NURS 6051 The Application Of Data To Problem-Solving

Name: NURS 6051 The Application Of Data To Problem-Solving
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Description: A Sample Answer For the Assignment: NURS 6051 The Application Of Data To Problem-Solving Title: NURS 6051 The Application Of Data To Problem-Solving NURS 6051

A Sample Answer For the Assignment: NURS 6051 The Application Of Data To Problem-Solving

Title: NURS 6051 The Application Of Data To Problem-Solving

NURS 6051 The 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.

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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.

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

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?

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References

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

RE: Initial Post

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Importance of Data Collection

ESAS Data Collection

References

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.

Telemedicine is a sustainable type of healthcare and can open several doors for treatment for patients and practitioners. It saves time, and treatment is convenient and affordable for people who dread visiting the doctor and avoid going to the hospital. In addition, telehealth is helpful in diagnosis, administrative work, and professional and patient education.

A study assessing the effectiveness of telehealth consultations discovered they could improve patient outcomes in certain areas. Telehealth may not help and completely replace traditional office visits — after all, many services and procedures can only be done in person — but it can reduce the need for them. Telehealth effectively reduces the spread of infectious diseases, especially in this Coronavirus (COVID-19) warfare. When other patients have an infectious disease, they can stay home and call their healthcare provider to get treatment. By staying at home, patients do not expose their illnesses to healthcare professionals and other patients. Patients also reduce the chances of contracting an infectious disease from another person or transmitting and spreading their own while using telehealth services.

References

Aggarwal, A. (2017). Telepyschiatry: Current outcomes and future directions. International Journal of Clinical Psychiatry and Mental Health, 5. https://doi.org/10.12970/2310-8231.2017.05.07Links to an external site.

Menage, J. (2020). Why telemedicine diminishes the doctor-patient relationship. BMJ, m4348. https://doi.org/10.1136/bmj.m4348Links to an external site.

Stokel-Walker, C. (2020). Why telemedicine is here to stay. BMJ, m3603. https://doi.org/10.1136/bmj.m3603Links to an external site.

Telephone triage

The phone rings on a busy Saturday afternoon and the pleasant voice of a registered nurse answers professionally, greeting the caller seeking advice and care. This could be a day for a typical for an ambulatory telephone triage nurse. The concept of telephone triage and consultation can be one of a registered nurse using evidence-based algorithms from electronic databases. The nurses, like most nurses, working in a progressive health care industry are using technology to counsel patients. According to McGonigue & Mastrian, (2022), “For information to be valuable, it must be accessible, accurate, timely, complete, cost-effective, flexible, reliable, relevant, simple, verifiable, and secure.” p.9.

This information could be valuable to many leaders in the healthcare team. Accessibility would be easiest in form of electronic records and telephone recordings. McGonigue & Mastrian (2022), argue, “Computer science offers extremely valuable tools that when used skillfully, can facilitate the acquisition and manipulation of data and information by nurses, who then can synthesize the data into an evolving knowledge and wisdom base ”p. 35). Accurate and timely information could be an interest in nursing quality and control.

One argument on how telephone triage could be cost-effective is that paying nurses to man the phone lines is cheaper than using inappropriate resources such as the emergency room to care that can be directed elsewhere. Flexibility, reliability, simple, verifiable and secure would require a more in-depth look into the nature of telephone triage and program development within a system, but the concept of triage nursing seems to be malleable to the interest of how the data would be used.

An additional source of centralized evidence-based algorithm software program could also be used and from my research is being used in assisting the nurses to effectively triage the caller and ensure best practice standards. Documentation done by triage nurses would have data from the callers that are subjective and objective, the nursing assessment, and recommendations based on the call.

From this data collection, multiple departments within healthcare could use this or would have an interest in this data collection. Intradisciplinary teams have an opportunity to look at how to retrieve data from electronic retrieval of health records or from recorded lines if those are being used. An ambulatory nurse manager might be interested in using the data as a system educator of staff development and improvement strategy to support the training needs within their triage staff.

