NURS 6051 Discussion Application of Data to Problem-Solving

Walden University NURS 6051 Discussion Application of Data to Problem-Solving-Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University NURS 6051 Discussion Application of Data to Problem-Solving assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for NURS 6051 Discussion Application of Data to Problem-Solving                     

 

Whether one passes or fails an academic assignment such as the Walden University NURS 6051 Discussion Application of Data to Problem-Solving depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

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The introduction for the Walden University NURS 6051 Discussion Application of Data to Problem-Solving is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

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After the introduction, move into the main part of the NURS 6051 Discussion Application of Data to Problem-Solving assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for NURS 6051 Discussion Application of Data to Problem-Solving                     

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for NURS 6051 Discussion Application of Data to Problem-Solving                     

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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A Sample Answer For the Assignment: NURS 6051 Discussion Application of Data to Problem-Solving

Title: NURS 6051 Discussion Application of Data to Problem-Solving

NURS 6051 Discussion Application of Data to Problem-Solving

NURS 6051 Discussion Application of Data to Problem-Solving

I like your senario  and would to emphasize the need for health care staf to learn how to navigate health informatics like EPIC. It is like an acquisition, storage, retrieval and use of health information.  Health informatics promotes efficient and effective patient care through the fluid transmittance and retrieval of health care information.  The use of technology such as computer systems, software and other technologies promote informatics.  A good and simple example of the efficiency and importance of informatics can be seen when considering mail via the post office and emails via computer systems and network.

The delivery of mail using email transmittance allows for the quick, efficient and certain delivery of information.  Sending information through the post office takes time, vulnerable to be lost as well as being damaged.  The same efficiency is needed in addressing patient Care as patients lives at times will be dependent on the efficient transmittal of information.  A patient, for example, that meets in a car accident and requires emergency surgery, would benefit from health informatics as the patient’s medical history is readily retrievable from a health care informatics system that links providers to each other.  Imagine calling around for patient information or worst yet, writing letters to request patient information.  Antiquated systems can jeopardize patient care and patient safety (Alotaibi and Frederico, 2017).

As the main health care personnel, nurses are charged with the responsibility of operating systems that utilize informatics.  In addition, nurses should be able to efficiently and fluently use those systems.  It is therefore important that nurses understand the full purpose of informatics as well as to navigate any system in their network that utilizes informatics.  This is a critical part of nursing care as it promotes proper nursing care for patients as well as to increase positive outcome for the patients as well.  Informatics should also be part of the core curriculum in nursing school because it teaches student nurses how to better care for their patients (Leung et. al., 2015).  In addition, this core curriculum should again be reinforced in the clinical setting, as there are nuances to different informatics network systems.

The nurse should be familiar with these nuances so that they can best utilize the system when dealing with health informatics.  Nurses understanding and use of informatics should be greater than any other personnel in the clinical setting as the nurse is the main point of contact for patient care.  A nurse, for example, may alert the doctor or others of a patient’s pre-existing conditions or allergies thereby preventing any type of accident.  The nurse should also be able to properly train other personnel in using health informatics.  In training a new on how to use health informatics, it is also important that the nurse possess basic technology skills such as computer skills and understanding how software works.  Health informatics is the wave of the future and the nurse should also be at the forefront of this wave as it directly impacts patient care and patient outcome.  It has also been shown that hospitals that uses health informatics efficiently, has more positive patient outcomes (Snyder et. al., 2011).

References:

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on

patient safety. Saudi medical journal, 38(12), 1173–1180.

Snyder, C. F., Wu, A. W., Miller, R. S., Jensen, R. E., Bantug, E. T., & Wolff, A. C.

(2011). The role of informatics in promoting patient-centered care. Cancer journal (Sudbury, Mass.), 17(4), 211–218.

Leung AA, Denham CR, Gandhi TK, Bane A, Churchill WW, Bates DW, et al. A safe

practice standard for barcode technology. J Patient Saf. 2015;11:89–99.

Sample Answer for NURS 6051 Discussion Application of Data to Problem-Solving Included

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 is heavily reliant on data as well. Nursing informatics seeks to ensure that nurses have access to the most up-to-date information in order to solve healthcare problems, make decisions in the best interests of patients, and contribute to knowledge.
In this Discussion, you will consider a scenario that would benefit from data access and how such access could aid in problem solving and knowledge formation.

To Get Ready:

• Consider the informatics and knowledge work concepts presented in the Resources.
• Consider a hypothetical scenario based on your own healthcare practice or organization in which data access/collection and application would be required or beneficial. Your scenario could include a patient, staff, or management issue or gap.

By the third day of Week 1,

Post a description of your scenario’s main point. Describe the data that could be used as well as how it could be collected and accessed. What kind of knowledge could be derived from that data? How would a nurse leader apply clinical reasoning and judgment to learn from this experience?

By Week 1’s Day 6

Respond to at least two of your colleagues* on two different days, asking clarifying questions about the

scenario and data application, or offering additional/alternative ideas for applying nursing informatics principles.
Click the Reply button to the right to reveal the textbox where you can enter your message. Then, to post your message, click the Submit button.
*Note: Throughout this program, your fellow students are referred to as colleagues.
TINA

Week 1 Discussion Post

Importance of Data Collection

The collection of data in healthcare is crucial in improving patient outcomes. Healthcare is ever-changing, with improvements occurring continuously (Laureate Education, 2018). Nurses must be involved in data collection and understand the importance of the interpretation of this data. Then the information can be used to treat patients more effectively, offer a comparison, and give a more tailored plan of care.

ESAS Data Collection

In my current job, we collect data using the Edmonton Symptom Assessment Scale (ESAS). The ESAS symptom tool was initially developed in 1991 to gauge symptom burden in palliative/hospice patients (Hui and Bruera, 2016). On each visit with a patient, they are asked to rate nine symptoms on a zero to ten scale, with ten being the worst possible. Symptoms include pain, depression, and shortness of breath, to mention a few. If unable to rate the nurse rates based on observation. Once the data is collected, it is stored in the EHR and can be viewed at any time.

