Discussion: Application of Data to Problem-solving

Question Description

There are few professions in the modern era that do not rely on data to some way.
Stockbrokers rely on market data to provide financial advice to their clients.
Meteorologists rely on weather data to forecast weather conditions, whereas realtors use data to make property acquisition and sale recommendations.
In these and other instances, data not only assists practitioners in resolving difficulties, but also contributes to the practitioner’s and 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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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?

RE: Discussion – Week 1

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One vital area of data collection in my personal nursing practice is when data is to be collected before the patient is admitted. I work as a full-time nurse in psychiatric and behavioral health for the older age group, where one of the criteria before admission is to have full background information before arrival into the facility. I must ensure that the new patient met before admission. Then I proceed with the knowledge acquisition process to learn as much as I can about the patient coming my way. Data collection about this patient before admission is with the use of the electronic medical record. The data collected would be primary and secondary diagnosis, past medical and surgical history, laboratory results, and assessments from transferring facility, drug history, recent hospital admissions, and drug allergy.

Psychiatric nurses who are actively engaged in the optimization of the EHR to support behavioral health population management can expect to generate improvements in clinical outcomes while also cost-effectively directing meaningful actions geared at the prevention and treatment of mental health disorders and the myriad of co-occurring health conditions (Stoots, 2015). This data should be collected before the admission of any patient to the facility. Moreover, the use of the computer system had helped with the provision of detailed information and safety alerts compared to when the manual method of data collection was used before the intervention of Florence Nightingale (mother of modern nursing). However, the Electronic Health Record is not the latest computer device for collecting data; however, this is being updated from time to time .

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The hypothetical scenario I chose to discuss entails discovering a patient’s negative psychiatric reaction to a medication prescribed during a previous hospitalization. An adverse reaction is a side effect caused by medication administration. The onset of the negative reaction can be abrupt or gradual. An adverse drug event (ADE), an adverse drug reaction (ADR), an adverse effect, or an adverse event are all terms for this. For these patients, this can be upsetting. The majority of psychotic medications, however, have serious side effects that may not have been listed on the previous admission or discharge chart. Medication discontinuation may be observed without a specific reason. However, one of the admission nurse’s roles during the history-taking process is to inquire about drug history, which includes allergy and adverse reaction history. In addition, the vast majority of these patients are disoriented and unable to recall their medications. As a result, prior to admission, data must be collected and analyzed.

Knowing that a patient has had some medication reactions will help the psychiatrist and other team members manage patients more effectively. For example, if it is determined that a manic patient was aggressive and engaged in self-injurious behavior in response to a previously used medication, we would ensure that the medication was not used again while the patient was under our care. The medication and any side effects will be documented in the medical record. A nurse once forgot to inquire about the medication’s side effects, and the patient was still given it. We had to call in the Rapid Response Team to save the patient. The RRT was able to reverse the negative reaction, which was fortunate for the facility. Having the patient’s information prior to admission, in my experience, has been beneficial because it prepares the admission nurse and every other member of the team who will manage the patient after admission.

This information can be obtained from the medical record; however, a detailed medical history obtained from the patient or a family member who is oriented in time, person, and place is preferable. Communication and ongoing collaboration among team members are critical for the overall care of the patient. Because the computers in my facility are linked with local hospitals and providers, access is granted as needed. Finally, nursing practice science is built on the steps of gathering information, applying knowledge to a problem, and acting prudently (McGonigle & Mastrian, 2017). A previous history/record or data gathered from previous hospitals where my patients have been admitted, on the other hand, will serve as a foundation on which I will build during the admission process.

References

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

Nagle, L. M., Sermeus, W., & Junger, A. (2017). Evolving Role of the NursingInformatics Specialist. Studies In Health Technology And Informatics, 232, 212–221. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF.

Ruan, T., Lei, L., Zhou, Y., Zhai, J., Zhang, L., He, P., & Gao, J. (2019). Representation learning for clinical time series prediction tasks in electronic health records. BMC Medical Informatics and Decision Making, 19(Suppl 8), 259. https://doi-org.ezp.waldenulibrary.org/10.1186/s12911-019-0985-7

Stoots, M. (2015). Unlocking Electronic Health Record Data Helps Drive Behavioral HealthPopulation Management. Journal of the American Psychiatric Nurses Association, 21(5), 348–350. doi:10.1177/1078390315608193

Scenario is early ambulation in post surgical to prevent post operative problems ( example: DVT, Pneumonia, Pain, etc.)

APA format and minimum of 3 citations. intext and references.

I will provide 2 sources, one website and one PDF file and then you can use whichever ones you would like.

https://www.himss.org/library/healthcare-informati…

RE: Discussion – Week 1

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Nurses at the neonatal intensive care unit (NICU) see a lot of central lines. CLABSI (central line-associated bloodstream infection), which can increase mortality and morbidity in pre-term newborns, lengthen hospital stays, and increase complications and associated expenses, is a concern with central lines despite their potential life-saving benefits (Oh et al., 2020). There is a significant risk of an increase in CLABSIs at any healthcare facility using central lines. When it comes to reducing the incidence, enhancing patient care, and optimizing patient outcomes of CLABSIs, collecting data and studying possible causes would be quite beneficial to the nurse leader.

