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NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING

NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING

BY DAY 3 OF WEEK 1

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

BY DAY 6 OF WEEK 1

Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.

 The Application of Data Collection to Problem Solving and Knowledge Formation in Nursing.

Data collections in healthcare is crucial to problem solving in order to deliver adequate health care services. Nursing informatics is essential in supporting and accelerating learning within the health care system. Data collection helps to generate knowledge that is embedded into the core practice of medicine and leads to continual improvement in care (Borksy et al, 2019) NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING. Data and information collection is very important in decision making and problem solving in recent times. Health care professional utilize data collections to provide effective solutions to problems and for better decisions. Nursing informatics deals with information technology and analytical sciences in nursing practice to identify, manage, define, build knowledge and data in nursing practice (Nagle et al, 2017).

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A hypothetical scenario i will be considering that will benefit from access to data, and which will facilitate problem solving is Triaging mental health patients, using children as case study. At Psychiatric emergency where i work, most of the time we encounter scenarios like this, trying to gather data information from patients in order to be able to render the help they need. Adolescents come in with little or no insight to their condition or situation NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING. As nurses, in a situation that we are unable to gather much information from the patient, we utilize the notes stored in the patient’s chart from previous encounters. Retrieving past records of patients always help to understand many things about the patient, which may include previous diagnosis, medical history, medication history. The retrieval of this previous data usually assists providers to be able to understand the patient better by building knowledge and help to solve problems at hand. Data collection is important in this scenario, to assess and determine what mental disorder the patient is suffering from. Other data to be collected include result of investigations, and patient’s behavioral pattern. According to AAP- AACAP-CHA (American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association) in October 2021, emergency declaration in children’s mental illness called for strategies to meet challenges in child mental health care through innovation and action. Give to the rapidity with which shifts toward health information technology have occurred, child psychiatric education may wish to seek training for themselves through departments of clinical informatics. This relationship may provide exchange of knowledge.

Healthcare Providers can determine the trends in patient condition, and monitor the patterns of the disorder among the group of people under study (McGonigle & Mastrian, 2017). Nurses can also utilize data information and information gathered to determine the best treatment plan for an individual with mental disorder. To support a vision of a learning health system with the capacity to provide timely and improved mental healthcare for children, there must be solid connections between data collection, development of clinically useful tools, and adequate communication, to support quality of care (Bruni et al, 2021) NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING.

References.

American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s hospital (2021). Declaration of a national emergency in child and adolescent mental health. Retrieved from https://www.aap.org/en/advocacy/chil-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in=child-and-adolescent-mental-health/.

Borsky A.E., Flores E.J., Berliner E., Chang C., Umschield C. A., Chang S.M. (2019). Next steps in improving healthcare value: AHRQ evidence-based practice Center Program applying the knowledge of practice to data cycle to strengthen the value of patient care. J. Hosp Med 2019; 14:311

Bruni T., Lalonde L., Maragakis A., Lee J., Caserta A., Kulbourne A.M., Smith S., Qringer K., Quigley J., McCaffery H., Lancaster B. (2021). The use of electronic health record tools to improve evidence-based treatment of adolescent depression in primary care. Acad. Pediatr. 2021; 21: 1195-1202. doi: 10.1016/j.acap.2021.05.022

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

Nagle, L., Sernius, W., and Junger, A. (2017). Evolving role of the nursing informatics specialist. Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.uni.ch/resource/serval;BIB_4A0FEA56B8CB.POO1/REF.

 

SAMPLE POST 2

Application of Data to Problem Solving.

Healthcare professionals constantly process and utilize data and information to ensure safety as they provide care to the patients (McGonigle & Mastrian, 2022). They acquire bits of data and information and transform it into knowledge that is vital in assessment and formulation of treatment plans used in management of patients. Recent times have seen advances in Telemedicine where consultations and diagnoses are being made through computer technology and remote nursing monitoring (Nagle, Sermeus & Junger, 2017). It therefore is important to maintain integrity and quality of data for it to be valuable and meaningful to inform decision making.

