Discussion: The Application of Data to Problem-Solving

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Module 1 Discussion

Transforming Nursing and Healthcare Through Technology

             “ Healthcare Informatics is defined as, the integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information”( Sweeney, 2017). Nursing informatics is described as “ A specialty that integrates nursing, computer science, and information science to manage and communicate data, information, and knowledge in the nursing practice, “ according to the ANA ( Sweeney, 2017).

Health Care Scenario

            Nurses play a vital role when it comes to triaging patients. Triage nurses are able to decipher which level of care patients would benefit from.  Judgment calls may be made in the event of an emergency. Homecare measures are provided to the patient to prevent an unnecessary medical bill. Nurses are able to determine when a health concern of the patient should be evaluated in a clinical setting. Triage nurses are also implemented during mass casualty disasters or incidents to prioritize patients’ basic needs and treatment. Triage systems are known as an essential aspect when it comes to managing community disasters ( Bazyar, Farrokhi, & Khankeh, 2019).

Data to be Collected and Accessed

            Data is collected through physical assessment or a phone conversation. To access this information, it is often is found in an electronic medical record. Documentation of the concern is put into the patient’s chart so if another healthcare professional needs to review or evaluate the patient’s beginning symptoms, then it can be accessed. During mass casualties, often a physical assessment is made and then the patient is tagged with a specific color. The colors indicate if treatment is urgent, if treatment can wait, or if the patient is injured severely and is not going to make it.

Clinical Reasoning and Judgement

            According to the book, “ Nursing Informatics,” collecting data is more beneficial if the data has integrity and quality (McGonigle & Mastrian, 2017, p. 23). Data that is more efficient in quality provides more accurate and relevant concepts (McGonigle & Mastrian, 2017, p. 23). Whereas, data integrity identifies the complete and consistent data (McGonigle & Mastrian, 2017, p.23). The implementation of clinical reasoning and judgment occurs based on the data that is collected about the patient, which can be turned into a care plan to encourage the patient to manage their health.

Conclusion

            As a triage nurse, data collection is an essential part of deciphering a patient’s care plan. Once the data is properly collected, then clinical judgment and reasoning can be applied to assess the patient further or to provide specific treatments. As nurses, it is crucial to implement current knowledge and build on knowledge to provide optimal patient care. 

References

Bazyar, J., Farrokhi, M., & Khankeh, H. (2019, February 12). Triage systems in mass casualty incidents and disasters: A review study with a worldwide approach. Open access Macedonian journal of medical sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390156/.

McGonigle, D., & Mastrian, K.G. (2017). Nursing Informatics and the Foundation of Knowledge (4^th ed.). Jones & Bartlett Learning.

Sweeney, J. (Feb, 2017). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21( 1), Available at http://www.himss.org/ojni

 

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6 months ago

Dorothy Chudi-Agbaku 

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Hi Kirsi,

Your post is good. Your scenario of the duties of a triage nurse is clear but I don’t understand how the triage nurse at this moment would benefit from access to data and the input from the access would help problem-solving in this emergency situation. Actually, I worked in ER for years but that was in my home country and we hard copy documentation of patient’s data. According to Butler and his colleagues (2018), nurses are also known to spend most of the time with patient’s and as a result have the opportunity to continuously assess patient’s condition and update it accurately in the EHR for other healthcare professionals to rely on for patient’s management. As technology is evolving, nurses’ knowledge of informatic is increasing as well so that patients would experience enhanced delivery of care, improved health outcomes, and advanced patient education (Sweeney, 2017).

Dorothy

References

Butler, R., Monsalve, M., Thomas, G., Herman, T., Segre, A., Polgreen, P., Suneja, M. (2018). Estimating time physicians and other health care workers spend with patients in an intensive care unit using a sensor network. The American Journal of Medicine, 131(8), 972.e9-972.e15. https://doi.org/10.1016/j.amjmed.2018.03.015. Epub 2018 Apr 9. PMID: 29649458.

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

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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6 months ago

Kirsi Hoselton 

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6 months ago

Dorothy Chudi-Agbaku 

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6 months ago

Kirsi Hoselton 

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Hi Dorothy,

            You ask a great question! From personal experience, in a clinical setting previous documentation of injections and injectable medications can be traced back to provide safe patient care (Hoselton, 2021).  It allows the health professionals to ensure that there were no medical errors made. Also, as a triage nurse, I receive many calls from patients daily who are calling for advice. (Hoselton, 2021)  Sometimes the call is spent providing patient education on how to treat symptoms at home. Although, sometimes the call is spent advising the patient that they need to be seen in a clinical or hospital setting. Therefore, an electronic medical record can provide other professionals with information about the patient’s symptoms throughout a care system, include the emergency room. This is a beneficial way to review the patient’s status when symptoms first began because over time symptoms can worsen from when the call was made. Therefore, electronic medical records can provide crucial information about the patient within a health organization to provide safe and competent patient care (Hoselton, 2021).

 

Reference

 

Hoselton, K. (2021) Unpublished manuscript, Walden University.

