Posted: January 24th, 2023

The Application of Data to Problem-Solving Discussion Example Essays

Discussion – Week 1

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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.

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.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

*Note: Throughout this program, your fellow students are referred to as colleagues. The Application of Data to Problem-Solving Discussion Example Essays

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6 months ago

Amy Birkenstamm

RE: Discussion – Week 1

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Amy Birkenstamm

NURS 6051 Discussion Post 1

As an aesthetic nurse injector, I specialize in facial aesthetics as well as wellness for my patients. I own my own medical spa and my team and I strive to give our patients the best care day in and day out. One area in my practice that benefits from access to data is in the case of an adverse event such as blepharoptosis (drooping of an eyelid) due to migraine of neurotoxin. This is rare with an incidence of 2-5% (King, 2016). This can affect patients for up to 3 months, affecting them physically as well as emotionally due to their temporary altered appearance. It is important that all nurses within this scope of practice have access to updated, reliable data to give the best instruction on how to handle these situations in the most informed way possible.

In recent years, OTC eye drops have been effective to a certain extent in treating blepharoptosis. In more severe cases, patients are prescribed apraclonidine, an alpha2-adrenergic agonist, which causes muscles of the eyelid to contract quickly and elevate 1-3mm (Scheinfield, 2005). In a study included in Journal of the Neurological Sciences, 100% of patients responded with some improvement to their ptosis 20-30 minutes after using apraclonidine (Jankovic, Vijayakumar, and Wijemmanne, 2017).

In a recent severe incident of ptosis at one of my peers’ business, apraclonidine drops showed little to no improvement for her patient. Data and research was required to find a better option for the patient to find relief while her one eyelid struggled to open. Through her research she found a new FDA approved eyedrop called Upneeq, which works in a similar fashion to the other drops but is more potent. Data findings on Upneeq included an increase from baseline in mean number of points seen on superior visual field, as well as an increase from baseline in upper eyelid elevation (Wilson, 2020). This study was done with 304 patients. With incorporating Upneeq into her care for this particular patient she saw almost immediate and drastic improvement. In this scenario, new data findings helped not only her patient, but also herself and other practitioners around her to work more confidently due to the collection of newer information.

References

King, M. (2016, December). Management of ptosis. Retrieved May 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300727/

N;, S. (n.d.). The use of apraclonidine eyedrops to treat ptosis after the administration of botulinum toxin to the upper face. Retrieved May 28, 2021, from https://pubmed.ncbi.nlm.nih.gov/15748550/

Wijemanne, S., Vijayakumar, D., & Jankovic, J. (n.d.). Apraclonidine in the Treatment of Ptosis. Retrieved May 28, 2021, from https://www.jns-journal.com/article/S0022-510X(17)30194-6/pdf

Wilson, L. M. (2020, October 01). JAMA ophthalmology PUBLISHES pooled analysis of data from two Phase 3 clinical trials of UPNEEQ™ (oxymetazoline hydrochloride, 0.1% solution) for ACQUIRED PTOSIS. Retrieved May 28, 2021, from https://www.biospace.com/article/releases/jama-ophthalmology-publishes-pooled-analysis-of-data-from-two-phase-3-clinical-trials-of-upneeq-oxymetazoline-hydrochloride-0-1-percent-solution-for-acquired-ptosis/

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

RE: Discussion – Week 1

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Good response Amy.  Thank you for getting us started in week 1.

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6 months ago

Bailey Schaal

RE: Discussion – Week 1

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Amy,

What an interesting scenario! I have little to no knowledge on aesthetic injections. As you own your own medical spa, where do you look for to find the best EBP methods to use? Is this the first time you have ever heard of the first two eye drops not working? Is there any underlying condition that makes someone more likely to experience an adverse effect like the ptosis? Using informatics to find data on unlikely scenarios is the aesthetic field could help you be ready right when it happens, or you could also use the information to help colleagues working in the same field. Do you already have a protocol or way you access data on your field? Is it all your responsibility to analyze healthcare data too see if it should be applied at your workplace? It is the role of many supervisors or nurses managers to interpret healthcare data and apply it to their work to improve patient outcomes (Duquesne University, 2020). It will be interesting to know your role in using informatics in your business since you are likely very involved in the decision and policy making.

Reference

Duquesne University. (2020, April 16). Nurse leaders using informatics. https://onlinenursing.duq.edu/blog/nurse-leaders-using-informatics-the-past-present-and-future/

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6 months ago The Application of Data to Problem-Solving Discussion Example Essays

Marisa Buffa

RE: Discussion – Week 1

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The Benefits of Data in Problem Solving

Scenario

In the Emergency Department (ED), data is consistently used to determine the severity of an emergency. When a patient comes to the ED, the triage nurse asks questions, visually assesses, and performs vital signs to determine the appropriate Emergency Severity Index (ESI) level. The ESI level ranges from 1 (loss of life or limb, most emergent) to 5 (non-emergent). This 5-level triage algorithm prioritizes patients that need to be seen first against those with less urgent conditions (AHRQ, 2020).

Accessing Data

During the triage process, the ED nurse rapidly assesses the patient. This involves observing life-threatening visual cues such as a diaphoretic patient holding his chest or an inactive and lethargic infant. Gathering information to determine how the patient appears and behaves alerts the nurse if the patient needs to be rushed into the ED or bumped up in line to be seen immediately by a provider. This visual assessment coupled with objective data such as vital sign measurements taken from the vital sign machine or cardiac abnormalities obtained from an EKG machine allows the ED nurse to assign the most fitting ESI level on the electronic health record (EHR). The EHR’s triage note also allows the ED nurse to write subjective data available to view by the ED team.

Clinical Significance

            The nurse relies heavily on triage experience and knowledge to help sort through less emergent patients. Oftentimes, the Emergency Department sees patients with conditions that a primary care physician can solve. In 2019, the average cost of treating a patient in the ED with a primary care complaint was about 12 times higher ($2,032 vs. $167) than if the patient was seen in the office by their primary physician (Williams, 2019). Hypothetically, using the ESI data, lower acuity patients could be directed to primary care doctors for their complaints instead of consuming ED resources resulting in longer wait times and delays in treating acutely ill patients (Uscher-Pines et al., 2013).

Application of ESI Data

            Using the ESI algorithm, once the triage nurse determines which patients have primary care provider complaints, in-house primary physicians could (theoretically) take over care of these patients. These patients could be slotted for times to meet with the primary care doctor instead of waiting for treatment from the ED team. Here, the primary care team could use their own data to take care of these patients and provide the appropriate treatment. This would decrease healthcare spending and fragmented care while improving patient satisfaction and wait times (Kirkpatrick, 2017).

Conclusion

Utilizing healthcare technology to enhance Emergency Department visits not only aids patients but benefits nursing as well. As data such as the ESI algorithm is used to differentiate life-threatening concerns from non-emergent ones, treatment can be instituted by the appropriate team allowing ED nurses to focus on their acutely ill patients.

References

Emergency Severity Index (ESI): A triage tool for the emergency department. AHRQ. (2020, May). https://www.ahrq.gov/patient-safety/settings/emergency-dept/esi.html.

Kirkpatrick, W. (2017, January 2). The consequences of emergency Department Overuse. The Consequences of Emergency Department Overuse. https://wellness.totalaccessmedical.com/blog/the-consequences-of-emergency-department-overuse.

Uscher-Pines, L., Pines, J., Kellermann, A., Gillen, E., & Mehrotra, A. (2013, January). Emergency department visits for nonurgent conditions: Systematic literature review. The American journal of managed care. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4156292/.

Williams, J. P. (2019). ‘Avoidable’ er visits fuel health care costs. U.S. News & World Report. https://www.usnews.com/news/health-news/articles/2019-07-22/avoidable-er-visits-fuel-us-health-care-costs.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

RE: Discussion – Week 1

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Thank you Marisa.  Good example of the use of technology in health care.

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6 months ago

Federica Clay

RE: Discussion – Week 1

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Marisa,

            The information gathered through the triage questionnaire and the nurse’s initial assessment of the patient is a great example of obtaining valuable information to make appropriate decisions. This further upholds the statement made by McGonigle and Mastrian (2017) that “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.”

            The Application of Data to Problem-Solving Discussion Example Essays I feel that staff nurses can play an even bigger part in nursing informatics by “monitoring the use of new technology by doing the following: monitoring and maintaining vigilance over data/technologies to identify those that add value to a given health situation; recognizing that nurses, other clinicians and patients may engage and assume responsibility independently and or interdependently for specific data (e.g., remote monitoring, self-monitoring, wearables, appliances)” (Nagle et al., 2017). These practices may also further decrease healthcare spending, wait times, and increase patient satisfaction rates.

Resources

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4^th ed.). Burlington, MA: Jones & Bartlett Learning. Chapter 1, Nursing Science and the Foundation of Knowledge” (pp. 8)

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/REF

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6 months ago

Alexis Liggett

RE: Discussion – Week 1 Peer Response 1

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Marisa,

            For starters, great post! Being a perioperative and post-anesthesia care unit (PACU) nurse, I work closely with the emergency department. The vast amount of information you provided helped give me a better idea of how the emergency department functions. One area of your post caught my eye the most, your clinical significance section. The hospital I work at is bursting at the seams due to the drastic influx of patients. Although the influx of patients coincides with the vastly changing pandemic, we also see just as many cases for instances that are non-emergent. “Factors that have been speculated to be associated with non-emergent use have been noted to include low socioeconomic status, lack of access to primary care, lack of insurance, convenience of “on demand care” and the patient’s individual perception of their complaint urgency” (Rocovich, 2012, para. 1).

Over the years, there has been a steady increase in the amount and acuity of patients visiting the emergency department. Every year, there are over 100 million individuals that seek and receive emergency care. As you stated, triage nurses rely heavily on experience and knowledge to differentiate emergent from non-emergent patients. “The purpose of triage is to identify patients needing immediate resuscitation, to assign to a pre-designed patient care area, and to initiate diagnostic/therapeutic measures as appropriate” (Wang et al., 2011). Nurses must identify low acuity patients that could be seen and treated by their primary care physician. This not only saves hospital resources but makes more time for acutely ill patients.

