The Use Of Clinical Systems To Improve Outcomes And Efficiencies

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New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings. 

To Prepare:

  • Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
  • Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
  • Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

  • Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
  • Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples. 

Resources:

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

  • Chapter 14, “The Electronic Health Record and Clinical Informatics” (pp. 267–287)
  • Chapter 15, “Informatics Tools to Promote Patient Safety and Quality Outcomes” (pp. 293–317)
  • Chapter 16, “Patient Engagement and Connected Health” (pp. 323–338)
  • Chapter 17, “Using Informatics to Promote Community/Population Health” (pp. 341–355)
  • Chapter 18, “Telenursing and Remote Access Telehealth” (pp. 359–388)

Rao-Gupta, S., Kruger, D. Leak, L. D., Tieman, L. A., & Manworren, R. C. B. (2018). Leveraging interactive patient care technology to Improve pain management engagement. Pain Management Nursing, 19(3), 212–221. doi:10.1016/j.pmn.2017.11.002

Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. doi:10.3390/informatics4030032

https://www.healthit.gov/faq/what-electronic-health-record-ehr
https://www.himss.org/library/ehr/
https://class.waldenu.edu/bbcswebdav/institution/USW1/201970_27/MS_NURS/NURS_5051_WC/artifacts/USW1_NURS_5051_Dykes.pdfhttps://class.waldenu.edu/bbcswebdav/institution/USW1/201970_27/MS_NURS/NURS_5051_WC/artifacts/USW1_NURS_5051_Dykes.pdf

Rurbic:

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

·   Properly identify 5 peer-reviewed articles selected.
·   Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.–

Levels of Achievement:  Excellent 77 (77%) – 85 (85%)    Good 68 (68%) – 76 (76%)    Fair 60 (60%) – 67 (67%)    Poor 0 (0%) – 59 (59%)   

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)   

Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)   

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%) 

 
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Fundamentals Of Practical Nursing

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Throughout history nurses have provided health care to patients during the life span. Whether it is in the setting of war caring for the wounded, hospitals caring for the sick, or hospice caring for the dying – nurses have made a number of contributions to the medical profession. Originally nurses and the nursing profession did not receive credit for the care they gave, but that changed during the 19th century when nurses began to build that foundation that modern nursing sits on today. By understanding and learning about the contributions that some famous historical nurses made, you will begin to better appreciate all nurses throughout history.

Take a look at the famous nurses that have changed history, pick one of these nurses to share, and include the following:

  1. Background of the nurse (personal and professional)
  2. Greatest contributions
  3. How did they change history?
  4. Why you choose this nurse and what you admire about this nurse?

Please make an initial post by midweek, and respond to at least two other student’s posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Please check the Course Calendar for specific due dates.

 
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Magnesium Sulfate During Pregnancy Teaching

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Teaching Experience

1. Purpose: To document and evaluate teaching skills necessary to provide teaching to an individual client with a demonstrated need. With the completion of this assignment the student will be able to achieve the following objectives.

  1. Demonstrate ability to thoroughly assess the learning styles of an individual or family using given developmental or cultural models.
  2. Demonstrate ability to anticipate learning needs based on developmental or cultural assessments.
  3. Identify and utilize teaching/learning principles to facilitate achievement of learning goals and outcomes.
  4. Select and prioritize learning strategies based on the developmental or cultural assessment to achieve learning goals and outcomes.
  5. Support rationales for teaching plan using teaching and learning theories from required readings with references

2. Nursing Competencies:

  1. Assessing and identifying developmental, cultural, and socioeconomic factors affecting a client.
  2. Providing evidence-based health information and teaching based on developmental, cultural, and socioeconomic factors affecting a client or family
  3. Integrating teaching/learning activities into client interactions based on developmental, cultural, and socioeconomic factors affecting a client or family.
  4. Incorporating health promotion and teaching into the plan of care based on developmental, cultural, and socioeconomic factors affecting a family or client.