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6 months ago

Kirsi Hoselton 

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 Hi Tina,

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

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

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

 

 

 

 

References

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

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

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6 months ago

Dorothy Chudi-Agbaku 

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            With the advancement in technology and the wider use of tele health services as the world experience covid-19 pandemic, healthcare organizations and professionals are able to manage data appropriately and this has changed the care delivery, better management of scarce resources and ensured a smooth daily operation. Nursing profession has also been influenced by informatics especially in the area of maintaining accuracy and transfer of patient’s data and care. Nurses spend most time with the patient and as a result have the opportunity of gathering, documenting and communicating accurate data gathered through assessment of patients which can be used by other healthcare professionals (Butler et al., 2018). According to McGonigle and Mastrian (2017), the use of electronic health record (EHR) and the introduction of technology in healthcare system has advanced the level of care by promoting communication, minimizing medical errors, supporting decision-making, ensuring consistency in delivery of quality care.

            Whenever there is a transfer of care from one care unit or facility to another the benefits of ability to access patient’s electronic data are innumerable. In order to avoid medical errors, it is necessary to ensure that confidential health care data are safely and efficiently transferred by implementing accurate data management systems (Adane, 2019). I work in a hospital unit but I have a friend who has some medical conditions such as type 2 diabetes, obesity and high blood pressure and was being managed by her primary physician. She started having menorrhagia just after her last annual health screening and was referred to a gynecologist. With the order of MRI for her, the MD relied on the data faxed by her primary physician to find out that she has been on metformin and thus advised appropriately to avoid lactic acidosis. He also cancelled pap smear ordered and relied on the result faxed from the previous MD, thus avoiding repetition of care, wasting of time and increasing cost.

            These data either qualitative or quantitative can be collected through history taking and interviews, first time encounter and continuous assessments, tests and laboratory investigations and treatment modalities. Patient’s data can be safely kept and transmitted technologically or manually as hard copies. It has many uses including providing patient with consistent care, improve patient care in a care facility, sharing information for quality and better patient outcomes, and assisting in healthcare research (University of Illinois, 2020).

            As a nurse leader, in the midst of evolving healthcare and informatics comprising of new technology, her experience and knowledge in these areas keeps growing (Sweeney, 2017). A nurse leader could use the new knowledge to enhanced delivery of care, improved health outcomes, and advanced patient education. For example, education about medication can be included in the patient portal to ensure patient’s adequate knowledge about the medications.

References

Adane, K., Gizachew, M., & Kendie, S. (2019). The role of medical data in efficient patient care delivery: A review. Risk Management and Healthcare Policy, 12, 67–73. https://doi.org/10.2147/RMHP.S179259

Butler, R., Monsalve, M., Thomas, G., Herman, T., Segre, A., Polgreen, P., Suneja, M. (2018). Estimating time physicians and other health care workers spend with patients in an intensive care unit using a sensor network. The American Journal of Medicine, 131(8), 972.e9-972.e15. https://doi.org/10.1016/j.amjmed.2018.03.015. Epub 2018 Apr 9. PMID: 29649458.

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

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

University of Illinois. (2020). 4 Uses for Patient Care Data. https://healthinformatics.uic.edu/blog/4-uses-for-patient-care-data/

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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

Class:

Should there be one National electronic heath care record?  What would be the pros and cons?

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6 months ago

Dorothy Chudi-Agbaku 

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Hi Dr. Moyers,

            Although it is believed that healthcare should be portable, unfortunately health records are not, since required health information are still either faxed or sealed in an envelope and mailed (Persaud, 2019). Many countries like Canada are considering the one National electronic healthcare record which has some pros and cons. According to Persaud, with one national record, there would be complete information for care and patients do not need to remember for instance the vaccines received and date, radiography and investigations would not be repeated as a result of unavailability of the previous results and primary physicians would not have difficulty in piecing together what happened to his patient either on admission or in the emergency. This would bring about much improvement in the healthcare system. For example, there was a report of an increase by 40% in the availability of needed records during patient’s clinical encounters in the US Department of Veterans Affairs after their implementation of their national electronic health record in 1999 (Persaud, 2019). On the other hand, there are some cons involved in having one national health record, which include the possibility of the central server being hacked by criminals and this would expose patient’s confidential and sensitive data, cause unavailability of patient’s information resulting to slowing down of patient’s care services (O’Connor, 2021).

Dorothy.

References

O’Connor, S. (2021). Pros and Cons of Electronic Health Records. https://www.adsc.com/blog/pros-and-cons-of-electronic-health-records

Persaud N. (2019). A national electronic health record for primary care. Canadian Medical Association Journal, 191(2), E28–E29. https://doi.org/10.1503/cmaj.181647

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6 months ago

salome ugwu 

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Hi Dorothy

             I enjoyed reading your post, you made a lot of educative points. The nursing profession  relies heavily on data and communication. 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. One crucial area of data collection in my personal nursing practice is the collection of patient data before their admission. I work with a big organization on their hospice homecare department as admission nurse , so it is extremely important to have a level of background information on my patients before they admit into hospice care. I must first ensure that the new patient will meet our admission criteria. I can then begin the knowledge acquisition process to learn as much as I can about the patient coming my way. The institution that I work for use Epic system for all their different departments. So if a patient has being in the ER or any other different department within that same institution, I am able to access that report from different department so far it is within the institution and I must confess that helps a lot to get patient history, sequence of treatment and then determine their prognosis and hospice eligibility. The technology has aid in continuity of care to patient and easy reports keeping everybody that are involved in the care very informed on what is going on with the patient.