The tool is useful mainly for the comparison of symptom reports and the management of those symptoms. For example, the management of a patient’s pain is crucial in hospice care. If pain was reported and the medication regimen changed or increased, the data collected through the ESAS would help determine if the change was effective. This would be seen by a decrease in the rating for pain with each visit. If the data shows the patient is rating pain at the same level or higher, we would know medication adjustments are warranted again. With this data available and knowing how to interpret it, patients can receive the care they deserve.
Nursing is an “information-intensive profession” (McGonigle and Mastrian, 2017). We, as nurses, must collect, process, and use the data collected every day. As nurse leaders, interpreting the data is critical to providing the best care possible. Data collection, interpretation, and use will continue to be a part of nursing that can be used to improve patient outcomes.

References

Hui, D., & Bruera, E. (2017, March). The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments. Journal of Pain and Symptom Management. Retrieved November 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337174/
Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed., pg.9). Burlington, MA: Jones & Bartlett Learning.

Response

Hello Tina,

This is insightful. The application of healthcare data is important in improving treatment processes. Healthcare data is important in research and evidence-based practice. The success of healthcare practices depends on the accuracy of methods used in data collection. The ESAS symptom tool is one of the most common methods of data collection; the tool was designed to aid the assessment of nine common symptoms of cancer, including nausea, tiredness, pain, depression, drowsiness, anxiety, wellbeing, appetite, and shortness of breath (Hui & Bruera, 2017). The system has successfully been used by different healthcare organizations to collect and analyze patients’ data. The data collected by this tool can be analyzed to enhance quality improvement processes (Moskovitz et al., 2019). For instance, data on pain can be used to enhance pain management among cancer patients and other patients involved in the treatment processes. The data collected can also be used in the determination of trends of healthcare delivery (Pastorino et al., 2019). From the discussion, one of the questions I would ask is; what types of data are collected by The ESAS symptom tool? How can this data be analyzed to determine trends in healthcare delivery processes?

 References

Hui, D., & Bruera, E. (2017, March). The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments. Journal of Pain and Symptom Management. Retrieved November 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337174/
Moskovitz, M., Jao, K., Su, J., Brown, M. C., Naik, H., Eng, L., … & Liu, G. (2019). Combined cancer patient–reported symptom and health utility tool for routine clinical implementation: a real-world comparison of the ESAS and EQ-5D in multiple cancer sites. Current Oncology, 26(6), 733-741. https://doi.org/10.3747/co.26.5297
Pastorino, R., De Vito, C., Migliara, G., Glocker, K., Binenbaum, I., Ricciardi, W., & Boccia, S. (2019). Benefits and challenges of Big Data in healthcare: an overview of the European initiatives. European journal of public health, 29(Supplement_3), 23-27. https://doi.org/10.1093/eurpub/ckz168

RE: Discussion – Week 1 initial post

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I have spent the last 10 years working in emergency rooms as a staff nurse. One of the biggest challenges that my department faces regularly is delays with getting admitted patients out of the ED and onto their assigned units. These delays negatively impact the patients waiting for emergency treatment in the lobby and hallway stretchers. There are a number of factors that can prolong ED length of stay. Some of these include lack of bed availability due to hospital overcrowding, treatment delays such as loss of IV access, and delays caused by hospital personnel during the handoff report process (Paling et. al, 2020). Some of these factors, such as hospital overcrowding, are unavoidable and difficult to work around, which is why it is important for hospitals to assess which factors they can control to expedite patient flow out of the emergency room.

For my hospital’s scenario, the emergency department would collect data about admission delays that are specifically caused by disruptions in the nursing telephone report process. In my current workplace, there is not a standardized electronic handoff form, despite the fact that several studies have demonstrated the efficiency and increased patient safety outcomes associated with the transition to standardized electronic nursing report (Wolak et al., 2020). Instead, the ED nurse calls the receiving unit on the telephone, gives a verbal patient care handoff, and then transfers the patient to their hospital room. By collecting data about where in the handoff process delays are occurring, the ED could try to streamline the handoff process with the medical floors

The emergency department nurses would collect quantitative data about the length of time between the first attempt to call report to the medical floor, and the time of the patient’s actual departure from the ED. The data would be recorded in the section of the EMR called “time to disposition” for each patient that is admitted.

The ED leadership team could then pull a certain number of charts per month (or all the admission charts, if time allowed) and assess how long it takes on average for patient transfer to happen after report. Generally, most hospitals set their goals for disposition time for handoff and transfer within a 30-minute window (Potts et. al., 2018). If there are frequent delays causing transfer time to take greater than 30 minutes, the ED leadership team or unit-based council could meet with leadership from the floors where patient transfer takes the longest. By demonstrating the hard numbers associated with patient care delays, the teams could better understand the factors that lead to admission delays and work together to find solutions that expedite the admissions process.

References:

Paling, S., Lambert, J., Clouting, J., González-Esquerré, J., & Auterson, T. (2020). Waiting times in emergency departments: Exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data. Emergency Medicine Journal. https://doi.org/10.1136/emermed-2019-208849
Potts, L., Ryan, C., Diegel-Vacek, L., & Murchek, A. (2018). Improving patient flow from the emergency department utilizing a standardized electronic nursing handoff process. JONA: The Journal of Nursing Administration, 48(9), 432–436. https://doi.org/10.1097/nna.0000000000000645
Wolak, E., Jones, C., Leeman, J., & Madigan, C. (2020). Improving throughput for patients admitted from the Emergency Department. Journal of Nursing Care Quality, 35(4), 380–385. https://doi.org/10.1097/ncq.0000000000000462

Response

This is insightful Andrea; admission delays often lead to adverse treatment outcomes. The delays in patients’ admission to different hospitals are attributed to the increased number of patients or overcrowding. The impacts of delayed admission can be severe, including longer hospital stays, the inability of patients to access appropriate beds, and experienced healthcare experts (Goertz et al., 2020). Most patients leave without getting treatment due to delayed admissions to different healthcare facilities (Paling et al., 2020). There is a need for quality improvement to facilitate improvements in admission rates.