References

Rocovich, C., & Patel, T. (2012). Emergency department visits: Why adults choose the emergency room over a primary care physician visit during regular office hours? World journal of emergency medicine, 3(2), 91–97. https://doi.org/10.5847/wjem.j.issn.1920-8642.2012.02.002

Wang, L., Zhou, H., & Zhu, J. F. (2011). Application of emergency severity index in pediatric emergency department. World journal of emergency medicine, 2(40, 279-282. https://doi.org/10.5847/wjem.j.1920-8642.2011.04.006

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6 months ago

Kene Fall

RE: Discussion – Week 1

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Hello Marisa, I enjoyed reading your very informative post! I agree with you that data is consistently used to determine the severity of an emergency. Due to the understaffing of hospitals, patients are waiting longer than average to be seen by a healthcare provider. This leads to triage nurses using the ESI to avoid daily care for patients with more critical illnesses (Shelton, R. 2009). As Emergency Department (ED) level one trauma nurse, our ED is always overcrowded, and triage nurses prioritize patients using the ESI. The only downfall of using the ESI is the confusion it brings patients and incorrect triaging base on ESI (Grossmann et al., 2012) The Application of Data to Problem-Solving Discussion Example Essays.

Reference:

Grossmann, F. F., Zumbrunn, T., Frauchiger, A., Delport, K., Bingisser, R., & Nickel, C. H. (2012). At Risk of Undertriage? Testing the Performance and Accuracy of the Emergency Severity Index in Older Emergency Department Patients. Annals of Emergency Medicine, 60(3), 317–325. https://doi-org.ezp.waldenulibrary.org/10.1016/j.annemergmed.2011.12.013

Shelton R. (2009). The emergency severity index 5-level triage system. Dimensions of Critical Care Nursing, 28(1), 9–12. https://doi-org.ezp.waldenulibrary.org/10.1097/01.DCC.0000325106.28851.89

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6 months ago

Amy Birkenstamm

RE: Discussion – Week 1

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Marisa,

Great post and as a former ED nurse, I can totally relate to the efficient processes of using technology for proper communication amongst all health care providers especially in the emergency environment. Prioritizing and communication is key in order to effectively treat patients and provide the best care and safety.

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6 months ago

TYLENEA JONES

RE: Discussion – Week 1

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This scenario is a great example of the benefits of technology. Being able to assess a patients condition sooner rather than later could be the difference between life and death. According to Sweeney, J. (2017),  skills needed include understanding of data collection, storage, and extraction, in addition to an appreciation for the power of data to drive and inform practice”. This also highlights the importance of continuing education in the medical field so that we can stay current with technology and its advances. “The role of the informatics nurse specialist will continue to evolve at an increasingly rapid rate in the coming years” Nagel et. al (2017).

References

Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies for Nurses in the Future of Connected Health, 212-221. doi:10.3233/978-1-61499-738-2-212.

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).

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6 months ago

Mercy Ambe Mbu

RE: Discussion – Week 1

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Hi Marissa,

I appreciate the information. I have always perceived triage as a very challenging task. I worked in an emergency department for the first time when there were severe staffing shortages. I found out that determining the Emergency severity index was key to the patient’s plan of care. According to Mistry et al. (2018), accurate and reliable triage determines safe prioritization of care and resource allocation. The data collected and documented into the Electronic health record (HER) determines the accuracy of diagnoses, first-line treatment, length of stay, and the patient’s admitting department.

My concern about the ESI was the variability between assessments. Two different nurses can obtain different results for the same patient. The variability is related to the subjectiveness of the nurse. Despite the variability of the ESI, it is still widely utilized in emergency rooms. The tool can be challenging when used in hectic and bustling settings or during staff shortages; it is difficult to say that nurses need appropriate training, but experience and continuous education helps to reduce the variability in results The Application of Data to Problem-Solving Discussion Example Essays.

References

Mistry, B., Stewart De Ramirez, S., Kelen, G., Schmitz, P. S. K., Balhara, K. S., Levin, S., Martinez, D., Psoter, K., Anton, X., & Hinson, J. S. (2018). Accuracy and Reliability of Emergency Department Triage Using the Emergency Severity Index: An International Multicenter Assessment. Annals of Emergency Medicine, 71(5), 581–587. https://www-sciencedirect-com.ezp.waldenulibrary.org/science/article/pii/S0196064417317456

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6 months ago

Jessica Ferrin

RE: Discussion – Week 1

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            Utilizing an Enhanced Recovery After Surgery (ERAS) protocol can decrease the length of stay and postoperative complications. One of the critical data collection elements in an ERAS cardiac surgery recovery program is early ambulation, which my hospital firmly adheres to (Hirji et al., 2021). I currently work in a cardiovascular intensive care unit (CVICU) after recently stepping down from clinical management on our cardiac surgical step-down unit. Due to the infrastructure issues of the CVICU, transferring post-surgical patients to the step-down unit when ordered is imperative to their enhanced recovery. Early ambulation post-operatively decreases complications such as deep vein thrombosis, pulmonary emboli, improves pain control, decreases the risk of cardiac dysrhythmias, and improves patient independence (Mayor, 2018). Recently with staffing shortages hospital-wide and bed availability, our patients are being held in the CVICU extra day(s) so the nursing supervisor can decompress the emergency department and admit them to our step-down unit. As a manager, it became increasingly difficult to advocate for my patients to the nursing supervisor and articulate the importance of transferring out of the CVICU was. Utilizing data collected by our informatics team to provide senior leadership with information about how prolonged stays in the CVICU caused the increased length of stay and postoperative complications would be beneficial.

            Data will need to be collected from all patients who received transfer orders to the step-down unit and not moved out due to nursing supervisor discretion. Patients who remained in CVICU due to medical instability will remain excluded from the data. To assist with the data collection, the CVICU manager and surgical step-down manager would need to collaborate and devise a system to track patients who did not transfer out when ordered. This data could be collected monthly and presented to the informatics team, also known as the clinical documentation improvement team (CDI), to evaluate. The CDI team could also enlist assistance from case management, who can speak to the impact staying additional days had on the patient’s health, the financial aspect of the patient’s hospitalization, and the discharge plan.

            Documentation is vital with hospital reimbursement, and nurse leaders play a significant role in ensuring their departments are documenting accurately. Sweeney (2017) states that without nurse leaders assessing how information is organized in the electronic health record, organizations may not be compliant with the Meaningful Use aspect of the Health Information and Technology for Economic Clinical Health Act (HITECH). Patient-centered care is at the forefront of patients’ successful recovery, and this is discussed preoperatively with all of our cardiac surgical patients. Additional time spent in our CVICU is also met with decreased patient satisfaction requiring management to intervene and provide service recovery. The data collected by the managers, informatics team, and case managers will be used to develop key points to present to senior leadership at my facility to encourage and support timely transfers as ordered. The Application of Data to Problem-Solving Discussion Example Essays

References

Hirji, S.A., Salenger, R., Boyle, E. M., Williams, J., Reddy, V. S., Grant, M. C., Chatterjee, S., Gregory, A. J., Arora, R., & Engelman, D. T. (2021). Expert Consensus of Data Elements for Collection for Enhanced Recovery After Cardiac Surgery. World Surg (45), 917–925. https://doi.org/10.1007/s00268-021-05964-1

Mayor, M. A., Khandhar, S. J., Chandy, J., & Fernando, H. C. (2018). Implementing a thoracic enhanced recovery with ambulation after surgery program: key aspects and challenges. Journal of thoracic disease, 10(Suppl 32), S3809–S3814. https://doi.org/10.21037/jtd.2018.10.106

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).

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6 months ago

Jessica Ferrin

RE: Discussion – Week 1

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Dr. Moyers,

I am having a hard time pasting my work so that my reference format isn’t compromised.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

RE: Discussion – Week 1

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No worries Jessica.  Blackboard will often mess up format.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

RE: Discussion – Week 1

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Good response Jessica. Your post leads me to a question….

Class:

How does data become information?

Dr. Moyers

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6 months ago

Kirsi Hoselton

RE: Discussion – Week 1

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Dr. Moyers,

            Essentially data is a building block to form information that can be documented within a medical record to gain insight into what is going on with a patient (Sadan, 2020). Data collection is essential to providing accurate information. Data is an essential concept within quantitative research (Sadan, 2020). Data is collected in a variety of ways, such as; observations, vitals, questionnaires, interviews, or self-reporting to name a few (Sadan, 2020). From there the data is turned into information. Exceptional collected data can enhance patient findings and lead to possible diagnosis (Sadan, 2020). Once a diagnosis is created information regarding the diagnosis can be provided to the patient. As health care professionals, it is essential to gather the needed data to create an inference about what is going on with the patient.

References

Sadan, V. (2020). Data collection for Quantitative Research. Research Methods in Business Studies, 153–181. https://doi.org/10.1017/9781108762427.013

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6 months ago

Miguel Rodrigo Estrera

RE: Discussion – Week 1 Initial Post The Application of Data to Problem-Solving Discussion Example Essays

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

RE: Discussion – Week 1 Initial Post

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Thank you Miquel. Your post leads me to a question…

Class:

What is a root cause analysis?

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6 months ago

Tammy Rodgers

RE: Discussion – Week 1 Initial Post

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Dr. Moyer,

Without looking up the actual textbook definition and using a sentinel event for an example, team members will gather the chart and any other information that may be needed, and track the patient’s stay preceding and up to when the event occurred to analyze the point of breakdown or where an area of opportunity may have been in the patient’s treatment. Once the issue or area is identified, then a performance improvement plan can be created and implemented to possibly prevent an incident in the future. It is an analysis and identification of the underlying issue that may have created the negative outcome.

Tammy

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6 months ago

Miguel Rodrigo Estrera

RE: Discussion – Week 1 Initial Post

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Hello Dr. Moyer,

Thank you for the response to my Discussion post. Root cause analysis (RCA) is a structured procedure utilized to investigate the causes of significant adverse occurrences. It is one of the most extensively used retrospective strategies for identifying potential safety issues today. By identifying and removing the latent mistakes that frequently underlie undesirable outcomes, the goal of RCA is to prevent future harm (Patient Safety Network, 2019).

The root causes of an incident are the fundamental difficulties that led to its occurrence, and they can be found by utilizing a systematic inquiry technique (Haxby & Shuldham, 2018). In the field of healthcare, and particularly in nursing, root cause analysis is critical. Nurses can learn from patient safety incidents and apply their knowledge to enhance patient care through this systemic approach (Haxby & Shuldham, 2018). Following a root cause analysis, improving patient safety is dependent on the team taking remedial action, implementing improvements, and evaluating the results of these actions.

