NR 361 Week 2 Discussion Topic, Experiences With Healthcare Information Systems
NR 361 Week 2 Discussion Topic, Experiences With Healthcare Information Systems
NR 361 Week 2 Discussion Topic, Experiences With Healthcare Information Systems
Most of my nursing experiences with healthcare information systems are from nursing school as a nursing student. I had clinical rotations at nursing home, short/Long-term rehab center, and hospitals. In nursing home setting, they use both paper and computer charting. Paper charting is used for daily activities such as vital signs, In&out and daily schedule. Computer charting is used for administration, health history, meds record, doctor’s order, and notes. In rehab center, they used computer basis charting all the time, but they also provided a binder with paper sheets/forms for each patient at nurse station. I feel kind of like this style especially when computer is not enough for everybody to use, or computer doesn’t work for some reason. The information is actually straight forward for nursing student who want to know the whole picture of patient and not familiar their electrical information system. In hospital setting, I was able to have experiences with EPIC system. As a student, we have access to the system with our own username and password, but we are not allowed to do documentation unless it approved by our supervisor. I thought it is simple and straight forward to use after training. “Due to the applied nature of HIT, provision of skilled training plays a critical role in adoption and maximized use of HIT. Nurses, Physicians, allied health care professional, and healthcare support staff must become skilled in both the use of computer technology and the use of health-information system; effective training is a key piece of this process.” (Hebda, Hunter, & Czar, 2019 p. 219.)
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I am currently in orientation at a long term rehab center in Connecticut where I had clinical rotation as a nursing student last year. The transition is a lot easier for me since I practiced there for a whole semester, and they basically had no big change of the information system. I believe my previous nursing experience in the facility as a nursing student build a very good foundation for successful transition. They use Point Click Care system for data entry including health history, assessment, treatment, notes such as fall accident, fracture, ulcers, etc. They also have paper sheet for charting since they just have two computers available at nurse station. At the end of the shift, the floor supervisor will check everything and enter the data into computer selectively.
Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses & healthcare professionals (6th ed.). Pearson.
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My experience with different healthcare information systems is limited because I have only worked at one hospital. When I started at this hospital, the physicians were still hand-writing orders and progress notes. They had already integrated a basic electronic charting system called Meditech, for the nurses to chart and the secretaries to transcribe the hand-written documentation from the physicians. In 2013, my hospital converted to all electronic medical records and overall it was an easy transition. As a 19-year-old, computers and new applications did not scare me. But I believe the sudden implementation of this system forced some of the older physicians and nurses out of the hospital setting. My experience with healthcare information systems has been positive. According to our textbook, Electronic Health Records have the ability to “add decision support and flag potentially dangerous drug interactions, verify medications, and reduce the needs for risky tests and procedures” (Hebda, Hunter, & Czar, 2019, p. 119). One example of how this feature has helped me is when I have patients who are receiving IV Furosemide, the system will alert me if the patient’s last Potassium level was low and it has not been re-drawn recently. The government was a driving force in the implementation of electronic healthcare information systems. In 2009 President Barack Obama signed a piece of legislation called the Health Information Technology for Economic and Clinical Health (HITECH) Act. This act provided more than $35 billion to hospitals and clinics to encourage the use of Electronic Health Records (Reisman, 2017).
References
Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses & healthcare professionals (6th ed.). Pearson.
Reisman M. (2017). EHRs: The Challenge of Making Electronic Data Usable and Interoperable. P & T : a peer-reviewed journal for formulary management, 42(9), 572–575.
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.
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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.
NR 361 Week 2 Discussion Topic, Experiences With Healthcare Information Systems
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.
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?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
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.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Participation: RN-to-BSN
In discussions, you, as a student, will interact with your instructor and classmates to explore topics related to the content of this course. You will be graded for the following.
1. Attendance
Discussions (graded): Discussions are a critical learning experience in the online classroom. Participation in all discussions is required.
2. Guidelines and Rubric for Discussions
PURPOSE: Threaded discussions are designed to promote dialogue between faculty and students, and students and their peers. In the discussions students:
- Demonstrate understanding of concepts for the week
- Integrate scholarly resources
- Engage in meaningful dialogue with classmates
- Express opinions clearly and logically, in a professional manner
Participation Requirement: You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday.
Participation points: It is expected that you will meet the minimum participation requirement described above. If not:
- You will receive a 10% point deduction in a thread if your response to the initial question is not posted by 11:59 p.m. MT on Wednesday
- You will also receive a 10% point deduction in a thread if you do not post at least three (3) times in each thread on at least two (2) separate days.
3. Threaded Discussion Guiding Principles
The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
4. Participation Guidelines
You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday. Discussions for each week close on Sunday at 11:59 p.m. Mountain Time (MT). To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. For courses with Week 8 graded discussions, the threads will close on Wednesday at 11:59 p.m. MT. All discussion requirements must be met by that deadline.