References

Vanneste, D., Vermeulen, B., & Declercq, A. (2013). Healthcare professionals’ acceptance of BelRAI, a web-based system enabling person-centred recording and data sharing across care settings with interRAI instruments: a UTAUT analysis. BMC Medical Informatics & Decision Making, 13(1), 129. https://doi-org.ezp.waldenulibrary.org/10.1186/1472-6947-13-129

 

Zare, Z., & Jebraeily, M. (2018). Patients’ Perceptions of Applying Information and Communication Technology Tools in Self-care and Factors Affecting It. Acta Informatica Medica : AIM : Journal of the Society for Medical Informatics of Bosnia & Herzegovina : Casopis Drustva Za Medicinsku Informatiku BiH, 26(2), 102–105. https://doi-org.ezp.waldenulibrary.org/10.5455/aim.2018.26.102-105

 

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6 months ago

Mauricio De Regules 

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Dorothy, 

I completely agree with what you said. The systems we use in the hospital have advanced drastically over the years and the medication errors have been minimized thanks to the proper transfer of electronic records from one hospital to another. Result Through the electronic nursing records, it can be found that comprehensive nursing service varied in the records of “fall prevention activities” and “check of the patient’s condition (Lee & Yu, 2018). Like you said, many of the benefits are also related to their pocket since it would be unfair to charge patients twice for a service that was done not too long ago just like lab tests or an MRI. While nurses must strive to transfer accurate patient information at the right place and at the right time, the managers must facilitate this by providing appropriate guidelines and standards, as well as adequate personnel and resources (Olsen et al., 2013). 

References: 

Lee, S. H., & Yu, S. (2018). Changes in nursing professions’ scope of practice: A pilot study using electronic nursing records. Health Policy & Technology, 7(1), 15–22. 

 

Olsen R., Hellzén, O., Enmarker, I., (2013). Nurses’ information exchange during older patient transfer: prevalence and associations with patient and transfer characteristics. International Journal of Integrated Care, 13(1). https://doi-org.ezp.waldenulibrary.org/10.5334/ijic.879 

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6 months ago

Chaquita Nichols 

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Healthcare Scenario

I work in a hospital setting in which we are constantly assessing patients. We thrive off patient safety. Each hospital has its own charting system in which we depend on accuracy. Once we put our data in the system it alerts us of any irregular values according to each hospital. Being in the healthcare profession we rely a lot on data. Within the charting system for nurses, we have a lot of different things we must keep up with such as patients at risk for falls, critical labs, or new orders. It is always a pain to have to go to different areas in a chart just to see results, but the way these systems are set up,  make it so everything is on one page. They also came up with a task list that ensures that important task is taken care of such as wound care or rounds.

Data Accessed and Knowledge Derived

One of the scenarios that come to mind is when we have patients come in with symptoms of sepsis. A patient comes in and we enter the vital signs into our system and then our system sends out a sepsis alert. There was a time in which we would have to call the doctor and wait for orders. But with the new and updated system, the system sends out an alert to the phlebotomist and the pharmacy. The phlebotomist comes to draw the necessary labs and the pharmacy prepares the necessary medications. We as nurses also have a protocol to follow until the doctor calls back. So, we don’t have to hold up patient care. The doctors are also able to log into the patient’s account at home from their devices.

Clinical Reasoning and Judgement

Even though as nurses we are trained to know signs and symptoms of certain illnesses, each hospital’s protocols defer. It is good to have a good information management system set up. “Part of good information management ensures that care providers have resources that they need to provide safe, efficient, quality care such as policy and procedure manuals or drug databases” (Hebda T., Czar P. pp 5). So, by there being information preprogrammed into the system, it can pinpoint when patient ranges are abnormal and that something needs to be done. Due to the knowledge of the nurse leaders, they can jump in and help also. “The high-performance the expectation of nurses is dependent upon the nurses’ continual learning, professional accountability, independent decision making, and creative problem-solving abilities” (Brenner P., Hughes RG, Sutphen M., (n.d.).  Usually, the nurse leaders have the most experienced and know what to expect from these types of patients.   

Conclusion

“Nursing informatics has been traditionally defined as a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice” (McGonigle D., Mastrian K. G. pp. 7). The healthcare system is constantly changing so the data that is set up for us is also altered. There are people that try to make our jobs safer and easier. When we discuss the healthcare systems, we think about patient safety. So, the nurses that deal with nursing informatics take that into consideration. There are many different systems out there such as Epic or Cerner. Each of those systems is different but still focuses on patient safety.

 

References

Benner P., Hughes R.G., Sutphen M. (n.d.). Clinical Reasoning, Decision-making, and Action: Thinking Critically and Clinically.

Hebda, T., & Czar, P. (2012). Handbook of Informatics for Nursing & Healthcare Professionals (5^th ed.). Pearson Education.

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

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Thank you Chaquita.  Another example of how technology can serve to improve safety and patient outcomes.

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6 months ago

Tanaka Ruzvidzo 

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Dear Chaquita, I enjoyed reading about your healthcare scenario. This led me to think of the importance of timeliness in providing care. Due to nurse informatics, we have the use of electronic health records that enables us to chart patient information in real time. “Digital tools potentially offer opportunities to ensure that patients are directed to the most appropriate care for their needs within an optimised timeframe” (Dewsbury, 2019).  

