Purpose

The purpose of this activity is to deepen learning through reflective inquiry. It will allow for expansion in self- awareness, identification of knowledge gaps, and assessment of learning goals.

Course outcomes: This assessment enables the student to meet the following course outcomes:

1.  Assess the impact of informatics and information technology on organizational systems, change, and improvement. (PO6)

2.  Use information technology to collect and analyze data to generate evidence-based nursing practice across healthcare settings. (PO7)

3.  Design programs that monitor and evaluate outcomes of care, care systems, and quality improvement. (PO7)

4.  Evaluate the types of healthcare information systems, knowledge-based systems, patient care technology, and the impact on patient safety, quality of care and outcome measurement. (PO7)

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5.  Appraise consumer health information sources for accuracy, timeliness, and appropriateness. (PO7)

6.  Resolve ethical and legal issues related to the use of information, communication networks, and information and patient care technology. (PO6)

Due date: Sunday 11:59 p.m. MT at the end of Week 7. The Late Assignment Policy applies to this assignment.

Total points possible: 100 points

Preparing the assessment: Follow these guidelines when completing this assignment. Contact your course faculty if you have questions.

1.  Write a brief 1-2 paragraph weekly reflection addressing the questions posed in the Reflect section of each weekly module. Edit your Reflection to include each weekly reflection.

2.  Include the following sections in your Reflection.

Week 1

§  As you assess your learning, provide one specific example of how you achieved the weekly objectives.

§  What do you need to heighten your informatics competencies to positively impact patient safety, quality care, and complement your role as a DNP Scholar?

§  What do you value the most about your learning this week?

Week 2

§  As you assess your learning, provide one specific example of how you achieved the weekly objectives.

§  How will you promote collaborative, inter-professional relationships in a rapidly transforming healthcare environment?

§  What do you value most about your learning this week?

Week 3

§  As you assess your learning, provide one specific example of how you achieved the weekly objectives.

§  What new skills or competencies should you consider after the learning this week?

§  What do you value most about your learning this week?

Week 4

§  As you assess your learning, provide one specific example of how you achieved the weekly objectives.

§  What concepts, theories, models, tools, techniques, and resources in this week had you not considered before?

§  What do you value most about your learning this week?

Week 5

·   

o   

§  As you assess your learning, provide one specific example of how you achieved the weekly objectives.

§  How might you use this week’s information to benefit your organization and staff in your future role as a DNP practice scholar?

§  What do you value most about your learning this week?

Week 6

·   

o   

§  As you assess your learning, provide one specific example of how you achieved the weekly objectives.

§  What skills do you need to implement the concepts learned this week and how will you develop them?

§  What do you value most about your learning this week?

Week 7

·   

o   

§  As you assess your learning, provide one specific example of how you achieved the weekly objectives.

§  What skills do you need to implement the concepts learned this week and how will you develop them?

§  What do you value most about your learning this week?

3.  Writing Organization and Mechanics

4.  Grammar and mechanics are free of errors.

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he initial thoughts on reading the AACN information systems/technology essentials for DNP graduate

   The initial thoughts while reading this essential is focused on the role played by the information technology in the improvement of healthcare services received by the patients. Information technology is gaining momentum and every industry is adopting it. The healthcare sector has not been left behind and every healthcare organization is making sure that its workers are well equipped with the skills and knowledge about the utilization of information technology. Nurses who are directly handling patients are required to have skills in information technology, therefore, it is becoming part of the daily routines of the nurses. The adoption of information technology is aimed at ensuring that nurses can manage the adverse effects caused by prescription or medication errors (Feldman et al., 2018). It is used to replace the paper-based system of recording patient information.

Whether something surprising was found

   Even though there was prior knowledge about the role of DNP in clinical decision-making and showing leadership by using the information and technologies, it was a surprise to learn that DNP also participates in legal and ethical issues. The personal perception before this essential was that the development of the legal and ethical guidelines are the roles left to the bodies or organizations that guide the practices of the national organizations that set the standards of practice for nurses (Kruse & Beane, 2018). Such guides or the standards of practices are aimed at preventing the potential harm that might occur as a result of the technology applications.