References

Haxby, E., & Shuldham, C. (2018). How to undertake a root cause analysis investigation to improve patient safety. Nursing Standard, 32(20), 41. The Application of Data to Problem-Solving Discussion Example Essays doi:http://dx.doi.org.ezp.waldenulibrary.org/10.7748/ns.2018.e10859

Patient Safety Network. (2019, September 7). Retrieved from Root Cause Analysis: https://psnet.ahrq.gov/primer/root-cause-analysis

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6 months ago

Kirsi Hoselton

RE: Discussion – Week 1 Initial Post

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6 months ago

TYLENEA JONES

RE: Discussion – Week 1 Initial Post

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Miguel,

            I have some experience in working with insurance reimbursements in the past and with the advancement of technology it has become a lot easier to track trends for denials. Turn around times for payments are crucial to a healthcare organization therefore being able to easily retrieve data from electronic systems become a very useful tool. The nurse informatics specialist can assist with “oversight of organizational workload measurement systems, and project leadership” Nagel et. al (2017). According to Sweeney (2017), the technology boom at the turn of the century has helped informatics and information systems further evolve.

References

Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies for Nurses in the Future of Connected Health, 212-221. doi:10.3233/978-1-61499-738-2-212.

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).

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6 months ago

Mercy Ambe Mbu

RE: Discussion – Week 1 Initial Post

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Hi Miguel,

Great and insightful post. Health insurance denial is one of my pet peeves regarding patient care. Until today I have had difficulties accepting that health insurance claims are denied even when patients need it the most. Hospitals and other health facilities are becoming more careful about patients’ insurance because they do not want to lose money. Hospitals lose about 3 to 5% of revenue in an insurance claim denial, and though denials can be appealed, the process can be overwhelming and time-consuming. I have encountered situations that patients did not receive a specific therapy because their insurance will not reimburse the procedure. Instead of a Ketamine therapy that has been effective in the past, the patient had to alternate to Electroconvulsive therapy, which is less expensive. Even though his depression was better, his stay in the hospital was prolonged. My argument is that what is the essence of denying an effective therapy and pay lesser hospitalization days but instead will pay for more days with less effective therapy. Does the cost not amount to the same at the end of the day? Payors

Interestingly, you thought of collecting data on insurance denial, especially finding out why payors decline insurance claims. The data you collect will be an excellent base for facilities to use for improvement. It might interest you to look at the Lean Sigma Six methodology utilized in some emergency departments to change the mindset of workers to improve the registration process. According to Kovach and Borikar (2018), this approach focused on reducing denials by enhancing the hospital’s Emergency Center registration process, and thorough and complete registrations reduce incomplete insurance information by 67%. Complete registration might be an excellent place to start for most facilities.

References

Kovach, J. V., & Borikar, S. (2018). Enhancing Financial Performance: An Application of Lean Six Sigma to Reduce Insurance Claims Denials. Quality Management in Health Care, 27(3), 165–171 https://journals.lww.com/qmhcjournal/Abstract/2018/07000/Enhancing_Financial_Performance__An_Application_of.9.aspx

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6 months ago

Adam Hundley

RE: Discussion – Week 1 Initial Post The Application of Data to Problem-Solving Discussion Example Essays

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Response 2

Miquel,

Insurance informatics is a great example of how data acquisition and technology can combine to track trends. I wish that would have come to mind for me as I have some insurance experience. Unfortunately, my speculation is that the informatics are used to limit care. However, that is not always the case. In the case of Medicare and Medicaid, informatics can help increase the accuracy for services and increases expediency of those services (online.regiscollege.edu, n.d). Some insurance companies also attempt to identify patients that are likely to be readmitted to the hospital and connect them with outside educational services to help curb the readmission (elearning.scranton.edu, n.d).

References

4 ways that informatics could improve health care treatment. (n.d.). online.regiscollege.edu. Retrieved September 4, 2021, from https://online.regiscollege.edu/blog/4-ways-informatics-improve-health-care-treatment/

How health informatics transforms the insurance industry. (n.d.). elearning.scranton.edu. Retrieved September 4, 2021, from https://elearning.scranton.edu/resources/article/how-informatics-transforms-the-insurance-industry/

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6 months ago

Amy Birkenstamm

RE: Discussion – Week 1 Initial Post

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From my understanding, a root cause analysis (RCA) is the process of discovering the root causes of problems in order to identify appropriate solutions. In the above case, the nurse leader has the role of identifying, problem solving, then coming up with a solution to improve overall processes. Incorporating informatics and health information technology systems can help make this process more fluent and effective.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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6 months ago

Ivo Ngosong

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After many years of working as an enlisted nurse in an inpatient rehabilitation unit, I’ve come to realize that one of the most serious issues we face is inadvertent patient falls. Patients in an inpatient rehabilitation facility typically report feeling more independent as a result of the long hours they spent receiving physical and psychological care in the hospital. This discernment usually causes the sufferers to move and deal with particular necessities without requesting assistance. Despite the fact that their physical and verbal therapy progresses, many individuals are still not in a protected position to perform these activities without supervision. Patients who act too quickly risk collapsing, preventing them from completing all of their upgrades, resulting in severe damage and prolonging the length of their medical clinic stays (Mckechnie et al., 2015). As a result, information on patient falls may be beneficial to attendants and medical caretaker pioneers in order to reduce the number of patient falls.

Medical care informatics has provided several better-than-ever methods for gathering and deciphering information. Information collection devices can organize numerous information components to aid in following the examples of medical issues (McGongile and Mastrian, 2017). Information elements that might be used in relation to patient falls include the number of falls, events that cause falls, patient-explicit variables, and fall outcomes. Such data can be collected in an electronic data set, such as an electronic well-being record (EHR). There might be a standardized structure inside the electronic data base to be completed following patient fall instances. Because the data would be collected in an electronic database, it would be effectively available to any medical care faculty who could analyse and apply the obtained information (Sweeney, 2017). Attendants, nurturing pioneers, specialists, actual advisors, word associated specialists, and that’s just the tip of the iceberg make up this medical services task force The Application of Data to Problem-Solving Discussion Example Essays.

The collection of information in an electronic data set can aid in the recognition of patterns by providing a lot of information triggering pools of information (McGongile and Mastrian, 2017). Specifically related to falls, electronic information information can aid in detecting conditions that are likely to prepare the way for a fall as well as which patients are likely to fall. Over time, this data can also reveal information about the number of falls that have occurred and the severity of those falls if the data is collected regularly. Because of the enormous amount of data that electronic information systems may give, physicians can use the outcomes to develop effective medications and prevent adverse health consequences from occurring (Gamache et al., 2018). When electronic information reveals patient characteristics and situations that are deeply associated with falls, nurturing pioneers may take out mediations that are explicitly focused on the concerns, which can aid in reducing the incidence of falls by a significant margin. These types of interventions might include constant adjustment, warnings, and education for the patient. Attendant pioneers can also obtain information on the viability of mediations based on later electronic data gathered on the frequency and severity of falls, which can be used to guide their decisions.

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. doi:10.1055/s-0038-1667081

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Mckechnie, D., Fisher, M. J., & Pryor, J. (2015). The characteristics of falls in an inpatient traumatic brain injury rehabilitation setting. Journal of Clinical Nursing, 25(1-2), 213-222. doi:10.1111/jocn.13087

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).

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jennifer girgis

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Kene Fall

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Tae Kim

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6 months ago

ZULFIQAR ABBAS

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Hi Ivo,

I have similar kind of feelings because I also work in a long-term and post-acute rehabilitation facility. I agree with you that one of the big concerns over there is fall and fall prevention. I would say all the residents regardless of anything has significant falls risk. Some residents fall more frequently, some fall multiple times in a day or even in a shift. We have a long protocol when some fall and monitor them very closely. What do you do in your facility when someone falls and what are the fall preventions measures you use?

I agree EHR made significant progress in this regard especially in long-term care where most residents cannot remember their medical history, medications, and other pertinent data. The electronic medical record is the one that can tell us all this valuable information regarding the patient’s fall. As I said earlier we have to document how many times patients fell in 30 days and 180 days and any harm, again EHR pulls out the data. Information technology and proper communication help in fall prevention and fall risk and decrease the healthcare cost and patient’s harm (Ogonowski, et al; 2016). IT helped in the advancement of nursing practice in various ways. For example, informatics helps improve the patient outcome, decreases the cost, medication errors in the perioperative stage (Sweeney, 2010).

                                                                                  References

Ogonowski, C., Aal, K., Vaziri, D., Rekowski, T. V., Randall, D., Schreiber, D., … & Wulf, V. (2016). ICT-based fall prevention system for older adults: qualitative results from a long-term field study. ACM Transactions on Computer-Human Interaction (TOCHI), 23(5), 1-33.

Sweeney, P. (2010). The effects of information technology on perioperative nursing. AORN journal, 92(5), 528-543.

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6 months ago

ZULFIQAR ABBAS

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Hi Ivo,

I have similar kind of feelings because I also works in a long term and post-acute rehabilitation facility. I agree with you that one of the big concerns over there is fall and fall prevention. I would say all the residents regardless of anything has significant fall risk. Some resident fall more frequently, some fall multiple time in a day or even in a shift. We have a long protocol when some falls and monitor them very closely. What do you do in your facility when someone fall and what are the fall preventions measures you use?

I agree EHR made a significant progress in this regard especially in long-term care where most residents cannot remember their medical history, medications, and other pertinent data. Electronic medical record is he one that can tell us all these valuable information regarding the patients. S I said earlier we have to document that how many times patient fell in 30 days and 180 days harm, again EHR pulls out the data. Information technology and proper communication help in fall prevention and fall risk and decreases the healthcare cost and patient’s harm (Ogonowski, et al; 2016). IT helped in advancement of nursing practice in various ways. For example, informatics helps improve the patient outcome, decreases the cost, and medication errors in perioperative stage (Sweeney, 2010).

                                                                                  References

Ogonowski, C., Aal, K., Vaziri, D., Rekowski, T. V., Randall, D., Schreiber, D., … & Wulf, V. (2016). ICT-based fall prevention system for older adults: qualitative results from a long-term field study. ACM Transactions on Computer-Human Interaction (TOCHI), 23(5), 1-33.

Sweeney, P. (2010). The effects of information technology on perioperative nursing. AORN journal, 92(5), 528-543.

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6 months ago

ZULFIQAR ABBAS

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Sorry, I posted a have reply twice.

