Challenges in Practice

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Scenario: 

 The radiologist at your hospital reports to the administrator that 30 patients have been diagnosed with brain tumors during the past 2 months. The administrator requests a report detailing the number of patients diagnosed with brain tumors during the past 6 months. However, the radiology department uses a free-text entry for their diagnoses, and their system does not communicate with the larger electronic health record (EHR) system installed at the hospital. You recognize an opportunity to address challenges with the EHR system in your hospital and decide to also write a proposal for a solution to improve your hospital’s EHR system. 

 compose a proposal for how the hospital in the scenario might overcome each of the following challenges related to the scenario:

  • Vocabulary standards
  • Interoperabiliy
  • Workarounds
  • Patient safety
  • Patient privacy and security when pulling reports
  • Recommend a change theory that might assist in your convincing the hospital administration to implement the EHR solution and improvements you propose. Be specific and provide examples.
  • Support your proposal by explaining how the EHR solution might benefit data analysis for the promotion of improved health outcomes.
  • Provide references within 5 years to support your answers.
  • Note: The title page, introduction, summary, and references are in addition to the required page count.

W3R see attachment

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Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .



Jacqueline Kenney

Good Evening Professor,

 

              I work in one of the largest hospital systems in Atlanta. The facility I work for has the bed capacity for 686 patients. The hospital specializes in cardiovascular procedures (the implantation of the LVAD) and transplantation of liver, and kidneys. The hospital attracts people from across the country. People coming from literally every state, and sometimes from out of the country.

            The area where I see the EHR impeding patient care, and again this might be in part, due to end-user negligence, are providers not utilizing the information and data contained within the patient's EHR frequently enough.  We run off a system called EPIC (EHR). I have come to realize most hospitals in the state of Georgia, and other states use EPIC as well.  Embedded within the EPIC system is a hyperlink called Care Everywhere. The Care Everywhere tab allows all providers on the EPIC system to see notes, documentation, tests results, frequency of visits, and more. This data covers every hospital, clinical, urgent care, and office visit the patient has encountered so as long as the facility is on the EPIC system. I believe the shear amount of medical information becomes overwhelming and time consuming to comb through, especially for medical providers who are already seeing numerous patients at the bedside and in specialty offices. 

          Despite medical documentation being readily available to providers across the healthcare spectrum, there seems to be little time for a busy Cardiologist to review necessary documentation from the patient's Pulmonary doctor, or the notes placed from Endocrinology. Often a patient comes for a visit due to CAD, but the patient is also a diabetic with uncontrolled elevated blood glucose. We know one disease process feeds the other, but in spite of the EHR containing valuable patient data, providers are still missing imperative clinical information required to treat the patients holistically. 

          The one department which I see consistently using chart review to coordinate care with patients, providers, and families are RN Case Managers within the hospital setting.  RN Case Managers, and Care Coordinators are responsible for knowing what is missing in the patient continuum of care. The RNCM interfaces with the providers, and assists in providing education to both medical MDs and patients regarding critical clinical information which will advance the clinical process and bring better patient outcomes. McBride & Tietze (2018) discussed unintended harm, or consequences suffered by patients with the implementation of the EHR. One such consequence has to do with physicians required to research, and review copious amounts of previous documentation, as well as being required to spend greater amounts of time entering documentation.  Such time consuming tasks often create information, and important patient data not being read, or documented in an effort to save time, and so providers can physically see more patients. 

 

Resources

                FAAN, S.M.P.R. C., & FAAN, M.T.P.R. F. (2018). 
Nursing Informatics for the Advanced Practice Nurse (2nd ed.). Springer Publishing LLC. 

https://ambassadored.vitalsource.com/books/9780826140555Links to an external site.

           Williams, M. D., Asiedu, G. B., Finnie, D., Neely, C., Egginton, J., Finney Rutten, L. J., & Jacobson, R. M. (2019). Sustainable care coordination: a qualitative study of primary care provider, administrator, and insurer perspectives. 
BMC health services research, 
19(1), 92. https://doi.org/10.1186/s12913-019-3916

 Reply

SOAP note CKD

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SOAP note follow up chronic kidney disease stage 2

UTI in a 10 years old child

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Discussion topic: Pediatric SOAP NOTE about UTI in a 10 years old child

  

Requirements

Ø The discussion must address the topic

Ø Rationale must be provided

Ø Use at least 600 words (no included 1st page or references in the 600 words)

Ø May use examples from your nursing practice

Ø Formatted and cited in current APA 7

Ø Use 3 academic sources, not older than 5 years. Not Websites are allowed.