The changes that have been witnessed in the practice setting over the past five years as a result of the technology and evidence-based practice

    Based on what has been observed concerning the practice within the facility of employment, it is clear that the management is in the front line to ensure that information technology is implemented and made to be the routine practice. The is ongoing training of recruits on the use of computers and other electronic equipment such as computers, health applications on cell phones, tablets, and laptops among others (Kruse & Beane, 2018). The hospital has employed three nurse informatics who have assisted in ensuring that the skills and knowledge on the use of information technology are adopted and implemented.

    Most of the patients’ health recordings in the facility are now becoming paperless and this is aimed at increasing the safety of patient’s health information. Patient information is transferred from one department to the other through an electronic approach. The hospital is also attempting to manage the number of patients visits by implementing telemedicine to support the home-based care services (Kruse & Beane, 2018). Currently, the facility has a policy in its recruitment procedure that every application must be computer literate to ensure that the cost burden in training the recruits is reduced.   

The changes expected to witness in the practice setting for the next five years.

    Concerning the pace at which the management of this facility is supporting the implementation of the information technology, it is highly likely that every aspect of healthcare service will be handled electronically. The home-based care setting that has been started will increase to ensure that patients who are not able to reach healthcare facilities are treated (Kinnunen et al., 2019).

How the changes affected the nursing practice in the setting

     Several effects have been brought by the changes or adoption of information technology nursing practice. It has enabled the registered nurses to improve efficiency and communicate more successfully. It has helped in improving the nursing care services in remote areas since nurses can manage patients left at home by following the instructions provided by the physicians.

References

Feldman, S. S., Buchalter, S., & Hayes, L. W. (2018). Health information technology in healthcare quality and patient safety: A literature review. (Links to an external site.) JMIR medical informatics, 6(2), e10264. https://doi.org/10.2196/10264

Kinnunen, U. M., Heponiemi, T., Rajalahti, E., Ahonen, O., Korhonen, T., & Hyppönen, H. (2019). Factors related to health informatics competencies for nurses—results of a national electronic health record Survey (Links to an external site.). CIN: Computers, Informatics, Nursing, 37(8), 420-429. https://doi.org/10.1097/CIN.0000000000000511 (Links to an external site.)

Kruse, C. S., & Beane, A. (2018). Health information technology continues to show a positive effect on medical outcomes: Systematic review (Links to an external site.). Journal of Medical Internet Research, 20(2). https://doi.org/10.2196/jmir.8793

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The two EHR software that will be discussed is mainly eClinicalWorks and Care360. eClinicalWorks is a company that sells electronic medical record EMR, personal health record software, practice management, and services to healthcare providers (eClinicalWorks, 2021). The Care360 is a breed-based EHR solution mainly designed for ambulatory services. The software is developed and sold by Quest Diagnostics, which is used for patient scheduling and medical billing modules. The best thing about it is that it offers vital patient data anywhere anytime (Care360, n.d.).

     A comparison between the two software is that the eClinicalWorks are mainly available as an on-site client/server, mainly used as software as a service, and can be purchased collectively or even individually. The records, when integrated, can be used in reviewing patient health records, allergies, labs and diagnostics tests, past visits, current medication. The software comes with an added advantage that patients can use to request prescription refills, send messages, review lab results, and set appointment reminders. The main target of eClinicalWorks is for a physician’s practice to use, view, and analyze the patient’s wellness data based on the client’s consent (eClinicalWorks, 2021).

       The Care360, in contrast, is a secure and mobile EHR platform that is used to create efficiency and credibility in medical operations. The software is mainly used by staff to generate practical medical history lab and practice-related reports on patients and gives the data with adequate efficiency. The software also comes with an e-prescription, customizable templates, and lab management capabilities and functions that can make patients’ care the best, mainly on reporting results that all the outcomes and treatments are based on it all (Care360, n.d.).

