020). The use of telehealth has exploded since the beginning of the pandemic in March 2020. According to data from the U.S. Centers for Medicare & Medicaid Services(CSM), more than 34.5 million telehealth services were delivered in Medicaid and other government programs from March through June, which is more than 2,500% increase compared to the same period in 2019 (Donlan, 2020).
References
Donlan, A. (2020). Lawmakers Introduce New Bill Paving the Way for Home Health Telehealth
Reimbursement. https:www.homehealthcarenews.com/2020/10/lawmakers-
introduce-new-bill-paving-the-way-for-home-health-telehealth-reimbursement.
Quinn, Winifred. (2018). Using Telehealth to Improve Home-Based Care for Older Adults and Family
Caregivers. Retrieved from https://www.aarp.org/content/dam/aarp/ppi/2018/05/using-
telehealth-to-improve-home-based-care-for-older-adults-and-family-caregivers.
Sweeney, Julianne. (2017). Healthcare Informatics.
https://www.himss.org/resources/healthcare-informatics
Wicklund, Eric.2020. The Promise and Potential for Telehealth in Home Health.
https://www.google.com/amp/s/mhealthintelligence.com/features/amp/the-promise-and-potential-for-telehealth-in-home-health.
Vida Sarpong
Vida Sarpong
Nov 30, 2022Nov 30, 2022 at 4:53pm
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Hello Isabelle,
I really enjoyed reading your post and I agree that the advancement of nursing informatics is essential to the progress of healthcare.
One of the primary roles of a nurse informatic is to analyze a wide variety of data to pinpoint solutions that will allow an organization’s
nurses to provide higher quality care in addition to finding solutions that will enable nursing staff to operate in a more cost-efficient manner.
Once a nursing informatics professional has found such solutions via data analytics, they are then responsible for helping communicate,
integrate, and implement those solutions with the nurses under their charge as well as the organization’s decision. (Post University, 2022).
Through the utilization of nursing informatics, there is more precision and accuracy in data collection. Data is the lifeblood of nursing
informatics. That data and information can be used to measure the success of the various protocols, processes, and procedures used in a
healthcare organization. A nurse informaticist will measure and analyze how specific parts of the organization are performing, with a focus
on the resulting patient outcomes. They can then make changes to specific parts of the process to streamline activities, avoid bottlenecks, and
improve care. Informaticists will see what the results are and continue making changes to enhance every part of the clinical care process.
(Grenuk, 2021). Since the work of healthcare providers is challenging, nursing informatics has enabled us to maintain a comfortable
standard of living in the medical field.
References
Grenuk, S. R. J. N. (2021). How Nursing Informatics Improves Patient Care. TigerConnect.
https://tigerconnect.com/blog/how-nursing-informatics-improves-patient-care/Links to an external site.
Post University. (2022). Nursing Informatics: Where Nursing and Technology Coincide
https://post.edu/blog/what-is-nursing-informatics/Links to an external site.
Flavia Nagenda
Flavia Nagenda
Dec 1, 2022Dec 1, 2022 at 10:55pm
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Hi Isabella,
I enjoyed reading your post. Nurse leaders must be able to apply good clinical reasoning and judgment to analyze healthcare problems, determine the data to be collected, interpret the data collected, and develop evidence-based strategies to solve the problems (Clemett, 2021). Therefore, I commend you for demonstrating such sound clinical reasoning in your post. Using telehealth technology to collect patient’s data is an appropriate and cost-effective way to leverage information technology in healthcare. Omboni et al. (2019) explained that the remote patient monitoring function of telehealth services can be used to collect and monitor the vital signs of patients. The data collected is analyzed to spot irregularities that may warrant a medical intervention. As such the technology plays a big role in helping clinicians provide prompt medical attention to patients with hypertension or other heart diseases.
References
Clemett, V. J., & Raleigh, M. (2021). The validity and reliability of clinical judgement and decision-making skills assessment in nursing: a systematic literature review. Nurse Education Today, 102, 104885.
Omboni, S., Tenti, M., & Coronetti, C. (2019). Physician–pharmacist collaborative practice and telehealth may transform hypertension management. Journal of human hypertension, 33(3), 177-187.
Andrea White
Andrea White
Dec 3, 2022Dec 3, 2022 at 10:35pm
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Response # 2
Hi Isabella,
I enjoyed reading your discussion post on telehealth. The terms telehealth and telemedicine are often used interchangeably. Telehealth is a subset of e-health and is the use of telecommunications technology in health care delivery. (Gajarawala & Pelkowski, 2021)
Both telehealth and telemedicine cover comparable services. For patients to receive treatment via either service. While the terms telehealth and telemedicine should not be used interchangeably. Telehealth health focuses on telecommunications and information technology (IT) to provide access to health assessment, diagnosis, Telehealth offers a broad concept of telemedicine that includes technology used to collect, and convey data such as telephones, email and remote patient monitoring. (Kichloo et al., 2020)
Reference
Gajarawala, S. N., & Pelkowski, J. N. (2021, February 17). Telehealth benefits and barriers. The journal for nurse practitioners : JNP. Retrieved December 3, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577680/
Kichloo, A., Albosta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, J., Aljadah, M., Chakinala, R. C., Kanugula, A. K., Solanki, S., & Chugh, S. (2020, August 18). Telemedicine, the current COVID-19 pandemic and the future: A narrative review and perspectives moving forward in the USA. Family medicine and community health. Retrieved December 3, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437610/
Collapse SubdiscussionAtem Orock
Atem Orock
Nov 30, 2022Nov 30, 2022 at 4:27pm
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Discussion Post Week 1: Application of Data to Problem Solving
Scenario:
A patient, 11 years old, had a mass removed from spine, and has sutures running down his back from the top of his spinal cord. The patient is admitted to the inpatient rehab unit for therapy. The patient has a neurogenic bladder and requires cathing every 4 hours. On this day, the patient’s 8am void after cathing had a foul odor and was cloudy. The patient also complained of back spasms and pain. Compared to the patient’s baseline vitals, these were accompanied by fever, tachycardia, and hypotension. (Urinary Tract Infections in Children, 2022) After assessment by the registered nurse, the medical team is notified, urinalysis and other tests are ordered after medical assessment.
Collection and Usage of Data
Whenever a problem presents itself in a healthcare setting, assessment is the initial method of data collection. Data collection here includes head to toe analysis of the problem, including signs and symptoms. Based on knowledge as a registered nurse, an idea is already built regarding what could be the problem here which is suspected urinary tract infection. Based on this data collection, technology becomes involved through urinary testing. The information collected is accurate because it is verifiable, secure, complete, and accurate. (McGonigle & Mastrian, 2022, p. 9) A diagnosis was then made which led to prescription of the appropriate antibiotics to resolve the problem.
Leadership
A nurse leader uses clinical reasoning and judgment in the formation of knowledge from this experience by using this information as a statistic or data for future reference. The next time a patient presents with such a scenario, this could help the nurse leader work faster knowing that it was data that has been seen and recorded before and the problem can be solved a lot faster. The problem was solved not by 1 team member only, but by the whole team including the nurses, medical team and technology used in the lab. They all organized around one patient to bring about the desired result in solving the problem. (Nagale et al, 2017, p. 215)
References
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist Links to an external site. Links to an external site.. In J.
Urinary Tract Infections in Children: Symptoms, Diagnosis & Treatment – Urology Care Foundation. (n.d.). https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-children
Deanna Linn Howe
Deanna Linn Howe
Dec 1, 2022Dec 1, 2022 at 2:19pm
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Hi Atem and all,
Thanks for sharing an example of how useful technologies are to develop practices that will improve the delivery of patient care and recording of patient outcomes. McGonigle and Mastrian (2018) describe healthcare professionals as knowledge workers that collect information daily and make it relevant to promote positive health outcomes. Moreover, the widespread use of electronic health record (EHR) in the hospitals and clinics improves data input and sharing of information to develop an active collaboration of healthcare professionals. As nurses, we must be compliant in charting the relevant data (e.g. vital signs) of our patients to share with the care team to deliver safe care. The vast collection of data in the EHR will allow healthcare professionals to provide quality safe, evidence-based practices, and improve health outcomes (Sweeney, 2017). There is such a need for organization of the data! We can have hundreds of pieces of information but if it is not organized it becomes unusable. How is your workplace using data to improve patient outcomes? Thanks, Dr. Howe
McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Sweeney, J. (2017, Feb.). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21( 1 Links to an external site.), Retrieved from http://www.himss.org/ojniLinks to an external site.