The algorithms that result from data entered chart the next course of action. Additionally, possible diagnoses are derived enabling quick access to necessary services. For instance, something as critical as a patient having a stroke, allows clinicians to ask the right questions and depending on the answers will in the case of a Code Stroke enable speedy transportation to radiology. Sometimes critical decisions are extremely time sensitive and can be the difference between life and death. Nurse informatics has therefore bridged the gap in this regard.  

Sepsis is of national concern due to the number of deaths from this diagnosis. According to Shappell et Al (2020) EHR-based clinical surveillance is a promising new tool that may provide more reliable information on sepsis incidence and outcomes and thereby help drive further innovations and improvements in sepsis prevention, detection, and management. This will hopefully improve patient outcomes and become a tool that clinicians can rely on. 

References 

Dewsbury, G. (2019). Use of information and communication technology in nursing services. British Journal of Community Nursing, 24(12), 604–607. https://doi-org.ezp.waldenulibrary.org/10.12968/bjcn.2019.24.12.604 

Shappell, C. N., Klompas, M., & Rhee, C. (2020). Surveillance Strategies for Tracking Sepsis Incidence and Outcomes. Journal of Infectious Diseases, 222, S74–S83. https://doi-org.ezp.waldenulibrary.org/10.1093/infdis/jiaa102 

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6 months ago

Chaquita Nichols 

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Thank you for your response. I feel that as healthcare advances, so will the need for Nursing Informatics Specialist. “The future Nursing Informatics Specialist with function in the context of virtual care delivery, be informed by data aggregated for a multiplicity of sources and real-time knowledge generation that will inform individualized care” (Nagle, L., Sermeus, W., Junger A. (n.d.)). I think that there are a lot of nurses that don’t know about the opportunities that are available to them in the field of nursing informatics. “Advanced credential and certification have afforded nurses the opportunity to achieve credibility and legitimacy regarding the specialty informatics knowledge and skills they bring to bear in nursing practice and academia and healthcare in general” (Nagle, L., Sermeus, W., Junger A. (n.d.)). Nursing informatics plays a big role in providing ways to make our jobs safer and easier. They develop different protocols for different diagnoses so that there would not be a delay in patient care. Just like the example you gave about the stroke code. The data intel’s the responsibility of each department. As the patient is being asked certain questions, the information is being entered into a system in which there is the process of elimination to provide the necessary care. That way the patient is guided in the right direction to receive the necessary care. They can get the correct screenings, labs, and medications because each department will get prompted to do something based on the data entered.  “Part of good information management ensures that care providers have resources that they need to provide safe, efficient, quality care such as policy and procedure manuals or drug databases” (Hebda T., Czar P. pp 5).

Hebda, T., & Czar, P. (2012). Handbook of Informatics for Nursing & Healthcare Professionals (5^th ed.). Pearson Education.

 

Nagle, L., Sermeus, W., & Junger, A. (2017).  Evolving Role of the Nursing Informatics Specialist. In J. Murphy, W. Goosen, & P. Weber  (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF

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6 months ago

Sophie Enjema Ndumbe 

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Scenario

I work in a rehabilitation hospital, the facility has realized that most patients who have indwelling urinary catheters usually suffer from urinary tract infections. This is an ongoing problem, and it has been around for a long time. The facility in trying to find out the means of reducing infections. They need data on the number of patients who got urinary tract infection using urinary catheters and those who did not get it, how long they use the catheters before contracting the disease, for those who did not get the disease, how long have they been using catheters. These data will help them to make inform decisions on whether they have to reduce the number of days of using an indwelling urinary catheter. Proper assessments need to be before a urinary catheter is inserted to an individual (Elpern, 2016).

 

Description of how the data might be collected or accessed and how the data could be used

The data could be collected from the hospital’s patient medical record, this will include all the patients who have urinary catheters. In addition, the nursing staff or the infectious disease control nurse can interview all the patients with urinary catheters. The patients will be asked questions that allow them to explain how they feel with the catheter, give any difficulties that they are experiencing with their catheter like burning, itching, blood in urine, lower abdominal pain, chills cloudy urine etc. After this data have been collected, the patients will have to do a urinalysis and urine culture test to determine those with urinary tract infection. Shadle et al. (2021) states “75% of hospital-acquired urinary tract infections are attributed to indwelling urinary catheter use” (p. 63).

What knowledge might be derived from that data?

How long does patients use catheters before they are diagnosed with urinary tract infection.

Ways to prevent urinary infections in people with urinary catheters

The time frame to determine if a patient is likely to get urinary tract infection or not with a catheter

Educating patients and staff on how to care for urinary catheters

How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

The Nurse leader will understand why some patients are likely to develop urinary tract infection than others. They will use this knowledge to educate the nurses on how to properly assess patients with indwelling urinary catheters to reduce the prevalence of urinary tract infections. The nurse leader will understand when it is necessary to request urinalysis and urine culture for various patients with catheter base on their assessment reports. Using evidence-based knowledge from previous experiences, the nurse will be able to provide proper care and thus educate the patient on how to prevent catheter urinary tract infections. Treatment will proceed based on the results of the test. Also, since the nursing leader is aware that most patients with indwelling urinary catheter are at risk of developing urinary tract infections, they would educate the patients on proper catheter care.

