Feb 23, 2024 Discussion: The Application of Data to Problem-Solving
Discussion: The Application 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.
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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.
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I agree that technology is and will magically help improve efficiency in the health care setting. Many a times, i refer to the QSEN competencies whenever i think about technology and health care. For instance, at the moment technologies such as tele-health, tele-nursing, and tele-medicine as well as remote health monitoring are already in use and are impacting health sciences immensely. For example, as opposed to the traditional use of home-visits to offer ongoing patient education, remote health education and follow-up technologies can be used.
In addition, remote health monitors including wearable technologies such as wrist watches can monitor a myriad of physiological variables and relay that information to a care provider in the event of an emergency care need. These are just examples of the current changes in health sciences’ practice that have been orchestrated by the technologies we have. However, can this match up to patient-centered care for example? The rapport, the patient-provider relationship, etc may all be compromised? According to a study, there was reported high quality care with technology.
References
Nwosisi, E., Carl, L. and Nwosisi, C. (2012) “A meta-analysis summary of information technology lack of connectivity and usability in Patient Centered Care,” International Journal of Engineering and Technology, 4(5), pp. 512–517. Available at: https://doi.org/10.7763/ijet.2012.v4.422.
“Weekly assessment of patient symptoms using simple technology translates to higher-quality, patient-centered care” (2021) Default Digital Object Group [Preprint]. Available at: https://doi.org/10.1200/adn.21.200749.
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.
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? Discussion: The Application of Data to Problem-Solving
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
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)
24Slides. (2018). How to make an infographic in PowerPoint. Retrieved September 27, 2018, from https://24slides.com/presentbetter/how-make-infographic-powerpoint/
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & 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).
Note: You will access this article from the Walden Library databases.
In the video Health Informatics and Population Health: Trends in Population Health, contributors discuss how current and future generations of patients are more knowledgeable, and more involved in their healthcare than in past generations. The internet and advances in artificial intelligence make access to databases with information on health diagnostics, personal lab results, and treatment options readily available (2018). Nurses need to make use of these advances in technology, a database that gives real-life tips and suggestions on hands-on patient care would be invaluable for bedside nurses.
Nurses are taught basic nursing skills in school, but only through personal experience and dissemination of knowledge from other nurses do they acquire additional skills needed to care for patients in real life. This database would include suggestions for patient care that would consist of tips on tasks such as inserting a Foley catheter on an obese female patient, how to assist a trauma patient onto a bedpan, the best way to remove adhesive from a patient with impaired skin integrity.
Nurses are smart and have unlimited ingenuity, and this database would include nurses’ contributions from all over the world. The data bank would serve to develop knowledge formation of different techniques and skills and assist in problem-solving when a nurse is presented with a skills dilemma. Nurse leaders should use this database to promote a better quality of patient care and to help other nurses by disseminating knowledge they have acquired throughout their careers. Database developers should seek the input of experienced nurse leaders, relying on their sound clinical judgment to determine the safety and accuracy of the information and techniques shared in the database.
With this data base, nurses could take a virtual team approach to problem-solving involving patient treatment and care. In the article Evolving Role of the Nursing Informatics Specialist, the authors think that in the future, “Teams will work across boundaries of organizations and will be organized around a particular patient” (Nagle, Sermeus, & Junger, 2017, p. 215). This type of database can be maintained and accessed via the internet or cloud, “cloud storage is data storage provided by networked online servers that are typically outside of the institution whose data are being housed”(McGonigle & Mastrian, Chapter 3). I believe a hybrid of public and private cloud would be the best way to generate collaboration and inclusiveness while protecting the integrity of the data collected and disseminated.
References
Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in
Population Health [Video file]. Baltimore, MD: Author.
McGonigle, D., & Mastrian, K. G. (). Nursing informatics and the foundation of knowledge (4th ed.). [Ereader]. Retrieved from https://ereader.chegg.com/#/books/9781284142990/cfi/6/20!/4@0.00:0
Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. Forecasting Informatics Competencies for Nurses in the Future of Connected Health, 212-221. http://dx.doi.org/10.3233/978-1-61499-738-2-212
RE: Discussion – Week 1
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Response to Terra Plank
Technology will continue to transform the way nursing care is delivered. ICU units often have automated deterioration detection using electronic medical record data (EMR), which can reduce the risk of failure to rescue. Automated deterioration detection using EMR data is a crucial aid in caring for patients in the ICU, but variable EMR detection approaches and performance can limit its usefulness. You talked about how the patient’s data from the monitors flows into their EMR, where the data collected uses algorithms to create warnings such as sepsis. According to Despins (2018), algorithms to detect the occurrence of severe sepsis or septic shock incorporate a combination of data points, which can include information from microbiology culture orders, vital signs, laboratory values, and the presence of vasopressors such as norepinephrine infusions (p.326 ).