The quality improvements should rely on the data collected in the course of operation. The application of the EMR system is one of the best methods of data collection in healthcare (Pastorino et al., 2019). Measuring and recording the time taken during hospital admission is necessary for determining areas that require adjustments. Through the analysis of the collected data or information, healthcare institutions are able to initiate quality improvement processes and ensure effective outcomes in the management of patients. One of the questions that I would ask is: What variables ought to be involved in the data collection processes

References

Goertz, L., Pflaeging, M., Hamisch, C., Kabbasch, C., Pennig, L., von Spreckelsen, N., … & Krischek, B. (2020). Delayed hospital admission of patients with aneurysmal subarachnoid hemorrhage: clinical presentation, treatment strategies, and outcome. Journal of neurosurgery, 134(4), 1182-1189. https://doi.org/10.3171/2020.2.JNS20148
Paling, S., Lambert, J., Clouting, J., González-Esquerré, J., & Auterson, T. (2020). Waiting times in emergency departments: Exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data. Emergency Medicine Journal. https://doi.org/10.1136/emermed-2019-208849
Pastorino, R., De Vito, C., Migliara, G., Glocker, K., Binenbaum, I., Ricciardi, W., & Boccia, S. (2019). Benefits and challenges of Big Data in healthcare: an overview of the European initiatives. European journal of public health, 29(Supplement_3), 23-27. https://doi.org/10.1093/eurpub/ckz168

Importance of Data Collection

The collection of data in healthcare is crucial in improving patient outcomes. Healthcare is ever-changing, with improvements occurring continuously (Laureate Education, 2018). Nurses must be involved in data collection and understand the importance of the interpretation of this data. Then the information can be used to treat patients more effectively, offer a comparison, and give a more tailored plan of care.

ESAS Data Collection

In my current job, we collect data using the Edmonton Symptom Assessment Scale (ESAS). The ESAS symptom tool was initially developed in 1991 to gauge symptom burden in palliative/hospice patients (Hui and Bruera, 2016). On each visit with a patient, they are asked to rate nine symptoms on a zero to ten scale, with ten being the worst possible. Symptoms include pain, depression, and shortness of breath, to mention a few. If unable to rate the nurse rates based on observation. Once the data is collected, it is stored in the EHR and can be viewed at any time.

The tool is useful mainly for the comparison of symptom reports and the management of those symptoms. For example, the management of a patient’s pain is crucial in hospice care. If pain was reported and the medication regimen changed or increased, the data collected through the ESAS would help determine if the change was effective. This would be seen by a decrease in the rating for pain with each visit. If the data shows the patient is rating pain at the same level or higher, we would know medication adjustments are warranted again. With this data available and knowing how to interpret it, patients can receive the care they deserve.
Nursing is an “information-intensive profession” (McGonigle and Mastrian, 2017). We, as nurses, must collect, process, and use the data collected every day. As nurse leaders, interpreting the data is critical to providing the best care possible. Data collection, interpretation, and use will continue to be a part of nursing that can be used to improve patient outcomes.

 References

Hui, D., & Bruera, E. (2017, March). The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments. Journal of Pain and Symptom Management. Retrieved November 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337174/
Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed., pg.9). Burlington, MA: Jones & Bartlett Learning.

RE: Initial Post

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I appreciated reading your article. It is fascinating to hear the perspectives of various nursing specialties. You discuss the ESAS scale, which is used to measure symptom burden in patients receiving palliative care. This closely resembles a clinical institute of alcohol withdrawal assessment. In these evaluations, a form is filled out and a number appears. These are useful tools, but I’m curious about their potential future. How can we use information technology to improve the efficacy of these evaluations?
In my previous post, I mentioned the possibility of integrating all assessments into software that could potentially display the patient’s health trajectory. We do a great deal of legwork to collect and document these assessments, and it often feels as if we are not getting our money’s worth. Why isn’t this data being analyzed if it is being collected and recorded?

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I concur 100 percent. We collect so much information during admissions, evaluations, and discharges, but it is frequently underutilized. Our ESAS screenings utilize data to determine the likelihood of mortality or revocation. Even though the data has been compiled and is easily accessible, few people actually utilize it. In our current system, some of our nurses do not even know how to access it. It is very helpful for me to know how the patient is progressing and whether any adjustments are necessary. We appreciate your comment.

Sarah Gabua Walden Instructor Manager

RE: Initial Post

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Excellent post. Where would you look for the data that you are trying to address and how will this help your scenario?

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The information collected by the ESAS screening tool is readily accessible in the EMR of each patient. The likelihood of mortality or revocation is calculated based on the data entered by nurses during admission and routine visits. Each patient’s medical record contains a dashboard containing this information. It provides a visual representation of the patient’s deterioration or response to medication changes, as well as the data collected by visit date. This information helps us understand the progression of the disease and provides insight into what changes must be made to better manage pain, anxiety, and other symptoms. Thank you for your inquiry.RE: Initial Post
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This is illuminating. Utilizing healthcare data to enhance treatment procedures is crucial. Healthcare information is essential for research and evidence-based practice. The success of healthcare practices depends on the precision of data collection techniques. The ESAS symptom tool is one of the most prevalent data collection methods; it was designed to assist in the evaluation of nine common cancer symptoms, including nausea, fatigue, pain, depression, drowsiness, anxiety, wellbeing, appetite, and shortness of breath (Hui & Bruera, 2017).

Various healthcare organizations have utilized the system successfully to collect and analyze patient data. This instrument collects data that can be analyzed to improve quality improvement processes (Moskovitz et al., 2019). For example, pain data can be used to improve pain management among cancer patients and other patients undergoing treatment. The collected information can also be used to determine trends in healthcare delivery (Pastorino et al., 2019). What kinds of data are collected by the ESAS symptom tool? is one of the questions I would ask based on the discussion. How can this data be analyzed to identify trends in the delivery of healthcare?

