Feb 23, 2024 NURS 6051 The Application Of Data To Problem-Solving
NURS 6051 The Application Of Data To Problem-Solving
NURS 6051 The Application Of Data To Problem-Solving
I like your senario and would to emphasize the need for health care staf to learn how to navigate health informatics like EPIC. It is like an acquisition, storage, retrieval and use of health information. Health informatics promotes efficient and effective patient care through the fluid transmittance and retrieval of health care information. The use of technology such as computer systems, software and other technologies promote informatics. A good and simple example of the efficiency and importance of informatics can be seen when considering mail via the post office and emails via computer systems and network.
The delivery of mail using email transmittance allows for the quick, efficient and certain delivery of information. Sending information through the post office takes time, vulnerable to be lost as well as being damaged. The same efficiency is needed in addressing patient Care as patients lives at times will be dependent on the efficient transmittal of information. A patient, for example, that meets in a car accident and requires emergency surgery, would benefit from health informatics as the patient’s medical history is readily retrievable from a health care informatics system that links providers to each other. Imagine calling around for patient information or worst yet, writing letters to request patient information. Antiquated systems can jeopardize patient care and patient safety (Alotaibi and Frederico, 2017).
As the main health care personnel, nurses are charged with the responsibility of operating systems that utilize informatics. In addition, nurses should be able to efficiently and fluently use those systems. It is therefore important that nurses understand the full purpose of informatics as well as to navigate any system in their network that utilizes informatics. This is a critical part of nursing care as it promotes proper nursing care for patients as well as to increase positive outcome for the patients as well. Informatics should also be part of the core curriculum in nursing school because it teaches student nurses how to better care for their patients (Leung et. al., 2015). In addition, this core curriculum should again be reinforced in the clinical setting, as there are nuances to different informatics network systems. The nurse should be familiar with these nuances so that they can best utilize the system when dealing with health informatics.
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Nurses understanding and use of informatics should be greater than any other personnel in the clinical setting as the nurse is the main point of contact for patient care. A nurse, for example, may alert the doctor or others of a patient’s pre-existing conditions or allergies thereby preventing any type of accident. The nurse should also be able to properly train other personnel in using health informatics. In training a new on how to use health informatics, it is also important that the nurse possess basic technology skills such as computer skills and understanding how software works. Health informatics is the wave of the future and the nurse should also be at the forefront of this wave as it directly impacts patient care and patient outcome. It has also been shown that hospitals that uses health informatics efficiently, has more positive patient outcomes (Snyder et. al., 2011).
References:
Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on
patient safety. Saudi medical journal, 38(12), 1173–1180.
Snyder, C. F., Wu, A. W., Miller, R. S., Jensen, R. E., Bantug, E. T., & Wolff, A. C.
(2011). The role of informatics in promoting patient-centered care. Cancer journal (Sudbury, Mass.), 17(4), 211–218.
Leung AA, Denham CR, Gandhi TK, Bane A, Churchill WW, Bates DW, et al. A safe
practice standard for barcode technology. J Patient Saf. 2015;11:89–99.
The collection of data in healthcare is crucial in improving patient outcomes. Healthcare is ever-changing, with improvements occurring continuously (Laureate Education, 2018). Nurses must be involved in data collection and understand the importance of the interpretation of this data. Then the information can be used to treat patients more effectively, offer a comparison, and give a more tailored plan of care.
ESAS Data Collection
In my current job, we collect data using the Edmonton Symptom Assessment Scale (ESAS). The ESAS symptom tool was initially developed in 1991 to gauge symptom burden in palliative/hospice patients (Hui and Bruera, 2016). On each visit with a patient, they are asked to rate nine symptoms on a zero to ten scale, with ten being the worst possible. Symptoms include pain, depression, and shortness of breath, to mention a few. If unable to rate the nurse rates based on observation. Once the data is collected, it is stored in the EHR and can be viewed at any time.
The tool is useful mainly for the comparison of symptom reports and the management of those symptoms. For example, the management of a patient’s pain is crucial in hospice care. If pain was reported and the medication regimen changed or increased, the data collected through the ESAS would help determine if the change was effective. This would be seen by a decrease in the rating for pain with each visit. If the data shows the patient is rating pain at the same level or higher, we would know medication adjustments are warranted again. With this data available and knowing how to interpret it, patients can receive the care they deserve.
Nursing is an “information-intensive profession” (McGonigle and Mastrian, 2017). We, as nurses, must collect, process, and use the data collected every day. As nurse leaders, interpreting the data is critical to providing the best care possible. Data collection, interpretation, and use will continue to be a part of nursing that can be used to improve patient outcomes.
References
Hui, D., & Bruera, E. (2017, March). The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments. Journal of Pain and Symptom Management. Retrieved November 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337174/
Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed., pg.9). Burlington, MA: Jones & Bartlett Learning.