Ø Plagiarism is NOT permitted

I have attached a sample, the rubric, and the template

discussion

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  1. After studying the lesson “Nursing Leadership” in Chapter 21 of the textbook (eBook), open a discussion forum by answering the following questions:
  2. What is leadership?
  3. What is a leader?
  4. How does a nurse demonstrate leadership characteristics? Explain.
  5. Do you think Florence Nightingale was a leader in the nursing profession? Why?          Explain.
  6. Describe the following types of leadership: autocratic, democratic, and Laissez-Faire. Give an example of each one within the nursing field.
  7. This topic will be part of class discussion this week (Module 7).
  8. In addition to the eBook, you are required to use at least two more primary references.
  9. Remember APA style when use references “in-text” citation and in the References at the final of your publication.
  10. Submission Instructions:
  • Submit your discussion post by 5:59 PM Eastern on Thursday, October 5th, 2023. 
  • Your initial post should include at least 2 academic sources, formatted and cited in APA.
  • Respond to your classmates’ discussion posts by 11:59 PM Eastern on Saturday, October 7th, 2023. Ask a question, and provide a different viewpoint.

POLICY/REGULATION FACT SHEET

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POLICY/REGULATION FACT SHEET

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

· Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.

· Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).

· Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page not including the title and reference page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

· Briefly and generally explain the policy or regulation you selected.

· Address the impact of the policy or regulation you selected on system implementation.

· Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.

· Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

· Use APA format and include a title page, in-text citations, and reference page.

· Use the Safe Assign Drafts to check your match percentage before submitting your work.

nov 5

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ASSESSING A HEALTHCARE PROGRAM/POLICY EVALUATION

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

RESOURCES

Required Readings

· Milstead, J. A., & Short, N. M. (2019). 
Health policy and politics: A nurse's guide (6th ed.). Jones & Bartlett Learning.

· Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116–124 only)

· Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). 

Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transitionLinks to an external site.
. 
American Journal of Public Health, 93(8), 1261–1267.

· Shiramizu, B., Shambaugh, V., Petrovich, H., Seto, T. B., Ho, T., Mokuau, N., & Hedges, J. R. (2016). 

Leading by success: Impact of a clinical and translational research infrastructure program to address health inequitiesLinks to an external site.
. 
Journal of Racial and Ethnic Health Disparities, 4(5), 983–991.

· Williams, J. K., & Anderson, C. M. (2018). 

Omics research ethics considerationsLinks to an external site.
. 
Nursing Outlook, 66(4), 386–393.

·
Document: 

Healthcare Program/Policy Evaluation Template (Word document)

image1

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 


WEEKLY RESOURCES

To Prepare:

· Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.

· Select an existing healthcare program or policy evaluation or choose one of interest to you.

· Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

· Describe the healthcare program or policy outcomes.

· How was the success of the program or policy measured?

· How many people were reached by the program or policy selected?

· How much of an impact was realized with the program or policy selected?

· At what point in program implementation was the program or policy evaluation conducted?

· What data was used to conduct the program or policy evaluation?

· What specific information on unintended consequences was identified?

· What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

· Did the program or policy meet the original intent and objectives? Why or why not?

· Would you recommend implementing this program or policy in your place of work? Why or why not?

· Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

BY DAY 7 OF WEEK 10

Submit your completed healthcare program/policy evaluation analysis.

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the 
Turnitin Drafts from the 
Start Here area. 

1. To submit your completed assignment, save your Assignment as 
WK10Assgn+LastName+Firstinitial

2. Then, click on 
Start Assignment near the top of the page.

3. Next, click on 
Upload File and select 
Submit Assignment for review.

image2

Rubric

NURS_6050_Module05_Week10_Assignment_Rubric

NURS_6050_Module05_Week10_Assignment_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeProgram/Policy EvaluationBased on the program or policy evaluation you seelcted, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:·   Describe the healthcare program or policy outcomes.·   How was the success of the program or policy measured?·   How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?·   At what point in time in program implementation was the program or policy evaluation conducted?