References

Hui, D., & Bruera, E. (2017, March). The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments. Journal of Pain and Symptom Management. Retrieved November 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337174/
Moskovitz, M., Jao, K., Su, J., Brown, M. C., Naik, H., Eng, L., … & Liu, G. (2019). Combined cancer patient–reported symptom and health utility tool for routine clinical implementation: a real-world comparison of the ESAS and EQ-5D in multiple cancer sites. Current Oncology, 26(6), 733-741. https://doi.org/10.3747/co.26.5297
Pastorino, R., De Vito, C., Migliara, G., Glocker, K., Binenbaum, I., Ricciardi, W., & Boccia, S. (2019). Benefits and challenges of Big Data in healthcare: an overview of the European initiatives. European journal of public health, 29(Supplement_3), 23-27. https://doi.org/10.1093/eurpub/ckz168

RE: Discussion – Week 1 initial post

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I have spent the last decade as a staff nurse in emergency rooms. Delays in transferring admitted patients from the emergency department (ED) to their assigned units are a persistent obstacle for my department. These delays negatively affect the patients waiting in the lobby and hallways for emergency care. There are a variety of factors that can lengthen ED stays. Lack of bed availability due to hospital overcrowding, treatment delays such as loss of intravenous access, and delays caused by hospital staff during the handoff report process are a few of these issues (Paling et. al, 2020). Some of these factors, such as hospital overcrowding, are unavoidable and difficult to circumvent; therefore, hospitals must determine which variables they can influence to improve patient flow out of the emergency room.

For my hospital’s scenario, the emergency department would collect data on admission delays that are caused by nursing telephone report process disruptions. In my current workplace, there is no standardized electronic handoff form, despite numerous studies demonstrating the increased efficiency and patient safety outcomes associated with the adoption of standardized electronic nursing report forms (Wolak et al., 2020). Instead, the ED nurse contacts the receiving unit via telephone, provides a verbal handoff of patient care, and then transfers the patient to his or her hospital room. By collecting data on where delays occur in the handoff process, the ED could attempt to streamline the handoff process with medical floors.

The emergency department nurses would collect quantitative data on the duration between the patient’s first attempt to call the medical floor and their actual departure from the ED. The data would be recorded in the “time to disposition” section of the EMR for each admitted patient. The ED leadership team could then retrieve a certain number of charts per month (or all admission charts, if time permitted) and determine the average time it takes for patient transfer to occur after report. In general, the majority of hospitals aim to complete handoffs and transfers within a 30-minute window (Potts et. al., 2018). If frequent delays cause patient transfer times to exceed 30 minutes, the ED leadership team or unit-based council could meet with the leadership of the floors where patient transfer times are the longest. By demonstrating the hard numbers associated with patient care delays, teams could better comprehend the factors that lead to admission delays and work collaboratively to find solutions to expedite the process.

 References:

Paling, S., Lambert, J., Clouting, J., González-Esquerré, J., & Auterson, T. (2020). Waiting times in emergency departments: Exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data. Emergency Medicine Journal. https://doi.org/10.1136/emermed-2019-208849
Potts, L., Ryan, C., Diegel-Vacek, L., & Murchek, A. (2018). Improving patient flow from the emergency department utilizing a standardized electronic nursing handoff process. JONA: The Journal of Nursing Administration, 48(9), 432–436. https://doi.org/10.1097/nna.0000000000000645
Wolak, E., Jones, C., Leeman, J., & Madigan, C. (2020). Improving throughput for patients admitted from the Emergency Department. Journal of Nursing Care Quality, 35(4), 380–385. https://doi.org/10.1097/ncq.0000000000000462

RE: Discussion – Week 1 initial post

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Great post. What are some ways that you can bridge the gap between practice and knowledge?

RE: to Dr. Gabua
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Thank you, Dr. Gabua. In a large hospital, it can be difficult to bridge the gap between knowing that a process needs improvement and actually incorporating those improvements into daily practice. Once information regarding telephone report delays has been collected, it will be communicated to the nursing staff. Either the administration leadership team or the unit-based practice council could design an electronic report form and solicit feedback on the form through staff meetings. The staff can be trained on a new electronic report form in the EMR once the emergency department decides to take action to address the problem with patient care/transfer delays. The implementation of the new report system will require collaboration and targeted in-service training, but the benefits to the patients should be substantial.

RE: Main Post – Week 1
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Carter-Templeton (2019) describes the critical function of nursing informatics, which utilizes technology to collect data that will improve clinical processes and clinical judgment, hence enabling the development of future innovations. Carter-Templeton (2019) explains that the Alliance for Nursing Informatics (ANI) intends to transform healthcare through nursing informatics and by allowing ANI leadership to participate in educational opportunities that allow mentorships for a few years to create members who are skilled in communication, networking, negotiation, leadership, and management. Conduent Health Healthcare Provider Solutions (2017) has developed Midas’s online care management system, which transforms data into performance-enhancing information. Conduent Health Healthcare Provider Solutions (2017) provides examples of its capabilities, including as quality improvement and patient risk reduction, case management, and central line infection prevention.

Conduent Health Healthcare Provider Solutions (2017) states that it is the largest provider of business processes services with advanced capabilities in analyzing and processing data that is entered into the program to create interventions that directly affect the issue at hand to reduce any adverse risks that are currently occurring in a particular healthcare facility. Midas delivers and develops “an personalised patient care plan worksheet that incorporates goals, results, and actions to meet Joint commission requirements” (Conduent Health Healthcare Provider Solutions, 2017, para 8).