A quality nurse might want to use this data to help in creating of protocol development and safety improvements for effective triage and outcomes. Ambulatory providers could use data to see the patient population’s interests and barriers to care and from there use it to modify their practices. Health information technology departments within health care organizations could be supportive of this nursing department in implementing programs in making documentation more time efficient and detailed. Nursing leadership could use this as a cost-effective strategy.

All departments could build off one another and become temporary team members to gain knowledge and benefit in patient care and satisfaction. Emerging roles could be created as, “Teams are working across boundaries of organizations and will be organized around a particular patient.” (Nagale et al, 2017, p. 215). Within most healthcare systems the mission and visions of these organizations are built on patient outcomes and patient centered care. An informatics nurse specialist could support patients, nurses, providers, and leaders with the interpretation of data analytics and therefore participate in applying new knowledge from data to wisdom. (Nauright et al., 1999)

This hypothetical scenario of a nurse working at a telephone triage call center would benefit immensely from data access, problem-solving and the process of knowledge formation. In a real-time, scenario, I could see how this could impact patient care and outcomes on a global level and be a perfect role for a nurse informatics specialist to pilot.

References

Nauright,L.P.,Moneyham,L.& Williamson,J.1999. Telephone triage and consultation: An emerging role

for nurses,Nursing Outlook, 47(5) , 219-226.https://doi.org/10.1016/S0029-6554(99)90054-4.

Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist Links to an external site. Links to an external site.. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221).

McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.

It was great going through your post. Telehealth is a crucial part of our healthcare system, especially with technological advancement in the recent past. I agree with the benefits of telehealth, as your post indicated.It allows access to healthcare information in a swift manner. Technology helped telemedicine reduce congestion in hospitals as patients can easily access information via teleconference. It has also expanded the opportunities for the nurses who interact closely with the patients.
Telemedicine is a sustainable type of healthcare and can open several doors for treatment for patients and practitioners. It saves time, and treatment is convenient and affordable for people who dread visiting the doctor and avoid going to the hospital. In addition, telehealth is helpful in diagnosis, administrative work, and professional and patient education.
A study assessing the effectiveness of telehealth consultations discovered they could improve patient outcomes in certain areas. Telehealth may not help and completely replace traditional office visits — after all, many services and procedures can only be done in person — but it can reduce the need for them. Telehealth effectively reduces the spread of infectious diseases, especially in this Coronavirus (COVID-19) warfare. When other patients have an infectious disease, they can stay home and call their healthcare provider to get treatment. By staying at home, patients do not expose their illnesses to healthcare professionals and other patients. Patients also reduce the chances of contracting an infectious disease from another person or transmitting and spreading their own while using telehealth services.

References

Menage, J. (2020). Why telemedicine diminishes the doctor-patient relationship. BMJ, m4348. https://doi.org/10.1136/bmj.m4348Links to an external site.

Stokel-Walker, C. (2020). Why telemedicine is here to stay. BMJ, m3603. https://doi.org/10.1136/bmj.m3603Links to an external site.

A nursing home trach to vent patient comes in to the ER. Their vital signs are a Temperature of 101 F, heart rate of 110, respiratory rate of 24, BP of 85/60. He complains of pain in his back and upon assessment we see a large amount of discharge from his stage 4 sacral wound. Blood work is drawn and white blood cells are greater than 16,000/mm3, with a lactic level of 3. The vital signs are inputted into my charting system, Epic, by the nurse. With Epic, we get an automatic pop-up that due to this patients vital signs, this patient meets sepsis criteria and should be worked up appropriately. When the lab results come back, they are automatically added to epic, which also triggers the sepsis warning. The nurse and provider document their physical assessment, including the stage 4 wound, which along with the sepsis warning pop-up, help us think this may be the source of their infection.

Data collection, Knowledge Derived, Clinical Reasoning:

As you can see from the description of the scenario, data like vital signs, blood work, and a physical assessment are collected and assessed. Knowledge can be derived from that data from our medical knowledge, but as a reminder, the charting system can remind us that a patient meets sepsis criteria. Based on the physical assessment, the nurse can use clinical reasoning and judgement to find the cause of the abnormal vital signs and blood work. The likely diagnosis is sepsis due to a sacral wound. These criteria in the EHR are developed based on evidence-based studies, such as the International Guidelines for Management of Severe Sepsis and Septic Shock (Dellinger et al., 2012). I see this scenario very often when I worked as a medical step-down nurse, where many chronically ill, bed-bound, chronically vented nursing home patients came in.