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6 months ago

Sophie Enjema Ndumbe

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Hi Ivo,

Nice discussion, falls occur everyday in our society there are my reasons why people fall. Assessing patients thoroughly and putting in place measures to prevent falls will help to solve this problem. Most patients feel that when they start doing physical therapy, they can become independent which is not true, they must be cleared by therapy before doing approved activities. Fall increase morbidity, mortality rate and length of time patients stay in the hospital (López-Soto et al., 2021).

I agree with you collecting data from an electronic health record, this will make it easy for the staff or the nurse to know more about the patient, their history, any illness that might put them at risks for falls and their progress. Through this measures can be put in place to reduce the rate of falls or prevent them from happening. Falls cost the hospital and the individual a lot of money and doing a thorough assessment should focus on history of falls, mobility, disease condition, balance, visual impairment, cognitive deficit (While, 2018).

References

López-Soto, P. J., López-Carrasco, J. de la C., Fabbian, F., Miñarro-Del Moral, R. M., Segura-Ruiz, R., Hidalgo-Lopezosa, P., Manfredini, R., & Rodríguez-Borrego, M. A. (2021). Chronoprevention in hospital falls of older people: protocol for a mixed-method study. BMC Nursing, 20(1), 1–9. https://doi-org /10.1186/s12912-021-00618-y

While, A. (2018). Timely intervention can reduce the cost of falls. British Journal of Community Nursing, 23(4), 206. https://doi-org /10.12968/bjcn.2018.23.4.206

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6 months ago

Alexis Liggett

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Healthcare Scenario

            I currently work in perioperative services in an Acute Care Setting. Working in perioperative services, I am responsible for both preparing and recovering patients from surgery. One of the responsibilities of a recovery nurse, or post anesthesia care unit (PACU) nurse, is to accurately assess and care for our patients following the administration of anesthesia. In this department, strong assessment skills are crucial. In the PACU we assess for many different things, but the main one is malignant hyperthermia (MH). Malignant hyperthermia is a life-threatening reaction to medications used for anesthesia. Malignant hyperthermia generally involves a temperature that is dangerously high, tachycardia, arrhythmias, mottled skin, muscle spasms and rigid muscles (Mayo Clinic, n.d.). Although MH is extremely rare, it is still something that we need to assess all patients for. With this discussion post, I am going to focus on the scenario that a patient is in a MH crisis.

Assessment and Data Collection

            As previously mentioned, in this line of work assessment skills are crucial to the care and safety of our patients. PACU nursing was developed to accurately assess and quickly detect, or anticipate, adverse events such as MH (Smedley, 2012). Not only are assessment skills important, but the accuracy of the handoff between nurses is vital. The operating room nurse (OR circulator) gives the PACU nurse a detailed report about the patient including their medical history, antibiotics given, and the procedure performed. The certified registered nurse anesthetist (CRNA), too, gives report to the PACU nurse regarding what medications were given to the patient, fluids given, vital signs during surgery, and the patient’s overall response to anesthesia during the procedure.

During the recovery process, our patients are attached to continuous monitoring so we can monitor vital signs such as blood pressure, oxygen saturation, heart rate, end-tidal CO2, and respirations. This allows us to accurately monitor and assess our patients throughout the duration of their recovery. These vital signs are the obvious signs and symptoms that typically lead a nurse to a diagnosis of MH.

Clinical Significance

Currently, there are not many additional tools out there to aid in screening for MH. There are diagnostic tests requiring muscle biopsies or genetic testing, but little resources to help with early recognition (Mayo Clinic, n.d.). The facility I work at has begun discussing using an app to help nurses screen their patients for MH in the recovery room. This app is to be used with all patients and is believed to catch MH sooner, thus reducing the life-threatening affects.

Conclusion

            Accurately assessing and identifying the clinical signs of MH, prioritizing patient screening, and using the technology made available are all key measures to reducing the instances of MH. These screening tools and apps should be made available in all perioperative units as well as any other unit where anesthesia could be administered. Malignant hyperthermia can occur at any point during the administration of anesthesia, so all nurses need to be prepared and accurately trained for the safety of our patients.

References

Mayo Clinic. (n.d.). Malignant hyperthermia. Retrieved August 30, 2021, from https://www.mayoclinic.org/diseases-conditions/malignant-hyperthermia/symptoms-causes/syc-20353750

Smedley, P. (2012). Patient Risk Assessment in the PACU: An Essential Element in Clinical Decision Making and Planning Care. British Journal of Anesthetic and Recovery Nursing, 13(1-2), 21-29. doi:10.1017/S1742645612000174

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Robin Moyers WALDEN INSTRUCTOR MANAGER

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Marisa Buffa

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6 months ago

Federica Clay

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Alexis,

            I enjoyed learning from your post about malignant hyperthermia and how your hospital is accessing and using data that is obtained by using an app. McGonigle and Mastrian (2017) state that “for information to be valuable, it must be accessible, accurate, timely, complete, cost-effective, flexible, reliable, relevant, simple, verifiable, and secure. Knowledge is the awareness and understanding of a set of information and ways that information can be made useful to support a specific task or arrive at a decision.” The way that your hospital is obtaining this data by using an app and forming it into knowledge is the epitome of valuable information.

If this approach can be used hospital-wide, it can benefit many other organizations such as clinics, other departments within the hospital, and even other hospitals. Nagle et al. (2017) stated that “management continuity is referring to a consistent and coherent approach to the health problem across organizations and boundaries” Management continuity is not only for nursing leaders, but for all of nursing staff in those involved in patient care and can greatly benefit other organizations if used appropriately.

Resources

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4^th ed.). Burlington, MA: Jones & Bartlett Learning. Chapter 1, Nursing Science and the Foundation of Knowledge” (pp. 9)

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/REF

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Jessica Ferrin

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Alexis,

            Working in the cardiovascular intensive care unit (CVICU), we sometimes operate as a glorified cardiovascular post anesthesia care unit (PACU). Your post was very informative, and reminded me that I need to be carefully assessing my post anesthesia patients for malignant hyperthermia. Since malignant hyperthermia can affect 1 in 5,000 to 50,000 patients, it is imperative PACU nursing staff carefully assess their patients for any signs and symptoms (U. S. National Library of Medicine, 2020). You mentioned an application available to nursing staff to screen their patients for malignant hyperthermia in the recovery area. Is this separate from the electronic health record (EHR)? Interoperability, or the ability of systems to exchange information is vital in today’s medical society (Ehrestein et al., 2019). Having the accessibility between your facility’s EHR and application would allow the information to exchange seamlessly, and therefore helpful to all healthcare providers. This would help information from becoming fragmented. I’m excited to hear about your endeavors with this application!

References

Ehrestein, V., Kharrazi, H., Lehmann, H., & Taylor, C. O. (2019). Tools and technologies for resistry interoperability, registers for evaluating patient outcomes: A user’s guide (Vol. 3rd Edition). Rockville, MD: Agency for Healthcare Research and Quality (US). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK551878/

S. National Library of Medicine. (2020, August 18).Malignant Hyperthermia. Retrieved September 1, 2021, from Genetics: https://medlineplus.gov/genetics/condition/malignant-hyperthermia/#frequency The Application of Data to Problem-Solving Discussion Example Essays

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ZULFIQAR ABBAS

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6 months ago

April Ward

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Discussion Week 1

Scenario:

Working in mental healthcare, there is a large amount of informatics/data that is used to determine if a client is having a severe mental health emergency or if they may have a less severe, but none the less, disturbing difficulty of finding the correct medication for them. Not only does the mental health nurse or nurse practitioner use her eyes and assessment skills to determine the level of anxiety the client is exhibiting, but the voice of the client, or listening to them, can give a great deal of information. Lab tests, such as medication levels, drug screens and genetic tests are also useful in assisting with the appropriate diagnosis and treatment of those with mental illness.

Data:

According to the CDC (2021), the National Health Interview Survey (NHIS) collects mental health data and determines if individuals are utilizing needed mental health services. When there are clients who come to our facility and have tried many different medications, yet continue to have problems controlling their anxiety, depression, mania, or audio/visual hallucinations, genetic testing may be the best way to gather the necessary data to help these clients. As mentioned in the Laureate Education (2018) video in this module, genomics assists people in learning more about themselves. This is true in medical and mental health. Being able to know if a certain medication can aid in your mental health is a giant step in the right direction, when someone has had a difficult time in discovering which medications will work for them.

Also, when the client is not in the office, tele-psychiatry is essential in this day and age to obtain data by seeing the client no matter where they are.  Nursing, as described by Nagle, et al. (2017), is able to be delivered virtually now, nearly everywhere in the world.  This marvel of medicine has helped to save many lives as well as having aided in improved mental health.  We are able to go to the jails, prisons and even to homeless people in the streets to be able to connect them to a practitioner to be able to not only talk to them, but to see if there are any extrapyramidal symptoms that the client may be exhibiting that could be contributed to use of antipsychotic medications or antidepressants.  The Substance Abuse and Mental Health Services Administration (2021), states that use of drug screens (in combination with mental health assessment) is also very useful in ruling-out drug use, determining if the client may be experiencing drug-induced psychosis, or if it is a true mental health crisis.

Using Data and Judgement:

If there were a person at their home who called stating they were having a mental health emergency, the crisis nurse would go to the home and use tele-psychiatry with the nurse practitioner (NP) to gather visual and auditory data for the NP. The nurse could further gather data by genetic testing (a mouth swab test), collect a urine sample for a drug screen and check vital signs gathered by blood pressure, oxygen saturation monitoring, pulse and temperature check. Drug screens are also used to determine if someone is taking their prescribed medication or not. This data would be assessed and results given to the NP, so that knowledge formation could be made and the mental health crisis could be solved or diminished. The gathering of this information aids us in determining if this client should go to a hospital or if they can successfully be treated at home.

Conclusion:

Informatics is vital to the gathering of information to make an informed decision and aid those with mental illness.

                                                          References

CDC (2021).  Data and statistics.  Retrieved from https://www.cdc.gov/mentalhealth/data_publications/index.htm

Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.

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/REF

Substance Abuse and Mental Health Services Administration (2021).  Drug testing resources.  Retrieved from https://www.samhsa.gov/workplace/resources/drug-testing

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you April. Good use of teleheath.