Shaquilla Williams
Shaquilla Williams
Nov 30, 2022Nov 30, 2022 at 6:05pm
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Scenario
Chronic illnesses are common in the United States and they warrant continued medical attention, from medication, medical procedures, and regular consultation. Consider a hypothetical patient, J.D., 39, female, living with hypertension and diabetes, under active management. Both conditions were diagnosed more than 10 years before, for which medical management was instituted, together with a pledge of routine clinic contacts for screening and management of potential complications. Consider that J.D. would want to conceive, with the full knowledge of potential intrapartum complications such as placental insufficiency, intrauterine growth restriction, and macrosomia on the part of the fetus.
Data Collection
Throughout the management of chronic conditions, data has been collected and updated regularly, not limited to hospital visits, location, health attendant, blood sugar and blood pressure values, medication, and compliance. Each of these data sets can be collected throughout the whole management period, in as much detail as possible. Collection tools may range from smart devices, smartphones, tablets, and computer systems that will store numeric data, pictures from summarized reports, and even imaging outputs from advanced imaging techniques, all stored digitally (Krick et al., 2019). For retrieval, an integrated system, with ease of retrieval linked to a specific patient identifier with their name can be instituted, where a simple search query may reveal information in totality or as easily visualized summaries, as per the needs at a particular time.
Knowledge Derived
Should a more traditional data storage and management system be used, there is a high risk of data loss and reduced ease of retrieval. Reduced compliance has been linked to higher rates of progression to hypertensive urgencies and emergencies, with visual loss, renal disease, and cardiac compromise as some of the expected long-term complications. We also expect complications with ill-managed diabetes. These complications can easily be prevented with an intuitive and accurate data collection tool that provides relevant and instant insights to nursing personnel as management continues (Krick et al., 2019). Trends are easily captured, and compliance with medication can be monitored when the patient is also involved in decision-making, in a bid to foster patient-centered care.
In J. D’s case, decision-making regarding the possibility of conception, obstetric management, and targeted postpartum care becomes easier through the analysis of past data. The progression of the disease is easily assessed, and the effectiveness of the medical intervention is also obtained (Lira et al., 2020). The continuity of access to the data from internal medicine to the obstetrics team will also help seamless medical decision-making based on past data and trends. Further down the line, J.D. can be confident that her medication can be adjusted accordingly to pregnancy-safe alternatives, and adverse effects anticipated. Delivery options can also be anticipated beforehand. Chronic illnesses significantly impact patient stability and fetal outcomes, and therefore having enough information at their disposal will help nurses better.
Nursing Leadership and The Knowledge
In the model of patient-centered management, nurses play a dominant role in data collection and communication of pertinent findings to other healthcare professionals as well as the patient (Lira et al., 2020). For healthcare professionals, this information is crucial in guiding therapeutic strategies such as physiotherapy adjustments, nutrition adjustments, and medical adjustments as needed by physiotherapists, nutritionists, and medical doctors respectively (Hämel et al., 2022). Even then, the biggest hurdle will exist when it comes to helping clients deal with their illnesses while preserving as much autonomy as possible. Intervention on the part of nurse leaders may be low in most cases as they argue that in their work, they have sufficiently made the patient aware of how to deal with their illness, self-management, and prevention of complications (Luo & Yang, 2018). Intervening becomes hard due to an imbalance between according as much autonomy of the patient and their knowledge of the best medical and nursing outcomes.
The imbalance may be due to in part, data inadequacy and low utility. Advanced data storage and retrieval mechanisms can intervene, offering nurses a first glance at improved nursing care based on quick visualization (Krick et al., 2019). This ability becomes easier to clue in patients on their care. Policy making also becomes easier where, in the absence of data privacy violation guidelines, nursing leaders can use trends and demographic conclusions from the collected data to shape intrahospital patient care guidelines (Luo & Yang, 2018). Less time is spent on data retrieval and analysis, and more focus is spent on assisting nurses throughout the hospital. the imbalance discussed may also lead to burnout from nurses, when even though nursing outcomes are well to the staff, lack of data to guide the patient may be lacking and therefore improvising a barrier in advising the clients due to respect for patient autonomy (Hämel et al., 2022). As the data collected guides an increase in the nursing knowledge base, it also guides improved patient care on their part, and this can be fostered by the nursing leaders involved. in this regard, the leaders should also encourage proactive data collection, synthesis, and research done by the nurses to further work towards achieving improved patient outcomes in the end.
References
Hämel, K., Röhnsch, G., Heumann, M., Backes, D. S., Toso, B. R., & Giovanella, L. (2022). How do nurses support chronically ill clients’ participation and self-management in primary care? A cross-country qualitative study. BMC Primary Care, 23(1). https://doi.org/10.1186/s12875-022-01687-x
Krick, T., Huter, K., Domhoff, D., Schmidt, A., Rothgang, H., & Wolf-Ostermann, K. (2019). Digital Technology and nursing care: A scoping review on acceptance, effectiveness and efficiency studies of informal and formal Care Technologies. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4238-3
Lira, A. L., Adamy, E. K., Teixeira, E., & Silva, F. V. (2020). Nursing education: Challenges and perspectives in times of the COVID-19 pandemic. Revista Brasileira De Enfermagem, 73(suppl 2). https://doi.org/10.1590/0034-7167-2020-0683
Luo, S., & Yang, H. H. (2018). Using Technologies in Nursing Research Education. CIN: Computers, Informatics, Nursing, 36(6), 293–304. https://doi.org/10.1097/cin.0000000000000420
Collapse SubdiscussionPatricia Okoye
Patricia Okoye
Nov 30, 2022Nov 30, 2022 at 6:11pm
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Nursing informatics is a concept that integrates information science, computer science, and nursing science to facilitate efficient data management and utilization in the nursing and healthcare process (McGonigle & Mastrian, 2017). Nearly all professions currently rely on computer and information science to collect, analyze, and interpret organizational data, thus making it easy for organizations to anticipate issues and make decisions promptly (Backonja et al., 2022). Some technologies used in nursing informatics include electronic health records (EHRs), electronic medical records (EMRs), online portals, and others used by nurses and other healthcare professionals to manage and address patient health issues and data (Backonja et al., 2022). Components of nursing informatics are also used in psychiatric mental health to manage patient data, plan treatment regimens, and analyze patient symptoms.
One time in a local psychiatric and mental health clinic, I observed that most patients overstayed in the facility, and they were not getting any better during their stay. I also observed that patients were admitted to various units depending on their chief complaints without assessments for comorbid mental health disorders and other diseases. I enquired why most patients treated for psychiatric and mental health disorders presented with other clinical conditions and why the management found it difficult to provide comprehensive care that addressed all the patient’s physical, psychological, and emotional needs. It was explained that mental health disorders are diverse and that most of the symptoms used to diagnose mental health disorders are similar, making the appropriate diagnosis a challenging endeavor. Further explanation was that diagnosing mental health disorders is undertaken using the DSM-V criteria manual, which may not be 100% accurate in diagnosing patients with comorbid mental health conditions. The number of hospital readmissions in the facility kept increasing due to relapses and the emergence of other symptoms.
Description of Data that could be used
To mend this gap and ensure that all patients receive optimal care that meets all their needs, providers can collect and use the patient’s demographic data (age, sex, race, residence, education, occupation, and others) to understand what mental health problems affect specific demographic groups in the community (Backonja et al., 2022). Informatics can also be used to collect and analyze patients’ clinical data, including medical history, hospitalizations, current medications, and other EHRs data before planning and administering treatments to patients (Backonja et al., 2021). It would also be important to collect the patient’s social data to identify various health risks associated with social determinants of health (SDOH), access to health information, and available social support networks. Data on patients’ behaviors and lifestyles can also be collected and analyzed to establish the relationship between their behaviors/lifestyles and strategize patient education and health promotion (Backonja et al., 2021). These data pieces can be collected through family health assessments, community surveys, patient feedback after discharge, and general health assessments.
Knowledge derived from the Data
The data can provide insightful knowledge on the prevalence and incidence rates of mental health diseases across population groups. It can also be used in the identification of available mental health resources, access rate to the resources, and SDOH affecting access to appropriate mental health services (Backonja et al., 2021). Moreover, data on social life can help psychiatric mental health workers to identify behavioral and lifestyle practices within communities and populations that influence their mental and physical health status (McGonigle & Mastrian, 2017). Providers can also use the data in planning public health promotion programs and initiating behavioral health education and awareness programs.