Supporting Data:

As described by Walden University, very soon artificial intelligence is going to be a great support to medical professionals, where when a patient comes in with a certain complaint, asking a certain set of questions will help diagnose or rule out the most common possible conditions (Walden University, 2018). This does not replace the nurse or physician but certainly supports us in our decision-making, just like how the Epic Sepsis warning helps remind us to keep this diagnosis in mind if the patient meets the initial criteria.

Public Health Informatics professionals are the ones who make it so that an EHR like Epic works between different hospitals, outpatient offices, and more (Public Health Informatics Institute, 2017). For example, I would be able to see that the above patient in my scenario had a recent primary care office visit for a fever 1 week prior, and was discharged on antibiotics. When the provider enters the billing code for sepsis, it is thanks to the work of Informatics professionals that that code can be translated from ICD-10 to another medical billing language, so that everyone including insurance companies are receiving the correct information (Public Health Informatics Institute, 2017).

References:

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

Public Health Informatics Institute. (2017). Public Health Informatics: “translating” knowledge for health Links to an external site. [Video file]. Retrieved from https://www.youtube.com/watch?v=fLUygA8Hpfo

Dellinger, Levy, Rhodes, Annane, Gerlach, & Opal. (2012). Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012. Guideline Central. Retrieved 2022, from http://content.guidelinecentral.com/guideline/get/pdf/3525.

Accurate and timely information could be an interest in nursing quality and control. One argument on how telephone triage could be cost-effective is that paying nurses to man the phone lines is cheaper than using inappropriate resources such as the emergency room to care that can be directed elsewhere. Flexibility, reliability, simple, verifiable and secure would require a more in-depth look into the nature of telephone triage and program development within a system, but the concept of triage nursing seems to be malleable to the interest of how the data would be used.

References

Nauright,L.P.,Moneyham,L.& Williamson,J.1999. Telephone triage and consultation: An emerging role

for nurses,Nursing Outlook, 47(5) , 219-226.https://doi.org/10.1016/S0029-6554(99)90054-4.

McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.

Sample Answer for NURS 6051 The Application Of Data To Problem-Solving Included

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?

As healthcare professionals, we use and rely on evidence-based practice to treat and provide care for the patients we serve. The workflow that we follow as Registered Nurses help keep our patients safe while providing high quality care as apply methods that are tried and true. The technology that we use in healthcare keep us efficient with our time and allows us to communicate with each other. Having access to this data/information and being able to reference and plan care accordingly allows for the best decision making. Whether inpatient or outpatient, clinicians and patients utilize online portal systems, electronic medical records, data collection devices such as vital sign machines and glucometers (Sweeney J., 2017).

As a nurse in the ICU if I had a patient come from a MedSurg unit who was found unconscious by the rounding nurse with a sp02 of 76%, blood pressure of 80/52 and a heart rate of 56. Having access to the EMR would allow me all necessary patient information during the current admission including allergies, medication, ADL function and a full head to toe assessment of the patient who is arriving to my unit in distress. This patient’s oxygen saturation is now 70% on arrival to my unit and the anesthesia team is at the bedside intubating the patient for airway protection while I am receiving bedside report. Last reported activity was patient A&O x4 upright independently enjoying a meal. This information would also be documented in the EMR. Having access to the patient’s electronic medical health record would allow myself and the Intensivist along with the code team a better understanding of the patient’s base line and what could have possibly happened. This would lead to us as healthcare providers formulating a treatment plan for the critical patient. The EMR is used to store the assessments and information gathered about a patient in an organized fashion.

As the health care team, with variation in access to the chart depending on role, we are able to access this information to learn more about our patients to better care for them. As a nurse in the situation, I would listen to the report taken from the frantic nurse and scan the chart for possible missed pertinent information while discussing possible causes with the code team such as aspiration. As nurses we look listen and touch our patients to get a full picture, in emergency situations such as this one a skilled nurse must critically think, implement orders and discuss simulations to get the best outcomes. Time is of the essence and having the information available to reference keeps our patients safe and allows us to connect the dots.