3. Plan: submitted to the clinical instructor during the teaching experience. Your clinical instructor must approve the topic.

  1. Develop nursing diagnosis (NANDA)
  2. Develop two (2) learning objectives
  3. State methodology (teaching methods)
  4. Provide and utilize teaching aids
  5. State needed resources

4. This write-up should be 2 pages to follow the Teaching Experience Rubric.

 
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To be one of the best organizations the mission statement and values set forth by that organization must show respect and overall care for the employees representing such.

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To be one of the best organizations the mission statement and values set forth by that organization must show respect and overall care for the employees representing such. Organizations like ones we work for have a duty to provide the highest of quality care for patients while maintaining safety. In order to perform at these levels it starts with great communication methods.  As many know communication is a crucial element at the forefront of all successful businesses.  At times the downfalls of organizations stem from unhealthy communication lines. Many organizations lack healthy work environments due to communication breakdown (Laureate Education, 2018). Individuals must know how to communicate thoroughly and effectively. 

 A healthy working environment is essential to overall staff and patient satisfaction. When staffs are being treated fairly and under the right conditions results are felt through patient satisfaction surveys and such.  Within organizations the culture is created with an attempt to amplify the healing and health of the populations serviced (Marshall  & Broome, 2017). When there are broken lines of communication, disruptive behaviors and such it causes a great deal on incivility amongst staff.  According to Marshall & Broome (2017), incivility can be classified as behaviors of low intensity which is displayed as being impolite, or rude placing strains on the working environment (p.76).  After taking the workplace assessment this week, my organization was determined to be an unhealthy environment. My work place would be classified as uncivil with this score based on such determining factors such as the lines of communication amongst each other, the fact staff feel over worked with patient acuity and workloads, and the issues with retention of staff.

                An incident in my workplace where I was a key witness of incivility was with a nurse leader and nurse manager. She was very demeaning with every word she spoke. She was not that took well to constructive criticism, but would greatly give out with much pleasure. There was a difficult patient on our unit for a lengthy time. He was very rude to all staff, very manipulative, and demanding. As much as we all kept trying to keep the moral from drowning because of his behaviors, this one particular day I must say the patient won. The nurse leader received a phone call from this patient which was discharged a day before. The patient was calling regarding medications he thought he had left and was informed the medication was not with us but was with him at discharge. The patient began to become frustrated with the nurse leader. While this conversation took place, the nurse manager overheard this interaction. She instructed the nurse leader to hang up the phone and tell the patient we did not have anything that belongs to him. The nurse leader was trying to diffuse the situation with the patient, and be very courteous and diligent. The nurse manager was still in front of the nurse leader and instructing her to hang up the phone on the patient. Again the nurse leader is trying her best to ease off the phone, but clearly it was not fast enough for the nurse manager. The manager then hangs up the phone on the patient in mid-sentence. She then in the middle of the nurses’ station scolded the nurse leader about her conversation and her actions of insubordination towards her requests to hang up the phone. Staff all around was very shocked at this interaction and quickly shifted away. Now although this was not towards me, I felt every bit of sympathy for my fellow leader. She felt belittled, incompetent, and disrespected. This was no way a leader above us should act nor treat staff as such. The nurse leader did walk away and had a moment where she broke down and cried to me. I felt helpless at that moment, but I could not allow this behavior manager or not. I later talked to the manager and expressed my concerns regarding her actions. She did mention her frustrations, and that she did get carried away. Her frustrations grew from the patient overall and the difficult times he caused on our unit. The manager did express her feelings of sorrow towards her staff and fellow leader.

                The issue was resolved for the moment, but overall we did lose a great leader because the nurse transferred to another unit. I will say although the issue was addressed, it should have never happened and this is not something I can ever condone. In this profession of nursing we are looked upon as the most “trusted and caring professions” (Clark, Olender, Cardoni, & Kenski, 2011).  With this being said nothing short of those actions would make me feel comfort with a nurse like this and these behaviors. It is never ok to allow workplace violence and knowing that I was a voice for a peer allowed me to feel comfortable as a nurse leader and advocate for not only patient but my fellow staff.