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6 months ago

Tammy Rodgers

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Response 1 to April

April,

Great post regarding genetic testing related to psychiatric medications. I am in mental health as well and I am seeing genetic testing more frequently utilized in difficult patients. According to a study on patients with just the diagnosis of Major Depressive Disorder, the patients save nearly $4, 000 per year in healthcare and pharmaceutical costs due to the higher efficacy of prescribed medications and fewer clinical visits (Maciel, et al., 2018). Even though the estimated cost of genetic testing is approximately $2,000 (Maciel, et al., 2018), if it saves insurance companies and patients money in the long run, I do not understand why it isn’t utilized as standard lab testing in a patient’s treatment regimen.

You also mentioned telehealth in your post and it is another great resource for delivering good patient care. Telehealth has been growing in popularity, especially during the pandemic when patients were, and many continue to be, afraid to leave their homes. For those that already suffer from anxiety and depressive disorders, the pandemic has been detrimental to the mental health of many, and telehealth has given providers the ability to be “frontline caregivers in a crisis situation” (Sullivan, et al., 2020) to these individuals as well as to those that have newly developed symptoms related to the pandemic. In my opinion, it is an invaluable advancement in healthcare delivery.

Tammy

References

Maciel, A., Cullors, A., Lukowiak, A. A., & Garces, J. (2018). Estimating cost savings of pharmacogenetic testing for depression in real-world clinical settings. Neuropsychiatric Disease and Treatment, Volume 14, 225–230. https://doi.org/10.2147/ndt.s145046

Sullivan, A. B., Kane, A., Roth, A. J., Davis, B. E., Drerup, M. L., & Heinberg, L. J. (2020). The covid-19 crisis: A mental health perspective and response using telemedicine. Journal of Patient Experience, 7(3), 295–301. Retrieved September 1, 2021, from https://doi.org/10.1177/2374373520922747

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6 months ago

Paola Gaudioso

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April,

Your scenario is very common in the mental health field. There are so many scales and questions that we can use and ask as practitioners to attempt to understand and gather information to treat patients. Due to the pandemic telepsychiatry has been crucial due to the high demand for mental health services and the need for social distancing (Li et al., 2021). The hospital I work for offers teleassessments for our outpatient program that has turned to a zoom platform since the pandemic. I believe that these practices stay in play due to the ease of access for patients. There are more than 20 states that have given PMHNP full practice without the oversight of a physician, which allows them to prescribe and treat mental health needs in patients across the US (Finely et al., 2021). This is a huge win for advanced practice nurses. I think that these resources could help increase the care for patients across the US. The more advanced practice nurses can do for their patients the more care is available to patients. Informatics comes into play when gathering information to analyze what kind of care can be provided through telepsychiatry.

References

Finley, B. A., Shea, K. D., Maixner, R., & Slebodnik, M. (2021). Advanced Practice Registered Nurses Using Synchronous Telepsychiatry: Am Integrative Systemic Review. Journal of the American Psychiatric Nurses Association, 27(4),271-282.

http://doi-org.ezp.waldenulibrry.org/10.1177/1078390320939159

Li, Z,. Harrison, S. E., Li, X., & Hung, P. (2021). Telepsychiatry adoption across hospitals in the United States: A cross-sectional study. BMC Psychiatry,21.

https://doi-org.ezp.waldenulibrary.org/10.1186/s1288-021-03180-8

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Marisa Buffa

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jennifer girgis

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Being a part of in-home services, the team gathers information of how satisfied a patient is with each visit through four questions patient satisfaction survey. Questions staffs asked includes: 1) Does patient know when the next visit is, 2) do they understand their medications and its side effects, 3) does the visit succeeded patient expectations and 4) any suggestion or comments. There are two ways a patient can access this information either through a downloadable application, scanning the QR code located on the start of care booklet provided and explained by clinicians during the start of care process. And after each visit, patients are reminded to answer the questions by each discipline. By doing so, physical or occupational therapy, nurses, home health aide, social worker, speech therapy and dietician draw upon knowledge and conclusions to work on areas that are lacking and need improvements.

Provided that patient can answer the questions, has a smart phone or tablet device that has the capacity to download the application, or would remember to access the QR code located on the booklet. The information is then transferred to department managers to discuss within the team. The result of the collection process tells each employee especially the nurses to do a better job on customer service and patient experience. To be thorough on medication and disease management and each visit should encourage participation and not one way communication. Sometimes clinicians run autopilot with tasks and would talk constantly denying patient participation and interaction. Building good rapport between patient and clinicians is important for any change can be achieved with less difficulty. According to Nagel et al. (2017), at every level of organization, the nurses have been essential in every step of the systems life cycle and instrumental in the success of program implementations.

It is important to not only consider the technology at hand but also the workflow and the data collection process. (Sweeney, 2017) Nurse leaders, managers and administrators are responsible for leading a work environment. Though they are not on direct patient care, that doesn’t mean they cannot support the staff. Creating a positive culture and supporting the evolving functional system adaptation of electronic health record to improve patient care workflows are just some of the roles of nurse leaders. (Carson et al., 2021) Nurse leader’s uses clinical reasoning and judgment in the formation of knowledge and experience. They exercise transparency of the problem and results to each department, synthesizing the data collected and disseminating the information for better outcome to improve satisfaction ratings between patient and care on future visits. They encourage feedback from team thus prompting new data formulation and clinical experience. It is important to have proficiency in all aspects of nursing especially nursing informatics especially when supporting staff at any level. Regardless of practice arena, all nurses must use informatics and technology to inform and support that practice. (McGonigle & Mastrian, 2018, p. 13)

References

Carson, N., Campbell-Smit, B., Walters, W., Sharp, K., & Smailes, P. (2021). Electronic health record training for nurse leaders. Online Journal of Nursing Informatics (OJNI), 25 (2). Retrieved from https://www.himss.org/resources/online-journal-nursing-informatics

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies for Nurses in the Future of Connected Health, 212-221. doi:10.3233/978-1-61499-738-2-212 The Application of Data to Problem-Solving Discussion Example Essays

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).

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Robin Moyers WALDEN INSTRUCTOR MANAGER

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The Application of Data to Problem-solving

Healthcare Scenario

In a pediatric outpatient primary care clinic, one provider alone may see 15-20 children in a day, at the least. Some of those children may live in a home where food choices and physical activity may not be the healthiest. As healthcare providers, it is important to look at the whole child and family dynamic when assessing a child’s health status. Therefore, gaining data on children’s health in the home could help prevent certain mental and physical illnesses.

Data to be Accessed

            Some important data to be obtained could include the patient’s weight, blood pressure, a food diary for the patient, an activity diary, and a feelings/mood diary. Some other good ideas from Imoisili et al. (2021) would be to include hemoglobin A1c and liver markers such as ALT and lipids. Depending on the age, this could be done using a sort of game to help children be more motivated to document their daily choices. The patient could write it down in a notebook that the clinic can provide for them, or if they are younger, they can draw pictures in it. What might be useful for older children is documenting their food intake, activity level, or mood on a mobile device application that can be synced to the clinic’s medical record. The only one who would have access to this would be the patient’s provider. If the patient is using a notebook to write or draw in, they would simply return it once a week to the clinic to be documented in the medical record system.

Knowledge Derived from Data

            From this specific data, we can obtain a deeper knowledge of a patient’s life at home, of the food options the patient has available to choose from, their activity level, and their emotional state. All of these play a factor in a patient’s overall health. Each category of health affects the other. This knowledge can help us to target what needs to be focused on instead of simply telling the patient and his or her parents that they must eat healthier and be more physically active. Diving into what is really the issue behind the patient’s increased weight will provide more success rates for the patient and family. The underlying issue may not even be physical activity or food choices. It may be psychological stress on the child, in which case, resources would be provided for them to help resolve the psychological issue within the patient.

Clinical Reasoning and Judgement

            Clinical reasoning and judgement can be formed from the knowledge obtained from this specific data by observing the trends of certain ages and population groups in their physical activity and food choices. The nurse leader can infer from this information the influences of each individual patient’s daily life and possibly be able to offer suggestions of lifestyle changes that the family and patient can implement in their daily choices.

Application of Data

            With the application of this data obtained, we as healthcare providers must keep in mind that the “psychosocial concerns such as stress and dysfunction in the family, or a child’s experience with bullying can increase the chances of dropout” (Berry et al., 2021). So we must make sure that when we apply this new information to our patient’s lives, that we follow up with them and make sure we gave them the greatest chance of success for the future and for the rest of their lives. A study performed by Thompson et al. (2019) showed that regular checkups and teachings from nutrition specialists and behavioral specialists with the patient and family greatly increase the success rate in weight management over a two-year period.

Conclusion

            Pediatric obesity is a prevalent issue in today’s world, and as we integrate data that we obtain from current patients, we can positively affect the outcome of their health now and in future years to come. We can obtain data from our patients electronically or written. That is the beauty of today’s technology and our increasing ability to help our patients in more than just the conventional method.



Resources

Berry, D. C., Rhodes, E. T., Hampl, S., Young, C. B., Cohen, G., Eneli, I., Fleischman, A., Ip, E., Sweeney, B., Houle, T. T., & Skelton, J. (2021). Stay in treatment: Predicting dropout from pediatric weight management study protocol. Contemporary Clinical Trials Communications, 22. https://doi-org.ezp.waldenulibrary.org/10.1016/j.conctc.2021.100799

Imoisili, O. E., Lundeen, E. A., Freedman, D. S., Womack, L. S., Wallace, J., Hambidge, S. J., Federico, S., Everhart, R., Harr, D., Vance, J., Kompaniyets, L., Dooyema, C., Park, S., Blanck, H. M., & Goodman, A. B. (2021). Body Mass Index and Blood Pressure Improvements With a Pediatric Weight Management Intervention at Federally Qualified Health Centers. Academic Pediatrics, 21(2), 312–320. https://doi-org.ezp.waldenulibrary.org/10.1016/j.acap.2020.11.026

Thompson, K. L., Chung, M., Handu, D., Gutschall, M., Jewell, S. T., Byham-Gray, L., & Parrott, J. S. (2019). The Effectiveness of Nutrition Specialists on Pediatric Weight Management Outcomes in Multicomponent Pediatric Weight Management Interventions: A Systematic Review and Exploratory Meta-Analysis. Journal of the Academy of Nutrition and Dietetics, 119(5), 799–817. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jand.2018.12.008 The Application of Data to Problem-Solving Discussion Example Essays

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6 months ago

Tanaka Ruzvidzo

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Dear Frederica,

The healthcare scenario you have chosen of childhood obesity is indeed a major issue especially in the U.S. Due to this we are seeing younger people coming to the hospital with hypertension, myocardial infarction and other issues that otherwise were not seen in a young population. Children today live a very sedentary life, potentially leading to increased weight gain. If not checked, for some this can result in low self-esteem, leading to depression. Sutaria et.Al (2019), found strong evidence that obese female children have a significantly higher odds of depression compared with normal-weight female children.