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.

Importance of Data Collection

ESAS Data Collection

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.

References

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

This is insightful Tina 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

RE: Discussion – Week 1 initial post

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References:

Response

This is insightful. 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).

References

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The Application of Data to Problem-Solving

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

Working in the nursing field comes with great rewards and stressors that can affect the quality of care a nurse provides. One way to measure nursing staff satisfaction would be to collect data by asking various questions to rate overall staff satisfaction. Along with following up on the results to create resolutions to improve or maintain staff satisfaction. The relationship between job satisfaction and workload and quality of care affects nurses’ performance (Maghsoud, Rezaei, Asgarian, and Rassouli, 2022).

Increased stress plays a role in the quality-of-care nurses given to patients (Maghsoud et al, 2022). Workload can also be a stressor and negatively affect job satisfaction. Job satisfaction is a multidimensional concept that reflects the interaction between nurses’ expectations and values, their environment, and personal characteristics (Maghsoud et al, 2022). Improvement in nursing satisfaction is significant in providing high quality care with optimal outcomes (Maghsoud et al, 2022).

The nurse is a knowledgeable worker. Knowledge work is nonrepetitive, non-routine work that involves the use of cognitive activity (Mcgonigle and Mastrian, 2022) .All nurses use data and information (Mcgonigle and Mastrian, 2022).

Nursing leaders can use the information received from satisfaction surveys to improve the quality of nursing care (Nia, Sharif, She, Froelicher, Kaveh, and Rahmatpour, 2021). Leaders can do so by creating a favorable work environment for staff (Nia et al, 2021). A favorable work environment has an impact on overall care (Machesky, 2017).

By Day 6 of Week 1

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

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RE: Discussion – Week 1

COLLAPSE

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We live in an era where technology is on the rise and continues to progress within the healthcare field. Nursing informatics plays a big part in developing technology. Electronic health records (EHR) play a big part in how we function as a nurse today. Before my time as a nurse, I would always hear stories about how everything was done with pen and paper. Some nurses prefer the old ways, but my personal preference is doing everything on the computer. EHR refining may not seem so important to nurses working the floor, but it may mean everything for an informatics nurse.

EHR’s today have developed so well over the years, especially at bigger hospitals. They developed algorithms within our workflows that flag us, or pop up as an “alert”, just to make sure we are aware of certain issues. Ideas such as missed immunizations would pop up on the screen, or a bad mixture of vital signs could possibly you’re your patient may be having systemic inflammatory response syndrome (SIRS). In this given situation, it would “hint” at making a decision whether or not the patient should be evaluated for sepsis. According to Nibbelink et. al (2018), poor decision-making has been linked with up to 98,000 deaths in hospitals each year. EHRs are a huge database, and informatics nurses are able to gather and collect information regarding patient statistics.

More recently our hospital changed our diabetic ketoacidosis protocol to the two-bag method which has proven greater outcomes and shortens the length of admissions. Another example of another recent change to our protocol is that we have completely phased out the administration of tissue plasminogen activator (tPA) for acute ischemic stroke patients and have brought back the administration of tenecteplase (TNK) which completely overrides the need to infuse a medication of “x” amount of time. According to Zitek et. al (2020), tenecteplase has shown that it has fewer complications for acute bleeding complications when compared to tPA, and is less expensive.

The EHR that my hospital utilizes provides access to previous records from outside hospitals, but only if that hospital uses the same EHR. If a patient received care at a facility that did not utilize the EHR, then we would not have any access unless we request it. I think that having a database that is on the same platform would exponentially increase the quality of care, especially if the patient came in unresponsive and was resuscitated. Having the ability to see previous medical records is crucial. Without medical records, the quality of care decreases and essentially we are left to figure out what we “presume” rather than what we “know”.