How a Nurse Leader Would Use Clinical Reasoning and Judgment
A nurse leader would use clinical judgment to gain knowledge by using the aforementioned data to promote population health, advocate for different demographic groups and populations, and formulate new policies (Backonja et al., 2021). For example, a nurse leader would use clinical data to identify persistent disparities in mental health services access and engage the relevant agencies and provider groups in charting effective strategies for eradicating the disparities (Backonja et al., 2021). Nurse leaders can also use the data to write policy briefs, review current evidence-based practices for addressing mental health issues, and create awareness about various mental health concerns across population groups (McGonigle & Mastrian, 2017). Lastly, a nurse leader can use the data collected to promote public health through health education, awareness creation, and advocacy campaigns.
References
Backonja, U., Langford, L. H., & Mook, P. J. (2022). How to support the nursing informatics leadership pipeline: Recommendations for nurse leaders and professional organizations. CIN: Computers, Informatics, Nursing, 40(1), 8-20. https://doi.org/10.1097/CIN.0000000000000827.
Backonja, U., Mook, P., & Heermann Langford, L. (2021). Calling nursing informatics leaders: Opportunities for personal and professional growth. OJIN: The Online Journal of Issues in Nursing, 26(3), 1-8. https://doi.org/10.3912/OJIN.Vol26No03Man06
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Atem Orock
Atem Orock
Dec 1, 2022Dec 1, 2022 at 11pm
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Response 1 Week 1
Hello Patricia, thanks for an informative post. Recently, a friend of mine informed me that they want to work remotely from home so they plan on quitting their current job. Indeed, many different professions are relying on informatics and technology to make important timely decisions. (Backonja et al., 2022) Imagine not being able to communicate the right information about a patient who needs urgent attention and the patient ends up coding. The electronic medical records is a big win for the nurses as documentation time has been cut down to less than what it used to be. This ultimately leads to better and safer patient care. Data collected on a health issue of a patient, can be used across the hospital and this makes continuation of care easier. (McGonigle & Mastrian, 2017)
References
Backonja, U., Langford, L. H., & Mook, P. J. (2022). How to support the nursing informatics leadership pipeline: Recommendations for nurse leaders and professional organizations. CIN: Computers, Informatics, Nursing, 40(1), 8-20. https://doi.org/10.1097/CIN.0000000000000827 Links to an external site..
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Fatmata Mansaray
Fatmata Mansaray
Dec 3, 2022Dec 3, 2022 at 12:10am
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In today’s healthcare structure where so many of our resources are technology based, informatics is a much needed topic to explore for the APRN. Nursing is a science based profession and informatics includes the sciences’ of nursing, computers, and information, (DeNisco, 2021). Just today I have worked with my informatics team on reports between organizations for readmission data, interfaces for screening devices to feed data directly into our EHR, and automated appointment reminder functionality to decrease missed appointments. As a leader I must be involved to advocate for proper workflow, ensure the policy and procedure is appropriate, training is planned and all stakeholders are represented. Last week I assisted my education team in reviewing competencies for the nursing team related to our new medication scanners to improve our documentation process for medication administration. Nursing informatics policies are vital and need to be incorporated into both curriculum and practice, (Curan, 2003). Although I may not be an expert in informatics I know I must be involved and collaborative with the experts for continued effective improvements in healthcare.
References
Curran CR. Informatics competencies for nurse practitioners. AACN Clin Issues. 2003 Aug;14(3):320-30. doi: 10.1097/00044067-200308000-00007. PMID: 12909800.
DeNisco, S. M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. ISBN-13: 9781284176124
Beveine Rodney
Beveine Rodney
Nov 30, 2022Nov 30, 2022 at 6:40pm
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Scenario
Mary, 23 years old of North Carolina, decided to pursue a career in Engineering. Mary has a good relationship with her grandmother, Esther, so she decided to go to school in Maryland. She lived on campus and called her grandmother every day. Mary anxiously looked forward to spending the weekend with her grandmother. One weekend she arrived at the house and found her grandmother on the floor. “Grandma!” she exclaimed in a frightened voice. What happened? “Shut up and help me up this instant!” Mary was shocked by her grandmother’s reply. She ignored her and asked her again how she fell. “If you must know, deer were walking around the house.” Grandma, deer? “Yes, they were everywhere, you stupid girl,” “Grandma, you seem agitated and confused,” She convinced her grandmother to go to the doctor to check for broken bones or fractures due to the fall.
Data, Knowledge, and Reasoning
Mary explained how her sweet, kind grandmother suddenly changed her behavior and was confused. The clinician’s knowledge of how the elderly respond to infection and the given data led the clinical leader to ask Ms. Esther to provide a urine specimen and a urine culture. “The urine will be looked at in a lab to check for white blood cells, red blood cells, or bacteria”(Mayo Clinic, 2021). “The urine culture test tells your provider what bacteria are causing the infection. It can let your provider know which medications will be most effective”(Mayo Clinic, 2021). Nurse leaders use clinical reasoning and judgment to form knowledge that Ms. Esther had an infection. The clinical leader understands that it is crucial to take note of any changes in the elderly’s prior status because they typically do not exhibit typical indications of infection as the younger population (Alpay et al., 2018). Ms. Esther was diagnosed with a UTI infection and was prescribed antibiotics. She quickly recovered and returned to her sweet persona. “Technology continues to shift the nursing field in many ways, with the pace of change expected to increase with time” (Bailey, 2020). Nursing technology has saved many lives and improved patient care and outcomes.
Reference
Alpay, Y., Aykın, N., Korkmaz, P., Güldüren, H. M., & Çevik Çağlan, F. (2018). Urinary tract infections in the geriatric patients. Pakistan Journal of Medical Sciences, 34(1). https://doi.org/10.12669/pjms.341.14013
Bailey, S. (2020, June 3). How Technology Has Changed the Role of Nursing. NurseJournal. https://nursejournal.org/articles/technology-changing-nursing-roles/
Mayo Clinic. (2021, April 23). Urinary tract infection (UTI) – Diagnosis and treatment – Mayo Clinic. Mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/diagnosis-treatment/drc-20353453
Karla Pineda
Karla Pineda
Nov 30, 2022Nov 30, 2022 at 6:43pm
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NURS6051 Post 1/Module 1
Reflection on the concepts of informatics and knowledge work as presented in the Resources.
The concept of informatic and knowledge is presented as the nursing profession is one that relies heavily on the utilization of information, and the foundation of nursing practice science is comprised of the stages of utilizing information, applying knowledge to a situation, and responding with wisdom. On the other hand, the Information is made up of data that gets transformed into interventions by the application of knowledge. McGonigle and Mastrian (p.1540, 2022) define Nursing Informatics as “The synthesis of nursing science, information science, computer science, and cognitive science for the purpose of managing, disseminating, and enhancing healthcare data, information, knowledge, and wisdom to improve collaboration and decision making; provide high quality patient care; and advance the profession of nursing”.
A hypothetical situation prompted by my place of employment involves point-of-care (POC) technology. POC technology refers to devices that are intended to be used at the location where patient care is being delivered. Nurses are making use of a variety of new point-of-care technology to provide higher-quality treatment for their patients. In this scenario (during an emergency code), is necessary that all vital sign machines be outfitted with point-of-care (POC) technologies, which enable nurses to scan patients and transmit the data that is collected. Nursing documentation is a dynamic and complex process, and this would eliminate the need for the nurses to write multiple notes related to the patients’ vital signs and then manually enter them into the charting, which both ensures that the vital signs are accurate and saves time. (Williams, 2020).
The field of healthcare has been subjected to a significant and positive transformation as a result of the introduction of new technologies, and nurses all over the country are increasingly depending on these advancements. Even though technology will never be able to fully replace the personal touch and human care that nurses provide, it can unquestionably make their jobs much easier. The fields of nursing and health care are beginning to recognize the growing significance of informatics because of developments in technology and methods of providing medical care.
References
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REFLinks to an external site.
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.
Williams, Benjamin Caleb. “8 Nursing Technologies Transforming Patient Care.” EduMed.org, 20 Feb. 2020, www.edumed.org/blog/8-technologies-revolutionizing-patient-care.