       The most helpful software that is best suited for a hospital, the workplace of choice, is eClinicalWorks because it has broad and diverse uses other than just lab reporting and billing practices, which are the mainly provided services by Care360. eClinicalWorks is also an EHR software that can work with any hospital system while integrating the Healthcare Enterprise standards. In terms of features, mainly cloud-based vendor services based on its eClinicalWorks 10e suite, which offers tools with big data and telehealth services and can be used in a wide range of activities. The ability to be customized and the effectiveness of the operations is mainly increasing and satisfying (eClinicalWorks, 2021).

      The hospital workplace required adopting an EHR that will establish the most exclusive services without using different platforms to create the needed change. It is thus sound mind to say that effective utilization of the practices will make it possible to manage and control all outcomes in the hospital. eClinicalWorks, for instance, also has extensions like Health and Online Wellness and Population Health (CCMR). Thus, the choice for eClinicalWorks is the best practice possible that can be used to analyze to cater for all electronic health care records and enhance the shift from traditional recording methods to more exquisite and detailed electronic health records which are safe in a hospital setting and system (eClinicalWorks, 2021).

References

Care360. (n.d.). https://www.healthitoutcomes.com/doc/care-0002.

eClinicalWorks. (2021, May 11). eClinicalWorks. https://www.eclinicalworks.com/.

  • Discuss how telehealth can assist to address equality of health care resource distribution. What barriers must be removed to achieve well-being, sufficiency, and health care access for all? 

      Telehealth can provide better patient care since it would be possible to assess patient information using a single computer. The fact that patients are provided with telemonitoring devices connected to the hospital system and their unique accounts results in a centralized method to manage their data. Resource distribution thus becomes cheaper and more accurate for the patients. Barriers in telehealth involve limited understanding of insurance covers, inaccessibility of community health resources, and inappropriate knowledge sharing (Almathami et al., 2020). These barriers can get eliminated by improving patient knowledge and ensuring the healthcare environments are equipped with reliable technology to connect with patients. Ensuring patients possess self-care desires is the best option in improving health environments and promoting accessibility to the suitable medicine and treatment procedures.

  • In your discussion, consider concepts such as equity, respect, self-determinism, health literacy, cyclic disadvantage, and health care disparities among marginalized populations or groups.

      Healthcare disparities like discrimination affect equity that is required to improved positive health management. It is difficult for healthcare providers to generate high quality of life without understanding social factors like employment, lifestyle, income, accessibility to healthcare (CDC, 2021). Marginalized populations like African Americans and Hispanics access limited healthcare since they focus majority of their earnings on social needs. It is thus difficult to provide reliable healthcare improvement and procedures when patients’ physical conditions require better care. Cyclic disadvantage cause development of unhealthy behaviors and physical wellbeing when the affected persons become maladapted to their conditions. It is thus difficult to offer reliable care for such patients that find it hard to access affordable and high-quality care.

  • Compare and contrast how each patient may benefit from telehealth services and the ethical considerations from the viewpoint of the nurse.

      Mr. Kasich can benefit from telehealth since he lives far from the healthcare provider. It would be effective to use telehealth to offer physicians his physical health status as the telemonitoring device records all physical statuses. Since Mr. Kasich suffers from lung cancer, heart failure, and diabetes, the processing of monitoring his vital signs is suitable to since his illnesses are chronic and can only get managed and have reduced severity.

            Mr. Lane shall benefit from telehealth since he spends most of his time in his truck. It is thus difficult for him to access physical healthcare facilities when his conditions need attention. Telehealth would provide a suitable method to communicate with physicians while on the road. In this way, it would be possible to generate reliable health improvement and management of the patient’s physical conditions.

 Reference

Almathami, H. K. Y., Win, K. T., & Vlahu-Gjorgievska, E. (2020). Barriers and Facilitators That Influence Telemedicine-Based, Real-Time, Online Consultation at Patients’ Homes: Systematic Literature Review. Journal of Medical Internet Research, 22, (2). https://doi.org/10.2196/16407 (Links to an external site.).  

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One of the leading causes of the global burden of disease, which is prevalent in my community is drug/alcohol abuse. According to Degenhardt et al. (2018), excessive drug and alcohol use can lead to adverse consequences in a community’s social aspects, productivity, economy, and health. IHME (2017) asserts that everyone deserves to live a long and healthy life. Therefore, the community must apply the relevant evidence-based interventions to deal with drug/alcohol abuse and lower the burden of disease associated with it. Murray et al. (2018) reveal that effective interventions in having desirable mortality and morbidity rates in society.