Information science, computer science, and nursing all come together in the field of nursing informatics (McGonigle & Mastrian, 2017). Nurse leaders can use data collected on their unit and benchmarked against similar units to identify areas for improvement in regard to CLABSIs, which can then be implemented. Patient data is gathered by Ontario’s Critical Care Information System (CCIS) from all levels 2 and 3 critical care units (Criticall Ontario, n.d.). Nursing leaders can utilize CCIS data to compare the rates of CLABSIs at other hospitals.

Prevention and reduction measures can then be put into place from this point onwards. Using 3M Curos disinfection caps for line hubs, for example, was used after our NICU noticed a rise in CLABSIs. “70 percent isopropyl alcohol” is found in the cap, and disinfection is complete in one minute (3M, n.d.). Up to a week is permissible with the cap on. The Curos caps were widely used in Ontario’s NICUs because of the clinical evidence supporting their usage in lowering CLABSIs.

As an intensive care nurse for nearly a decade, I’ve seen a lot of ICU readmissions. When this happens, I can’t help but feel as if we’ve betrayed the patient and let them down. Intensive care unit readmissions have been linked to a greater mortality rate and higher hospital expenses, according to research (Ponzoni et., 2017). ICU to general floor transfer of a post-operative patient is a common event. Early indicators of clinical deterioration, such as tachycardia, hypotension, dyspnea, and a change in consciousness, trigger a quick reaction within hours to days. Patients who return to the intensive care unit (ICU) do so with less activity and sleep, inadequate nutrition, and a longer recovery time. However, I’m curious to learn more about the factors that contribute to ICU readmissions and whether collecting and using data could help us reduce readmissions.

Data analysis could shed light on risk factors for readmissions. Patients who have had a lengthy surgery and required ICU care are more likely to be readmitted. Our patients with liver failure are frequently admitted and readmitted with hepatic encephalopathy. There have been numerous readmissions within hours of ICU discharge. Are we rushing patients out of the ICU due to a lack of ICU beds? Should an ICU discharge score be implemented? Can we take control of our lack of sleep, activity, and appetite? What would that entail?

What I’ve observed and these questions can be addressed through data collection rather than anecdotal information. We can, for example, collect the amount of time a discharging provider spends with the patient on the day of discharge. Less time may be related to readmissions. We can also identify specific surgeries that cause readmissions. These are just two examples of data that can lead to tangible change, resulting in fewer ICU readmissions.

Reference

Discussion: Application of Data to Problem-solving

Ponzoni C.R., Correa T.D., Filho R.R., Pardini A, Schettino G.P. 2017. Readmission to the Intensive Care Unit: Incidence, Risk Factors, Resource Use, and Outcomes. A Retrospective Cohort Study. doi: 10.1513/AnnalsATS.201611-851OC. PMID: 28530118.

RE: Discussion – Week 1

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Informatics is the science of storing, retrieving, and analyzing data. It has a significant impact on every aspect of the profession. The Informatics system, when used correctly, makes jobs easier and more accurate. It also aided in the timely resolution of the problem. Informatics systems are extremely important in the nursing profession. Nursing informatics is a nursing field that combines nursing, computer, and information sciences to maintain and develop medical data and systems to support nursing practice and improve patient care outcomes (Registered Nursing, 2020). Based on my personal experiences as a nurse, I believe that incorporating technology into medical care not only makes jobs easier, but it also increases patient, provider, and nurse satisfaction.

Technologies reduce medical errors and give nurses more time to care for patients rather than documenting. “The emergence of new health care paradigms will result in greater connectivity between care providers and patients, as well as a wide range of emerging technologies and an increasing emphasis on data analytics, making the integration of informatics competencies into every area of nursing an absolute necessity” (Nagle, Sermeus, & Junger, 2017). Overall, nursing informatics is a growing and popular nursing field that is critical in promoting patient-centered healthcare and educating providers and patients.

The basic normal baseline is determined by regular evaluation and data comparison. If it is higher or lower than the baseline, it indicates that something is wrong with the patient. McGonigle and Mastrian (2017) explained in their nursing informatics book that “experienced nurses, thinking back to their novice years, may recall feeling like their head was filled with bits of data and information that did not form any cohesive whole.” Nurses and providers used to have to use their knowledge to evaluate, store, and retrieve data in their heads, which resulted in a medical error.

There is a true scenario that comes to mind that I will never forget. It was about one of my patients who had come in after having sigmoid colon resection surgery. There was already a risk of bleeding with that patient. I did receive a stable patient from PACU, and patients were able to walk, were stable with all vitals, and could tolerate pain level. Because that was the med surge floor, most of our patients remained in the unit without a Telemetry monitor, and we do take vitals every four hours unless something critical occurs. We have one guardian nurse at my workplace who evaluates all patients from hospitals and their vitals and NEWS score from one room in a computer. If anything unusual occurs, such as vitals that are higher than normal, the guardian nurse notifies each nurse. My post-op patient had a high heart rate and a low blood pressure that night (a sign of internal bleeding). The guardian nurse was able to alert me during my busy hour with five patients due to technology and informatics system; we were able to intervene patient and immediately gave blood and moved to ICU for a higher level of care. Thus, this true scenario from my nursing experiences demonstrates that the informatic system plays a critical role in saving patients’ lives every day.

References

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

Nagle, L. M., Sermeus, W., & Junger, A. (2017). The evolving role of the nursing informatics specialist. Studies In Health Technology And Informatics, 232, 212–221.

Registered Nursing, (2020). What is nursing informatics & how to become a nurse informaticist? Retrieved February 25, 2020, from https://www.registerednursing.org/nursing-informatics/

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
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Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
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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 al

Discussion: Application of Data to Problem-solving