Collapse SubdiscussionSameerah Johnson
Sameerah Johnson
Nov 30, 2022Nov 30, 2022 at 6:45pm
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The Application of Data To Problem Solving
A hypothetical scenario based on my healthcare practice that would benefit from the collection and application of data is related to the issue of alarm fatigue. In my experience, nursing staff have struggled with properly distributing attention for critical safety alarms and non-threatening alarms because there was no distinction between the two when patients required attention. Let us assume that nursing fatigue becomes so significant that nurses experience sensory overload and stress, while the quality of care decreases as they cannot focus on patients who need assistance the most.
The scenario requires a data-collecting method that would enhance patient-nurse communication and enable the nursing staff to distinguish between critical and non-critical alarms. These objectives adhere to such roles of nursing informatics as supporting clinicians and patients with real-time knowledge generation for individualized care (Nagle et al., 2017). In particular, the data may be collected with patient input when they summon a nurse. They may be provided with a multiple-choice query that specifies the reason for their request, such as care-related questions, need for comfort adjustments, safety concerns, and symptoms experiences. The program may further rely on cloud computing to sort alarms based on urgency, giving priority to safety concerns and threats to patient well-being. According to McGonigle and Mastrian (2022), this information is valuable because it adheres to the requirements of timeliness, relevance, simplicity, accessibility, cost-effectiveness, and flexibility. Subsequently, nurses would receive alarm notifications according to their current availability and workload, directing less occupied nurses toward urgent alarms and more occupied nurses toward situations that are not time-sensitive.
A nurse leader would implement clinical judgment while monitoring the alarms to decide how to appropriately distribute time and resources based on patient needs and nursing staff workload. In the long term, accumulating and analyzing this data through clinical reasoning should reveal patterns in patient behavior, showing which concerns are the most prevalent reasons for alarms. The knowledge of these patterns would further contribute to maintaining a high quality of care and continuously improving resource distribution. The suggested approach corresponds to the definition of nursing informatics as a science that manages and communicates “data, information, and knowledge in nursing practice” (Sweeney, 2017). Collecting and assessing information about alarms before going to the patient should improve the quality of care through the appropriate distribution of resources, enhance the effectiveness of patient-nurse and nurse-nurse communication, and prevent alarm fatigue.
References
McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). essay, Clifton, VA: IMIA and IOS Press.
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
Isabelle Compere-Louis
Isabelle Compere-Louis
Dec 3, 2022Dec 3, 2022 at 6:40pm
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Hello Sameerah,
I enjoyed reading your post!
Reading your post, I can connect it to Nurse Burnout which can manifest as physical and Mental fatigue. Burnout defines as “an accumulation of work-related mental stress in people-oriented occupations,” has been an issue of concern for decades for healthcare workers, especially nurses. Healthcare organizations and nursing administration should develop strategies to protect nurses from the threat of resource loss to decrease burnout, and future research that examines the relationship between professional nurse burnout manifests as fatigue and patient safety (Prapanjaroensin, A. et al., 2017). Nurses report that enhanced EHR displays can reduce cognitive load, thus leading to decreased burnout and increased patient safety. Electronic health records (EHR) can help improve care coordination and help provide higher quality and safer care for patients by providing accurate, up-to-date, and complete information about patients, enabling quick access to patient records, enabling safer, more reliable prescribing, and helping reduce medical errors (Masterson, 2017).
References
Prapanjaroensin, A et al. (2017). Conservation of Resources theory explains burnout in the nursing profession. https://doi.org/10.1111/jan13348
Masterson, Les. (2017). Nurses are burnt out. Here’s how hospitals can help https://www.healthcaredice.com/news/nurses-are-burnt-out-heres-how-hospitals-can-help/442640/
Collapse SubdiscussionAmandeep Kaur Deol
Amandeep Kaur Deol
Nov 30, 2022Nov 30, 2022 at 7:30pm
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Clinical reasoning and judgment are necessary during patient care and data utilization in healthcare facilities. Healthcare providers rely on available data and information to ensure that solving patients’ healthcare problems. (Sweeney, 2017). I am currently working in the healthcare setting, and we have an electronic medical record system to access patients’ health information and data. Based on that, data like abnormal vital signs, lab results, Pain level, intake output, and medication records show trends for the patient, like a patient is high react, which we can utilize for the early detection of sepsis. The Cerner system automatically calculates a patient’s sepsis risk, generating a sepsis alert, which helps healthcare professionals to assess and plan care for patients accordingly, which prevents worsening patient recovery outcomes and healthcare costs on complications. As per facility protocol, once a sepsis alert pops up on the screen, we must assess the patient, obtain a new set of vitals, notify the supervisor and call the healthcare provider to notify a patient is at SIRS alert.
Collection and usage of data:
Assessment is the initial method of data collection whenever a problem presents itself in a healthcare setting. Data collection includes head-to-toe assessment, including signs and symptoms, Vital signs, and lab results. Diagnosing sepsis can be complicated due to the unspecific sign and symptoms of the condition, which can mimic another disease process. The progression of sepsis is also quick, and the mortality increases as the disease process spread; with early identification and treatment, an estimated 80% of sepsis mortalities could be prevented. (Parnas,2020). Electronic sepsis alerts for nursing have been proven to precede intensive care unit (ICU) referral, triggering early sepsis recognition and intervention. Rapid treatment of sepsis allows us to improve the outcomes of the patient. The knowledge gained is the patient’s risk for sepsis, which allows for timely and accurate treatment from healthcare providers.
In conclusion nursing informatics is the foundation that transforms the protocols that are made, such as sepsis protocols for those showing evidence of infection. Based on the data that has been collected enables healthcare workers to provide improved treatment based on the data. In reflection, this data allows for proper diagnosis and better patient outcomes, an overall healthcare goal we, as nurses, hope to reach.
References:
Kroning, M. (2018). Nursing Informatics. 59 clicks in the EHR. Nursing management , 49(5),10-14.
https://doi-org.ezp.waldenlibirary.org/10.1097/01.NUMA.0000532337.74937.a1Links to an external site.
Parnas, M.L. (2020). Fighting sepsis to improve outcomes and rescue cost. MLO: Medical Laboratory Observer, 52(2), 30-32.
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1).
Deanna Linn Howe
Deanna Linn Howe
Dec 1, 2022Dec 1, 2022 at 2:25pm
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Hi Amandeep and all,
I appreciate your comments in this post. In today’s world of healthcare, things change on an almost daily basis. Therefore, it is increasingly important for healthcare professionals to remain as up to date as possible. This makes continuing education an absolute must. Because of technology, furthering one’s education is so much easier now than ever in the past. In fact, many professionals prefer internet-based learning due to busy schedules, time constraints, and travel costs. There are many methods available to help update technical education and informatics skills in nurses. How are nurses updating their informatics skills in your work area? Thanks, Dr. Howe
Vida Sarpong
Vida Sarpong
Dec 1, 2022Dec 1, 2022 at 5:09pm
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Hello Amandeep,
Thank you for the post, it was very intriguing. I also believe that clinical reasoning and nursing judgment, as well as data utilization,
are vital during patient care in the healthcare environment. The American Philosophical Association (APA) defined critical thinking as
purposeful, self-regulatory judgment that uses cognitive tools such as interpretation, analysis, evaluation, inference, and explanation of the
evidential, conceptual, methodological, criteriological, or contextual considerations on which judgment is based. A more expansive general
definition of critical thinking is. . . in short, self-directed, self-disciplined, self-monitored, and self-corrective thinking. It presupposes assent
to rigorous standards of excellence and mindful command of their use. (Hughes et al., 2008). In all, clinical judgment development is
necessary because it leads to appropriate nursing diagnoses, clinical decision-making and health promotion. (Seidi et al., 2015)
References
Hughes, R., United States. Agency for Healthcare Research and Quality, & Robert Wood Johnson Foundation. (2008). Patient Safety and Quality: An Evidence-based Handbook for Nurses. Agency for Healthcare Research and Quality.
Seidi, J., Alhani, F., & Salsali, M. (2015). Nurses’ Clinical Judgment Development: A Qualitative Research in Iran. Iranian Red Crescent Medical Journal, 17(9).
https://doi.org/10.5812/ircmj.20596Links to an external site.
