NURS 6050 Application of Data to Problem-Solving
NURS 6050 Application of Data to Problem-Solving
Few professions in the modern era do not rely on data to some extent. Stockbrokers rely on market data to provide financial advice to their clients. Meteorologists use weather data to forecast weather conditions, while realtors use data to advise on property purchases and sales. In these and other cases, data not only aids in problem solving but also contributes to the practitioner’s and 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 for NURS 6050 Application of Data to Problem-Solving:
- 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 of NURS 6050 Application of Data to Problem-Solving
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?
I currently work in the emergency department where they use data in many ways to improve the flow and outcomes of the department to enhance patient care. My suggestion for them would be to collect a “door to disposition time”, as stated in the Society for Academic Emergency Medicine (2018) “a good clinician thinks about patient disposition from the moment he or she enters the room.” First, a goal should be set to be able to determine if the desired outcome was achieved. For example, a goal door to disposition time could be 3 hours. This time clock can start from the time of a patient’s registration to the time the physician decides to admit or discharge a patient. This would mean counting how long it takes the department to get a patient triaged, see a doctor, complete any imaging or lab work, treat, and decide the final plan of care for the patient. This clock can also be available for all providers to access and see in the patient’s electronic medical record chart.
“Leadership is defined as the art of influencing others to achieve their maximum potential to accomplish any task, objective, or project” (Specchia et al., 2021) A nurse leader could use the data collected from the door to disposition time clock to determine what the delays are in getting a patient admitted or discharged. Is there a delay in being seen by a doctor? Is there a delay in collecting blood work or urine samples? Is there a delay in administering medications? These questions could all be answered by a nurse leader using clinical reasoning and the knowledge they have gained from the door to disposition time to evaluate where the delays are coming from so that they can develop a plan to make any necessary improvements to get a patient discharged or admitted sooner. As Gruppen (2017) stated, “most educational interventions that focus on clinical reasoning are also (perhaps implicitly) conveying knowledge in critical areas of medicine and it is this knowledge acquisition that fosters better performance.” A nurse leader can then reevaluate the success of their improvements by analyzing the door to disposition time and make any further adjustments as necessary. The nurse leader can then continue the process of clinical reasoning until they reach their goal door to disposition time.
Gruppen L. D. (2017). Clinical Reasoning: Defining It, Teaching It, Assessing It, Studying It. The western journal of emergency medicine, 18(1), 4–7. https://doi.org/10.5811/westjem.2016.11.33191
Society for Academic Emergency Medicine (2018). Disposition of the Emergency Department Patient. Society for Academic Emergency Medicine. https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m3-curriculum/disposition/disposition-of-the-emergency-department-patient
Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership Styles and Nurses’ Job Satisfaction. Results of a Systematic Review. International journal of environmental research and public health, 18(4), 1552. https://doi.org/10.3390/ijerph18041552
By Day 6 of Week 1 of NURS 6050 Application of Data to Problem-Solving
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Elizabeth, Great discussion. Healthcare and nursing informatics are vastly growing fields within the medical field and continuously incorporate new and evolving technology (Sweeney, J., 2017). The steps of using information, applying knowledge of the data to a problem, and acting with wisdom are the basis of a nursing science practice (McGonigle, D., & Mastrian, K. G., 2022). How do you think these practices will grow to further monitor ED practices to allow for growth, better care for the patients, and improve disposition time? Do you see growth will help the patient and nurse have better outcomes in the ED?
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1).
I believe that growth will help the patient and nurse have better outcomes in the emergency department. Nursing is always changing with new evidence-based practices providing us with many options to improve our nursing skills. So yes, I believe these practices will grow to better monitor these ED patients in a positive way.
One challenge the nurse leader might experience could be implementing the changes that have been created to meet the overall goal. One problem involved with implementing change is short staffing in not only the emergency department but also in the lab department, imaging department, environmental services, and registration. All these departments are working together to make a successful visit for each patient but, if they don’t have the staff to be successful then the appropriate changes might not take effect. Some of our staff have been replaced by travelers who might only be with us for eight weeks so having consistency with regular staff who can maintain these changes could also become troublesome.