     A search for three randomized control trials (RCT) addressing an intervention to ease the burden of disease yields the following results:

  • RCT 1: The results of RCT 1 are reported in an article titled “Effect of Alternative Income Assistance Schedules on Drug Use and Drug-Related Harm: A Randomized Controlled Trial” by Richardson et al. (2021).
  • RCT 2: The results of RCT 2 are reported in an article titled “Internet-Delivered Treatment for Substance Abuse: A Multi-Site Randomized Controlled Clinical Trial” by Campbell et al. (2014).
  • RCT 3: The results of RCT 3 are reported in an article titled “Screening and Brief Intervention for Drug Use in Primary Care: The ASPIRE Randomized Clinical Trial” by Saitz et al. (2014).

    The database source of RCT 1 is Lancet. The database source of RCT 2 is the National Center for Biotechnology Information. The database of RCT 3 is the Journal of the American Medical Association.

     An evidence synthesis of the three RCTs: In RCT 1, Richardson et al. (2021) investigated the impact of monthly disbursement of income assistance on illicit drug use. It was hypothesized that consumption patterns of drugs and alcohol are associated with payments, a phenomenon known as, ‘the check effect.’ Participants in the trials were placed in three groups with different frequencies of income disbursement. The results showed that there was increased drug and alcohol abuse among the participants whenever payment was disbursed to them. Thus, Richardson et al. (2021) recommended the adoption of modified income assistance payment schedules that can prevent drug/alcohol use escalations.

            In RCT 2, Campbell et al. (2014) investigated the effectiveness of an internet-based therapeutic education system on the treatment of drug/alcohol use disorders. This system was compared to the standard therapy offered to clients in a community center. The results suggested that there was a lower dropout rate in the internet-based therapeutic education system. Also, Campbell et al. (2014) concluded that this internet-based system has a high potential to enhance addiction treatment outcomes.

            In RCT 3, Saitz et al. (2014) investigated the efficacy of screening and brief intervention when dealing with the problem of drug/alcohol abuse. The participants were subjected to three conditions: motivational interviewing (MOTIV), brief negotiated interview (BNI), and no brief intervention. The results showed that none of the interventions was effective in lowering cases of drug/alcohol abuse. Overall, these three sources reveal various factors that impact drug/alcohol abuse. Therefore, when coming up with an intervention, it is essential to consider various elements that impact the client’s life to come up with a holistic intervention.

     As a DNP scholar, I will disseminate information to impact the point of care by using three techniques: presentations, papers, and posters. Depending on my target audience, I will implement the appropriate technique to have a significant outcome on their healthcare needs. Christenbery and Latham, (2013) assert that the use of presentations, papers, and posters can help nurses disseminate various types of information effectively to facilitate positive healthcare outcomes.

References

Campbell, A. N. C., Nunes, E. V., Matthews, A. G., Stitzer, M., Miele, G. M., & Polsky, D. (2014). Internet-delivered treatment for substance abuse: A multi-site randomized controlled clinical trial. Am J Psychiatry, 171(6), 683–690.

Christenbery, T. L., & Latham, T. G. (2013). Creating effective scholarly posters: A guide for DNP students. Journal of the American Academy of Nurse Practitioners25(1), 16-23.

Degenhardt, L., Charlson, F., Ferrari, A., Santomauro, D., Erskine, H., Mantilla-Herrara, A., … & Vos, T. (2018). The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet Psychiatry5(12), 987-1012.

IHME (2017). The global burden of disease. IHME. http://www.healthdata.org/sites/default/files/files/infographics/GBD2015_Brief_Final_6_12_17.pdf

Murray, C. J., Mokdad, A. H., Ballestros, K., Echko, M., Glenn, S., Olsen, H. E., … & Jonas, J. B. (2018). The state of US health, 1990-2016: Burden of diseases, injuries, and risk factors among US states. JAMA-Journal of the American Medical Association319(14), 1444-1472.