The use of telemedicine may be a great way to keep track of the health status of a child, help with an exercise regimen whilst also giving a peek into their home environment. According to Hsu et.Al (2021), when supervised by a clinical dietitian, telemedicine based elastic band resistance exercise intervention led to significant reductions in BMI, body fat, total cholesterol, LDL, and triglyceride levels in patients with obesity. This is useful not only for physical well-being but for mental health as well. Promotion of health using available technologies also appeals to the younger generation who are introduced to electronic gadgets at a young age and the medical field needs to take advantage of this. This way it can be used in a relaxed and fun environment whereby the effort by the patient is minimal.

References

Hsu, Y.-I., Chen, Y.-C., Lee, C.-L., & Chang, N.-J. (2021). Effects of Diet Control and Telemedicine-Based Resistance Exercise Intervention on Patients with Obesity and Knee Osteoarthritis: A Randomized Control Trial. International Journal of Environmental Research and Public Health, 18(15). https://doi-org.ezp.waldenulibrary.org/10.3390/ijerph18157744

Sutaria, S., Devakumar, D., Yasuda, S. S., Das, S., & Saxena, S. (2019). Is obesity associated with depression in children? Systematic review and meta-analysis. Archives of Disease in Childhood, 104(1), 64–74. https://doi-org.ezp.waldenulibrary.org/10.1136/archdischild-2017-314608

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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6 months ago

Tiffany Turner

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6 months ago

Tanaka Ruzvidzo

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6 months ago

Tae Kim

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Thank you for a great post, Tanaka. It is not only critical to assess the suicidal risk on admission, each shift, and as needed but also to utilize coping skills to intervene suicidal thoughts and attempts.

Suicide is a serious issue that seems to keep growing despite prevention efforts. Suicides have increased by 24 percent in the past 20 years and now suicide is one of the top ten causes of death in the US. Not only is the problem growing there has been little progress over the last 50 years in understanding suicide and improving outcomes in at-risk individuals (Coppersmith et al., 2018). Identifying high-risk patients is difficult. RNs are considered “front-line” in suicide prevention because of their contact with patients but RNs rarely identify at-risk patients. Yet most people who do commit suicide had visited a healthcare provider within the previous month. Part of the reason for failing to identify at-risk patients is that most RNs have little or no training on how to assess, treat, evaluate or refer a suicidal patient. RNs , therefore, feel ill-prepared and afraid to talk to patients about suicide (Bolster et al., 2015). Although PMHNPs are better trained and should be better able to identify at-risk patients, this may not necessarily be the case. One study in rural Kentucky indicated that nine of ten psychiatric nurses surveyed overestimated their ability to identify and treat persons with suicidal ideation (France, 2019).

Informatics offers significant opportunities in the effort to identify at-risk patients. One example is through the natural language processing of social media. Studies with natural language processing and machine learning have detected quantifiable signals around suicide attempts and how to design an automated system for estimating suicide risk among patients. The results could be used by those without specialized mental health training (e.g., primary care doctors) to identify at-risk patients. Although this is a potentially life-saving technology, there may be ethical and privacy implications. So far this technology has been used only for individuals who have “opted in” for analysis and intervention (Coppersmith et al., 2018).

References

Bolster, C., Holliday, C., O’Neal, G., & Shaw, M. (2015, January) Suicide assessment and nurses: What does the evidence show?  The Online Journal of Issues in Nursing, 20(1).  https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No1-Jan-2015/Suicide-Assessment-and-Nurses.html

Coppersmith, G., Leary, R., Crutchley, P., & Fine, A. (2018). Natural language processing of social media as screening for suicide risk.  Biomedical Informatics Insights, 10, 1 – 11. https://journals.sagepub.com/doi/pdf/10.1177/1178222618792860

France, W. F. (2019).  Psychiatric nurses’ knowledge of suicide prevention. [Dissertation, Walden University]. Walden Dissertation and Doctoral Studies Collection.  https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=8505&context=dissertations

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6 months ago

April Ward

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6 months ago

Tae Kim

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When a patient or member of their family is ill, injured, or suffering from any medical condition, they and their families rely on healthcare experts to help them recover. We may help, but we can also cause harm if we make key mistakes. As nurses, we must use whatever tools we have at our disposal to enhance our capacity to serve while reducing the possibility of making mistakes. This is a career that largely relies on information. That data must be valuable and meaningful. The characteristics of valuable and meaningful information include “accessibility, security, timeliness, accuracy, relevancy, completeness, flexibility, reliability, objectivity, utility, transparency, verifiability, and reproducibility” (McGonigle & Mastrian, 2017, p. 23).

We utilize informatics from the time a patient is admitted until they are discharged at the hospital where I am presently working. Patient identification mistake is one of the avoidable issues. If they have the same first or last name, they are emphasized with a distinct letter style. In a typical scenario we use Medical Record Numbers (MRNs), patient’s initials, picture identifications and Contact Serial Numbers (CSNs). Additionally, we ask the patient to identify their name, date of birth, and scan their ID bracelet before administering medication or performing any treatments. When we collect blood for type and cross match for transfusion, we utilize two RNs to verify the patient information and compare them to the EHR. Of course, we are worried that a mistake in identification might lead to incorrect treatment, which could have significant or even deadly implications.

Patient identification may appear to be a simple procedure, but it may be complicated and requires careful preparation and attention to minimize errors when the patient’s information is stored in electronic health records (EHRs). Although technology is important in this process, it cannot assure effective patient identification on its own. Staff also must be adequately trained (Office for the National Coordinator for Health Information Technology, 2016).

Nurse managers may use information systems in their decision-making process. It is important that managers use EHR in determining how information is organized and categorized within the EHR. Health informatics bridges the gap between technology and processes to increase productivity, enhance healthcare, improve treatment, and empower patients (Sweeney, 2017). Serving on the frontline of health care, RNs and NPs should ensure their organization’s procedures minimize the risk of patient misidentification. The Office for the National Coordinator for Health Information Technology (2016) provides a self-assessment guide that can assist in assessing an organization’s patient identification status. RNs and NPs should have a role in setting priorities among recommended practices not yet addressed by the organization and ensure a plan is in place to maintain recommended practices already in place. They should ensure resources are dedicated to make necessary improvements and minimize the highest priority patient identification-related safety risks introduced by the EHR.

Nursing informatics will continue to grow and impact healthcare. Knowledge development in healthcare doubled every century until 1900. Now, however, it is estimated that knowledge will double every 18 months. And the pace will only get faster. The traditional way of developing procedures, protocols and care pathways often become obsolete and outdated between initiation and when they are finalized. Best practices can change very quickly and nurses must keep up. The only way to keep up is to integrate and embed the new knowledge in electronic records using algorithms and decision support systems (Nagle et al., 2017).

References

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning

Nagle, L. M., Sermeus, W., Junger, Alain. (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/REF

Office for the National Coordinator for Health Information Technology (2016, September).  General instructions for the SAFER self-assessment guides. https://www.healthit.gov/sites/default/files/safer_patient_identification.pdf

Sweeney, J. (2017, February). Healthcare informatics. Online Journal of Nursing Informatics (OJNI), 21( 1). https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=0&sid=6d52be0f-1109-4880-9113-9283e1b60660%40sdc-v-sessmgr03&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=128848047&db=rzh

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Goof insight Tae. As useful as technology can be, health care professional need to continue to be vigilant.

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6 months ago

ZULFIQAR ABBAS

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Hello Colleagues,

Currently, Information technology is a part of our daily life. IT is substantially involved in everyone’s life somehow for example, in school, work, personal life, or social aspects of our life as well. Nursing is also getting benefits from information technology. Nursing informatics is the integration of information technology with clinical nursing, management, and research as well (Darvish, et al; 2014). Since I am a new nurse only have experience of less than a year in nursing. I have never practiced nursing in paper format charting. I have heard that paper charting has a lot of problems and a high rate of medication errors in nursing and leading to reversible and irreversible events in healthcare. The Application of Data to Problem-Solving Discussion Example Essays

Since I have graduated, I have been working in a skilled nursing and long-term facility. I learned that informatics plays a significant role in all nursing specialties, but I could say that it has great importance in my workplace. As all my patients and residents are elderly have a lot of medical problems and especially, I would say the vast majority have dementia. These patients can’t remember their history, medical problems, and medications. The only source to get this information from is the Electronic Health Record. Informatics the EHR provides the maximum information to make a reasonable decision for the patients. Besides getting their health information we can also add and modify the plan of care, and they also access and update their demographic information.

A few weeks ago, I have been working as a float suspender/supervisor nurse over the weekend and floor nurse. One of the floor nurses came to me and asked about the Augmentin suspension for one of the very old residents who just came back from the hospital after being treated for sepsis and cellulitis there. I had work lately with the same resident and I do remember that she had already completed her Augmentin course a couple of days ago. I double-checked with the nurse and told her that she had completed oral antibiotics a couple of days ago. She was not sure, so I log in and showed her the orders and the last day of administration. Informatic the HER helped and prevented the medication error promptly. According to the Department of Health and Human Services, health information technology (HIT) helped in improving patient safety and quality of care (Paaske, et al; 2017). Patients and healthcare provider can access their records remotely rather than need a paper chart in the facility. According to the Center of Medicare & Medicaid Services (CMS), the meaningful use of informatics in healthcare reduces the patients’ harm and increases the reimbursement for the organization (Webb, 2021).



      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.

Paaske, S., Bauer, A., Moser, T., & Seckman, C. (2017). The benefits and barriers to RFID technology in healthcare. On-Line Journal of Nursing Informatics, 21(2).

Webb, N. (2021 Nursing Informatics as Caring: A Literature Review. Online Journal of Nursing Informatics

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Zulfiqar. Your post leads me to a question…

Class:

How could data collection on medication errors be used to prevent future errors?