Sepsis is a difficult condition to define and diagnose that requires time-sensitive therapies to prevent mortality and morbidity. One in four persons with sepsis will die. Early detection of sepsis leads to appropriate treatments and better outcomes. Critical care nurses work in complex, highly interruptive environments that require dual tasking, and most ICU nurses can accelerate the filtering and sense-making needed to respond to the multiple stimuli in an ICU. Unfortunately, the amount of task switching necessary to accomplish this level of response can lead to fatigue, and eventually, desensitization toward alarms occurs. According to Rincon, Manos, & Pierce (2017), “recent studies in ICUs indicate that biomedical devices can produce as many as one critical alert every 92 seconds with fewer than 15% being clinically relevant” (p. 460). You said you got a sepsis warning on your patient. How does your system alert you for a sepsis warning? Is it by a sound and visual display in the EMR?
References
Despins, L. (2018). Automated Deterioration Detection Using Electronic Medical Record Data in Intensive Care Unit Patients: A Systematic Review. CIN: Computers, Informatics, Nursing, 36(7), 323-330.
Rincon, T. A., Manos, E. L., & Pierce, J. D. (2017). Telehealth Intensive Care Unit Nurse Surveillance of Sepsis. CIN: Computers, Informatics, Nursing, 35(9), 459-464.
Healthcare professionals can ensure that their patients receive the best care if they are able to access medical records (McGonigle & Mastrian, 2017). Immunizations will be the focus scenario of this discussion. Immunization is recommended by a majority of clinicians, medical researchers, and healthcare facilities. There are several reasons why immunization is important but the most important ones are to protect oneself and those around you (Pelullo et al., 2020). Additionally, infectious diseases can be prevented using vaccines. The cooperation of the patient will determine the success of the immunization program (Pelullo et al., 2020).
Diseases that have no medical treatment can best be prevented by getting immunized. The vaccination will, therefore, protect those at risk of contracting conditions that are incurable and can result in complications or death at times. Those with impaired immune systems are susceptible to these conditions (Gold et al., 2020). Even though these people are vaccinated after developing the disease, the vaccination may not help them develop a strong immune system. To ensure that the illness is prevented, it is important to get vaccinated to ensure that one is fully protected from contracting the disease (Gold et al., 2020). Those people who have been immunized, are unlikely to be at risk of the epidemic.
Currently, at my organization, we work with schools, parents, and providers using immunization records for patients. However, treating families that keep moving across state lines and lack their immunization records would be difficult because clinicians will not be able to tell whether the child has received the vaccination. This will make parents track their children’s health records from their previous clinic or the immunization registry or their previous schools to get the information. Having a central hub database for all information will make it easier for parents and clinicians to access patient information.
Collected Data to Be Used and How It’s Collected
Data collected include; patient name: first, middle, last; patient birth date; patient sex/gender; patient race and ethnicity; patient birth order; patient birth State/country; mother’s name: First, middle, last, maiden; vaccine type; manufacturer; and vaccine dosage number. Currently, information for vaccine data is collected in an online database called, Immunization Information Systems (IIS).
According to the National Vaccine Advisory Committee’s standards, providers need to have full access to an individual’s immunization status at every medical encounter (Gold et al., 2020). Immunization information systems help ensure vaccinations across targeted populations as clinicians administer the vaccine across a tiered prioritization process. This system keeps track of vaccines that are administered to patients and informs providers when vaccines are due (Gold et al., 2020).
In my facility, clinicians have become fully prepared for vaccine administration and increase IIS use in the following ways: becoming comfortable and familiar with the IIS interface because patient vaccination information is readily available in the system workflow; communicating with the health system’s health IT department to see if manual data requests are required or if there is a real-time data flow between the system workflow and IIS platform; getting onboarded by the state or local health department; and communicating and sharing knowledge about the IIS with colleagues, hospital leaders, and administration to spread IIS awareness. From there, I would like to have a database that collects all of the vaccine information from each office and puts it into a central hub. Having this central hub of vaccine records would allow providers to pull vaccine records for their new patients. This would allow healthcare professionals to see their patient’s vaccination history and make clinical judgments when it came to vaccines.
Derived Knowledge
A lot of knowledge can be obtained from this data. Healthcare professionals would be able to see coverage rates in areas as well as areas of potential disease outbreaks. They would also be able to see how well community immunity (herd immunity) works. According to Ricc et al. (2020), community immunity is when enough people are vaccinated against a certain disease, it becomes hard for a disease to spread to unvaccinated people. Clinical vaccination sites are leveraging immunization information systems to order, distribute, and keep track of the vaccine. Broad and equitable use of vaccines will be instrumental in mitigating and managing different conditions (Ricc et al., 2020).
