Feb 23, 2024 Discussion: The Applications of Data to Problem-Solving
Discussion: The Applications of Data to Problem-Solving
Discussion: The Applications of Data to Problem-Solving
RE: Discussion – Week 1
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One pivotal area of health informatics within my personal nursing practice is the gathering of patient data before they are admitted into the hospital. I work in a critical care unit, so it is imperative to have that level of previous background information before admission into our facility. Data must first ensure that the new patient meets admission criteria, then I am able to learn about the patient in which I will be providing care for. One of the primary ways that informatics has changes nursing practice is through documentation (2020). This is where much of the data for nurses is obtained. During todays society, almost all nursing documentation is electronic, and this makes things much easier when trying to keep the patient’s medical history up-to-date and easily accessible.
The patient data that I collect before admission is based on the medical record that resides within the computer system. An abundance of this information comes from previous documentation that was entered under the medical record. The details that I collect would include their primary and secondary diagnoses, previous assessments, hospitalizations, past treatments, lab results, and medications used. Modern nursing care is driven by individual patient needs and history- information that is collected and organized in electronic patient records. Advances in medical informatics and widespread implementation of electronic medical records facilitate the implementation of best practices and improve quality of care in the ICU (HealthManagement.org, 2020). It is important to develop a new and updated plan based on what was documented in the past.
Throughout my time with the current health care organization I am employed with, many steps have been taken towards ensuring the security and well-being of our patients. We have no paper charting, as everything is currently charted electronically on our desktops or portable computers. Each patient on our unit receives a bar-coded wristband, which allows us to safely administer our medications and glucometer checks. I can think of one particular situation where I had both of my patients asking me for pain medication. Each patient had Morphine ordered for pain, but one consisted of 2 milligrams and the other 4 milligrams. Being a nurse in the ICU, things can get busy very quickly, and this makes it easy to make mistakes if you are not careful. Needless to say, I accidentally switched the dosages, almost giving the patient who had an order for 2 milligrams of morphine 4 milligrams instead. I did not catch this error until I scanned the patient’s bar coded wrist band, then scanned the medication. Our computer system gave me a pop-up warning that I did not need to proceed with this administration, as there was no active order for 4 milligrams of morphine within the patient’s chart. If there had been no way for me to verify the correct medication for the correct patient, I could have potentially given the patient too much mediation, thus causing possible issues. Bar code bands prevent harmful medication errors and help to prevent minor emergencies from becoming severe ones (Technologies, 2018).
References
HealthManagement.org. (2020, August 29). Medical Informatics Improves Quality of Care in the Intensive Care Unit. Retrieved August 30, 2020, from https://healthmanagement.org/c/icu/issuearticle/medical-informatics-improves-quality-of-care-in-the-intensive-care-unit
Informatics in Nursing: Impact and Importance: UIC Online. (2020, July 20). Retrieved August 30, 2020, from https://healthinformatics.uic.edu/blog/the-impact-of-health-informatics-on-nursing-practice/
Technologies, H. (2018, August 06). Importance of Patient Wristband in Healthcare. Retrieved September 01, 2020, from https://medium.com/@healteccbe/importance-of-patient-wristband-in-healthcare-d3cce9dc1c9c
ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Discussion: The Applications of Data to Problem-Solving
Discussion: 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?
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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.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 1
To participate in this Discussion:
Week 1 Discussion
Learning Resources
Required Readings
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.).
Burlington, MA: Jones & Bartlett Learning.
Chapter 1, “Nursing Science and the Foundation of Knowledge” (pp. 7–19)
Chapter 2, “Introduction to Information, Information Science, and Information Systems” (pp.
21–33)
Chapter 3, “Computer Science and the Foundation of Knowledge Model” (pp. 35–62)
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Infomatics 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
Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
Required Media
Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population
Health [Video file]. Baltimore, MD: Author.
Accessible player
Credit: Provided courtesy of the Laureate International Network of Universities.
Public Health Informatics Institute. (2017). Public Health Informatics: "translating" knowledge for health
[Video file]. Retrieved from https://www.youtube.com/watch?v=fLUygA8Hpfo
Technology has added so greatly to the effectiveness of our care. The work that has gone into vital signs and other assessment findings to create alerts when out of range is impressive. In paper forms, essential data can sometimes be missed or even go unnoticed, but having a system that connects the dots help health providers to see the bigger picture. “Advances in technology have been made available to aid nurses perform their jobs and care for patients more efficiently and safely. Nursing today is not the same as it was 30 years ago”(Pepito & Locsin, 2019).
As wonderful as technology is, it requires the working knowledge to derive or identify what is happening with the patients to offer the proper treatment. One cannot overlook the many lives technology has saved. Even the most prudent nurse can make a mistake. We have seen many things that improved in the area of medication administration. “On average, roughly 7,000 patients in the United States die each year from adverse drug events. To help curb these incidents, electronic medication administration has become commonplace”(Impact of Technology in Nursing | Nursing & Technology | Queens, 2020). Technology advancements are happening daily and will continue to revolutionize how we care for our patients. It is such a wonderful thing.