5. Grading Rubric
| Discussion Criteria | A (100%) Outstanding or highest level of performance |
B (87%) Very good or high level of performance |
C (76%) Competent or satisfactory level of performance |
F (0) Poor or failing or unsatisfactory level of performance |
|---|---|---|---|---|
| Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week. 16 points |
Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.
16 points |
Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.
14 points |
Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.
12 points |
Minimally addresses the initial discussion question(s) or does not address the initial question(s).
0 points |
| Integrates evidence to support discussion. Sources are credited.* ( APA format not required) 12 points |
Integrates evidence to support your discussion from:
Sources are credited.* 12 points |
Integrates evidence to support discussion from:
Sources are credited.* 10 points |
Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.
Sources are credited.* 9 points |
Does not integrate any evidence.
0 points |
| Engages in meaningful dialogue with classmates or instructor before the end of the week. 14 points |
Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.
14 points |
Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.
12 points |
Responds to a classmate and/or instructor but does not further the discussion.
10 points |
No response post to another student or instructor.
0 points |
| Communicates in a professional manner. 8 points |
Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).
8 points |
Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).
7 points |
Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).
6 points |
Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).
0 points |
| PARTICIPATION: Response to initial question: Responds to initial discussion question(s) by Wednesday, 11:59 p.m. M.T. |
0 points lost
Student posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT. |
-5 points
Student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT. |
||
| PARTICIPATION Total posts: Participates in the discussion thread at least three times on at least two different days. |
0 points lost
Posts in the discussion at least three times AND on two different days. |
-5 points
Posts fewer than three times OR does not participate on at least two different days. |
||
| NOTES: * Credited means stating where the information came from (specific article, text, or lesson). Examples: Our text discusses…. The information from our lesson states…, Smith (2010) claimed that…, Mary Manners (personal communication, November 17, 2011)…. APA formatting is not required. |
||||
| ** Assigned readings are those listed on the syllabus or assignments page as required reading. This may include text readings, required articles, or required websites. | ||||
| *** Scholarly source – per the APA Guidelines in Course Resources, only scholarly sources should be used in assignments. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Wikipedia, Wikis, .com website or blogs should not be used as anyone can add to these. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. Outside sources do not include assigned required readings. | ||||
| NOTE: A zero is the lowest score that a student can be assigned. | ||||
Share your experiences with healthcare information systems, past or present. Has it been an easy transition or difficult? Why do you believe your experience has been positive or negative? If you are currently not working in a healthcare setting, how has the medical record exposure in nursing school impacted your current knowledge?
I have worked in a variety of healthcare settings throughout my career before I became a nurse. You could even consider lifeguarding part of healthcare because I was CPR certified, although I didn’t ever have to document anything or save anyone. I worked in a doctor’s office for a few years while I was starting school. This office was private practice, so they didn’t have an electronic documenting system. All the charts were paper, and they were very heavy! If I took a call from a patient, I had to find their chart in the files and hand write what they needed and give it to the doctor for him to reply. I learned spelling and medical terms very quickly! Although this system mostly worked for their needs, I sometimes found other patients results in others charts. Every result was faxed to us and sorted and filed by hand. Therefore, a lot of mistakes were made and there wasn’t a great way to monitor that the correct papers were getting into the correct charts. If a specific result was lost, there was really no way to find out where it went, we would just have to have another copy faxed. Thankfully while I was there nothing catastrophic happened, but with no safeguards in place, it’s really only a matter of time. In a study comparing electronic documentation verses conventional (paper) charting, this found that the electronic documenting showed more diagnoses for each patient, less false or redundant ICD codes, and less time spent on documenting (Stengel, Bauwens, Martin, Kopfer, & Ekkernkamp, 2004). Improper or false ICD billing codes can get you in a lot of trouble, even if you’re not doing in on purpose. Medicare fraud is highly monitored and can negatively affect a physician’s medical license. Not to mention the potential repercussions for the patient receiving wrong information and potentially having to pay more money unnecessarily.
I found the transition from that old paper system to an electronic system to be very smooth. I often felt like I lacked detail in some instances and I know how important documenting is. But the amount of time I spent hand writing requests in the chart took away from the amount of detail I could put into it. I was already spending extra time after the office closed to call back the patients who had called that day, I didn’t have any extra time to write more. I can type a lot faster than I can write, so an electronic system would have really helped streamline this office. I understand how expensive it can be to convert, so I realize why they never changed over. I used Epic documenting now and I could not imagine what it would be like to try and document a hospital patient with a pencil and paper. I already spend a lot of time charting, I feel like I would never get the amount of detail necessary while trying to hand write all my documentation.
Stengel, D., Bauwens, K., Martin, W., Kopfer, T., & Ekkernkamp, A. (2004). Comparison of Handheld Computer-Assisted and Conventional Paper Chart Documentation of Medical Records: A Randomized, Controlled Trial. Journal of Bone and Joint Surgery, 86(3), 553-560.