Collapse SubdiscussionKristi Lynn Woodall
Kristi Lynn Woodall
Nov 30, 2022Nov 30, 2022 at 7:45pm
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Week 1 Discussion
Scenario:
The patient has been in the hospital for 14 days after a recent CHF exacerbation, with weeping edema to bilateral lower extremities causing cellulitis due to the inability to afford heart failure medications. The patient is in need of services that include physical therapy, occupational therapy, and a nurse for wound care and observation and assessment of CHF. The patient has a significant other who is willing and capable to perform wound care and has been watching the nurses perform this during the hospital stay. He requires DME which includes a walker and bedside commode due to safety concerns while ambulating. He requires stand-by assistance while ambulating since his leg hurt when he walks due to the swelling, cellulitis, and wraps on his legs. During the Length of stay meeting, although the patient is at high risk for readmission, he has gone over his allotted number of days here in acute care, and he does not want to go to a rehab facility. The next best option is to transition him home with home health services.
Data:
The data collected in the electronic medical record can help improve the function of staff as well as improve patient outcomes (Sweeney, 2017). Length of stay is discussed not only to reduce the cost of healthcare, but also to reduce chances of infection, and mortality of the patient with CHF, the longer length of stay may develop negative impacts on patient outcomes in acute care settings and post-discharge (Philbin et al., 1997). Having the ability to collect data on length of stay, diagnosis, and knowing that going home with services, and proper doctor follow-up can decrease chances of rehospitalization (Jencks et al., 2009). This data can facilitate problem identification, help with problem-solving, and essentially make an impact on nursing policy, and patient outcomes. It is proven that transitional care or home health services after discharge from an acute care setting can reduce rehospitalizations, reduce ED visits and reduce healthcare costs for people with the diagnosis of CHF (Chauhan, 2022). Overall collecting, and assessing the data can help reach achievable positive outcomes for both the hospital and the patient.
Leadership:
Being a nurse leader in this setting can help impact policy-making and change certain aspects of patient care. Having the role of the nurse leader as a knowledge worker can be involved in interpreting and collecting data to formulate knowledge from each patient, build upon their own foundation of knowledge on advancing technology, and read studies to address current issues (McGonigle et al., 2022). The nursing leader as a knowledge worker may also include using formal research techniques to evaluate the effectiveness of new practices implemented in patient care areas (McGonigle et al., 2022). Overall, the leader is a continuous learner, teacher, and specialist that can help positively impact patient outcomes with the data collected and shared with other nurses.
References:
Chauhan U, McAlister FA. Comparison of Mortality and Hospital Readmissions Among Patients Receiving Virtual Ward Transitional Care vs Usual Post discharge Care: A Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(6):e2219113. doi:10.1001/jamanetworkopen.2022.19113
Jencks, S. F., Williams, M. V., & Coleman, E. A. (2009). Rehospitalizations among patients in the medicare fee-for-service program. New England Journal of Medicine, 360(14), 1418–1428. https://doi.org/10.1056/nejmsa0803563Links to an external site.
McGonigle, D., & Mastrian, K. G. (2022). Chapter 1, “Nursing Science and the Foundation of Knowledge.” In Nursing Informatics and the foundation of knowledge (Fifth, pp. 15–17). essay, Jones & Bartlett Learning.
Philbin, E. F., & Roerden, J. B. (1997). Longer hospital length of stay is not related to better clinical outcomes in congestive heart failure. The American journal of managed care, 3(9), 1285–1291.
Sweeney, J. (Feb, 2017). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21( 1 Links to an external site.), Available at http://www.himss.org/ojniLinks to an external site.
Deanna Linn Howe
Deanna Linn Howe
Dec 3, 2022Dec 3, 2022 at 12:47pm
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Hi Kristi and all,
Thanks for sharing your experience. While the adoption of EHR systems promises a number of substantial benefits, including better care and decreased healthcare costs, serious unintended consequences from the implementation of these systems have emerged. Poor EHR system design and improper use can cause EHR-related errors that jeopardize the integrity of the information in the EHR, leading to errors that endanger patient safety or decrease the quality of care. These unintended consequences also may increase fraud and abuse and can have serious legal implications. On the other hand, improving EHR adherence by healthcare providers can be done by increasing numbers of successful implementations, growing consumer expectations for information only accessible via computer-based systems, and increased physician (i.e., end-user) awareness of functionality and benefits will ultimately lead to widespread adoption. You mention transitioning to a platform that has interoperability. How can you advocate for patient outcomes as a result on this new platform in your workplace? Thanks in advance, Dr. Howe
Fernando Davila
Fernando Davila
Nov 30, 2022Nov 30, 2022 at 7:54pm
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Healthcare and nursing informatics are growing fields in which varying forms of information are collected and used for the improvement of a process or the delivery of care
In healthcare, informatics is everywhere. The foundations have been around for decades but with the advent of the computer and electronic records it is even more prevalent now and easier to access and use. Electronic improvements have been responsible for enhancing the delivery of care throughout the modalities. (sweeney, 2017)
Currently working in home care, informatics can be beneficial in improving the efficiency of the nurse on the road. Unlike the traditional setting, the home care nurse needs to contend with a few caveats in their day, traffic, ineffective scheduling, patient emergencies can all affect how many patients the nurse can visit throughout the day. With informatics, data can be gathered and inputted into a system that efficiently routes the patient geographically to reduce the downtime of the nurse and improve efficiency and patient care. It is a general premise that information technology (IT) can address these challenges and enhance home health care services(Demiris, 2010)
Informatics is the key for improving workflow and increasing efficiency. In my scenario, the information gathered can be derived from electronic maps which would aid in the routing of the patient. Other information that can be derived could be already entered patient visit preferences and triage codes which would facilitate scheduling. The findings garnered from health IT systems, electronic health records and software tools can not only assist in nurses’ daily tasks but fuel transformation throughout a healthcare organization (Benefits of Informatics in Nursing, 2020)
References
Benefits of informatics in nursing. (2020, September 10). adelphi university. Retrieved November 30, 2022, from https://online.adelphi.edu/articles/benefits-of-informatics-in-nursing/Links to an external site.
Demiris, G. (2010, January 1). information technology and systems in home health care. National Library of medicine. Retrieved November 30, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK210061/Links to an external site.
sweeney, J. (2017). Healthcare informatics. online journal of nursing informatics, 21(1), 1–4. Retrieved November 30, 2022, from http://www.himss.org/ojniLinks to an external site.
Collapse SubdiscussionEsther O Adeyemo
Esther O Adeyemo
Nov 30, 2022Nov 30, 2022 at 9:09pm
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As the globe faces a covid-19 pandemic, advances in technology and the increased use of tele health services have allowed healthcare organizations and professionals to better manage data, which has altered the delivery of care, improved the allocation of limited resources, and guaranteed the continuity of daily operations. Informatics has also had an impact on the nursing profession, most notably in the areas of data accuracy and care coordination between facilities. Since they spend the most time with patients, nurses have a unique chance to collect, document, and communicate correct data collected through assessment of patients that can be used by other healthcare professionals (Butler et al., 2018). The use of electronic health records (EHR) and the introduction of technology in the healthcare system has improved the quality of care, as stated by McGonigle and Mastrian (2017), due to improved communication, reduced medical errors, aided decision-making, and guaranteed consistency in the delivery of high-quality care.
When a patient is transferred from one care unit or institution to another, having access to their electronic records is invaluable. Implementing reliable data management systems is crucial for preventing medical mistakes and ensuring the security of patients’ private health information (Adane, 2019). My primary care physician was managing a patient who had a history of type 2 diabetes, obesity, and high blood pressure on the hospital unit where I work. Menorrhagia began shortly after her most recent yearly checkup, at which point she was advised to see a doctor. The MD’s decision to order an ultrasound for her was based on information sent to him from her primary care physician. He also decided not to perform the pap smear he had scheduled, instead relying on the prior doctor’s faxed results. The fax can also include the patient’s current and past medical problems and drugs, which can help the treating physician make an informed decision on the best course of action. In the end, the doctor will gain an understanding of the other institution’s protocols for diagnosis and treatment. The doctor will also be able to see the authentication and authorization steps taken while accessing patient records, as well as his intended uses for the information.
A nurse manager in this situation will use clinical reasoning and judgment after carefully gathering and analyzing all relevant data pertaining to the patient’s condition. Managers need to be able to evaluate and adjust data within the information system so that they can make more informed decisions (Sweeney, 2017). After all, remote medical care is quickly becoming the norm around the world (Adane et al., 2019). These measures will guarantee that the patient in question receives an accurate diagnosis and, consequently, the greatest possible health results supported by evidence-based therapies.