References

Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. Journal of Nursing Administration, 41(7/8), 324–330. doi:10.1097/NNA.0b013e31822509c4

Laureate Education (Producer). (2018). Diagnosis: Communication Breakdown [Video file]. Baltimore, MD: Author.

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

 
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Communication in the workplace is key. It is what makes employees feel comfortable, valuable and successful, which allows them to work to their fullest potential.

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Communication in the workplace is key. It is what makes employees feel comfortable, valuable and successful, which allows them to work to their fullest potential. Effective communication not only builds trust between employers and employees, but has a direct effect on the health and safety of nurses and their patients (Bergman, Dellve, & Skagert, 2016). The Clark Health Workplace Inventory is a tool that is used to determine if a work environment is perceived as healthy. After completing the survey, the results showed that my workplace is an unhealthy environment. Oddly enough, my coworkers and I have had many conversations about some of the very topics discussed in this assessment. That is why this result doesn’t surprise me at all. One of the question on this assessment asked specifically about staffing, which is something that my unit struggles with consistently. The absence of adequate staffing makes the workload difficult to manage. It leads to unnecessary stress. Also, there were several questions pertaining to clear communication through all the levels of the organization, which is something that I think my organization could get better at too. There are a lot of decisions made about the staff without actually getting the staff’s input on those decisions beforehand. It can make employees feel as though their thoughts or input doesn’t matter. No one can expect for every workplace to be perfect. In fact, any work environment has its issues and aspects that make people unhappy. However, overall employees should find some happiness in their jobs. Whether it be the impact of their work, location, coworkers, incentives, or opportunities for career advancement.

Incivility in the Workplace

Incivility in the workplace can cause employees to have little to no happiness in their jobs. Marshall & Broome define incivility as “ behavior of low intensity that can include such behavior as being rude, discourteous, impolite, or violating workplace norms or behavior” (pg, 76). I worked at a subacute rehabilitation center where the Director of Nursing behaved in this manner. She was very demeaning and aggressive when she would speak to the staff. It made for a very stressful environment. The nursing staff constantly felt like we were walking on eggshells, never knowing when we would have an encounter with her. There was a constant turnover of staff, not only among the staff nurses but mostly with the unit managers who worked directly under her. Even though she was a great nurse, I felt that she was not a good nurse leader for this reason. Although several nurses made her aware of their thoughts on how she treated and spoke to people, I can’t remember anything being done on a larger scale to combat the incivility. Looking back, I worked at this facility as a brand new nurse and really did not know that things could be done differently as far as leadership goes. I also wasn’t aware at the time of how working with this person impacted my views on the workplace as a whole. 

References

Bergman, C., Dellve, L., & Skagert, K. (2016). Exploring communication processes in workplace meetings: A mixed-methods study in a Swedish healthcare organization. Work, 53(3), 533-541. DOI: 10.3233/WOR-162366

Clark, C.M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer

 
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Reply DB 8 health care policy

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1-Rosquete

One of the ways nurses can help reduce challenges in the LGBTQ community is through helping to implement policies and laws in health institutions through sexual orientation non-discriminatory guidelines. Once they are formulated, they should be communicated to all the employees in the hospitals to educate them on the existence of this group among the patients and how they should treat them to avoid any form of discrimination. Also, the management should communicate to them the various actions that the organization is likely to take in case these laws are violated.

The second way is through reprimanding to ensure that no one goes unpunished in case of any discriminatory actions against the patient who identifies as LGBTQ in the healthcare facility. If the organization does not have any formal non-discriminatory policy, then it should come up with one and communicate it to every department in the organization (Köllen, 2016). Also, the organization should prohibit invasion of privacy, emotional distress, defamation and harassment of this particular groups in the health facility. And the occurrence of any of these should be reacted upon efficiently. Such laws and punishments are likely to scare away any employees who could be thinking of any form of discrimination against the LGBTQ community.