Response
This is insightful. The application of healthcare data is important in improving treatment processes. Healthcare data is important in research and evidence-based practice. The success of healthcare practices depends on the accuracy of methods used in data collection. The ESAS symptom tool is one of the most common methods of data collection; the tool was designed to aid the assessment of nine common symptoms of cancer, including nausea, tiredness, pain, depression, drowsiness, anxiety, wellbeing, appetite, and shortness of breath (Hui & Bruera, 2017).
The system has successfully been used by different healthcare organizations to collect and analyze patients’ data. The data collected by this tool can be analyzed to enhance quality improvement processes (Moskovitz et al., 2019). For instance, data on pain can be used to enhance pain management among cancer patients and other patients involved in the treatment processes. The data collected can also be used in the determination of trends of healthcare delivery (Pastorino et al., 2019). From the discussion, one of the questions I would ask is; what types of data are collected by The ESAS symptom tool? How can this data be analyzed to determine trends in healthcare delivery processes?
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References
Hui, D., & Bruera, E. (2017, March). The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments. Journal of Pain and Symptom Management. Retrieved November 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337174/
Moskovitz, M., Jao, K., Su, J., Brown, M. C., Naik, H., Eng, L., … & Liu, G. (2019). Combined cancer patient–reported symptom and health utility tool for routine clinical implementation: a real-world comparison of the ESAS and EQ-5D in multiple cancer sites. Current Oncology, 26(6), 733-741. https://doi.org/10.3747/co.26.5297
Pastorino, R., De Vito, C., Migliara, G., Glocker, K., Binenbaum, I., Ricciardi, W., & Boccia, S. (2019). Benefits and challenges of Big Data in healthcare: an overview of the European initiatives. European journal of public health, 29(Supplement_3), 23-27. https://doi.org/10.1093/eurpub/ckz168
RE: Discussion – Week 1 initial post
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I have spent the last 10 years working in emergency rooms as a staff nurse. One of the biggest challenges that my department faces regularly is delays with getting admitted patients out of the ED and onto their assigned units. These delays negatively impact the patients waiting for emergency treatment in the lobby and hallway stretchers. There are a number of factors that can prolong ED length of stay. Some of these include lack of bed availability due to hospital overcrowding, treatment delays such as loss of IV access, and delays caused by hospital personnel during the handoff report process (Paling et. al, 2020). Some of these factors, such as hospital overcrowding, are unavoidable and difficult to work around, which is why it is important for hospitals to assess which factors they can control to expedite patient flow out of the emergency room.
For my hospital’s scenario, the emergency department would collect data about admission delays that are specifically caused by disruptions in the nursing telephone report process. In my current workplace, there is not a standardized electronic handoff form, despite the fact that several studies have demonstrated the efficiency and increased patient safety outcomes associated with the transition to standardized electronic nursing report (Wolak et al., 2020). Instead, the ED nurse calls the receiving unit on the telephone, gives a verbal patient care handoff, and then transfers the patient to their hospital room. By collecting data about where in the handoff process delays are occurring, the ED could try to streamline the handoff process with the medical floors.
The emergency department nurses would collect quantitative data about the length of time between the first attempt to call report to the medical floor, and the time of the patient’s actual departure from the ED. The data would be recorded in the section of the EMR called “time to disposition” for each patient that is admitted. The ED leadership team could then pull a certain number of charts per month (or all the admission charts, if time allowed) and assess how long it takes on average for patient transfer to happen after report.
Generally, most hospitals set their goals for disposition time for handoff and transfer within a 30-minute window (Potts et. al., 2018). If there are frequent delays causing transfer time to take greater than 30 minutes, the ED leadership team or unit-based council could meet with leadership from the floors where patient transfer takes the longest. By demonstrating the hard numbers associated with patient care delays, the teams could better understand the factors that lead to admission delays and work together to find solutions that expedite the admissions process.
References:
Paling, S., Lambert, J., Clouting, J., González-Esquerré, J., & Auterson, T. (2020). Waiting times in emergency departments: Exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data. Emergency Medicine Journal. https://doi.org/10.1136/emermed-2019-208849
Potts, L., Ryan, C., Diegel-Vacek, L., & Murchek, A. (2018). Improving patient flow from the emergency department utilizing a standardized electronic nursing handoff process. JONA: The Journal of Nursing Administration, 48(9), 432–436. https://doi.org/10.1097/nna.0000000000000645
Wolak, E., Jones, C., Leeman, J., & Madigan, C. (2020). Improving throughput for patients admitted from the Emergency Department. Journal of Nursing Care Quality, 35(4), 380–385. https://doi.org/10.1097/ncq.0000000000000462
Response
This is insightful Andrea; admission delays often lead to adverse treatment outcomes. The delays in patients’ admission to different hospitals are attributed to the increased number of patients or overcrowding. The impacts of delayed admission can be severe, including longer hospital stays, the inability of patients to access appropriate beds, and experienced healthcare experts (Goertz et al., 2020). Most patients leave without getting treatment due to delayed admissions to different healthcare facilities (Paling et al., 2020).