References

Nibbelink, C. W., Young, J. R., Carrington, J. M., & Brewer, B. B. (2018). Informatics Solutions for Application of Decision-Making Skills. Critical care nursing clinics of North America, 30(2), 237–246. https://doi.org/10.1016/j.cnc.2018.02.006

Zitek, T., Ataya, R., & Brea, I. (2020). Using Tenecteplase for Acute Ischemic Stroke: What Is the Hold Up?. The western journal of emergency medicine, 21(2), 199–202. https://doi.org/10.5811/westjem.2020.1.45279

Response

Adrian, your response is insightful and detailed. I agree with you. Essentially, the implementation of an electronic health record (EHR) is challenging. As such, it is important to plan the implementation process to help in reducing errors. The key considerations in the implementation plan include assessment of selection criteria, interoperability with other systems, accessibility of the system, confidentiality, and the integrity of patient health data (Ratwani et al., 2018). The other key considerations include regulatory compliance and accuracy of the EHR systems.

EHR is essential in enhancing logistical productivity in the workflows and provide safe way for patient care. To improve the efficiency, the EHR implementation team should comply with various best practices such as selecting the implementation committee among the stakeholders, define the implementation cost, develop a user training program, test EHR, and outline critical success factors and assessment strategies (Baumann et al., 2018). Moreover, before applying the implemented EHR, it is imperative to set a testing protocol to ensure that areas that might bring confusion are identified and managed. Successfully implemented EHR system is likely to foster success in patient care, reduce delays, and increase satisfaction among health care workers (Aguirre et al., 2019).

References

Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation: a review of resources and tools. Cureus, 11(9). doi: 10.7759/cureus.5649

Baumann, L. A., Baker, J., & Elshaug, A. G. (2018). The impact of electronic health record systems on clinical documentation times: A systematic review. Health Policy, 122(8), 827-836. https://doi.org/10.1016/j.healthpol.2018.05.014

Ratwani, R. M., Savage, E., Will, A., Arnold, R., Khairat, S., Miller, K., & Hettinger, A. Z. (2018). A usability and safety analysis of electronic health records: a multi-center study. Journal of the American Medical Informatics Association, 25(9), 1197-1201. https://doi.org/10.1093/jamia/ocy088

Healthcare technology is essential in patient care. As healthcare professionals, we must always be ready to embrace change. Nurses must be aware of available healthcare technology for problem-solving skills, which will help improve patient care. Nursing informatics integrates nursing science with information technology to identify, analyze and communicate healthcare data (Kassam et al., 2017). Easy access to medical records is essential in the provision of quality healthcare services. Utilization and application of knowledge from healthcare foundation is the basis of nursing science (McGonigle&Mastrian, 2021).

One scenario that I would use informatics is in immunizations. In my current place of work, I work with parents and healthcare providers on vaccination records for patients. A problem arises when families have to relocate to other states without their vaccination records. These parents are not sure whether their children have been vaccinated, and they must the previous state immunization registries. It would thus be essential to have a centralized immunization registry. This system will track the vaccine given to patients and the due dates for the vaccines. Healthcare providers can thus access patient vaccination records and use them to make clinical decisions.

There is a lot of knowledge that can come from this data. Healthcare professionals can determine vaccination rates and map out areas of potential outbreaks. Nurse leaders are critical in ensuring the quality and safety of healthcare services (Goh, Ang& Della, 2018). Nurse leaders can utilize judgment and clinical reasoning with knowledge from this data to discuss reasons for the low uptake of immunization. This can help them to develop policies to ensure that patients and communities are educated on the benefits of vaccinations. Nurse leaders can also be aware of contraindications of vaccines for specific patients by having access to the central database. A centralized vaccine database is beneficial not only to the patient but also to the healthcare professionals. Patients will receive vaccines that will help them, and healthcare professionals will have an efficient vaccination system.

References

Goh, A. M., Ang, S. Y., & Della, P. R. (2018). Leadership style of nurse managers as perceived by registered nurses: A cross-sectional survey. Proceedings of Singapore Healthcare, 27(3), 205-210.

Kassam, I., Nagle, L., &Strudwick, G. (2017). Informatics competencies for nurse leaders: Protocol for a scoping review. BMJ Open, 7(12), e018855.

McGonigle, D., &Mastrian, K. (2021). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers.