References
Adane, K., Gizachew, M., & Kendie, S. (2019). The role of medical data in efficient patient care delivery: A review. Risk Management and Healthcare Policy, 12, 67–73. https://doi.org/10.2147/RMHP.S179259
Butler, R., Monsalve, M., Thomas, G., Herman, T., Segre, A., Polgreen, P., Suneja, M. (2018). Estimating time physicians and other health care workers spend with patients in an intensive care unit using a sensor network. The American Journal of Medicine, 131(8), 972.e9-972.e15. https://doi.org/10.1016/j.amjmed.2018.03.015. Epub 2018 Apr 9. PMID: 29649458.
McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1. University of Illinois. https://healthinformatics.uic.edu/blog/4-uses-for-patient-care-data/
Nneka Ogbonnaya
Nneka Ogbonnaya
Dec 3, 2022Dec 3, 2022 at 9:54pm
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Hi Esther,
Great read! Nurse leaders should have good judgment and clinical reasoning skills. They should be able to identify problems, analyze them, and provide solutions based on evidence-based research (Gonzalez, 2018). In your described scenario, retrieving the patient’s data from the EHR was the best course of action. An EHR stores a variety of patient data including vital signs, medical diagnoses, medical histories, diagnostic test results, and progress notes (Atasoy 2019). These data can be used to analyze the progress of the patient and help new clinicians coming on board the case quickly get up to speed. The usage of EHRs in this way highlights the importance of health information technology and data to improve care processes.
References
Atasoy, H., Greenwood, B. N., & McCullough, J. S. (2019). The digitization of patient care: a review of the effects of electronic health records on health care quality and utilization. Annual review of public health, 40, 487-500.
Gonzalez, L. (2018). Teaching clinical reasoning piece by piece: A clinical reasoning concept-based learning method. Journal of Nursing Education, 57(12), 727-735.
Mackenzie Hudnall-Ellington
Mackenzie Hudnall-Ellington
Nov 30, 2022Nov 30, 2022 at 10:28pm
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A 34 year old male arrives to the ED self reporting suicidal ideation, auditory, and visual hallucinations after using meth, and drinking a fifth of vodka. Pt states he used after being served divorce papers and that he has been drinking a fifth of vodka daily for a few months now. Pt has a history of being a high utilizer. PMH of poly-substance use, generalized anxiety disorder, major depressive disorder, and hep. C. Pt has been using substances since he was 11. During admission pt has CIWA ordered q 2 hours.
In order to properly treat, educate, and support patients who suffer from alcohol use disorder or any substance use disorder assessment tools need to be utilized. These assessment tools are created with health informatics “health informatics, particularly, analysis of electronic health record data, enables discovery of target areas for quality improvement, disparities in mental health service access and delivery, and predictive characteristics of populations at risk for adverse outcomes, such as suicide and psychiatric hospitalizations” (Edgcomb, 2021). For alcohol use disorders, using CIWA protocol and EHR system assessment tools such as AUDIT “AUDIT provides a framework for intervention to help risky drinkers reduce or cease alcohol consumption and thereby avoid the harmful consequences of their drinking. The AUDIT also helps to identify alcohol dependence and some specific consequences of harmful drinking.” (World Health Organization, 2001) and allows staff to have easily accessible information is necessary to ensure that trend monitoring can be a streamlined process. When utilizing these assessment tools, EHRs have the ability to create alerts that will notify anyone caring for the patient that the patient has a history of substance use.
I work in a behavioral health hospital in KS and while it took time to transition from free-text notes to evaluation/assessment tools, once the tools were in place and used properly, the ability to quickly access each patients personal history of substance use made the triage process more efficient. Providers had the most difficulty transitioning from dictating a note to completing an assessment tool “physicians often chose to document this information through free-text, rather than making use of the structured format. While using free-text allows for physicians to record more specific, detailed information, it makes it more difficult to track the data over time. As a result, it is harder to analyze trends, and the ability to use the data is effectively limited.” (UTHealth Houston, 2016). My hospitals EHR system has a place for a ‘comment’ at the end of CIWA and AUDIT and anything typed into that section will trigger an alert if/when the patient is admitted to the hospital again. There is also a specific tab in our chart by exception system that allows us to quickly view all historical data. This use of health informatics tools has made it easier for providers to admit the triage psych patients to the best suited unit for their needs and has cut down how often we are needing to transfer patients to a new unit. From the nursing perspective on my unit, knowing which patients have a history of seizures or delayed withdrawal has been the most beneficial. These tools have also improved patient education and benefited the social workers/case managers when they are assisting the patients with obtaining housing and other resources before discharge.
References
Edgcomb, J. (n.d.). Leveraging Clinical Informatics to improve mental health care. Psychiatry. Retrieved November 30, 2022, from
https://medicine.yale.edu/psychiatry/education/map/support/edgecomb/#:~:text=Health%20informatics%2C%20particularly%2C%20analysis%20Links to an external site.
of,as%20suicide%20and%20psychiatric%20hospitalizations
How health informatics is changing the way we look at alcohol consumption. SBMI. (n.d.). Retrieved November 30, 2022, from https://sbmi.uth.edu/blog/mar-Links to an external site.
16/how-health-informatics-is-changing-the-way-we-look-at-alcohol-consumption.htm
World Health Organization. (2001). Audit : The Alcohol Use Disorders Identification Test : Guidelines for use in primary health care. World Health Organization.
Retrieved November 30, 2022, from https://www.who.int/publications/i/item/WHO-MSD-MSB-01.6a
Shirley Moreta
Shirley Moreta
Nov 30, 2022Nov 30, 2022 at 11:28pm
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he Center for Disease Control and Prevention
Shirley Moreta
Walden University
Transforming Nursing & HC-Winter 2022
Dr Deanna Linn Howe
November 30, 2022
The Center for Disease Control and Prevention
The Center for Disease Control and Prevention (CDC) is concerned with global health (The Lancet, 2020). It partners with countries worldwide to ensure they are equipped to deal with health threats to protect citizens from their adverse outcomes. The goals of the CDC are to strengthen health systems by improving health security (Centers for Disease Control and Prevention, 2022). The CDC partakes in various research and contributes to the overall body of health information by providing key health information that protects citizens from health threats (The Lancet, 2020). Moreover, it’s concerned with providing response strategies in cases of health threats that may impact the lives of citizens.
CDC and Evidence-Based Practice
The mission of the CDC is to protect citizens from health risks (Centers for Disease Control and Prevention, 2022). CDC conducts extensive research on diseases, patterns and management and applies relevant technology in mitigating these health risks. It also trains healthcare professionals on detection and prevention strategies (CDC, 2022). Additionally, it applies wide-scale data analysis in disease and proven management approaches to curb the probable health risks.
The work of the CDC is grounded on evidence-based practices. CDC is involved with disease tracking and monitoring of potential health threats (CDC, 2022). These are carried out through surveillance techniques and evidence-based scientific research. The relevant data is then analyzed and mitigation strategies are identified (The Lancet, 2020). A response plan is then developed to mitigate these health threats and also develop strategies to avoid future threats. Current technology and science are deployed in the steps to prevent and curb various diseases.
My Perception of the CDC
My perception of the CDC hasn’t changed much as I had a clear understanding of the CDC and its operations not only in the United States but also worldwide. I’ve learned that it partners with several other organizations to promote health security. I’ve understood the key role the CDC plays in protecting citizens worldwide and its adoption of evidence-based strategies.
References
(2022). Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; U.S. Department of Health & Human Services. https://www.cdc.gov/Links to an external site.
Centers for Disease Control and Prevention. (2022, April 29). Mission, Role and Pledge. Cdc.gov. https://www.cdc.gov/about/organization/mission.htmLinks to an external site.
The Lancet. (2020). Reviving the US CDC. The Lancet, 395(10236), 1521. https://doi.org/10.1016/s0140-6736(20)31140-5Links to an external site.
Collapse SubdiscussionOluremilekun Taylor
Oluremilekun Taylor
Dec 1, 2022Dec 1, 2022 at 12:08pm
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DISCUSSION 1 APPLICATION OF DATA IN NURSING
Informatics is the application of information and technology to enhance communication, increase knowledge sharing, reduce human error, and support decision-making within healthcare institutions (Sharma, Devi, & Sharma, 2020). An example is an automated alarm to remind medical teams of important medication processes, hence minimizing errors. Additionally, the application of informatics in the healthcare sector ensures compliance to practice guidelines in the healthcare sector. When informatics is implemented effectively, it results in a faster medication process which is helpful in cases of emergencies by improving the safety of the patient. Informatics improves the decision-making processes by reducing overreliance on memory which is associated with a higher level of human errors during the medication process.