There is a need for quality improvement to facilitate improvements in admission rates. The quality improvements should rely on the data collected in the course of operation. The application of the EMR system is one of the best methods of data collection in healthcare (Pastorino et al., 2019). Measuring and recording the time taken during hospital admission is necessary for determining areas that require adjustments. Through the analysis of the collected data or information, healthcare institutions are able to initiate quality improvement processes and ensure effective outcomes in the management of patients. One of the questions that I would ask is: What variables ought to be involved in the data collection processes?
References
Goertz, L., Pflaeging, M., Hamisch, C., Kabbasch, C., Pennig, L., von Spreckelsen, N., … & Krischek, B. (2020). Delayed hospital admission of patients with aneurysmal subarachnoid hemorrhage: clinical presentation, treatment strategies, and outcome. Journal of neurosurgery, 134(4), 1182-1189. https://doi.org/10.3171/2020.2.JNS20148
Paling, S., Lambert, J., Clouting, J., González-Esquerré, J., & Auterson, T. (2020). Waiting times in emergency departments: Exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data. Emergency Medicine Journal. https://doi.org/10.1136/emermed-2019-208849
Pastorino, R., De Vito, C., Migliara, G., Glocker, K., Binenbaum, I., Ricciardi, W., & Boccia, S. (2019). Benefits and challenges of Big Data in healthcare: an overview of the European initiatives. European journal of public health, 29(Supplement_3), 23-27. https://doi.org/10.1093/eurpub/ckz168
RE: Initial Post
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Top of Form
Importance of Data Collection
The collection of data in healthcare is crucial in improving patient outcomes. Healthcare is ever-changing, with improvements occurring continuously (Laureate Education, 2018). Nurses must be involved in data collection and understand the importance of the interpretation of this data. Then the information can be used to treat patients more effectively, offer a comparison, and give a more tailored plan of care.
ESAS Data Collection
In my current job, we collect data using the Edmonton Symptom Assessment Scale (ESAS). The ESAS symptom tool was initially developed in 1991 to gauge symptom burden in palliative/hospice patients (Hui and Bruera, 2016). On each visit with a patient, they are asked to rate nine symptoms on a zero to ten scale, with ten being the worst possible. Symptoms include pain, depression, and shortness of breath, to mention a few. If unable to rate the nurse rates based on observation. Once the data is collected, it is stored in the EHR and can be viewed at any time.
The tool is useful mainly for the comparison of symptom reports and the management of those symptoms. For example, the management of a patient’s pain is crucial in hospice care. If pain was reported and the medication regimen changed or increased, the data collected through the ESAS would help determine if the change was effective. This would be seen by a decrease in the rating for pain with each visit. If the data shows the patient is rating pain at the same level or higher, we would know medication adjustments are warranted again. With this data available and knowing how to interpret it, patients can receive the care they deserve.
Nursing is an “information-intensive profession” (McGonigle and Mastrian, 2017). We, as nurses, must collect, process, and use the data collected every day. As nurse leaders, interpreting the data is critical to providing the best care possible. Data collection, interpretation, and use will continue to be a part of nursing that can be used to improve patient outcomes.
References
Hui, D., & Bruera, E. (2017, March). The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments. Journal of Pain and Symptom Management. Retrieved November 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337174/
Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed., pg.9). Burlington, MA: Jones & Bartlett Learning.
It was great going through your post. Telehealth is a crucial part of our healthcare system, especially with technological advancement in the recent past. I agree with the benefits of telehealth, as your post indicated.It allows access to healthcare information in a swift manner. Technology helped telemedicine reduce congestion in hospitals as patients can easily access information via teleconference. It has also expanded the opportunities for the nurses who interact closely with the patients.
Telemedicine is a sustainable type of healthcare and can open several doors for treatment for patients and practitioners. It saves time, and treatment is convenient and affordable for people who dread visiting the doctor and avoid going to the hospital. In addition, telehealth is helpful in diagnosis, administrative work, and professional and patient education.
A study assessing the effectiveness of telehealth consultations discovered they could improve patient outcomes in certain areas. Telehealth may not help and completely replace traditional office visits — after all, many services and procedures can only be done in person — but it can reduce the need for them. Telehealth effectively reduces the spread of infectious diseases, especially in this Coronavirus (COVID-19) warfare. When other patients have an infectious disease, they can stay home and call their healthcare provider to get treatment. By staying at home, patients do not expose their illnesses to healthcare professionals and other patients. Patients also reduce the chances of contracting an infectious disease from another person or transmitting and spreading their own while using telehealth services.