Another challenge within the knowledge model could be obtaining the knowledge. If the data cannot be consistently collected that could skew the results and the goal might not be appropriately met. The emergency department is open 24/7, 7 days a week, 365 days a year. The number of patients that arrive in the department can be very different when comparing daytime vs nighttime, weekends vs weekdays, holidays, etc. Data should be collected with the knowledge of these various factors to be able to overcome this challenge.
I agree that implementing changes when the unit is short-staffed can be challenging. According to Saxton & Nauser (2020), ED nurses are the most difficult to retain, and it is estimated that 20% of RNs leave within the first year of hire while 33% leave within two years of hire. Nurses leave their jobs based on factors such as a lack of administrative support, unhealthy work environments and inappropriate staffing, all of which can be frustrating barriers to effective care delivery (Delgado, 2021). Shortage in other departments does not help implement changes either as staff continues to quit the healthcare career altogether. The hiring process can be lengthy because the applicants may not fit the position requirements when the department implements changes. To attract high-quality employees that do their best work requires the organization to use information technology.
Delgado, S. (2021). Nurse staffing: A reason to leave and a reason to stay. American Association of Critical- Care Nurses. https://www.aacn.org/blog/nurse-staffing-a-reason-to-leave-and-a-reason-to-stay
Saxton, R., & Nauser, J. (2020). Students’ experiences of clinical immersion in operating room and emergency department. Nurse Education in Practice, 43 doi:http://dx.doi.org/10.1016/j.nepr.2020.102709
Good day, Elizabeth.
Thank you for taking the time to share your thoughts with us this week.
In many ways, healthcare technology and innovation can help us improve our work flow in hospitals and health-care facilities.
Remote patient monitoring and wearable technology
In both inpatient and outpatient settings, healthcare wearables are increasingly being used to promote patient involvement.
Wearable technology can assist in obtaining a comprehensive picture of a patient’s vital signs, including pulse, temperature, respiration, blood pressure, and heart rate.
Instead of manually monitoring and documenting vital signs once or twice a day, the information is automatically logged throughout the system, supporting data-driven decision making.
Mobile apps are being used to increase patient involvement.
Consider anything you might need, and chances are you’ll be able to find an app for it. So, what’s the deal with healthcare delivery lagging behind? Mobile health apps are proven to be a viable technique for increasing patient involvement and improving the hospital experience. From medication reminder apps to mobile patient portals that provide you an overview of the therapy being administered in the palm of your hand, mobile apps in the healthcare field are here to stay.
Patients can also get automatic reminders to refill their prescriptions, which will improve their health.
You may be aware of the HillRom hospital beds’ ability to continuously monitor heart rate and respiratory rate via a contact-free method while patients are in bed. This is great because we only get vital signs on an interval basis. Heart rate isn’t continuously monitored on a regular ward unless the patient is on telemetry. There isn’t always a need for telemetry, but even patients without cardiac history can deteriorate. Unless we are in their room constantly, we may not be aware until it is too late. “Despite the Q4 standard for vitals, intervals between vitals can be eight hours or longer…Unrecognized patient deterioration may occur during these intervals.”(210721-en-r2_centrella-bed-hr-rr_brochure-hr.pdf, 2021) The beds don’t transmit to the EMR, the ones at my hospital don’t, but they have an audible alarm for when the heart rate and respiratory rate are out of range. We have only been using this function for two months, and it has alerted me on two occasions to deterioration of my patient. Both times, the patient was stabilized before they got worse.
Another remote monitoring technology that has advanced recently monitor pacemakers. Patients now have the ability to interrogate their devices at home. They used to be able to do a basic check on the device by placing their phone over their pacemaker, but now they can do so much more. It is amazing how technology can positively impact healthcare.
210721-en-r2_centrella-bed-hr-rr_brochure-hr.pdf [PDF]. (2021). Retrieved March 4, 2022, from https://www.hillrom.com/content/dam/hillrom-aem/us/en/marketing/products/contact-free-continuous-monitoring-powered-by-earlysense/documents/210721-EN-r2_Centrella-Bed-HR-RR_Brochure-HR.pdf
Read Also: NURS 6050 Nurse Leader as Knowledge Worker