A hypothetical scenario I can imagine is giving a patient wrong medication. This is a scenario whereby I am working in a very busy set up, I arrive for my shift after a two week break, and I jump into work. While on it, I realize I have given wrong medication to a patient, Mr. PN. This is a scenario which can be sorted by application of data. First, a system which has patient names, patient file number and their condition is the simplest thing that can happen. Secondly, verification of the right medication by clicking on the patient’s name and looking up the provider’s orders. Then lastly, scanning the medication to verify it is correct. These are the data application situations that would sort me. This data however needs to be encrypted and accessed by authorized staff who have log in details and are required to log out once they are done.
In this scenario, a nurse leader would use clinical reasoning by sorting the situation first. The first step when one has given wrong medication is to stop the medication. For instance, stop the infusion. Then, it is good to document this. In terms of judgement in the formation of knowledge, the nurse should first acknowledge their mistake, without blaming anyone. Secondly, the nurse will look into the 5 rights of medication administration. The nurse can then present her thoughts on how information technology would have helped minimize the error.
References
Otokiti, A. (2019). Using informatics to improve healthcare quality. International journal of health care quality assurance.
Pramanik, M. I., Lau, R. Y., Azad, M. . K., Hossain, M. S., Chowdhury, M. K. H., & Karmaker,
K. (2020). Healthcare informatics and analytics in big data. Expert Systems with Applications, 152, 113388.
Rahimi, B., Nadri, H., Afshar, H. L., & Timpka, T. (2018). A systematic review of the technology
acceptance model in health informatics. Applied clinical informatics, 9(03), 604-634.
Sharma, K., Devi, S. D., & Sharma, B. (2020). The Role of Nursing Informatics in the Healthcare Sector. Journal of Critical Reviews, 7(10), 1364-1369.
Anupa Mukundram Mehta
Anupa Mukundram Mehta
Dec 2, 2022Dec 2, 2022 at 8:46pm
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This is a great example of how nursing informatics has improved patient safety, as one of the most important tasks of an RN is to give medication correctly. I found a study that compared an emergency department that used an electronic medical record, and another that used handwritten records within the same organization. The results showed 50% fewer medication errors in the emergency department that adopted the electronic medical record versus the one that did not (Vaidotas et al., 2019). This is a very significant amount and there are many possible reasons for this, which you discussed. Another way electronic health records have reduced medical errors in medication administration is in how they will trigger alerts for drug-to-drug interactions, as well as interactions between drugs and the patient’s documented allergies (eduhealthsystem, 2022).
References:
Eduhealthsystem. (2022, June 13). How ehrs can help prevent medical errors. EduHealthSystem. Retrieved December 1, 2022, from https://www.eduhealthsystem.com/blog/how-ehrs-can-help-prevent-medical-errors/#:~:text=EHRs%20can%20help%20prevent%20medical%20errors%20by%20triggering%20alerts%20in,effects%20and%2For%20adverse%20reactions.
Vaidotas, M., Yokota, P. K. O., Negrini, N. M. M., Leiderman, D. B. D., Souza, V. P. de, Santos, O. F. P. D., & Wolosker, N. (2019, July 10). Medication errors in emergency departments: Is electronic medical record an effective barrier? Einstein (Sao Paulo, Brazil). Retrieved December 1, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611086/
Nneka Ogbonnaya
Nneka Ogbonnaya
Dec 2, 2022Dec 2, 2022 at 9:14pm
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Hi Oluremilekun,
I enjoyed reading your post. Informatics has profoundly improved patient outcomes by reducing errors, increasing efficiency, and introducing the use of big data to make inferences about patients’ health (Gamache et al., 2018). Therefore, it is in the interest of nurse leaders to familiarize themselves with the workings of information technology to improve the outcomes of their patients. In the scenario you described, the medication error can be averted by the use of a barcode scanner. This technology is usually the last checkpoint for medication errors because it is often used at the bedside in in-patient settings (Rodziewicz et al., 2018). A nurse scans the patient’s tag to confirm that the correct dose of the right medication was administered to the right person. The barcode scanner picks up the encoded patient’s data with the precise medication prescribed by the physician which the nurse can use to determine the appropriateness of the medication being administered and avoid errors.
References
Gamache, R., Kharrazi, H., & Weiner, J. P. (2018). Public and population health informatics: the bridging of big data to benefit communities. Yearbook of medical informatics, 27(01), 199-206.
Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2022). Medical error reduction and prevention. In StatPearls [Internet]. StatPearls Publishing.
Careen Lynette Sisk
Careen Lynette Sisk
Dec 2, 2022Dec 2, 2022 at 11:45pm
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Week 1 Response 2
Hello Oluremilekun! I appreciated your post because you mentioned medication scanning. I work in a facility that uses this kind of system, and for the most part, it does a good job of preventing medication errors. The patient must be scanned first, then their medication list comes up. Then each medication must be scanned individually. Alerts populate for many reasons, like if it hasn’t been enough time since the last dose given, the medication has been discontinued, or only a portion of what was scanned is to be given. These alerts make it so nothing else can be scanned until the alert is addressed, so the nurse is sure to see the message and be aware of what they are doing during their medication pass. The system does its job, but the people using it also must be sure they are paying attention to the system and following orders correctly. “If BCMA (barcode medication administration) is not integrated well into nursing workflow, workarounds may occur that deviate from the expected use (Strudwick et al., 2018).” Our facility requires that nurses must scan at least 95% of patients and 95% of medications to comply or nurses will receive corrective action. The computer system for medication administration is smart, but so are we! McGonigle and Mastrian (2022) explained that “in the healthcare environment, the hardware, software, networking, algorithms, and human organic information systems work together to create meaningful information and generate knowledge.” We need to be able to use the technology we have as well as our own clinical knowledge to create the best patient outcomes.
References:
McGonigle, D., & Mastrian, K. (2022). Nursing Informatics and the Foundation of Knowledge (5th edition). Jones & Bartlett Learning.
Strudwick, G., Reisdorfer, E., Warnock, C., Kalia, K., Sulkers, H., Clark, C., & Booth, R. (2018). Factors Associated with Barcode Medication Administration Technology That Contribute to Patient Safety: An Integrative Review. Journal of Nursing Care Quality, Volume 33(1), 79-85. DOI: 10.1097/NCQ.0000000000000270
Deanna Linn Howe
Deanna Linn Howe
Dec 3, 2022Dec 3, 2022 at 12:43pm
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Hi Oluremilekun and all,
Thanks for your comments. Many hospitals use medication scanning as a way to improve patient safety with incorporation of health information technology (HIT). Point-of- care barcode scanning decreases medication errors while contributing to patient safety. Pharmacy’s electronic drug library needs to have the same unit of measurements as a physician’s computerized prescriber order entry (CPOE), otherwise point-of-care barcode scanning will fail . At times a nurse may need to administer a medication in an emergency situation, and the medication will not scan which causes uncertainty and delays in administration. This is the point in which some nurses participate in work-arounds which can lead to more patient safety issues. Do you think nurses rely on HIT as a substitute for practicing the 6 rights of safe medication administration? What are some solutions for this technology related to your scenario? Thanks, Dr. Howe
Thanks, Dr. Howe
Collapse SubdiscussionNneka Ogbonnaya
Nneka Ogbonnaya
Dec 1, 2022Dec 1, 2022 at 11:11pm
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Scenario
A 70 years old Asian female was hospitalized after suffering from a myocardial infarction. After the adequate medical intervention, her condition was stabilized and she is now ready to be discharged. She lives alone with her cat and has refused to move into a nursing home despite repeated appeals by her children. The patient has had hip replacement surgery but still admits to difficulty walking. Her medical history indicates hypertension, rheumatoid arthritis, and coronary artery disease.