The scenario that I would consider benefitting from access and collection of data in my organization is medication errors. Data that can be utilized in this case is alphanumerical e.g., patient’s names, medical record numbers; audio data like sounds from monitor alarms, taped or recorded messages and image data such as patient pictures. This data can be used to identify the right patient by their correct names, date of birth, medical record number. The alert monitors in the system will go off to alert you if the medication being issued is not the correct one or if there’s a deficit in the dosage, and the image data e.g., patient picture will be used to compare in real time to the patient. This knowledge can be utilized to identify any errors that may arise during medication administration.

Nurse managers can use this knowledge to identify the gaps that led to the errors and keep other staff informed on ways to minimize such errors. The use of health informatics is not only relevant in clinical settings but also managerial settings (Sweeney ,2017), hence the knowledge of medical errors can be communicated to other members of staff through other healthcare informatic avenues such as emails, fax, or instant messenger within the organization to pass across the message to avert more errors NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING.

References

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

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). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics21(1), 4–1.

 

NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING SAMPLE RESPONSE 

Thank you for your post XX,

The use of an EMR to reduce errors in medication administration is a great use of data technology to help deliver nursing care. Ratanto et al., (2021) support that the use of an EMR in medication administration reduces errors. Your post focuses on the identification of the right patient, the right medication, and the right dosage.

Besides errors in medication administration, data technology can also be used to monitor for potential medication interactions. Gefen et al., (2020) discuss a Calcium Channel blocker (that is no longer used in the US, but is still used in other countries) and the use of the EMR to monitor for drug interactions. EMRs can also be used to warn about potential adverse reactions between drugs. This is discussed by Wright et al., (2018) who acknowledge the ability of EMRs to warn about drug interactions, but also discuss the pitfalls of human reaction to such systems in the form of what they call “alert fatigue” (the potential for people to ignore the warnings if they are too frequent).

Rerferences

Gefen, D., Ben-Assuli, O., Shlomo, N., Robertson, N., & Klempfner, R. (2020). A case study of applying text analysis to identify possible adverse drug interactions: The case of Adalat (Nifedipine). Health Informatics Journal, 26(2), 1455–1464. https://doi.org/10.1177/1460458219882269

Ratanto, Sri Hariyati, R. T., Mediawati, A. S., & Eryando, T. (2021). The Effectiveness of Electronic Medication Administration Record: A Systematic Review. International Journal of Nursing Education, 13(3), 97–103.

Wright, A., Aaron, S., Seger, D. L., Samal, L., Schiff, G. D., & Bates, D. W. (2018). Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record. Journal of General Internal Medicine, 33(11), 1868–1876. https://doi.org/10.1007/s11606-018-4415-9 NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING

 

NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVINGSAMPLE POST 2

Initial Post

With the rise in technology, nursing informatics is in high demand. Currently, I am the surgery department director, but I also trained new staff on charting and navigating the eMR that my facility uses. I would not say I have the official title of “Nursing Informaticist,” but I enjoy educating and helping others, nurses and providers alike, with our eMR system. A common downfall I have witnessed is the blame placed on the eMR or the computer itself when it is not working as the operator would like. On the contrary, I find that many systematic improvements have been identified but are limited by the financial ability of my small institution.

While understanding that eMR’s allow for faster access to health records, sometimes something that can make the job easier can also have its limitations. One issue I have identified is the need for an informatics nurse at our facility. Being a small, rural hospital, the informatics nurse position would likely not be utilized full-time. There are many parallel challenges in a rural hospital regarding information technology. “Critical-access hospitals with certain types of technical assistance and resources available to support health IT were more likely to have adopted health IT capabilities and less likely to report significant challenges to EHR implementation and use, compared to other hospitals in the survey. It is important to ensure that the necessary resources and support are available to critical-access hospitals, especially those that operate independently, to assist them in adopting health IT and becoming able to electronically link to the broader health care system” (Gabriel et al., 2014).

Having quick access to health records is vital in caring for patients with considering the regulations on charting in Healthcare. Audits are completed to identify areas of strength and areas that require improvement. Audits can provide education opportunities and enlightenment to staff. “The reason for collecting and building data, information, and knowledge is to make informed, judicious, prudent, and intelligent decisions” (McGonigle et al., 2022).