By assessing key events or data stated in the program, the Midas program demonstrates substantial value in producing interventions and favorable results for future nurse leaders. Midas can establish outcomes, but a nurse leader’s ability to comprehend the correct implementation of the outcomes enables him or her to employ clinical reasoning and knowledge-based judgment. Since there is a scarcity of bedside nurses, the nurse-to-patient ratio is an example of a metric that might be used to collect information on current healthcare challenges that are at a record high. Paulson (2018) describes a study and its findings in relation to nurse-patient ratios using nursing informatics.

The hypothetical situation, which will soon be less speculative due to the nursing shortage sweeping every hospital, is based on using the Midas program to enter information regarding when staffing requirements are not reached and how this directly impacts patient care. Paulson (2018) noted that modern hospital personnel compute hours per patient day using the average number of patients in a day multiplied by thirty-one or three hundred and sixty-five days per year. The hour per patient per day does not account for patient acuity, so the number of nurses remains the same regardless of whether patient acuity is average or above average.

Paulson (2018) stated that if staffing requirements were not reached on a unit, patient mortality would increase, as would patient mortality if the majority of nurses had less than two years of experience. During this epidemic, many experienced nurses have retired, departed, or accepted travel contracts; hospitals are left with novice nurses and an insufficient number of nurses to adequately staff the hospitals. In any hospital, Midas would be useful for tracking and monitoring mortality rates caused by a nursing shortage and untrained nurses. Through Midas, a nurse leader would utilize clinical judgment and experience to propose actions to reduce mortality in the unit and to guarantee that the unit is adequately staffed.

 References

Carter-Templeton, H., & Sensmeier, J. (2019). The Value and Impact of the Alliance for Nursing Informatics Emerging Leaders Program. CIN: Computers, Informatics, Nursing, 37(12), 612–614. https://doi.org/10.1097/CIN.0000000000000603
Conduent Health Healthcare Provider Solutions . (2017). Midas Health Analytics Solutions Care Management – Improving Patient Safety and Quality Management. Retrieved November 27, 2021, from https://downloads.conduent.com/content/usa/en/brochure/midas-care-management.pdf.
Paulson, R. A. (2018, July). Taking Nurse Staffing . Retrieved November 27, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039374/pdf/numa-49-42.pdf.

Sarah Gabua Walden Instructor Manager

RE: Main Post – Week 1
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Excellent article. Where would you look for the data you’re looking for, and how will this help your situation?

Initial Post  Discussion – Week 1

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The application of data to problem solving is the topic of this discussion.
Nursing informatics is crucial for the healthcare industry. The field of nursing informatics combines technology and data to generate new knowledge and evidence that can be utilized by society (Laureate Education, 2018). Nurses utilize nursing informatics by integrating analytical data and science through health information, technology tools, health portals, mobile applications, social networking, and telehealth platforms, thereby enhancing workplace communication and enhancing patient care. Successful health care professionals must be aware that informatics is a tool that, when used strategically and appropriately, can lead to positive outcomes (Laureate Education, 2018).

Identifying sepsis through our EMR system, EPIC, is a nursing scenario that involves the collection and application of data in my healthcare practice. EPIC enables registered nurses to input patient information. I currently work in a Surgical Trauma Intensive Care Unit where patient documentation is nearly minute-by-minute consistent. The Nursing Informatics Team at our hospital developed an epic-based sepsis flagging system that pulls patients’ vital signs (heart rate, blood pressure, temperature, and respirations) in conjunction with lab values (white blood cell counts). If a patient’s lab values and vital signs surpass a critical threshold, a pop-up sepsis alert will indicate that the patient is at risk for sepsis or may be experiencing a septic episode, which must be acknowledged by the nurse and then the provider.

This flagging system has been extremely effective in our unit, allowing nurses to implement sepsis treatments or prevent the onset of septicemia. This technological tool developed by the nursing informatics team to flag sepsis through our epic EMR system has decreased septicemia in the intensive care setting.
Nursing Informatic Specialists are an invaluable asset in the health care industry, where technological advancements occur almost daily. This will result in increased responsibility for nursing informatic specialists, thereby expanding their scope of practice as care evolves. In addition to the current competencies, they will be required to assist other clinicians, patients, and families in assuming new roles, and to use data analytics to interpret and appropriately apply new knowledge (Nagle, L. et. al, 2017).

 References

Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). What is Informatics? [Video file]. Baltimore, MD: Author.
Nagle, L., Sermeus, W. & Junger, A. (2017). Evolving Rôle 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

RE: Initial Post Discussion – Week 1
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Great post. What are some strategies for bridging the gap between practice and knowledge?

A patient or institution’s re-admission to the hospital within 30 days of discharge is a scenario that nurse care managers have been attempting to avoid, but it is still evident. There are numerous reasons why the healthcare system develops processes to reduce the readmission rate; the most significant consequences of readmission are negative effects on the health of the population, poor payor reimbursement or sanction for the institution, and a perception of low-quality service standards (Upadhyay., 2019). Effective discharge planning that includes a thorough assessment of the patient’s social determinants, readmission risk, and barriers to a safe transition to the home or care facility is one of the primary focuses for preventing rehospitalization.

Social determinants such as ability to function independently, place of residence, presence or absence of a support system, availability of transportation to or from appointments, presence of funding or resources to obtain medications, ability to comprehend instructions or level of comprehension, and access to primary healthcare providers are examples of information that must be addressed (Jack et al., 2013). The care team can collect this information from the patient, their family, or their source of support in the emergency department or upon admission, and a nurse care manager can review it at any time.

The information will aid the nurse care manager in determining what obstacles must be overcome and what post-hospitalization services or resources the patient will need to successfully manage their care outside the hospital. In addition to social determinants, the LACE readmission risk tool scoring system that considers length of hospital stay, acuity of admission, comorbidities, and emergency department visits can be used to determine the most suitable discharge location for patients who scored highly on this assessment (Miller et al., 2018).