Data Collection
Data-driven knowledge has led to significant quality improvement in caregiving (McGonigle & Mastrian, 2022). Advances in health technology have led to the invention of several devices and systems that can collect, analyze, and interpret patient data. In the scenario above, the major challenge is preventing the reoccurrence of myocardial infarction. The usual strategy for promoting this outcome is to improve the monitoring of patient vitals and adherence to medication. Hence, the data to be collected is the patient’s vitals. To implement the strategy, telehealth technology will be deployed. Telehealth is a cost-effective way of delivering necessary care virtually. It reduces the cost of in-person visits to hospitals and offers an avenue for clinicians to monitor patients’ vitals using telehealth remote monitoring (Omboni et al., 2019). Physical devices like wristbands are worn by the patient and they transmit information on the patient’s vitals to an electronic health record that can be accessed by the clinician. The data is then analyzed to detect anomalies in the patient’s condition. Such information can then be used by the clinician to inform the adjustment of medication dose or other necessary medical interventions. Using telehealth technology will reduce the cost of care for the patient, improve the accuracy and quantity of data collected, and improve her comfort because she will not have to potentially aggravate her pain while travelling to the hospital.
Clinical Reasoning and Judgement in the Formation of Knowledge
Clinical reasoning and judgment are core concepts that apply to nurse leaders. A nurse leader must be able to critically analyze clinical problems, determine the information to be collected, interpret them, and devise strategies to solve the problem using evidence-based research (Manetti, 2019). Hence, knowledge is a critical component of nursing. Gonzalez (2018) points out that clinical reasoning is complex and involves the scientific evaluation of knowledge to solve problems. Therefore, a nursing leader must be able to critically analyze clinical challenges and decide on an appropriate intervention by extracting knowledge from available data and research.
References
Gonzalez, L. (2018). Teaching clinical reasoning piece by piece: A clinical reasoning concept-based learning method. Journal of Nursing Education, 57(12), 727-735.
Manetti, W. (2019, January). Sound clinical judgment in nursing: A concept analysis. In Nursing forum (Vol. 54, No. 1, pp. 102-110).
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Omboni, S., Tenti, M., & Coronetti, C. (2019). Physician–pharmacist collaborative practice and telehealth may transform hypertension management. Journal of human hypertension, 33(3), 177-187.
Mackenzie Hudnall-Ellington
Mackenzie Hudnall-Ellington
Dec 3, 2022Dec 3, 2022 at 4:06pm
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Nneka,
Great post! You are correct stating that nurse leaders much be to analyze challenges and decide on interventions. Nurse leaders must be knowledgeable in informatics ”nurse leaders must demonstrate capacities and develop specific informatics competencies in order to provide meaningful leadership and support ongoing transformation of the healthcare system.” (Kennedy, Moen, et al) in order to assist in developing the skillset necessary for their staff. When nurse leaders are involved in the development process, they are able to gather opinions from their staff who are the ones working with the charting systems and patients each day “nurses have the most communication with patients, and interact with technology more frequently. Using technology should create a positive attitude in nursing productivity.” (Darvish, et al, 2014).
References
Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and
the need for appropriate education. Global journal of health science, 6(6), 11–18. https://doi.org/10.5539/gjhs.v6n6p11
Kennedy, M. A., & Moen, A. (2017). Nurse Leadership and Informatics Competencies: Shaping Transformation of Professional Practice. Studies in
health technology and informatics, 232, 197–206.
Flavia Nagenda
Flavia Nagenda
Dec 3, 2022Dec 3, 2022 at 7:51pm
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Hi Nneka,
Thank you for such a wonderful illustration of the use of information technology in healthcare. Technology has changed the way clinicians offer traditional healthcare services. Particularly in the areas of optimizing workflow, eliminating errors, obtaining accurate patient data, visualizing data, and delivering interventions (Aceto et al., 2020). Therefore nurse leaders have to gain proficiency in utilizing such technology and the data gathered through them to make sound clinical decisions and improve patient outcomes. In the care of patients at risk for heart events like myocardial infarction, the use of mobile cardiac telemetry units remotely is clinically supported. A mobile cardiac telemetry unit is worn under a shirt and is capable of continuously measuring heart rate and rhythm for up to 14 days (Duncker et al., 2021). Hence it enables remote monitoring and prompt response to adverse events by clinicians. It also promotes adherence.
References
Aceto, G., Persico, V., & Pescapé, A. (2020). Industry 4.0 and health: Internet of things, big data, and cloud computing for healthcare 4.0. Journal of Industrial Information Integration, 18, 100129.
Duncker, D., Ding, W. Y., Etheridge, S., Noseworthy, P. A., Veltmann, C., Yao, X., … & Gupta, D. (2021). Smart wearables for cardiac monitoring—real-world use beyond atrial fibrillation. Sensors, 21(7), 2539.
Shirley Moreta
Shirley Moreta
Dec 10, 2022Dec 10, 2022 at 1:17am
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Discussion: Application of Data to Problem-Solving
Data and data analytics have become critical components of healthcare delivery implying that healthcare workers (HCWs) are leveraging collected data from patients through the electronic health records (EHRs) and electronic medical records (EMRs) among other approaches to make decisions. Health technology innovation tools like clinical decision support (CDS), artificial intelligence, and telehealth all require collected data to help providers and healthcare organizations make care delivery decisions (Adibuzzaman et al., 2018). The prevalence of chronic conditions like diabetes and hypertension among others requires effective use of data to attain better monitoring and make effective inferences to implement evidence-based practice (EBP) interventions to help patients.
A possible scenario that would need or benefit from access to and collection as well as application of data is one involving the management of patients undergoing treatment for chronic conditions like cancer and diabetes. For instance, a patient doing their diagnostic tests and screening processes like prostate specific antigen test (PSA) for prostate cancer and one requiring diabetes monitoring to control blood sugar levels implore providers to collect and use data in making any critical decision and developing plan of care. This implies that to effectively care for these two patients, the healthcare provider and organization must have access to their data; from the test results to the monitored data for the diabetic patient. In these scenarios, the required data are the results of the diagnostic and screening tests the patient underwent and the latest data on blood sugar levels for the diabetic patient. In this scenario the provider can access the patients’ data using their electronic health records (EHRs) system that comprises of laboratory results, clinical notes and other relevant patient data.
In real terms, the providers can get this information or data through their networks if the use a collective approach within the region or through other means like text messages and fax. These channels will allow the physician to know all the medical aspects and conditions as well as the medications the patients use to guide their treatment plans and medications. The physicians and other providers involved with the patients can learn about the procedures and policies used by other facilities or best practices in the industry (Luther et al., 2019). The collection and use of data in this case will also allow the physicians and other providers to know the authorization and authentication process of making patient records, especially purposes of collected data.
The knowledge that providers can derive from this data is increased understanding of the best approaches and types of tests that one undertakes while screening for cancer. The providers can also learn about ways to improve self-care and monitoring by leveraging technological devices and approaches like wearable devices such as smart watches to help patients maintain required blood sugar levels (Zhu et al., 2019). Primary care and prevention of these conditions in the population would be key and demonstrate to the stakeholders the importance of having such interventions to reduce susceptibility to the diseases.
Clinical reasoning and judgment in the formation of knowledge are essential for nurse leaders and even practitioners to leverage their competencies and create innovative ways to offer evidence-based practice (EBP) interventions (Yi et al., 2018). The nurse leaders would use their clinical reasoning and judgment to collaborate with other healthcare workers like laboratory technologists and pharmacists to develop and implement approaches to help deliver better patient outcomes in such scenarios. Effective communication with patients and increased focus on primary care interventions would help nurses ascertain the effectiveness of their disseminated knowledge, especially in the management of chronic conditions like diabetes.
References
Adibuzzaman, M., DeLaurentis, P., Hill, J., & Benneyworth, B. D. (2018). Big data in
healthcare – the promises, challenges and opportunities from a research perspective: A
case study with a model database. AMIA…Annual Symposium Proceeding. AMIA Symposium, 2018, 384-392. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977694/
Luther, B., Barra, J., & Martial, M. A. (2019). Essential nursing care management and
coordination roles and responsibilities: a content analysis. Professional Case Management, 24(5), 249-258. DOI: 10.1097/NCM.0000000000000355.
Yi, J. Y., Kim, Y., Cho, Y. M., & Kim, H. (2018). Self-management of chronic conditions using
mHealth interventions in Korea: a systematic review. Healthcare Informatics Research, 24(3), 187-197. DOI: 10.4258/hir.2018.24.3.187.
Zhu, R., Han, S., Su, Y., Zhang, C., Yu, Q., & Duan, Z. (2019). The application of big data and
the development of nursing science: A discussion paper. International Journal of Nursing Sciences, 6(2), 229-234. https://doi.org/10.1016/ijnss.2019.03.001
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