Continuous assessment of patients and proper communication with the physician will help slow down the rate of infections. If the physician is well informed about the progress of a patients, they may sometimes decide if the catheter should be removed to prevent further infection. If patients know how to take proper care of their urinary catheters it will prevent them from having infections. Also educating the nursing staff assigned to patients using catheters would reduce the rate of infections. For example, instituting preventive measure like providing catheter care every shift, empty the bag when it full, ensuring that the urine bag is in a lower position etc. Catheters should be removed after the indication of use is complete and the patient is voiding well (Williams, 2016).

 

Conclusion

By using the data collected from the above scenario, a healthcare facility can prevent patients from contracting urinary tract infections. They will have a mitigation strategy in place for early and easy detection of urinary tract infections in patients with urinary catheters and make it easier for them to treat the patients. Educating the patients and staff on proper catheter care will help prevent them for having infections.

 

References

Elpern, E. (2016). Prevention of catheter-associated urinary tract infections in adults. Critical Care Nurse, 36(4), e9–e11. https://doi-org /10.4037/ccn2016208

Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A bundle-based approach to prevent catheter-associated urinary tract infections in the intensive care unit. Critical Care Nurse, 41(2), 62–71. https://doi-org/10.4037/ccn2021934

Williams, L. (2016). Zeroing in on Safety: A pediatric approach to preventing catheter-associated urinary tract infections. AACN Advanced Critical Care, 27(4), 372–378. https://doi-org /10.4037/aacnacc2016297

 

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6 months ago

Miguel Rodrigo Estrera 

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Hello Sophie,

I enjoyed your very informative post regarding catheter-associated urinary tract infections.  Catheter-associated urinary tract infection (CAUTI), which is caused by an indwelling urinary catheter, is a major cause of healthcare-associated infection (HAI) in the United States. Hospital systems are putting significant effort into CAUTI reduction initiatives as a result of the national focus on HAI reduction and how these infections severely impact patient outcomes (Purvis, et al., 2017).  CAUTI occurrences are thought to be preventable in 69 percent of cases; in 2009, the US Department of Health and Human Services supported nationwide initiatives to reduce CAUTI rates. Avoiding unnecessary catheterization and lowering catheterization duration are among the measures taken to reduce CAUTI rates (e.g., by using reminder systems to encourage catheter removal when the catheter is no longer indicated) (Letica-Krigel, et al., 2019). As Nurse leaders, we can analyze the data gathered and develop programs to reduce CAUTI through evidence based practice.

 

References

Letica-Krigel, A., Salmasian, H., Vawdrey, D., Youngerman, B., Green, R., Furuya, Y., . . . Perotte, R. (2019, February). Identifying the risk factors for catheter-associated urinary tract infections: a large cross-sectional study of six hospitals. BMJ journals, 9(2). doi:10.1136/bmjopen-2018-022137

Purvis, S., Kenendy, G., Knobloch, M., Marver, A., Marx, J., Rees, S., . . . Shirley, D. (2017, October/ December). Incorporation of Leadership Rounds in CAUTI Prevention Efforts. Journal of NUrsing Care Quality, 318-323. doi:10.1097/NCQ.0000000000000239

 

 

 

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Good response Sophie.  These are great questions in searching the best practices!

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6 months ago

Adam Hundley 

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​Main post 

The resources we accessed for module one were able to open my eyes to just how much informatics is playing a role in patient care and education. Understanding that informatics mixes technology and information to turn that into something anyone can use is the key to helping me understand the discipline (Laureate Education, 2018). Even after seeing all the information, my mind is still sort of processing and “waking up” to the subtleties which informatics has already meshed into the hospitals where I work. Healthcare and informatics integration are growing throughout the industry (Sweeney, 2017).  I do believe as humans we tend to attempt to streamline all activities related to work and will continue to integrate informatics into healthcare. 

One incident I experienced within the last year quickly comes to my mind which could use some data collection and assimilation to direct future care and protocol. A patient in the ICU was extubated at about 1500 on a given day. This patient was in constant need of oral suctioning to clear their airway afterward. Due to a need for beds and to keep nurses in ratio, the patient was pushed out to the telemetry unit at 2000. The patient then coded early the next morning and eventually died a couple of months later after the doctors declared the anoxia from the code caused irreversible brain damage. The charge nurses argued with each other, one stating, “the protocol is to not transfer a patient until they have been extubated for twenty-four hours.” The other charge disagreed citing there was no such protocol. 

Having looked a little at informatics, I wonder if data gathered from patients who have been extubated could lead to a policy regarding the appropriate time to keep in the ICU. Certain data could be collected such as the need for oral suctioning, level of consciousness/orientation, and oxygen needs including work of breathing. The staff could then look at the disposition of these patients and their outcomes. This could lead to a “score”, if you will, which could determine if the patient could be transferred after a given number of hours. After the protocol is in place, the data could continue to be monitored. 

 

 

References 

Laureate Education (Producer). (2018). What is Informatics? [Video file]. Baltimore, MD: Author. 