Dr. Moyers

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6 months ago

Jessica Ferrin

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Dr. Moyers,

Data collection on medication errors can be used to prevent future errors by identifying the root cause of the error. For example, Bekes (2021) collected data on the setting, intervention, problem, and major findings as they studied pediatric medication errors. They used this data to formulate strategies to reduce medication errors in the pediatric perioperative area. Medication errors are so unfortunate, but as nurses we have an obligation to learn from those errors to prevent future errors from occurring. This is when data collection coupled with root cause analysis benefits both patients and practitioners equally.

References

Bekes, J. L. (2021). Pediatric Medication Errors and Reduction Strategies in the Perioperative Period. AANA Journal, 89(4), 319–324.

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6 months ago

Chaquita Nichols

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Congratulations on your journey into the nursing world. The more you do, the more knowledge you will gain. “Knowledge is the awareness and understanding of a set of information and ways that information can be made useful to support a specific task or arrive at a decision” (McGonigle D., Mastrian K. G. pp.9). Healthcare is constantly changing so we as nurses must learn to adapt. I have experienced paper charting and it is a big mark for error. One main thing was legibility. We really had a hard time reading each other’s handwriting. I am very happy with how far technology has come. Nursing informatics has played a part in designing a system for nurses. “The American Nurses Association (ANA) identified nursing informatics as “a specialty that integrates nursing, science, and information science to manage and communicate data, information, and knowledge in nursing practice” (Sweeney, J (n.d.)). I agree that a lot of patients are poor historians and, in your case, have dementia. I like that we can gather patient’s information from outside sources. For instance, if the patient doesn’t know their medications, we can pull up their pharmacy information to see the medications they were taking. It is important that nurses have access to patient information so we can provide quality care. “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” (McGonigle D., Mastrian K. G. pp.9).

References

McGonigle, D., & Mastrian, K. G. (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).

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6 months ago

Paola Gaudioso

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Scenario

For the last 6 years of my career, I have worked in the intake department of a behavioral health inpatient facility. There is a CABA questionnaire that is given to each adolescent patient and guardian when they are admitted into the facility and upon discharge. We are what is considered a level 1 facility where we treat acute mental health crises such as suicidal, homicidal, and actively psychotic patients. This assessment Child and Adolescent Behavior Assessment Scale are used to assess the patient’s behavior issues through both the patient and guardian.

Data Accessed

The data that is gathered from the initial CABA-Y will tell the clinical team how the patient is feeling and behavioral issues when they are admitted into the facility. The initial CABA-I is filled out by an adult that knows the patient’s behaviors. This can help the healthcare team determine consistency in the child’s behaviors and emotions. This data can help in treating the patient in an inpatient setting because you can rate the changes with the discharge assessment. Being able to see how the child was feeling and their behaviors from when they came into the facility and when they left is important to show that their mental health changed with medication management and groups. According to Morin et al. (2017), the scale is the basis for treatment.

Knowledge derived from the Data

The data from the CABA can be compiled and assessed to make sure that the patient’s needs are being met during treatment and what needs to be changed to help meet the needs if need be. Informatics comes to play when the data is gathered and analyzed by the team to determine what needs to be changed or what is working in the program being used to treat patients. Sweeney (2017) states that gathering the data is easy but putting it together to analyze it is where nursing informatics comes into play.

Clinical Reasoning and Judgment

Clinical reasoning and judgment can be made by gathering the data of these assessments scales to decide if patients are receiving the proper care. Being able to analyze the data and give feedback to the treatment team is the most important part. This data is important because it is one tool that can help determine if the level of care was conducive to the child’s care.

Application of Data

According to Morin et al. (2017), the CABA gives hospital staff an actual number when gathering information to determine the severity of the issue or behavior at intake and discharge in a simple questionnaire. The data can be applied in many ways once it is gathered. it can help staff change their programs to meet the needs of the clients. The data can also be addressed to group patients with like issues to treat them in a group together.

Conclusion

Informatics has a growing role in health care. there are so many ways that nurses are needed in this field to gather information. As health care evolves nurses can help use the information gathered in the delivery of care (Nagle, Sermeus, & Junger, 2017).

References

Morin, A. L., Miller, S. J., Smith, J. R., & Johnson, K. E. (2017). Reliability and Validity of the Child and Adolescent Behavior Assessment

(CABA): A Brief Structured Scale. Child Psychiatry and Human Development, 48(2), 200–213. https://doi-org.ezp.waldenulibrary.org/10.1007/s10578-016-0632-9

Nagle, L., Sereus, 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 Connecting Health (212-221). Clifton, VA: IMIA and IOS Press.

Retrieved from http://serval.unil.ch/respurces/serval:BIB_4A0/fea56B8CB.p001/REF

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4-1.

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6 months ago

April Ward

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Response #2

Paola,

I want to say what a good discussion post you wrote! It was very interesting and I am glad to see others who also work in mental or behavioral health. Adolescent mental health care is so vital to get started as soon as symptoms are noted. The use of the CABA questionnaire, as you stated, would prove to be very valuable for a before and after assessment tool.

Your informative post made me want to look up more information pertaining to this topic. Here in Mississippi, we have a Youth Risk Behavior Surveillance System (YRBSS) survey.  This survey asks questions pertaining to youth health and safety, violence, depression symptoms, drug, alcohol and tobacco use and any suicide attempts the youth may have made. The survey is completed by adolescents in several Mississippi middle and high schools every two years (Mississippi State Department of Health, 2017).

According to the Substance Abuse and Mental Health Data Archive (2019), the National Health Services Survey (N-MHSS) is another type of survey that assesses data on mental health services in mental health treatment facilities. This survey is used and information is obtained in all 50 states.

References

Mississippi State Department of Health (2017). Youth risk behavior surveillance system (YRBSS).  Retrieved from https://msdh.ms.gov/msdhsite/_static/31,0,299,363.html

Substance Abuse and Mental Health Data Archive (2019).  National mental health services survey (N-MHSS). Retrieved from

https://www.datafiles.samhsa.gov/dataset/national-mental-health-services-survey-2019-n-mhss-2019-ds0001

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6 months ago

Paola Gaudioso

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April,

I think that mental health needs to be incorporated into schools for teenagers. It is so important for them to know how to deal with issues. I feel that some kids are not given the proper tools to deal with different situations that arise and then end up in crisis. If schools incorporated this it could reach many children and give them building blocks to know what to do to avoid a crisis situation.

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6 months ago

Tammy Rodgers

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The Application of Data to Problem Solving

Healthcare Scenario

Seclusions and restraints are considered to be invasive procedures in the psychiatric setting and should always be utilized as a last resort (Al-Maraira & Hayajneh, 2019). These interventions should only be conducted when a patient is considered a harm to themselves or others and any attempt to verbally deescalate the patient has failed. Studies show that seclusions and restraints can cause harmful effects to a patient both psychologically and physically, especially if they suffer from previous trauma history (Chieze, et al., 2019). It is because of this that seclusions and restraints are closely monitored by state and national regulatory bodies and any increasing trend in seclusions and restraints within a facility need to be analyzed and critiqued for performance improvement. The purpose of this discussion is to pose the hypothetical scenario of an increase in seclusion and restraints within the facility, analyze data collection, and determine what knowledge can be gained with the information gathered.

Data to be Accessed

The number of seclusions and restraints can be tracked by gathering the incident reports from the required documentation packets and breaking them down to methods used, which unit or population where intervention occurred, and patient status prior to intervention. The data can also identify staff members working with the patient prior to the episode.

Clinical Reasoning and Judgement

.Collecting proper data that has both quality and integrity is essential to gaining valuable information that can be used to improve patient care (McGonigle & Mastrian, 2017, p. 23), and as a safety committee member and frontline worker, the opportunity to provide assistance to data analysis can be beneficial to identify causative factors for the increase in restraints.

The data that is collected can identify which techniques were utilized the most, justification of the intervention, which population experienced an increase in episodes, and which staff members were working the unit during the episodes. Once broken down into these categories, it can be determined whether the issues lie in the patient population dynamic, uneducated staff members that may need retraining, or staff that requires disciplinary action due to possible retaliation or unjustified interventions.

Application of Data

Once a primary causative factor has been determined, for instance, unit population dynamic on a particular unit, as a nurse in charge of the unit, a program change can be implemented that separates the population into groups that are to be kept apart during programming hours to de-escalate patient behaviors and triggers, therefore preventing restraints and seclustions. Data can be reanalyzed after a week to determine if there has been a decrease in the data trend. The Application of Data to Problem-Solving Discussion Example Essays

Conclusion

The invasive nature of restraints and seclusions can potentially be detrimental to patient status and must be used only as a last resort. These interventions are closely monitored by regulations and an increase in episodes will need to be analyzed followed by a performance improvement initiative. As frontline workers, nurses can help identify possible causative factors by reviewing the data, which in this case indicated a patient population issue, and suggest ways to combat the problem from a unit perspective that can decrease the invasive intervention and improve patient outcomes.

References

Al-Maraira, O. A., & Hayajneh, F. A. (2019). Use of restraint and seclusion in psychiatric settings: A literature review. Journal of Psychosocial Nursing and Mental Health Services, 57(4), 32–39. https://doi.org/10.3928/02793695-20181022-01

Chieze, M., Hurst, S., Kaiser, S., & Sentissi, O. (2019). Effects of seclusion and restraint in adult psychiatry: A systematic review. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00491

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

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6 months ago

Sophie Enjema Ndumbe

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Hello Tammy,

Nice write up, I agree with you that collection of proper data is necessary before restraining or secluding a patient. The nurses must follow the policy and procedures of their facility before secluding or restraining a patient. The nurse must have an order from the patient’s power of attorney, physician, and they should try all other interventions first. According to Dean (2007) patients have the right to be free from seclusion and restraint which are unnecessary. Facilities or organizations can use restrain to ensure safety of the patients and staff members. Restrain and seclusion is mostly common in psychiatric settings, proper assessment of patients and training of staff is necessary to reduce the rate of restrain and seclusion of patients. Restraint or seclusion should be the last resort.

Proper assessment must be done which will include a health history, physical examination, list of current medications, laboratory tests. When proper data is not collected about the patient treatment will be delayed and this will pose more risk to the patient and the organization. The use of restrain can causes physical harm to patients (Duxbury et al.,2019).

References

Dean KA. (2007). To restrain or not to restrain? Florida Nurse, 55(2), 17–18.