A nurse leader could use the data obtained from the assessment of social determinants and risk scores to gather more information about effective post-hospitalization services in the community that can be offered to patients or their families in the future. It could also result in a review of the current affiliations with accountable care organizations that fail to provide transitional care or the formation of a new partnership with an organization that has the potential to maintain the patient’s optimal health outside the acute care facility. The establishment of a task force to target patients with a high risk of readmission and the development of post-discharge programs designed to maintain their health while keeping them out of the hospital are also potential outcomes of this experience.

 References

Jack, B., Paasche-Orlow, M., Mitchell, S., Forsythe, S., & Martin, J. (2013). Re-engineered discharge (red) toolkit. AHRQ. Retrieved November 26, 2021, from https://www.ahrq.gov/sites/default/files/publications/files/redtoolkit.pdf.
Miller, W. D., Nguyen, K., Vangala, S., & Dowling, E. (2018). Clinicians can independently predict 30-day hospital readmissions as well as the lace index. BMC Health Services Research. Retrieved November 26, 2021, from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-2833-3.
Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals. Inquiry: a journal of medical care organization, provision and financing. Retrieved November 26, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614936.

RE: Reply

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We appreciate your post. I felt that many hospital readmissions might be prevented with good discharge planning and education, based on a project I completed for another class. According to Hughes and Whitham (2018), about 30% of readmissions are related to the same ailment or diagnosis for which the patient was initially admitted. It is probable that these patients were not sufficiently informed to manage their symptoms at home following discharge. As you mentioned, it is crucial to understand how these people will be cared for, who will care for them, and what environment they will return to.

I also feel that discharge planning should begin on day one in order to avoid any complications and attempt to resolve any concerns discovered prior to the day of discharge. Readmissions are not only a physical and financial burden for the patient, but also for the hospital. Reduction of readmissions enhances the patient’s quality of life and minimizes the budgetary effect (American Hospital Association, n.d.). Collecting data at the beginning and throughout a patient’s stay might be advantageous for minimizing the likelihood of readmission. It would also assist other professions in locating the proper home care resources. Again, many thanks for your post.

 References

American Hospital Association. Hospital readmission reduction program: AHA. (n.d.). Retrieved November 30, 2021, from https://www.aha.org/hospital-readmission-reduction-program/home

Hughes, L. D., & Witham, M. D. (2018, August 28). Causes and correlates of 30 day and 180 day readmission following discharge from a medicine for the Elderly Rehabilitation Unit. BMC geriatrics. Retrieved November 30, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6114496/

d using routinely collected daily data. Emergency Medicine Journal, 37(12), 781-786. http://dx.doi.org/10.1136/emermed-2019-208849

Thank you for sharing a scenario that could be used by nursing leaders. I’m fascinated by the ever-changing cognitive load the nursing profession requires and how in the past years with the integration of technology it continues to be changing. “Nurse leaders have a responsibility to recognize signs of cognitive overload among nurses and take active measures to reduce the cognitive burden and its consequences”(Collins, 2020, p. 44).

Electronic documentation in this scenario seems appropriate. If the nurse leaders are determining the connection between previous diagnoses and present, how would that be measured? If the staff nurses are documenting successful interventions, would it contribute to lowering or adding to the cognitive load of their staff? According to McGonigle & Mastrian, 2022, information can be overlapping phases. Would the staff be knowledge workers and nursing leaders be acquirers of the information?  I found your example to be a good case scenario to practice how to formulate knowledge processing with informatics. I asked questions because I liked your example. I wanted to see if how I rationalized the working parts would be similar to yours in examining the aspects of the Foundation of Knowledge model in improving patient outcomes and productivity within your scenario. Thank you for your post.

“Health information technology presents numerous opportunities for improving and transforming healthcare which includes; reducing human errors, improving clinical outcomes, facilitating care coordination, improving practice efficiencies, and tracking data over time” (Alotaibi & Federico 2019). Health care professionals rely on data from informatics tools every day for patient safety and improving patient outcomes. Nurses depend on automated blood pressure machines to produce numbers for patient blood pressure. Those numbers are data retrieve from tools to maintain patient safety. According to the Association of Medical Research Charities, “health information is leading to advances in the prevention, diagnosis, and treatment of diseases and conditions, as well as improvements to patient care” (AMRC, 2016). Another example could be a doctor telling his patient to take her blood daily at 5:00 pm and write it in a journal. Likewise, this data can be used to diagnose her with hypertension or perhaps determine which blood pressure medication to prescribe. 

References 

Alotaibi, Yasser K, and Frank Federico. “The impact of health information technology on patient safety.” Saudi medical journal vol. 38,12 (2017): 1173-1180. doi:10.15537/smj.2017.12.20631 

The Association of Medical Research Charities (2016). A matter of life and death: how your health information can make a difference. (n.d.). Retrieved October 4, 2020, from https://www.amrc.org.uk/ 

Mary, you brought out an extremely interesting idea that I had not previously thought of before! I appreciate the new insight that you have provided in your post. I agree that working in a psychiatric hospital where the incidence of escalating situations is common, the knowledge of de-escalation methods is vital. You brought out a great point that informatics contributes to the creation of patient-specific de-escalation methods through the data that can be obtained from charts and patient records. Since both informatics and healthcare are evolving at unprecedented rates there has also been a notable increase in the integration of new technologies which has led to increased ease of access to care (Sweeney, 2017). Another method that could be implemented is staff training days that study the use of different de-escalation methods, this way staff will be educated on multiple alternative methods to restraints. The use of informatics in this issue could lead to an increase in the correspondence between both patients and their providers (Nagle et. al., 2017).

Sample Answer for NURS 6051 Discussion Application of Data to Problem-Solving Included

TAMMY 

Week 1 Initial Post Tammy Starkey WELCOME! 🙂  

According to Kollerup, et al, in a study to test a 12-step process in medication management post hospitalization, a common issue was identified.   