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

 

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6 months ago

Tina Alino 

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Hello Adam,

I enjoyed reading your post. The shortage of nurses and working equipment has put a torn on the healthcare system, affecting our patients and families. Research shows that a heavy nursing workload unfavorably affects patient safety; it also negatively affects nursing job satisfaction and, as a result, contributes to high turnover and the nursing shortage (Haddad et al., 2020). Based on your scenario, that patient would have been left in the ICU because I work in the telemetry unit. I know that a nurse can have about 4 to 5 patients in my unit, making it hard for any nurse to take care of a critical patient like this one and still take care of 3 or 4 more patients.

Informatics technology (IT) has broadened the healthcare system and has made them grow both in the care they provide and in reducing the mortality rate seen due to medical error. It has also helped us decrease the amount of Health Insurance Portability and Accountability Act (HIPPA) violations seen among nursing staff. Research shows that before Congress passed the law for the effectiveness of HIPPA, one of their requirements was for the institution of federal standards to guarantee electronic protected health information security. They required that to ensure privacy, reliability, and availability of health information that protects individuals’ health information while also granting access for health care providers and health plans for continued medical care (Edemekong et al., 2021).

References

Edemekong, P. F., Annamaraju, P., & Haydel, M. J. (2021, February 4). Health Insurance Portability and Accountability Act. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK500019/

Haddad, L. M., Annamaraju, p., & Oney-Butler, T. J. (2020, December 14). Nursing shortage. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK493175/

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6 months ago

Mauricio De Regules 

RE: Discussion – Week 1

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Adam, 

I enjoyed reading your discussion, there in fact, a lot of weird scenarios throughout nursing that can be hard to deal with. But yes, hopefully with the use of more technology and information in general we can be on the same page for many of these controversial scenarios. Today, to maintain public health as one of nursing education’s main goals, much emphasis has been placed on evaluating and empowering nursing informatics competencies (Farzandipour & Mohamadian, 2021). In my career as a nurse, I have dealt as well with situations I was not extremely comfortable doing but nursing is sometimes not 100% like they teach you at school. A gap in informatics expertise amongst nursing students, practising staff and faculty has been noted globally, which reduces the potential for nurses to utilize technology to enhance patient care (O’Connor & LaRue, 2021). 

 

References: 

Farzandipour, M., Mohamadian, H., Akbari, H., Safari, S., & Sharif, R. (2021). Designing a national model for assessment of nursing informatics competency. BMC Medical Informatics and Decision Making, 21(1), 35. https://doi-org.ezp.waldenulibrary.org/10.1186/s12911-021-01405-0 

 

O’Connor, S., & LaRue, E. (2021). Integrating informatics into undergraduate nursing education: A case study using a spiral learning approach. Nurse Education in Practice, 50, 102934. https://doi-org.ezp.waldenulibrary.org/10.1016/j.nepr.2020.102934 

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6 months ago

salome ugwu 

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Hi Adam!

 

Your post captured my interest, incident like this one you shared on your post happens often more than we might think, and unfortunately it is our patients that are on the receiving end of such mistake which most times leads to death. Most informatics activity is aimed at reducing unnecessary errors, mistake, and misjudgments at the point of decision, insofar as these arise from inappropriate accessing and processing of data and information. Healthcare professionals use the results of scientific research, when available, and ‘big data’, when rigorously analyzed, as inputs into the probability judgements that need to be made in decision making under uncertainty. But these judgements are needed irrespective of the state of ‘the evidence’ and personalized evidence on person/patient-important criteria is very often poor or lacking. The Institute of Medicine’s landmark report asserted medical error is seldom the fault of individuals, but the result of faulty healthcare policy/procedure systems. Numerous studies have shown that information technology can shore up weak systems. For nursing, information technology plays a key role in protecting patients by eliminating nursing mistake. I believe, Informatics and technology will help in easy access of some protocols and procedure thereby helping to eliminate some mistakes like the one you narrated in your post.

 

 

 

 

 

References

Kaltoft, M. K., Nielsen, J. B., Salkeld, G., & Dowie, J. (2014). Enhancing informatics competency under uncertainty at the point of decision: a knowing about knowing vision. Studies in Health Technology and Informatics, 205, 975–979.

 

Simpson, R. L. (2005). Patient and nurse safety: how information technology makes a difference. Nursing Administration Quarterly, 29(1), 97–101. https://doi-org.ezp.waldenulibrary.org/10.1097/00006216-200501000-00015

 

 

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6 months ago

Bailey Schaal 

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6 months ago

Adam Hundley 

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6 months ago

Annisha Mcgowan 

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6 months ago

Bailey Schaal 

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6 months ago

TYLENEA JONES 

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6 months ago

TYLENEA JONES 

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6 months ago

Jessica Ferrin 

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6 months ago

Ivo Ngosong 

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6 months ago

Annisha Mcgowan 

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Tylenea awesome post. Catheter associated urinary infections (CAUTI’S) are one of the most avoidable hospital acquired infections. Analysis found that CAUTIs accounted for approximately 15% of reported HAI events annually (Shadle et al., 2021). Within the facility I am currently employed, patients with catheters are monitor closely. The process of monitoring starts at the time of insertion. The infection control departments keep a log of every patient with catheters. Nurses must complete continuing education courses regarding CAUTI’s yearly to stay up to date with new evidence-based practice. Many facilities have adopted maintenance bundles measures. These measures include maintaining a closed drainage system, unobstructed urine flow with no kinks or dependent loops, empty the catheter bag regularly, standard precaution with any care or manipulation, routine hygiene care to include twice-daily catheter care, catheter care with a bath and with any incontinence episode, and to maintain the seal between the catheter and bag tubing (Leontie, 2021). Following these bundles will decrease CAUTI’s therefore decreasing hospital expenses.