References
Aggarwal, A. (2017). Telepyschiatry: Current outcomes and future directions. International Journal of Clinical Psychiatry and Mental Health, 5. https://doi.org/10.12970/2310-8231.2017.05.07Links to an external site.
Menage, J. (2020). Why telemedicine diminishes the doctor-patient relationship. BMJ, m4348. https://doi.org/10.1136/bmj.m4348Links to an external site.
Stokel-Walker, C. (2020). Why telemedicine is here to stay. BMJ, m3603. https://doi.org/10.1136/bmj.m3603Links to an external site.
Telephone triage
The phone rings on a busy Saturday afternoon and the pleasant voice of a registered nurse answers professionally, greeting the caller seeking advice and care. This could be a day for a typical for an ambulatory telephone triage nurse. The concept of telephone triage and consultation can be one of a registered nurse using evidence-based algorithms from electronic databases. The nurses, like most nurses, working in a progressive health care industry are using technology to counsel patients. According to McGonigue & Mastrian, (2022), “For information to be valuable, it must be accessible, accurate, timely, complete, cost-effective, flexible, reliable, relevant, simple, verifiable, and secure.” p.9.
This information could be valuable to many leaders in the healthcare team. Accessibility would be easiest in form of electronic records and telephone recordings. McGonigue & Mastrian (2022), argue, “Computer science offers extremely valuable tools that when used skillfully, can facilitate the acquisition and manipulation of data and information by nurses, who then can synthesize the data into an evolving knowledge and wisdom base ”p. 35). Accurate and timely information could be an interest in nursing quality and control.
One argument on how telephone triage could be cost-effective is that paying nurses to man the phone lines is cheaper than using inappropriate resources such as the emergency room to care that can be directed elsewhere. Flexibility, reliability, simple, verifiable and secure would require a more in-depth look into the nature of telephone triage and program development within a system, but the concept of triage nursing seems to be malleable to the interest of how the data would be used.
An additional source of centralized evidence-based algorithm software program could also be used and from my research is being used in assisting the nurses to effectively triage the caller and ensure best practice standards. Documentation done by triage nurses would have data from the callers that are subjective and objective, the nursing assessment, and recommendations based on the call.
From this data collection, multiple departments within healthcare could use this or would have an interest in this data collection. Intradisciplinary teams have an opportunity to look at how to retrieve data from electronic retrieval of health records or from recorded lines if those are being used. An ambulatory nurse manager might be interested in using the data as a system educator of staff development and improvement strategy to support the training needs within their triage staff.
A quality nurse might want to use this data to help in creating of protocol development and safety improvements for effective triage and outcomes. Ambulatory providers could use data to see the patient population’s interests and barriers to care and from there use it to modify their practices. Health information technology departments within health care organizations could be supportive of this nursing department in implementing programs in making documentation more time efficient and detailed. Nursing leadership could use this as a cost-effective strategy.
All departments could build off one another and become temporary team members to gain knowledge and benefit in patient care and satisfaction. Emerging roles could be created as, “Teams are working across boundaries of organizations and will be organized around a particular patient.” (Nagale et al, 2017, p. 215). Within most healthcare systems the mission and visions of these organizations are built on patient outcomes and patient centered care. An informatics nurse specialist could support patients, nurses, providers, and leaders with the interpretation of data analytics and therefore participate in applying new knowledge from data to wisdom. (Nauright et al., 1999)
This hypothetical scenario of a nurse working at a telephone triage call center would benefit immensely from data access, problem-solving and the process of knowledge formation. In a real-time, scenario, I could see how this could impact patient care and outcomes on a global level and be a perfect role for a nurse informatics specialist to pilot.
References
Nauright,L.P.,Moneyham,L.& Williamson,J.1999. Telephone triage and consultation: An emerging role
for nurses,Nursing Outlook, 47(5) , 219-226.https://doi.org/10.1016/S0029-6554(99)90054-4.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist Links to an external site. Links to an external site.. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221).
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
It was great going through your post. Telehealth is a crucial part of our healthcare system, especially with technological advancement in the recent past. I agree with the benefits of telehealth, as your post indicated.It allows access to healthcare information in a swift manner. Technology helped telemedicine reduce congestion in hospitals as patients can easily access information via teleconference. It has also expanded the opportunities for the nurses who interact closely with the patients.Telemedicine is a sustainable type of healthcare and can open several doors for treatment for patients and practitioners. It saves time, and treatment is convenient and affordable for people who dread visiting the doctor and avoid going to the hospital. In addition, telehealth is helpful in diagnosis
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