The hospital’s changes in medication led the nurse to reconsider the prescriptions in the light of the patient’s current needs. Establishing order in the medication lists subsequently involved contacts with the hospital, the GP, nursing assistants and the family. Medication issues could not always be resolved during the initial visit, and a follow‐up visit was often required.  (Kollerup, et al 2018) 

As a community health nurse, since 2018, I have witnessed the challenges of medication reconciliation.  I have entered homes with a discharge list including a short list of medications, however, when I arrive at the patient’s home, I get the “tour”.  We amble from cabinet to cabinet, tackle box to tackle box, drawer to drawer.  I gather dozens of bottles of medications that the patient is determined to continue taking, while disregarding the new list that was established by the last MD office visit or the last hospitalization.  Sometimes, these bottles include a hodge-podge of random and most definitely expired pills poured into a bottle.  The patient is adamant that they have no difficulty taking their medications, that they are knowledgeable about the dosing and side effects and absolutely need no teaching currently.   However, as an experienced clinician, I concur with the opinion of the infamous and sassy, television star, “House”-EVERYBODY LIES!  Not really, but this thought does cross my mind from time to time.     

This creates a challenge for the home health nurse, we must then, quickly gain the trust of the patient and their caregiver, obtain orders from the MD, provide education, and ensure that all appropriate medications are sorted and taken appropriately.   

You make be asking yourself, what does this have to do with data collection?  My current, and much appreciated career within the home health umbrella is working as a clinical supervisor.  It is my job to be a “data detective”.  I spend my entire day, reviewing documentation, approving orders, ensuring accuracy, promoting positive outcomes, and improving the satisfaction of the patient and the caregiver.  I have a “hot topic book” in which I keep track of the “data” where I notice trends.  I determine weaknesses in documentation and failures in planning.  For example:  my current hot topics are infection reporting, occurrence reporting, order writing, pain assessment, medication reconciliation.  I am new again, to the state of Florida, therefore, new to this company.  The company is currently scoring low in satisfaction and low in the “STAR RATING”.  It is my responsibility to improve these outcomes.  I have been actively providing education to the skilled nurses that perform the assessments to improve the outcomes in these identified areas.  The patient is at significant risk for injury, decline in health status, rehospitalization and possibly death if medications are not reconciled correctly upon discharge from the hospital or MD office.   

In, Masetti, et al, it is stated in their study of medication problems upon discharge from a hospital, that in addition to the known risk factors in patients transferring from hospital to home care (age, polymedication, multiple providers), 3 major problems impacted upon medication safety: fragmented communication, unreliable medication availability and a poor prescription quality. Clinical pharmacists are an important option to improve medication safety assessment.  (Masetti, et al 2018). 

The data that I gather and interpret is utilized to provide education to the skilled nurses on my teams.  I am not re-inventing the wheel or re-creating processes.  I often get frustrated because the skill of medication reconciliation should be a basic nursing skill.  This important and key step in the assessment process is often overlooked or rushed.  The nurses need to gain confidence in dealing with the complicated family dynamics and in communication with the MD office.   

Medication reconciliation ensures that the patient has a correct list of medications, but many other issues affect the ability of the patient to successfully take those medications. Home care nurses gain important insights into both medication regimen complexity and patient and family perspectives while they are in the patient’s home.  (Sheehan, et al, 2018). 

Once, while in the Director of Nursing role, I attended a supervisory joint visit with skilled nurse, the patient was on coumadin, she was well controlled and only having her PT/INR checked monthly at this point, coumadin is automatically flagged a high-risk medication.  The skilled nurse dutifully documented with each previous visit that she discussed and reviewed all the medications with the patient.  I asked the patient to bring me her pill box, so I could check to see if her medications were due to be refilled, running low, etc.  This was just my standard assessment during each visit, when I was in the field nursing role.  The patient brought her bin filled with pill bottles.  I have a standard, “play stupid” role, in which I hold up a bottle and ask the patient:  1) what is this pill?  2)  what does it do for you?  3)  how many do you take?  4) what time of the day do you take it?  5)  what problems can you have if you take this medication?  I would expect, within a few weeks of being on home care service, the patient would be able to correctly identify several of their medications.  This patient was doing well, so I was initially impressed with the skilled nursing progress to goals.  Then, I dug deeper into the bin.  I picked up a total of 6 bottles of coumadin.  The patient had been taking 1 pill from each bottle.  She had gathered all her old bottles and dropped them in the basket and then followed the directions on the bottle.  MY HEART STOPPED!  This was an egregious error with potentially deadly results.  The was an extensive corrective action process immediately initiated.  And ever since, I have been committed, perhaps based out of mild PTSD, to ensuring that medication reconciliation is taken seriously and performed appropriately.  Nurses cannot take the patient’s word as proof that the patient and their caregiver understand their medication regimen.  Nurses must perform an actual assessment not an interview. 

  

References 

  

Kollerup, M. G., Curtis, T., & Schantz Laursen, B. (2018). Visiting nurses’ posthospital medication management in home health care: an ethnographic study. Scandinavian Journal of Caring Sciences, 32(1), 222–232. https://doi-org.ezp.waldenulibrary.org/10.1111/scs.12451 

  

Meyer-Massetti, C., Hofstetter, V., Hedinger-Grogg, B., Meier, C. R., & Guglielmo, B. J. (2018). Medication-related problems during transfer from hospital to home care: baseline data from Switzerland. International Journal of Clinical Pharmacy, 40(6), 1614–1620. https://doi-org.ezp.waldenulibrary.org/10.1007/s11096-018-0728-3 

  

Sheehan, O. C., Kharrazi, H., Carl, K. J., Wolff, J. L., Roth, D. L., Gabbard, J., & Boyd, C. M. (2018). HELPING OLDER ADULTS Improve Their Medication Experience (HOME). Home Healthcare Now, 36(1), 10–19. https://doi-org.ezp.waldenulibrary.org/10.1097/nhh.0000000000000632 

Sample Response for NURS 6051 Discussion Application of Data to Problem-Solving Included