Response

This is an excellent work. Your response is detailed, thoughtful, and well done. Essential, the choice of vaccine informatics is timely given the current wave of Covid 19 pandemic. Vaccine informatics is a field that creates and apply statistical, computational, and bioinformatics techniques to learn about vaccine and related issue in various phases of clinical trial, clinical uses, research, and surveillance (María et al., 2017). The public health globally has significantly increased because of the successful and efficient executions of immunization programs that use major infectious disease vaccines (Chong & Khan, 2019). Among the most popular vaccines that are used today include Pfizer and AstraZeneca for Covid-19. The positive effect of these vaccines on public healthcare demonstrated in the success of the global Covid-19 eradication programs. Vaccine informatics is crucial in clinical data by helping in the analysis of clinical vaccine trials. It can also trail immunization history in digital registries, timely discovery of the outbreak of vaccine preventable diseases, identification of alternative immunization methods, and scrutiny of vaccine safety issues (Naz et al., 2020).

References

Chong, L. C., & Khan, A. M. (2019). Vaccine target discovery. Encyclopedia of bioinformatics and computational biology, 241. doi: 10.1016/B978-0-12-809633-8.20100-3

María, R. R., Arturo, C. J., Alicia, J. A., Paulina, M. G., & Gerardo, A. O. (2017). The impact of bioinformatics on vaccine design and development. Vaccines, 2, 3-6. DOI: 10.5772/intechopen.69273

Naz, A., Shahid, F., Butt, T. T., Awan, F. M., Ali, A., & Malik, A. (2020). Designing multi-epitope vaccines to combat emerging coronavirus disease 2019 (COVID-19) by employing immuno-informatics approach. Frontiers in Immunology, 11, 1663. https://doi.org/10.3389/fimmu.2020.01663

Healthcare professionals can ensure that their patients receive the best care if they are able to access medical records (McGonigle & Mastrian, 2017). Immunizations will be the focus scenario of this discussion. Immunization is recommended by a majority of clinicians, medical researchers, and healthcare facilities. There are several reasons why immunization is important but the most important ones are to protect oneself and those around you (Pelullo et al., 2020). Additionally, infectious diseases can be prevented using vaccines. The cooperation of the patient will determine the success of the immunization program (Pelullo et al., 2020).

Diseases that have no medical treatment can best be prevented by getting immunized. The vaccination will, therefore, protect those at risk of contracting conditions that are incurable and can result in complications or death at times. Those with impaired immune systems are susceptible to these conditions (Gold et al., 2020). Even though these people are vaccinated after developing the disease, the vaccination may not help them develop a strong immune system. To ensure that the illness is prevented, it is important to get vaccinated to ensure that one is fully protected from contracting the disease (Gold et al., 2020). Those people who have been immunized, are unlikely to be at risk of the epidemic.

Currently, at my organization, we work with schools, parents, and providers using immunization records for patients. However, treating families that keep moving across state lines and lack their immunization records would be difficult because clinicians will not be able to tell whether the child has received the vaccination. This will make parents track their children’s health records from their previous clinic or the immunization registry or their previous schools to get the information. Having a central hub database for all information will make it easier for parents and clinicians to access patient information.

Collected Data to Be Used and How It’s Collected

Data collected include; patient name: first, middle, last; patient birth date; patient sex/gender; patient race and ethnicity; patient birth order; patient birth State/country; mother’s name: First, middle, last, maiden; vaccine type; manufacturer; and vaccine dosage number. Currently, information for vaccine data is collected in an online database called, Immunization Information Systems (IIS). According to the National Vaccine Advisory Committee’s standards, providers need to have full access to an individual’s immunization status at every medical encounter (Gold et al., 2020). Immunization information systems help ensure vaccinations across targeted populations as clinicians administer the vaccine across a tiered prioritization process. This system keeps track of vaccines that are administered to patients and informs providers when vaccines are due (Gold et al., 2020).

In my facility, clinicians have become fully prepared for vaccine administration and increase IIS use in the following ways: becoming comfortable and familiar with the IIS interface because patient vaccination information is readily available in the system workflow; communicating with the health system’s health IT department to see if manual data requests are required or if there is a real-time data flow between the system workflow and IIS platform; getting onboarded by the state or local health department; and communicating and sharing knowledge about the IIS with colleagues, hospital leaders, and administration to spread IIS awareness. From there, I would like to have a database that collects all of the vaccine information from each office and puts it into a central hub. Having this central hub of vaccine records would allow providers to pull vaccine records for their new patients. This would allow healthcare professionals to see their patient’s vaccination history and make clinical judgments when it came to vaccines.