References

Leontie, S. L. (2021). Utilizing a “Fight the Foley” Bundle to Reduce Device Utilization Rates and Catheter-Associated Urinary Tract Infections. Urologic Nursing, 41(4), 208–213.

Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit. Critical Care Nurse, 41(2), 62–71. https://doi-org.ezp.waldenulibrary.org/10.4037/ccn2021934

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6 months ago

Mauricio De Regules 

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The Application of data to problem-solving: The growing need for the development and advancement of nursing has resulted in seeking relevant data to help achieve this purpose in nursing. Nursing informatics is a practice within nursing that integrates the nursing science with several other analytical and information sciences to define, manage, identify and communicate information, knowledge, data, and wisdom within the nursing practice (HIMSS, 2021). One scenario that stands to benefit from access to data within nursing is patient satisfaction. Patient satisfaction data is engraved in patients’ opinions and ratings of nursing services offered in an institution and form an important pillar on which nursing has, over the years, been developed. While many healthcare institutions allow for collecting patient opinions on their satisfaction with the quality of services offered in these institutions, access to such data can help advance the nursing practice. For instance, such reviews form the core of a hospital’s directory information and are essential in managing patients, healthcare services, and public health services. They, therefore, form a crucial element of the decision making within a hospital and aid in problem-solving (Peak & Sinclair, 2002). The development and access to patient satisfaction data through a patient opinion database provides essential feedback about the services offered and is a source of recommendations on how service delivery can be improved in a hospital setting. As such, access to patient satisfaction data in nursing improves communication between patients and practitioners and can be an essential source of insights for improving the services offered (Nagle et al., 2017). Accordingly, patient satisfaction data improves the quality of an institution’s data by continuously reflecting current patient needs, thereby standing out as an essential tool for knowledge formation in a hospital. Through such opinions and feedbacks, a hospital’s management interacts with their clients and gets a deeper understanding of the quality of services they offer and what more could be done to improve these services. Therefore, access to patient satisfaction data is vital for the nursing profession and can facilitate problem-solving and knowledge formation within an institution. References: HIMSS. (2021). What is Nursing Informatics?. HIMSS. Retrieved 1 September 2021, from https://www.himss.org/resources/what-nursing-informatics. Peak, T., & Sinclair, S. V. (2002). Using customer satisfaction surveys to improve quality of care in nursing homes. Health and social work, 27(1), 75-79. Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Informatics Competencies For Nurses In The Future Of Connected Health, 1-10. https://doi.org/doi:10.3233/978-1-61499-738-2-212

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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6 months ago

Alexis Liggett 

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6 months ago

Mercy Ambe Mbu 

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6 months ago

Ivo Ngosong 

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6 months ago

Mercy Ambe Mbu 

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Hi Ivo,

Thanks for your response and insight. You are correct to say that Nursing informatics is crucial to advancing the profession and the quality of care.  As technology advances, healthcare organizations and providers can collect, analyze and leverage data more effectively, influencing how care is delivered, resources are managed, and teams operate daily. According to  Al-Hawamdih and Ahmad (2018), the success of healthcare institutions depends mainly on the quality of information. All information collected on patients and recorded in Electronic Health Records (EHR) is a good source for identifying gaps, research, and creating evidence to enhance patient care outcomes.  Determining best practices necessitate the use of informatics. 

 

References

Al-Hawamdih, S. & Ahmad, M. M. (2018). Examining the Relationship Between Nursing Informatics Competency and the Quality of Information Processing. CIN: Computers, Informatics, Nursing, 36 (3), 154-159. https://oce-ovid-com.ezp.waldenulibrary.org/article/00024665-201803000-00008/HTML

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6 months ago

Annisha Mcgowan 

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6 months ago

Mercy Ambe Mbu 

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Hi Annisha,

            Thank you for taking the time to respond to my post. I appreciate your contribution. Yes, I agree with you that statistics is vital at every level of practice. Data is essential in the identification of gaps in healthcare practice as well as in the evaluation of interventions. According to  Moule, Armoogum, Douglass, and Taylor (2017), evaluation is imperative in healthcare because it supports an evidence-based approach to practice delivery. Numbers are required to determine how far we achieve set goals and if we need to restrategize.

References

Moule, P., Armoogum, J., Douglass, E., & Taylor, D. J. (2017). Evaluation and its Importance for Nursing Practice. Nursing Standard (2014+), 31(35), 55. http://dx.doi.org.ezp.waldenulibrary.org/10.7748/ns.2017.e10782

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6 months ago

Tammy Rodgers 

RE: Discussion – Week 1

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Response 2 to Mercy

Mercy,

I work in an acute mental health hospital as well. I am envious that your facility has EHR while we still utilize paper charting. A study in the International Journal of Medical Informatics states that EHR is beneficial in helping to reach clinical decisions in a more timely manner regarding patient care but 48.8% of survey respondents voiced concern about third parties gaining access to health information (Entzeridou, et al., 2018). I can understand this concern but I do believe the benefit outweighs the risk.