Tammy, 

            I appreciated reading your post regarding the challenges you face as a home health nurse and the medication reconciliation process. As a nurse in the ER, I can tell you that there are fewer things that frustrate me more than having to add this task to my “to-do” list. Especially when the patient either 1) Has over a million medications that they take, and each with changes to their dosages 2) “Know” what they take, but really have no clue what the dosage is, or even the name of it 3) Have no idea. Most days, we are already running around in the ER trying to put out fires, so when the patient does not help us out with their medication reconciliation, oftentimes we are forced to leave that list incomplete and allow the patient to be admitted before the list is accurate. Thankfully, we do have a pharmacy tech that works certain days of the week to help us out with these issues, but for the most part, we as nurses are the ones that must get it done in a rapid yet accurate fashion. In a study conducted by (Monte et al., 2015) regarding medication reconciliations in the ER, it was estimated that approximately 60% of the reconciliations done during their studies had at least one medication error (did not specify if this was because of the patient giving the wrong info, or healthcare staff) and 40% of the completed reconciliations were attributed to a mistake done by the clinician putting in the information. Obviously, these mistakes can have dire consequences that can impact the patient’s admission and even discharge if they are not corrected. 

            Regarding the discharge medication reconciliation, it is crucial that the patient’s information be accurate. The authors (Sharma et al., 2012) point out that most patients that present to the emergency department are often in pain, or distress so it can be extra challenging to gather an accurate medication reconciliation from a poorly written list or a bag of pills that they may or may not be accurate. This is even more of a risk for the patient to be discharged with a faulty medication reconciliation, hence increasing the risk for life threatening medication discrepancies, especially if the patient takes multiple medications (Sharma et al., 2012). Thankfully, nurses like you can help prevent the damage from spiraling out of control when there is a thorough assessment performed, and adequate education for the patient. 

            To help with this medication reconciliation fallout, do you have any recommendations? Thankfully, electronic health records can be helpful with obtaining information if the patient has been to the hospital, however, it can also be inaccurate if they not updated. I am wondering if there could be a development of an app that can be used by the patient in real-time, or linked to their pharmacy that can be somehow imported into the EHR in the future? Or for the older populations, creating a medication list template that would be easy for them to fill out, and encouraging the frequent update of it? Perhaps with that information in your field of work, you could help find create a database that can track if these are effective tools for these patients. 

            Thanks to your post, I am reminded of the immense significance that accurate medication reconciliations have inpatient outcomes. Although I do always try my best, I will admit that the high-intensity nature of my job makes it difficult to see it as an important task, but it absolutely is. 

References 

Monte, A. A., Anderson, P., Hoppe, J. A., Weinshilboum, R. M., Vasiliou, V., & Heard, K. J. (2015). Accuracy of Electronic Medical Record Medication Reconciliation in Emergency Department Patients. Computers in Emergency Medicine, 49(1), 78–84. https://doi.org/10.1016/j.jemermed.2014.12.052 

Sharma, A. M., Dvorkin, R., Tucker, V., Marguiles, J., Yens, D., & Rosalia, A., Jr. (2012). Medical reconciliation in patients discharged from the emergency department. The Journal of Emergency Medicine, 43(2), 366–373. Retrieved December 1, 2020, from https://doi.org/10.1016/j.jemermed.2011.05.080 

Sample Answer for NURS 6051 Discussion Application of Data to Problem-Solving Included

CONNOR 

RE: Discussion – Week 1  

Being an ICU nurse, I often times manage patients in the elderly population who experience intense sundowning. Similar to ICU psychosis (or delirium brought on by the constant stimulation of the ICU), sundowning is described as “increased confusion and emotional behavioral disruptions, such as agitation and aggression, particularly during the late afternoon and early evening hours” (Todd, W., 2020). As referenced in an article posted in the Critical Care Nurses Journal, “opioids and benzodiazepine drugs are potentially inappropriate medication classes for the elderly because it can lead to over sedation, leading to more confusion” (Spiegelberg, J. et. al, 2020). In order to prevent this phenomenon, we often promote the use of light therapy.  

Elderly patients in the ICU often times experience sun downing. Although it is promoted, light therapy, or the use of light to upkeep the internal day and night cycle, is rarely used. According to Forbes et. al, “a decreased ability to maintain a stable circadian pattern of daytime arousal and nocturnal quiescence may contribute to sleep disruptions” (n.d.). This situation can call for data collection to assess the benefits of using light therapy to prevent situations of sundowning in elderly patients. Data could be collected in the form of tracking events of sundowning and having some of the test population exposed to light therapy and some with loose restrictions. This could produce results that test the effectiveness of light therapy and help establish more strict care that provides a healthier alternative.  

A nurse leader could in turn use this information to educate their team on the importance of keeping the lights turned off at night, reducing noise pollution, and promoting restful sleep. This will possibly prevent medicating patients with sedatives they may have never needed. I believe that by using non-pharmacologic interventions, we can reduce the amount of harm and risk of furthering the initial issue. As nurses, it’s our responsibility to do no harm and reduce risk of negative reaction and the information gathered from a figurative study on this topic could make this responsibility more feasible. 

  

References  

 Forbes, D., Blake, C. M., Thiessen, E. J., Peacock, S., Hawranik, P., & Forbes, D. (n.d.). Light therapy for improving cognition, activities of daily living, sleep, challenging behaviour, and psychiatric disturbances in dementia. Cochrane Database of Systematic Reviews, 2. 

  

 Spiegelberg, J., Song, H., Pun, B., Webb, P., & Boehm, L. M. (2020). Early Identification of Delirium in Intensive Care Unit Patients: Improving the Quality of Care. Critical Care Nurse, 40(2), 33–43. https://doi-org.ezp.waldenulibrary.org/10.4037/ccn2020706 

  

 Todd, W. D. (2020). Potential Pathways for Circadian Dysfunction and Sundowning-Related Behavioral Aggression in Alzheimer’s Disease and Related Dementias. Frontiers in Neuroscience, 14, 910. https://doi-org.ezp.waldenulibrary.org/10.3389/fnins.2020.00910