Derived Knowledge

A lot of knowledge can be obtained from this data. Healthcare professionals would be able to see coverage rates in areas as well as areas of potential disease outbreaks. They would also be able to see how well community immunity (herd immunity) works. According to Ricc et al. (2020), community immunity is when enough people are vaccinated against a certain disease, it becomes hard for a disease to spread to unvaccinated people. Clinical vaccination sites are leveraging immunization information systems to order, distribute, and keep track of the vaccine. Broad and equitable use of vaccines will be instrumental in mitigating and managing different conditions (Ricc et al., 2020).

Immunization information systems are part of the critical infrastructure being used in vaccine plans to coordinate among multiple partners and systems for vaccine allocation, distribution, administration, and monitoring (Ricc et al., 2020). With the IIS, clinicians can access vaccination status in real-time. Users can also gather and store patient data and document and track vaccine products and administered doses. With limited initial vaccine supply, IISs can assist in determining the equitable allocation of available vaccines, plan and forecast when additional doses are recommended, help ensure that patients are getting the correct vaccine, and monitor vaccination series completion (Ricc et al., 2020).

How Nurse Leaders Use Clinical Reasoning and Judgment in The Formation of Knowledge from This Experience

Nurse leaders, from this experience, can use clinical reasoning and judgment to ensure that they do not miss recommended vaccine doses in addition to not receiving unnecessary, extra doses. At the same time, when taking care of patients with medical conditions, they would have the necessary ability when it comes to adding contraindications and notices regarding certain vaccines into the system. The above implies that other providers would be aware of this if the patients ever moved or were sent to the hospital. Having the capability to access a patient’s immunization record from a central hub would be very helpful to not only healthcare professionals but to the patient as well. The more clinicians are aware of and connected to their IIS, the better the vaccination campaign will be in addressing equitable vaccine distribution, managing vaccine uptake, and monitoring vaccination series. Strengthening clinician engagement will lead to more robust IIS data, thereby enhancing clinical care and public health decision-making, which are critical to immunization programs under routine and emergency conditions.

References

Gold, M. S., MacDonald, N. E., McMurtry, C. M., Balakrishnan, M. R., Heininger, U., Menning, L., … & Zuber, P. L. (2020). Immunization stress-related response–redefining immunization anxiety-related reaction as an adverse event following immunization. Vaccine, 38(14), 3015-3020. https://doi.org/10.1016/j.vaccine.2020.02.046

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

Pelullo, C. P., Della Polla, G., Napolitano, F., Di Giuseppe, G., & Angelillo, I. F. (2020). Healthcare workers’ knowledge, attitudes, and practices about vaccinations: A cross-sectional study in Italy. Vaccines, 8(2), 148. https://doi.org/10.3390/vaccines8020148

Ricc, M., Vezzosi, L., Gualerzi, G., Bragazzi, N. L., & Balzarini, F. (2020). Pertussis immunization in healthcare workers working in pediatric settings: Knowledge, Attitudes, and Practices (KAP) of Occupational Physicians. Preliminary results from a web-based survey (2017). Journal of Preventive Medicine and Hygiene, 61(1), E66. https://doi.org/10.15167/2421-4248/jpmh2020.61.1.1155

In the current nursing practice, data is instrumental in problem-solving and the continuous delivery of patient-centered care. Through timely and accurate data, healthcare practitioners examine health problems in-depth and initiate innovative interventions. Data also helps public health providers to implement evidence-based interventions to optimize health and safety (Hedberg & Maher, 2018). My focus scenario is care improvement in the emergency room by addressing patient delays. The delays stem from long waiting times. In this case, patients with emergency health needs spend unnecessarily longer time between arrival and the time when they receive medication.