Nurse leaders can use clinical reasoning and judgment through the accumulation of experience and skills that they have obtained over time. The experience and knowledge to identify concerns and interpret data can assist in educating others. Cognitive Informatics is best defined by McGonigle et al. (2022) as computing and informatics theories that can be applied to help elucidate the information processing of the brain, and cognitive and neurological sciences can likewise be applied to build a better and more efficient computer processing systems (p. 73). Patel and Kanampallil (2015) expand by explaining how they found that most research contributions fell under the topics of decision-making, usability, and distributed team activities with a focus on studying behavioral and cognitive aspects of clinical personnel, as they performed their activities or interacted with health information systems.

References

Gabriel, M. H., Jones, E. B., Samy, L., & King, J. (2014). Progress and challenges: Implementation and use of health information technology among critical-access hospitals. Health Affairs33(7), 1262–1270. https://doi.org/10.1377/hlthaff.2014.0279

McGonigle, D., & Mastrian, K. G. (2022). Chapter 4: Introduction to Cognitive Science and Cognitive Informatics. In Nursing Informatics and the foundation of knowledge (5th ed., p. 73). essay, Jones & Bartlett Learning.

Patel, V. L., & Kannampallil, T. G. (2015). Cognitive Informatics in biomedicine and Healthcare. Journal of Biomedical Informatics53, 3–14. https://doi.org/10.1016/j.jbi.2014.12.007

 

NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING SAMPLE POST 3

Working in the operating room for more than a decade now, my role as a circulating nurse does not only rely on executing surgical care tasks but, most importantly, being an advocate for my patients, attending to their needs and safety aspects. My utmost priority is maintaining the safety of a vulnerable human being at the operating table. Sentinel events in the operating room have been a primary public concern all around the globe, which negatively impacts patients, caregivers, and health institutions. Recognizing these issues and providing preventative measures should be promoted to reduce the number of surgical errors that could lead to permanent physical impairment and even death to a patient. The World Health Organization imposed the Safe Surgical Checklist to ensure patient safety in the operating room and promote collaborative teamwork. According to the World Health Organization, compliance with the surgical checklist significantly reduces complications and death related to surgical interventions. Acknowledging one’s competency and taking a rightful place as an equal team member, surgical nurses should be encouraged to speak up and take responsibility for their patients (Willassen et al., 2018).

 

Patient care scenario:

A 70-year-old male scheduled for right total knee arthroplasty, patient, arrived in the pre-operative area at 5:30 am and was received by his pre-op nurse Mindy who assisted patient Rob in changing into a hospital gown. Nurse Mindy connected Patient Rob to the medical monitoring machine, inserted an intravenous catheter, did a physical assessment, and documented the patient medical history. While completing her charting, the anesthesiologist came, verified, and interviewed the patient. Patient Rob was scheduled for an anesthesia block before his surgery. The surgeon arrived in pre-op to see his patient, Dr. Smith, then talked to his patient, signed the consent, and performed skin marking; after a few minutes, he moved to the next bay to see his next patient in line. Circulating nurse Jane came to interview patient Rob after setting up the operating room. Nurse Jane verified the patient’s identification and confirmed the planned procedure by confirming the surgical consent with her patient and verifying it through the EPIC hyperspace documentation system under the active orders section. While the patient verbalized the surgical procedure, nurse Jane checked the laterality marking made by surgeon Smith; however, nurse Jane noticed the left knee had a skin marking instead of the right side. Nurse Jane then verified the consent again and double-checked the initial plan made by the surgeon in the orthopedic clinic during the patient visit and the physicians’ active order through the EPIC system on the patient’s file. Nurse Jane then informed her charge nurse on duty, and the surgeon was called back to the patient’s bedside to check the surgical order and the right laterality. The surgeon realized he had mistakenly marked the wrong site and admitted that he got mixed up with the other patient, for which he had six patients to be operated on that day. The error was detected before transferring the patient to the operating room. The circulating nurse submitted an incident report. This process involves recording near misses, injuries, and accidents inflicted on a patient under the Ikenet data system. Nurse Jane protected her patient from a serious medical error called “wrong site surgery” and took a preventative measure to prevent a future incident from happening again. Knowledge management plays a vital role in nursing science that focuses on ethical application and training in providing enhanced interventions of care for the restoration of health in generating nursing comprehension in the advancement of the nursing profession (McGonigle et al.,2022, pp.8-9). Nurse Jane followed clinical practice guidelines that promoted patient safety by providing a high-quality standard of care to her patient. The dissemination of clinical knowledge acquired from her nursing education and work experience guided her to reflect on the best practice expected from a healthcare provider.