Education is another strategy that can be employed to solve the issues. First, the management of health institutions should create awareness in the institution on the existence of the transgender and how they should be handled in the organization. Also, through sensitivity training classes, health experts, and other workers can recognize any discriminatory practices that may affect the well-being of the LGBTQ community as they receive health services in the institution (Taylor & Haider-Markel, 2014). Similarly, the LGBTQ patient must be taught about their rights and what they should do in case any of their rights and freedoms are violated. With such knowledge, it would be easier for all workers to be on the lookout to ensure that they do not cross their lines. Furthermore, the LGBTQ patient would be aware of their rights as patients and take appropriate steps whenever they are discriminated against by any health official.

Essential VII, Interprofessional Collaboration for Improving Patient and Population Health Outcomes, relates to the topic we are discussing this week because it claims that the quality of patient care is improved when members of the health care team work in collaboration to share their unique patient care perspectives. Each profession enters into practice with different skill sets, knowledge, and professional identities to enhance the care of the patient, yet many barriers exist between disciplines that can obstruct a team-based system.

References

Köllen, T. (2016). Sexual Orientation and Transgender Issues in Organizations: Global Perspectives on LGBT Workforce Diversity. Cham: Springer International Publishing.

Taylor, J. K., & Haider-Markel, D. P. (2014). LGBTQ rights and politics: Groups, issue framing, and policy adoption. Ann Arbor: University of Michigan Press.

2-alberto alfonsp

There are numerous challenges the U.S. health care system is facing, one of which is treatment of the LGBTQ community.  One of the major social trends is the growth of the LGBTQ population. According to Meerwijk and Sevelius (2017), there are about 390 LGBTQ adults per 1000,000. This population is expected to increase significantly in the near future.

            One area where the NP can improve and promote advocacy for the LGBTQ community is in reproductive services.  LGBTQ people have the right to safe abortion services, access to contraceptives, sexually transmitted infections (STI) testing and a range of other health services free from stigma, discrimination or coercion.  People who identify as LGBTQ can get pregnant, and young lesbian and bisexual women disproportionately experience unintended pregnancy.

            The NP can help provide accurate, comprehensive sex education to young LGBTQ people, and they can also help spread information about bias and misrepresentation of the LGBTQ population to community leaders.

            The NP may also begin by advocating for research that focuses on the group and on its structural factors. It can be said that a lack of research in one’s community can greatly affect and increase, among others, the percentage of homosexuals with HIV infections. For instance, one may conduct evidence-based practice projects in his or her community to see the percentage of cases that arise due to genetics, health behaviors, and social characteristics of the community (Page, 2012); factors which may influence the number of HIV cases. Afterwards, one may push for educational programs in one’s healthcare facility that inform HIV infected LGBTQ individuals how to prevent opportunistic infections. This may be accomplished by training nurses to provide appropriate educations to individuals struggling with the infection. Lastly, one could strive to educate nurses on the healthcare organization on the importance of treating members of the LGBTQ community with the same care given to other patients with the goal of preventing discrimination against the community (De Leon, 2015). This may be achieved by conducting a mandatory educational class on the topic for all healthcare providers in one’s organization. With this in mind, the Essential that most relates to this topic is the first Essential which focuses on a student’s background knowledge of Sciences and Humanities. This Essential is important because as stated in this discussion, the principle highlights the importance of following the nursing process and evidence-based practice for safe and effective patient-centered care (American Association of Colleges of Nursing, 2011).

References 

American Association of Colleges of Nursing. (2011). The Essentials of Master’s Education in Nursing. Washington, DC: Author American Association of Colleges of Nursing. Retrieved from http://www.aacnnursing.org/Portals/42/Publications/MastersEssentials11.pdf

Carabez, R. M., Eliason, M. J., & Martinson, M. (2016). Nurses’ Knowledge about LGBTQ 

            Patient Care. Advances in Nursing Science, 39(3), 257-271. 

            doi:10.1097/ans.0000000000000128.