The data that could be used to address this situation include patients’ health problems, waiting time, and possible health complications. As Paling et al. (2020) observed, long waiting time in the emergency room is associated with poor health outcomes, including complications and mortality. The data might be collected and accessed via a patient tracking system. In the emergency room and other units, patient tracking systems allow healthcare practitioners to log and monitor patients’ progress while receiving care and staying in the hospital. Typically, the data would be readily available in the system and would be accessed by authorized users. System security is crucial to avert the dangers of unauthorized access, such as privacy and confidentiality breaches.

The data can provide knowledge regarding the magnitude of waiting time in the emergency room. Typically, longer waiting time risks patients’ health and safety. A nurse leader could use clinical reasoning and judgment to form knowledge by applying analytical skills to make informed decisions. From a health perspective, clinical reasoning and judgment entail an in-depth analysis of issues to develop creative solutions for complex clinical situations (Hong et al., 2021; Guerrero, 2019). A nurse leader would benefit from a similar approach by analyzing patterns to understand the potential causes of patient delays and sustainable solutions. Such a response is a foundation of safe nursing care.

References

Hedberg, K., & Maher, J. (2018). Collecting data. Centers for Disease Control and Prevention. https://www.cdc.gov/eis/field-epi-manual/chapters/collecting-data.html

Guerrero, J. G. (2019). Practice rationale care model: The art and science of clinical reasoning, decision making and judgment in the nursing process. Open Journal of Nursing, 9(2), 79-88. https://doi.org/10.4236/ojn.2019.92008

Hong, S., Lee, J., Jang, Y., & Lee, Y. (2021). A cross-sectional study: what contributes to nursing students’ clinical reasoning competence?. International Journal of Environmental Research and Public Health, 18(13), 6833. https://doi.org/10.3390/ijerph18136833

The Application of Data to Problem-Solving

The data that could be used is based on handling the gap in nursing care’s steadiness to help boost patient safety. In order to access data, the qualitative exploratory, descriptive approach can be used. From a purposeful sample size of registered nurses, data can be collected. Notably, a nurse can successfully help regenerate and recognize the gap in the continuity of patient care (Jone & Johnstone,2019). The main area of focus in health care that would help acquire the data includes then perioperative, transitional care, emergency department, neurosciences, and rehabilitation. The analysis method that would be appropriate would be thematic and content analysis.

The knowledge that may be derived from the data about handling the gap in the steadiness of nursing care to help boost patient safety is that understanding and reinforcing the ability of health care providers is an effective way to increase safety. Competencies, collaboration, clinical experience, and education are key considerations for nurses to ensure patient care safety (Al Thobaity,2020). Additionally, when recruiting nurses from contrasting contexts such as propensity to change, insight and predictability are essential in determining the managing gap in health care settings.

A nurse leader would use clinical judgment and reasoning in knowing that it is essential to encourage a nurse safety net in health care. The benefit of the nurse safety net in the hospital setting is that it helps protect patients from experiencing any negative effect, positively impacting the managing gap (Suhonen, 2018). In addition, a nurse leader can acquire knowledge for the data about the barriers and enablers in managing and identifying the gap that will help in a positive patient care outcome.

References

John, B. S. (2020). Impacts of Healthcare Reform Platforms on Children with Special Healthcare Needs.

Lambrew, J. M. (2018). Getting ready for health reform 2020: What past presidential campaigns can teach us. Commonwealth.

Rundio, A., 2017. Counting the cost of healthcare reform. Nursing Management (2014+), 23(9), p.14.

A Sample Answer For the Assignment: NURS 6051 The Application Of Data To Problem-Solving

Title: NURS 6051 The Application Of Data To Problem-Solving

NURS 6051 The Application Of Data To Problem-Solving

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RE: Discussion – Week 1 initial post

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Sample Answer for NURS 6051 The Application Of Data To Problem-Solving Included

The Application of Data to Problem-Solving

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By Day 6 of Week 1

Importance of Data Collection

ESAS Data Collection

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RE: Discussion – Week 1 initial post

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The Application of Data to Problem-Solving

To Prepare:

By Day 3 of Week 1

By Day 6 of Week 1

RE: Discussion – Week 1

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Collected Data to Be Used and How It’s Collected

Derived Knowledge

How Nurse Leaders Use Clinical Reasoning and Judgment in The Formation of Knowledge from This Experience

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The Application of Data to Problem-Solving

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