Richardson, L., Laing, A., Choi, J., Nosova, E., Milloy, M. J., Marshall, B. D., … & Kerr, T. (2021). Effect of alternative income assistance schedules on drug use and drug-related harm: A randomized controlled trial. The Lancet Public Health6(5), e324-e334.

Saitz, R., Palfai, T. P., Cheng, D. M., Alford, D. P., Bernstein, J. A., Lloyd-Travaglini, C. A., … & Samet, J. H. (2014). Screening and brief intervention for drug use in primary care: The ASPIRE randomized clinical trial. Journal of the American Medical Association312(5), 502-513.

Describe the culture of your organization as it relates to patient safety.

Patient safety is a priority in our organization and to ensure that it is achieved, the organization encourages comprehensive communication between the healthcare staff. The organization also emphasized standardization in the delivery of services and stylistic practices are not tolerated. Nurses and other staff members are constantly trained about vulnerabilities and the promotion of patient safety. Additionally, the hospital policy requires that all mistakes in service delivery are reported to the right authorities.

Identify one opportunity to improve patient safety outcomes. Propose a strategy for the implementation of this improvement initiative.

An example of an opportunity to improve patient safety outcomes is the use of monitoring technology. Usually, healthcare workers attend to many patients during their shifts which makes it difficult for them to keep an eye on all of them. Monitoring technology can help notify the nurse when there is a problem with the patient, for example, in case of falls, and can also be used to verify medication thus preventing patient harm (Banka et al, 2018).

The implementation of this improvement initiative will require the involvement of the senior hospital management who will ensure the purchase and installation of the monitoring technology. The healthcare staff will also be trained on how to use this monitoring technology to enhance patient safety. There will be a way to measure the performance of the monitoring technology in terms of enhancing patient safety. This will determine whether or not the initiative will be fully adopted.

Describe the current technology used to support patient safety. Identify the potential unintended consequences of this technology. Propose solutions to address these potential consequences

The current technology used to support patient safety in our organization is the electronic health record. This is a way of storing patient information electronically. They help to ensure patient safety by reducing errors and misinterpretations that would negatively affect patient care. They also contain the patient’s medical history which helps healthcare professionals to carry out accurate diagnoses. It also helps to identify any allergies to medication that the patient might be having (Abul-Husn & Kenny, 2019).

One unintended consequence of this technology is privacy and security issues. Electronic health records can be hacked and when this happens, sensitive patient data can fall into the wrong hands. Another consequence is that data could get lost or destroyed leading to treatment errors. There are also chances of healthcare providers relying on inaccurate data during treatment especially if the patient’s medical record has not been updated in a long time (Abul-Husn & Kenny, 2019).

       To address these potential consequences, it would be important to ensure that all computers used to access patients’ records are secured with heavy passwords. It is also important to ensure that only authorized personnel can access these records and that they only access what they need. It is important to ensure that patient’s medical records are updated during every visit to ensure that the information available about them is accurate and up to date.

 Describe an incident in which patient safety was or had the potential to be compromised due to an emphasis on volume-based care.

Since volume-based care reimburses the service provider for particular services offered, most healthcare providers were only focused on providing more services (Jensen et al, 2018). There was a time our organization was using volume-based care and so providers would speed through patients to provide more services. During this time, a lot of patients were readmitted to the hospital due to incorrect medications, reactions to certain medications, among other causes. This is because the healthcare providers did not pay attention to patients’ medical details.

References

Abul-Husn, N. S., & Kenny, E. E. (2019). Personalized medicine and the power of electronic health records. Cell177(1), 58-69. Retrieved from https://www.sciencedirect.com/science/article/pii/S0092867419302223 (Links to an external site.)

Banka, S., Madan, I., & Saranya, S. S. (2018). Smart healthcare monitoring using IoT. International Journal of Applied Engineering Research13(15), 11984-11989. Retrieved from http://www.ripublication.com/ijaer18/ijaerv13n15_40.pdf (Links to an external site.)