Interestingly enough, I have never heard of the Broset Violence Checklist (BVC) but can see how it would be a useful tool to utilize on the unit. The BVC is also beneficial in an Emergency Department (ED) setting. A study notes that out of 2064 patients assessed by the BVC, 35 had aggressive behaviors and the predictive value of the BVC is 55.2% and the study deems it an appropriate tool to implement and use in the ED (Partridge & Affleck, 2018). I will suggest the tool be implemented in our facility.

Tammy

References

Entzeridou, E., Markopoulou, E., & Mollaki, V. (2018). Public and physician’s expectations and ethical concerns about electronic health record: Benefits outweigh risks except for information security. International Journal of Medical Informatics, 110, 98–107. https://doi.org/10.1016/j.ijmedinf.2017.12.004

Partridge, B., & Affleck, J. (2018). Predicting aggressive patient behaviour in a hospital emergency department: An empirical study of security officers using the brøset violence checklist. Australasian Emergency Care, 21(1), 31–35.

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6 months ago

Mercy Ambe Mbu 

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Hi Tammy,

I appreciate your response and insight. Thank you

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6 months ago

Paola Gaudioso 

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Mercy,

This was very interesting to me because I also work in an inpatient hospital and I have never used this scale. The hospital I work for is voluntary, but we still get patients that are violent.  I had to do some research to learn more about the tool. It seems that gathering information with in a 24 hour period can help predict how the patient will act on the unit (Sarver et al., 2019). Many psychiatric patients have violent tendencies and being able predict these behaviors can help the staffs on the units be aware of tendencies. Being able to track a patients behaviors in a system is helpful because unfortunately many psychiatric patients use hospitals frequently.

After a 5 year evaluation of charting the BVC it was found that there were 6 different behaviors that were predictive of violence and those were confusion, irritability, boisterousness, physical threats, verbal threats, and attacking objects (Almvik, 2003). After reading about the BVC scale it seems that this would be helpful in all inpatient hospitals to help with the revolving patients that come through. If staff is aware of patients and their behaviors they can decrease triggers and so forth. This would help decrease violence in the inpatient setting.

 Informatics plays a great role in this because the nurses can gather the information and do so much with it. The information can help decrease codes on the units and predict if more staff is needed. I know that in the hospital I work for all this would be extremely helpful to make sure our patients are receiving the best care possible.

References 

Almvik, R., Woods, P. (2003). Short-term risk prediction: the Brøset Violence Checklist. Journal of Psychiatric & Mental Health Nursing. 10(2), 236-238.

Sarver, W. L., Radziewicz, R., Coyne, G., Colon, K., & Mantz, L. (2019). Implementation of the Brøset Violence Checklist on an Acute Psychiatric Unit. Journal of the American Psychiatric Nurses Association, 25(6), 476–486. https://doi.org/10.1177/1078390318820668

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6 months ago

Mercy Ambe Mbu 

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Hi Paola.

Thank you for taking the time to respond and throwing more light to the BVC.

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6 months ago

Robin Moyers WALDEN INSTRUCTOR MANAGER

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Class,

Today is day 6. Make sure to have your three post in today.  We have had excellent discussions and sharing of information in data and the use of technology and informatics in nursing and healthcare.  Our next discussion thread will begin week 3 Module 2.  

Dr. Moyers

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6 months ago

Tiffany Turner 

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The Importance of Informatics within the Mental Health Community

Informatics plays such a large role in all areas of health care. Working for the Department of Mental Health allows me to provide care to people of various walks of life and also allows me to see the gaps within the healthcare system. I currently work for the aging population and many of my patients are not linked to Primary Care Providers. Approximately 40% of my patients believe their Psychiatric provides the same care as an Internist or Gerontologist. Therefore, many of my patients are not link to a PCP.  Informatics can integrate behavioral and physical health care needs to a community that lacks so much (Johnson & Meyer 2019). 

To integrate behavioral and physical health care informatics is vital (Cancer, 2011). Being able to collect the data on how many of those within the mental health care community is not linked to PCP would be the first data needed to be collected. This data would be collected by assessing each patient and/or caregiver being seen within the department rather or not they’re linked to a PCP. Upon collecting said data the needs of linkage to a PCP for out patients should be clearly define and thus policy changes should be developed to ensure patient are linked to PCP upon admission into the program. 

Nursing leaders can implement new polices in light of the data that would require staff to assess in coming patients for their last PCP appointment and PCP information. Many of the patients I provide care for are not in favor of doctor visits. Therefore, patients may not be forthcoming with PCP information which would require the initial screener to obtain the PCP contact information for verification. Overall, informatics provides critical information to providers, scientists and the pharmaceutical industry which leads to developing cutting edge advancements on how care is delivered within the health care system (Ranallo, et al, 2016). 

References

Cancer, J. (2011, August 17). THE ROLE OF INFORMATICS IN PROMOTING PATIENT-CENTERED CARE. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146983/

Johnson, S. R., & Meyer, H. (2019). Behavioral health. Modern Healthcare. https://www.modernhealthcare.com/reports/behavioral-health/

Ranallo, P. A., Kilbourne, A. M., Whatley, A. S., & Pincus, H. (2016). Behavioral health information technology: From chaos to clarity. Health Affairs, 35(6), 1106–1113. https://doi.org/10.1377/hlthaff.2016.0013