References
Impact of Technology in Nursing | Nursing & Technology | Queens. (2020, December 10). Qnstux; Queen University. https://online.queens.edu/resources/article/impact-technology-nursing/
Pepito, J. A., & Locsin, R. (2019). Can nurses remain relevant in a technologically advanced future? International Journal of Nursing Sciences, 6(1), 106–110. https://doi.org/10.1016/j.ijnss.2018.09.013
Rubric Detail
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Content
Name: NURS_5051_Module01_Week01_Discussion_Rubric
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List View
Excellent Good Fair Poor
Main Posting
Points Range: 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
Points Range: 0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3.
First Response
Points Range: 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
Points Range: 15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
Points Range: 13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Second Response
Points Range: 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
Points Range: 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
Points Range: 12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_5051_Module01_Week01_Discussion_Rubric
Nursing informatics is both a blessing and a curse to the profession. While I cannot argue that data collection for use in research has its value, I also believe it is contributing to the steep decline in job satisfaction of the workforce. Sikka et al. (2015) states that over half of US registered nurses worry about the impact their job has on their health and 35% felt like resigning from their jobs. It is ironic that data gives us this information and will be used to evaluate future trends while simultaneously contributing to the depersonalization of the profession. A reductionist analysis of this trend would lead us to consider why nurses enter the profession from the start. I doubt many nurses got into the profession, excited to see how linear equations can help them “care” for their patients and check the right boxes on their electronic flowsheets. A more likely assumption would be that nurses enter the profession because they are passionate, they want to make a difference, and they want to care for others (With emphasis on caring).
The hypothetical scenario I will explore is the following:
A hospital wants to reduce hospital acquired pressure injuries and leaves a committee of nurses to decide how to accomplish this. The committee concludes that they will use multiple strategies to reduce pressure injuries including an online education module about pressure injuries, requiring flowsheet documentation of turning patients every two hours, and completion of a “skin audit” with both nurses during bedside shift report. The skin audit requires signatures from the oncoming and outgoing RN, signifying that they discussed any skin injuries the patient may have, as well as the patient’s plan for mobility during shift report. Retroactive analysis of electronic charts and collection of skin audit forms after a period will be used to determine association between documentation of turns, completion of skin audits, and occurrence of pressure injuries in patients. This data will help the committee determine whether the implemented measures are helping to reduce the incidence of hospital acquired pressure injuries. The committee knows that for the new strategy and data collection to be effective, everyone involved must participate (Sweeney, 2017). They consider the questions they hope to answer by implementing these changes: Are patients with documented turns every two hours less likely to acquire pressure injuries during their hospitalization? Does completing the skin audit form at shift change decrease the incidence of pressure injuries?
The committee meets to discuss their findings. They begin the meeting by drinking coffee and talking about how overworked, underpaid and understaffed they are. Morale is low. They determine that skin audit forms are being completed at shift change 70% of the time, and most of the nurses on the unit are displeased with the added workload and extra form to complete at shift change every day. During retrospective chart analysis, the committee determines that when skin audit forms are completed more frequently, the patients seem to develop less pressure injuries. They also note that some nurses consistently forget to complete the audit form, while others achieve a near 100% compliance. Increased documentation of turns every two hours also appears to correlate with lower incidence of pressure injuries. One member of the committee recalls reading an article in their MSN program discussing nursing documentation which stated, “The accuracy of the intervention documentation was poor or moderate in 95% of the patient records” (Nagle et al., 2017). After hearing this information, another nurse suggests that perhaps nurses who accurately complete skin audits and flowsheet documentation are more ambitious and have a higher degree of personal accountability, thus leading to turning their patients more consistently.
During the next unit meeting, the nurse manager reveals that there has been an increase in incidental overtime. Unfortunately, each nurse is staying an average of 15 minutes extra at the end of their shift. With 40 nurses on the unit being paid time and a half for overtime, this translates to 15 paid hours. The nurse manager breaks the news that the director of nursing is not happy, and the unit is on a tight budget. Due to the combination of incidental overtime, paid hours for committee participation, and paid time for the committee chair to audit charts, the unit will need to cut 24 hours of clinical time from the schedule each week to compensate. Three months after implementation, the committee chair chooses to move into a leadership role within the facility, accepting a job as a nurse manager for another unit, touting their successful implementation of a policy to reduce hospital acquired pressure injuries as a major selling point during their interview.
References
Nagle, L. M., Sermeus, W., Junger, A., & Bloomsberg, L. S. (2017). Evolving role of the nursing informatics specialist. doi:10.3233/978-1-61499-738-2-212
Sikka, R., Morath, J.M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BJM Quality & Safety, 24, 608-610. doi:10.1136/bmjqs-2015-004160
Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.
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