Operating rooms are one of the hospital units that threaten patient safety. The incidence of adverse events and surgical complications continues to rise worldwide. The effects on morbidity and mortality in the operating room have been investigated in several studies. Most unwanted events associated with surgical care situations are preventable errors with safe surgical practices. In introducing the Surgical Safety Checklist, TR (SSCTR) emphasized the importance of best practice guidelines in the surgical department. A data analysis using the SPSS statistical software package, version 22.0, was described using standard deviators. The study stated that the barrier to an effective Surgical Safety Checklist was the surgeon’s unwillingness to wait for the checklist application stages. The second most common contribution to the problem was “filling in the list without reading it to the team.” Following the proper guidelines of the SSC protocol prevents surgical near misses and protects patients from surgical deaths (Kisacik et al., 2019).

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Implementation of the SSC entails its primary goal to support surgical practice, encouraging modifications in the clinical approach. With the introduction of the Surgical Safety Checklist by the World Health Organization, a significant reduction in surgical complications with mortality rate dropped from 1.5 to 0.8 % in a global hospital setting. Safety measures directly related to the clinical item list, such as airway evaluation performed before anesthesia induction, pulse oximeter use, the appropriate time for antibiotic prophylactic, verbal confirmation of patient identifiers, planned surgical procedure, instrumentation, sharps, and sponge counts should be completed. The data collected are documented electronically using Electronic Medical Records (EMR). Eisenhower Health Hospital utilizes the EPIC hyperspace data charting system where Universal Protocol guidelines are provided per surgical case. The positive contribution of the checklist intervention resulted in improved patient outcomes such as reduced infections, respiratory complications, bleeding, and cardiac complications. Perioperative nurses showed progress in their care by introducing SSC guidelines to protect their patients by ensuring core body temperature using a forced air-warming blanket and timely use of prophylactic antibiotics before the surgical incision commenced. However, the surgical team should observe the proper utilization of the checklist with a certain agility level to ensure that it is performed accordingly as an essential critical task to provide safe and high-standard surgical care. Nurse leaders face the daily challenges of making sure universal protocol in line with the surgical checklist is performed religiously. This routine can be overwhelming to the staff; nevertheless, operating room management should provide training and guidance to their department in adequately using the SSC and providing the rationale behind its protocol. The overall objective of promoting SSC in surgical practice is to improve the work process in the operating room, resulting in a safe clinical practice (Haugen et al., 2019).

 

                                                                                    References:

Haugen, A., Sevdalis, N., Softeland, E. (2019). Impact of the World Health Organization Safety Checklist on Patient Safety.

https://pubmed.ncbi.nlm.nih.gov/31090552/Links to an external site.

Kisacik, O., Cigerci, Y. (2019). Use of the Surgical Safety Checklist in the Operating Room: Operating Room Nurses’ Perspectives.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572950/Links to an external site.

McGonigle, D., & Mastrian, K. (2022). Nursing Informatics and the Foundation of Knowledge (5th ed.). Jones & Bartlett Learning.

Williassen, E., Jacobsen, I., Tveiten, S. (2018). Safe Surgery Checklist, Patient Safety, Teamwork, and Responsibility-Coequal Demands? A focus Group Study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881961/#bibr1-2333393618764070

 

NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING SAMPLE RESPONSE

Hi XX,

I appreciate how you implemented surgical nursing into this discussion topic. I am a fellow surgical nurse and am currently the director at the facility I work at. We are a small, rural hospital so I am also the only full-time circulator here. I love connecting with others in the surgical nursing field. With that, you brought a great topic up regarding the preoperative checklist and its implementation. Another check that is critical in surgery is the surgical counts performed by the scrub tech and circulator. All of these topics aid in ensuring patient safety as well as improving health care outcomes. Being an AORN member, I quickly referred to the policies related to Information Management and its importance in the perioperative setting. “Highly reliable data collection is not only necessary to chronicle the patient’s response to nursing interventions, but also to demonstrate the health care organization’s progress toward improving health care outcomes. Health care data collection and retention is rapidly transitioning from traditional paper formats to standardized electronic applications that incorporate criteria from statutes and regulations, accreditation requirements, and standards-setting bodies. Whether patient data are captured using paper or electronic formats, the nursing process should be completed for each surgical or procedural intervention performed” (AORN, 2021).

Overall and outside of surgery, EHR generally creates easier workflow and access for healthcare facilities. I would suggest that there is a rise in physical limitations that have been noted from nursing staff. At my facility, many of the nurses, myself included, have experienced symptoms of carpal tunnel syndrome, “tech neck” as it is referred to, and eye strain from continuous computer use. It can get challenging, but these issues are exchanged for the previous complaints of achy feet, sore back, and knee pain in the past. Just something to ponder. “With the old-fashioned paper-based medical records, it is possible that patient health records are spread across multiple doctors’ offices. In case a patient decides to move to another doctor, they may request a copy of their records to be sent to their new doctor, in order to provide them with a complete picture of their health. It is here problems start to crop up, like the patient finding it difficult to recall their previous visit information, missing, damaged or lost records, and illegible handwriting, to name a few. EHR seeks to digitize patient health records so that they are consistent and accessible by all of your healthcare providers” (Global Medical Scribe Society, 2022).

References

EHR – its importance and functions in the healthcare system. Global Medical Scribe Society | Valuable Insights on Medical Scribing. (2022, July 1). Retrieved December 1, 2022, from https://scribesociety.org/2021/10/12/ehr-its-importance-and-functions-within-the-healthcare-system/

Guidelines for Perioperative Practice: Information Management. Aornguidelines.org. (2021, September 14). Retrieved December 1, 2022, from https://www.aornguidelines.org/guidelines/content?sectionid=173732053&view=book

 

NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING SAMPLE RESPONSE 2

Thank you for your informative post regarding surgical data and how these sentinel events occur regularly. Surgical never events are common errors that happen too consistently throughout the world. Data regarding these events were collected between the years 1990 and 2010 in the United States. On average, the annual rate of surgical sentinel events was 4,082 events per year, or nearly 80 errors per week (O’Reilly, 2013). The number of errors is alarming, and with the chance of fatality to the patients on the operating room table, it is something that needs to be addressed correctly NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING.

The World Health Organization (WHO) published the Safe Surgery Checklist in 2009 to help combat the rate of mistakes in the operating room. According to the WHO, using the checklist reduces complications and mortality of surgical procedures by 30 percent or more (World Health Organization, n.d.). This number is impressive in the fight to have safer operations; however, some countries are slower to adopt this practice than others. In Europe, a study was conducted to observe the use of the checklist in different countries. Countries such as the UK, Ireland, the Netherlands, France, and Denmark showed nearly 100 percent use of the checklist before an operation. Other countries like Greece, the Czech Republic, Poland, and Hungary were less than 30 percent. This data was collected using an online database GlobalSurg Consortium. It is a system that has made it easier to gather and review data regarding the Safe Surgery Checklist usage in many countries around the globe (Weiser & Haynes, 2018) NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING. This is a prime example of how nursing informatics is being used on a global scale to tackle and global problem. I appreciate your post, as I was able to discover the use of informatics to help prevent surgical sentinel events.

References:

O’Reilly, K. B. (2013). Surgical errors: In ORs, “never events” occur 80 times a week. American Medical News.

Weiser, T. G., & Haynes, A. B. (2018). Ten years of the surgical safety checklist. Journal of British Surgery, 105(8), 927-929.

World Health Organization. (n.d.). Safe surgery. World Health Organization. Retrieved December 3, 2022, from https://www.who.int/teams/integrated-health-services/patient-safety/research/safe-surgery NURS-6051N Module 1 Discussion THE APPLICATION OF DATA TO PROBLEM-SOLVING

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