Immunization information systems are part of the critical infrastructure being used in vaccine plans to coordinate among multiple partners and systems for vaccine allocation, distribution, administration, and monitoring (Ricc et al., 2020). With the IIS, clinicians can access vaccination status in real-time. Users can also gather and store patient data and document and track vaccine products and administered doses. With limited initial vaccine supply, IISs can assist in determining the equitable allocation of available vaccines, plan and forecast when additional doses are recommended, help ensure that patients are getting the correct vaccine, and monitor vaccination series completion (Ricc et al., 2020).
How Nurse Leaders Use Clinical Reasoning and Judgment in The Formation of Knowledge from This Experience
Nurse leaders, from this experience, can use clinical reasoning and judgment to ensure that they do not miss recommended vaccine doses in addition to not receiving unnecessary, extra doses. At the same time, when taking care of patients with medical conditions, they would have the necessary ability when it comes to adding contraindications and notices regarding certain vaccines into the system. The above implies that other providers would be aware of this if the patients ever moved or were sent to the hospital.
Having the capability to access a patient’s immunization record from a central hub would be very helpful to not only healthcare professionals but to the patient as well. The more clinicians are aware of and connected to their IIS, the better the vaccination campaign will be in addressing equitable vaccine distribution, managing vaccine uptake, and monitoring vaccination series. Strengthening clinician engagement will lead to more robust IIS data, thereby enhancing clinical care and public health decision-making, which are critical to immunization programs under routine and emergency conditions.
References
Gold, M. S., MacDonald, N. E., McMurtry, C. M., Balakrishnan, M. R., Heininger, U., Menning, L., … & Zuber, P. L. (2020). Immunization stress-related response–redefining immunization anxiety-related reaction as an adverse event following immunization. Vaccine, 38(14), 3015-3020. https://doi.org/10.1016/j.vaccine.2020.02.046
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Pelullo, C. P., Della Polla, G., Napolitano, F., Di Giuseppe, G., & Angelillo, I. F. (2020). Healthcare workers’ knowledge, attitudes, and practices about vaccinations: A cross-sectional study in Italy. Vaccines, 8(2), 148. https://doi.org/10.3390/vaccines8020148
Ricc, M., Vezzosi, L., Gualerzi, G., Bragazzi, N. L., & Balzarini, F. (2020). Pertussis immunization in healthcare workers working in pediatric settings: Knowledge, Attitudes, and Practices (KAP) of Occupational Physicians. Preliminary results from a web-based survey (2017). Journal of Preventive Medicine and Hygiene, 61(1), E66. https://doi.org/10.15167/2421-4248/jpmh2020.61.1.1155
In the current nursing practice, data is instrumental in problem-solving and the continuous delivery of patient-centered care. Through timely and accurate data, healthcare practitioners examine health problems in-depth and initiate innovative interventions. Data also helps public health providers to implement evidence-based interventions to optimize health and safety (Hedberg & Maher, 2018). My focus scenario is care improvement in the emergency room by addressing patient delays. The delays stem from long waiting times. In this case, patients with emergency health needs spend unnecessarily longer time between arrival and the time when they receive medication.
The data that could be used to address this situation include patients’ health problems, waiting time, and possible health complications. As Paling et al. (2020) observed, long waiting time in the emergency room is associated with poor health outcomes, including complications and mortality. The data might be collected and accessed via a patient tracking system. In the emergency room and other units, patient tracking systems allow healthcare practitioners to log and monitor patients’ progress while receiving care and staying in the hospital. Typically, the data would be readily available in the system and would be accessed by authorized users. System security is crucial to avert the dangers of unauthorized access, such as privacy and confidentiality breaches.
The data can provide knowledge regarding the magnitude of waiting time in the emergency room. Typically, longer waiting time risks patients’ health and safety. A nurse leader could use clinical reasoning and judgment to form knowledge by applying analytical skills to make informed decisions. From a health perspective, clinical reasoning and judgment entail an in-depth analysis of issues to develop creative solutions for complex clinical situations (Hong et al., 2021; Guerrero, 2019). A nurse leader would benefit from a similar approach by analyzing patterns to understand the potential causes of patient delays and sustainable solutions. Such a response is a foundation of safe nursing care.
References
Hedberg, K., & Maher, J. (2018). Collecting data. Centers for Disease Control and Prevention. https://www.cdc.gov/eis/field-epi-manual/chapters/collecting-data.html
Guerrero, J. G. (2019). Practice rationale care model: The art and science of clinical reasoning, decision making and judgment in the nursing process. Open Journal of Nursing, 9(2), 79-88. https://doi.org/10.4236/ojn.2019.92008
Hong, S., Lee, J., Jang, Y., & Lee, Y. (2021). A cross-sectional study: what contributes to nursing students’ clinical reasoning competence?. International Journal of Environmental Research and Public Health, 18(13), 6833. https://doi.org/10.3390/ijerph18136833
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, 37(12), 781-786. http://dx.doi.org/10.1136/emermed-2019-208849
Name: NURS_5051_Module01_Week01_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
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.
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.
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.
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
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
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.
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.
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.
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
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 a
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