Jensen, J. K., Dyre, L., Jørgensen, M. E., Andreasen, L. A., & Tolsgaard, M. G. (2018). Simulation‐based point‐of‐care ultrasound training: a matter of competency rather than volume. Acta Anaesthesiologica Scandinavica62(6), 811-819. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/aas.13083

Hello Dr. Herlihy and classmates,

Scenario 1: social media posting

      Every time a patient visits any medical facility, they always expect quality care and confidentiality.  With increased and advanced technology, many people are capable of accessing patient’s information, making it difficult for healthcare workers to fully secure patients’ confidentiality. in the first place, healthcare personnel is supposed to ensure that the information that they share on their social media platforms no sensitive information is shared through these platforms because they are not secure. The information provided should not jeopardize the security and privacy of the patients. a nurse must first consider whether the information provided can lead to the patient’s identity being revealed and what the consequences are.

     This nurse has gone against the HIPAA rule. According to HIPAA, the patient’s demographic such as their past, present, or future, and health care they have received, should be protected (Cannon, & Caldwell, 2016). In this case, the nurse has revealed the patient data such as their weight and diagnosis, which can lead to the identification of the patient. Today, It is easier to access patient’s information due to the high technological advancement. Therefore, the healthcare providers are supposed to be very careful with the kind of information shared on the online platforms because once it is shared, they may have little or no control of who will access the information provided. this worker does not show any professionalism that is required by a health worker. Spreading the patient’s information on online platforms is illegal, and it is a violation of patient’s rights. Every time a patient visits any medical facility, they always expect quality care and confidentiality

 Scenario 2: presentation poster

     Privacy is the patient’s right to personal information protection.  Confidentiality is very critical in ensuring that the third party does not access the patient’s information. All healthcare professionals are bound by these rules that prohibit them from discussing a patient’s medical information with anybody else without consent. The patient’s information should also be stored in a way that guarantees the patient’s privacy. In this case, the nurse should use the pictures but de-identify all the data that can lead to the patient being identified by the third party.

     De-identification is removing identifiers from the health information that can help identify the patient, thus mitigating risks. De-identification also helps the healthcare workers to use the patient to support research without going against the set rules and regulations (Sokol, 2017). The HIPAA rules are critical in that it provides directions regarding re-identifying the PHI using a unique code. This code is very important and thus is not to be disclosed. In this case, the patient can use the client’s lesion for education purposes but ensure that there is no data that can lead to the identification of the patient by the third party. HIPAA provisions allow using information that does not identify the patient

Scenario 3: long term care

     There are various privacy and security issues that are related to a patient sharing their information with a long-term care facility. One of the major issues is the patient controlling the information that they provide to the healthcare workers. Therefore, there is a great concern regarding who should be controlling the access and the sharing of information in the long-term care facility. The patient information is critical, and the control issue should be appreciated with the owner’s approval. The patients are therefore supposed to control the information that they provide. In this case, Marcus is not sure who he should provide his information with. The patient may therefore hide some of the information because he is not sure who he should be providing the information with and the security of the provided information.

     There is also the other issue of trust between the patient and the healthcare provider. In order to have a successful healthcare system, trust between the patient and the healthcare providers is paramount. The absence of trust may make the patient fail to disclose the necessary information required to help better the patient’s outcome. Failure to disclose some information may lead to adverse effects. 

      There is also the likelihood of gaps in the legislative aspects of the privacy and security-related institutions that help safeguard the patient’s information. These gaps arise because of a lack of proper policies and lack of knowledge. This may lead to unauthorized persons accessing the patients’ information.

References

Cannon, A. A., & Caldwell, H. (2016). HIPAA violations among nursing students: teachable moment or terminal mistake—a case study. J Nurs Educ Pract6(12), 41-48. Retrieved from; https://www.researchgate.net/profile/Hollie_Caldwell/publication/305479324_HIPAA_violations_among_nursing_students_Teachable_moment_or_terminal_mistake-A_case_study/links/579787a108aec89db7b9a86b.pdf (Links to an external site.)

Sokol, A. J. (2017). Clinical Research and Data: HIPAA, the Common Rule, the General Data Protection Regulation, and Data Repositories. Merrill Series on The Research Mission of Public Universities, 47-62. Retrieved from: https://journals.ku.edu/merrill/article/view/7750/7359 (Links to an external site.)