Duxbury, J., Thomson, G., Scholes, A., Jones, F., Baker, J., Downe, S., Greenwood, P., Price, O., Whittington, R., & McKeown, M. (2019). Staff experiences and understandings of the restrain yourself initiative to minimize the use of physical restraint on mental health wards. International Journal of Mental Health Nursing, 28(4), 845–856. https://doi-org /10.1111/inm.12577

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6 months ago

Kene Fall

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6 months ago

salome ugwu

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6 months ago

Tina Alino

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Hello Salome,

The Healthcare system is a place where change is inevitable. The world is changing by making everything computerized, and the healthcare system is changing with them. I agree with you that working in an environment where everything is computerized decreases the number of medical errors seen.  According to Agrawal, 2009, systems that use information technology (IT), such as computerized physician order entry, automated dispensing, barcode medication administration, electronic medication reconciliation, and personal health records, are vital components of strategies to prevent medication errors, and a growing body of evidence calls for their widespread implementation (p.1).

I also worked in a long-term care facility as a new nurse, and I agree with you that there are so many medical errors in such facilities due to charting on paper. I remember witnessing a nurse that forgot to pass some medicationS to this patient, and because all she needed to do was to go and mark in the paper that she already gave those medications, she was not worried about it. Things like illegible handwriting is also a problem and can lead to diagnosing and ordering errors (Edwards and Moczygemba, 2004).

References

Agrawal A. (2009). Medication errors: prevention using information technology systems. British journal of clinical pharmacology, 67(6), 681–686. https://doi.org/10.1111/j.1365-2125.2009.03427.x

Edwards, M., & Moczygemba, J. (2004). Reducing medical errors through better documentation. The health care manager, 23(4), 329–333. https://doi.org/10.1097/00126450-200410000-00007

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Good insight Tina.  Technology has provided a platform for legible writing, which has served to increase safety and improve outcomes.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Salone. I really do like electronic health records. They are only been in existence for about 20 years, but I think they have prevented millions of medication errors over the last two decades.

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6 months ago

jennifer girgis

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Response 2.

Hi Salome thank you for your informative post.

In home care nursing, especially without electronic health records (EHRs) readily accessible before the visits, is very time-consuming. One can spend a lot of effort to prepare the necessary information for the patient and overlook some steps. In addition, pressure from variables (e.g., not finding internet hot spots due to location, electronic devices not working all of a sudden, time constraints) can affect accurate data gathering and documentation. Because of this situation, some use paper documentation, and some lead to EHRs workarounds. According to McGonigle & Mastrian (2018, p.23), accessibility, timeliness, accuracy, relevancy, and completeness are some characteristics of valuable, quality information.

When clinicians experience an EHRs system constraining their activities, it blocks their routines. As a result, some bypasses the system to what we call a workaround. It is skipping essential steps and data that others should have entered, but instead, other clinicians entered it for them or let EHRs guide the activities on the exact time but choose the latter. (Boonstra et al., 2021) Leading to improper documentation that could pose a danger on the part of the professional and patient.

With the use of EHRs, clinical reasoning, and judgment in forming knowledge, clinicians make a sound decision for patient well-being. Unfortunately, medication, medical, and diagnostic errors typically occur when any healthcare professional did not access EHR’s properly. (Kapaki & Souliotis, 2018) Medication errors are common wherever department it may be. But should be avoided at all costs. As a preventive measure in home care, as an example, clinicians check a patient’s medications with the discharge paper, EHRs medication list, and the actual medication bottles that the patient is currently taking, reporting them to providers if a discrepancy is present. Nursing leaders support and encourage these safety steps through staff need to be checking medication at each visit, weekly meetings paying attention to safety stories or concerns that others can learn from, and urging clinicians to make an incident report.

References

Boonstra, A., Jonker, T., Van Offenbeek, A.G., & Vos, J. (2021). Persisting workarounds in Electronic Health Record System use: types, risks, and benefits. BMC Med Inform Decis Mak, 21 (1), pp. 183.

Kapaki, V. & Souliotis, K. (2018). Defining Adverse Events and Determinants of Medical Errors in Healthcare. DOI: 10.5772/intechopen.75616

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

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6 months ago

Tina Alino

RE: Discussion – Week 1

COLLAPSE

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?

Description of Focus scenario

A patient advocate is what my healthcare scenario will be based on.

The scenario I choose to focus on involves a patient that was dropped off at the emergency department (ED) due to a non-healing wound to the sacrum and bilateral heel area. The patient was confused and weighed about 90pounds (looking so malnourished) with flexed lower extremities and flexed left arm. Upon assessing the patient, the nurse in charge opened what looks like a wound dressing to the patient’s sacrum, and maggots were falling out of the wound.

            I work in a med-surge unit as a bedside nurse, and as a bedside nurse, we see a lot of things and advocate for our patients as much as we can. I have come across patients that were neglected at home. Upon assessing my patient during admission, the kind of bruises and bedsores that I see on my patient can signal me to involve the patient advocate team to investigate the care the patient is receiving home. A patient advocate is an essential tool in nursing because we are the first to contact these patients, and for some of them who cannot verbally express themselves, we are to stand out for them. Patient advocacy is more like providing justice to our patients (Davoodvand et al., 2016).

Data that could be used and how the data might be collected and accessed

Data that could be used are information about patient’s upkeep at home. Information like; who is the primary caregiver of the patient at home? What caused the wound? How often does the patient get a bath? How well does the patient feed? In treating a patient, information gathered by any means can significantly guide and direct care (Nichol et al., 2020). Data can be collected by asking the patient and the family member who dropped the patient off some questions at the hospital. This is where the nurse also uses her nursing judgment to advocate for the patient by trying to gather all the necessary information about the upkeep of the patient.

Knowledge that can be derived from that data

Knowledge obtained from the data could give the provider more idea of how the patient was treated at home. That the patient appears to be neglected does not necessarily mean that the patient has been abused. It could be that patient’s provider is not knowledgeable on how to care for that patient. It is always essential that we base our care on facts when it’s hard to believe; we can collaborate with other healthcare teams for a better judgment.

Implementation of Nurse Leadership with clinical reasoning and judgment in the formation of knowledge.

Using clinical reasoning and judgment in the formation of knowledge requires nurses to know what it means to advocate for their patients. Nurses should be empathetic and protective of their patients. Knowing when to raise the alarm and involve an advocacy team in patients care is very important. A leader influences others in a good way, is a good team player, is a great teacher, is goal attainment, and is a motivator (Joseph and Huber, 2015). As a nurse leader, providing teaching to other healthcare providers, especially to new nurses, on how to advocate for their patients is very important.

Conclusion

Nurses have more direct interactions with patients and are ideally positioned to advocate for their patients. Being aware of the signs and symptoms of abuse can also help a nurse know when a patient needs help because some patients can be in an abusive home, but the fear of putting their family member in trouble might cause them to decide not to seek help.

References

Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: a qualitative study. Journal of medical ethics and history of medicine, 9, 5.

Nichol, J. R., Sundjaja, J. H., & Nelson, G. (2020, September 7). Medical history. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK534249/

Joseph, M. L., & Huber, D. L. (2015). Clinical leadership development and education for nurses: prospects and opportunities. Journal of healthcare leadership, 7, 55–64. https://doi.org/10.2147/JHL.S68071 The Application of Data to Problem-Solving Discussion Example Essays

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6 months ago

Kirsi Hoselton

RE: Discussion – Week 1

COLLAPSE

Hi Tina,

            I enjoyed reading your post. I think that patient advocacy is an essential part of nursing. Patient advocacy provides essential and effective nursing care (Shirmohammad, Abbaszadeh, & Ahmadi, 2016). It is crucial for the nurse’s role to provide empathy and advocate for patients (Shirmohammad et al., 2016). The collection of data provides health professionals with crucial information to be able to identify areas where the patient needs assistance. You make a good point regarding family interviews and asking various questions. Interviewing families can create a larger picture of the patients’ home situation. This includes the identification of physical or emotional abuse. Therefore, family members can be a credible source to gathering more information ( Lang, Marvel, Sanders, Waxman, Beine, Pfaffly, & McCord, 2002).

            As a clinical nurse, there have been numerous times that I have had to advocate for my patients. Especially, during the pandemic. For instance, health care is overloaded right now with the rise of COVID on top of everyday medical conditions. This has caused care to be overloaded in clinical, urgent care, and hospital settings. With virtual care on the rise to educate and treat patients regarding their symptoms. There have been a few incidences I had to explain to providers why a patient should be examined and treated in the clinic setting.

Patient advocacy puts a patient first and identifies the patients’ needs for better wellbeing. Patients rely on those around them with medical knowledge. This leads to optimal patient outcomes.

References

Lang, F., Marvel, K., Sanders, D., Waxman, D., Beine, K. L., Pfaff, C., & McCord, E. (2002, April 1). Interviewing when family members are present. American Family Physician. https://www.aafp.org/afp/2002/0401/p1351.html.

Shirmohammad, D., Abbaszadeh, A., & Ahmadi, F. (2016, June 11). Patient advocacy from the clinical nurses’ viewpoint: a qualitative study. US National Library of Medicine National Institutes of Health Search database PMC Search term Search. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958925/.

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6 months ago

Dorothy Chudi-Agbaku

RE: Discussion – Week 1

COLLAPSE

Hi Tina,

Your post is good. I wish to add that there are many other uses of knowledge derived from patient’s data. These data are collected through history taking, interview, assessments, and laboratory investigations and accurately recorded. And the information can be applied to ensure consistency in patient’s care, improve care, share information for better patient outcome and in healthcare research (University of Illinois, 2020). In terms of ensuring consistency of care to patient, a patient on admission maybe cared for by several doctors, nurses, and other professionals. And through logging in of patient care data, consistency is ensured for a better outcome. For example, I work in the post-partum unit and before we take a patient transfer from the labor and delivery (L/D), we go through the patient’s electronic medical record (EHR) to check the patient’s vital signs, blood loss, medications, current and previous medical history, and any other information of interest and these were recorded by other professionals either in the triage or L/D. The L/D nurse giving us handoff report may not give us half of the information we have already gotten about the patient through the data on EHR. The introduction of technology in healthcare system and the use of EHR has advanced patient’s care by promoting communication, minimizing medical errors, and supporting decision-making in delivery of quality care (McGonigle & Mastrian, 2017).

Dorothy.

References

McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

University of Illinois. (2020). 4 Uses for Patient Care Data. https://healthinformatics.uic.edu/blog/4-uses-for-patient-care-data/ The Application of Data to Problem-Solving Discussion Example Essays

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