De Leon, E. (2015). Gay and Racial/Ethnic identities, perceived discrimination, and participation in collective action. Available from ProQuest Central. (1767386662). Retrieved from https://search.proquest.com/docview/1767386662?accountid=158399

Page, M. J. (2012). Community level factors and HIV among marginalized populations in the united states. Available from ProQuest Central. (1040846909). Retrieved from https://search.proquest.com/docview/1040846909?accountid=158399 

 
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Describe the quality performance tools that may be used to demonstrate that the care and treatment rendered are both cost-efficient and of high quality.

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1. Suzanne Jones, 76-year-old patient with COPD is admitted to the ICU. Mrs. Jones is placed on mechanical ventilation to assist with her breathing. After 2 days on the ventilator, Mrs. Jones is extubated and then transferred to a medical-surgical unit. The medication regimen is adjusted during the hospitalization. Mrs. Jones is discharged home after 6 days. She and her family are pleased with the care she receive in the hospital. 

  1. Describe the quality performance tools that may be used to demonstrate that the care and treatment rendered are both cost-efficient and of high quality.
  2. Describe the quality performance tools that may be used to demonstrate that the nursing care utilized is evidence-based care and high quality, resulting in patient satisfaction and good patient outcomes.

2. The registered nurse working in the cardiac care clinic is tasked with implementing quality improvement measures. To educate the clinic staff, the nurse plans an in-service program to introduce concepts of quality improvement and evidence-based practice. Additionally, the role of the case manager will be included in the presentation. The nurse plans on using care of the patient with Congestive Heart Failure as a template, and prepares sample clinical pathways, care maps, and multidisciplinary action plans. 

  1. Describe how clinical pathways are used to coordinate care of caseloads of patients.
  2. What is the role of the case manager in evaluating a patient’s progress?
  3. What are examples of evidence-based practice tools used for planning patient care?
 
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as health care consumers, we all expect quality care and positive outcomes. It is important as professionals that we meet these demands of health care consumer

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as health care consumers, we all expect quality care and positive outcomes. It is important as professionals that we meet these demands of health care consumers. Consider the work of the major theorists you examined in this week’s Resources, and think about how these theories apply to your own experience as a health care customer and/or practitioner.

By Day 3

Post your definition of quality, and apply it to the work of one major quality theorist (e.g., Donabedian, Juran, Deming, Triple Aim (IHI) – Berwick). Identify a practice problem that you have had some experience with as a customer or as a practitioner, and explain how eliminating wasteful practices could have improved the experience. Include how your definition of quality applies to that experience.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist).

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old). (Refer to AWE Checklist, Capstone)

 
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Educational Resources in Infancy

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Assignment 2.1: Educational Resources in Infancy

Step 1: Review Chapter 3 on Infancy and reflect on the following scenario:

Educational DVD’s and toys have become popular amongst today’s society with the assumption that they raise intelligence in babies.

Step 2: In a two page paper: 

  • Discuss the cognitive, emotional, and physical (fine and gross) development that occurs in infancy.
  • Using the developmental concepts you discussed in infancy, apply the data to refute or support the claims of a book or educational program’s promise to help parents increase their babies’ intelligence. 
  • Based on valid research, what suggestions would you give to a patient’s parent to increase the intellectual development of infants?
  • Discuss how your knowledge of development within infancy can be applied in your Obstetrics and Pediatrics clinical rotation.

Provide 3-5 references for your submission.

 
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Developmental Theorist

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Developmental Theorist

Step 1: Research the major developmental theorists, Freud and Erikson from your readings in Chapter 1 and Chapter 2.

Step 2: Using your supportive findings and information from your assigned readings, write a 1-2 page paper on the following:

Compare and Contrast Freud and Erikson’s developmental theories

  • Include each of their stages of development.
  • Discuss the major characteristics associated with each stage of development.
  • Explain which theory you feel is more favorable.
  • Include 3-5 references to support your stance and findings.
 
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