35 to >31.0 pts

Excellent

Using sufficient evidence, response clearly and accurately describes the healthcare program or policy outcomes. …Response accurately and clearly explains how the success of the program or policy was measured. …Response accurately and clearly describes how many people were reached by the program or policy and accurately describes the impact of the program or policy. …Response accurately and clearly indicates the point at which time the program or policy evaluation was conducted.

31 to >27.0 pts

Good

Using sufficient evidence, response accurately describes the healthcare program or policy outcomes. …Response accurately explains how the success of the program or policy was measured. …Response accurately describes how many people were reached by the program or policy and accurately describes the impact of the program or policy. …Response accurately indicates the point at which time the program or policy evaluation was conducted.

27 to >24.0 pts

Fair

Description of the healthcare program or policy outcomes is inaccurate or incomplete. …Explanation of how the success of the program or policy was measured is inaccurate or incomplete. …Description of how many people were reached by the program or policy and the impact is vague or inaccurate. …Response vaguely describes the point at which the program or policy evaluation was conducted.

24 to >0 pts

Poor

Description of the healthcare program or policy outcomes is inaccurate and incomplete or is missing. …Explanation of how the success of the program or policy was measured is inaccurate and incomplete or is missing. …Description of how many people were reached by the program or policy and the associated impacts is vague and inaccurate or is missing. …Response of the point at which time the program or policy was conducted is missing.

35 pts

This criterion is linked to a Learning OutcomeReporting of Program/Policy Evaluations·   What data was used to conduct the program or policy evaluation?·   What specific information on unintended consequences was identified?·   What stakeholders were identified in the evaluation of the program or policy? Who would benefit the most from the results and reporting of the program or policy evaluation? Be specific and provide examples.·   Did the program or policy meet the original intent and objectives? Why or why not?·   Would you recommend implementing this program or policy in your place of work? Why or why not?·   Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

50 to >44.0 pts

Excellent

Response clearly and thoroughly explains in detail: -specific information on outcomes and unintended consequences identified through the program or policy evaluation. -the stakeholders involved in the program or policy evaluation. -who would benefit most from the results and reporting of the program or policy evaluation. -whether the program met the original intent and outcomes, including an accurate and detailed explanation of the reasons supporting why or why not. -whether the program should be implemented, including an accurate and detailed explanation of the reasons supporting why or why not. -at least two ways that the nurse advocate could become involved in the evaluation of the program or policy after 1 year of implementation.

44 to >39.0 pts

Good

Using sufficient evidence, response accurately identifies the data used to conduct the program or policy evaluation. Response explains in detail specific information on outcomes and unintended consequences identified through the program or policy evaluation. Response explains in detail the stakeholders involved in the program or policy evaluation. Response explains who would benefit most from the results and reporting of the program or policy evaluation. Response includes an accurate explanation of whether the program met the original intent and outcomes, including an accurate explanation of the reasons supporting why or why not. Response includes an accurate explanation of whether the program should be implemented, including an accurate explanation of the reasons supporting why or why not. Response includes an accurate explanation of two ways that the nurse advocate could become involved in the evaluation of the program or policy after 1 year of implementation.

39 to >34.0 pts

Fair

Response vaguely or inaccurately identifies the data used to conduct the program or policy evaluation. Explanation of specific information on outcomes and unintended consequences identified through the program or policy evaluation is vague or incomplete. Explanation of the stakeholders involved in the program or policy evaluation is vague or inaccurate. Explanation of who would benefit most from the results and reporting of the program or policy evaluation is vague or inaccurate. Explanation of whether the program/policy met the original intent and outcomes, and the reasons why or why not is incomplete or inaccurate. Explanation of whether the program or policy should be implemented, and the reasons why or why not, is incomplete or inaccurate. Explanation of ways that the nurse advocate could become involved in the evaluation or policy after 1 year of implementation is incomplete or inaccurate.

34 to >0 pts

Poor

Identification of the data used to conduct the program or policy evaluation is vague and inaccurate or is missing. Response includes vague and incomplete or is missing explanation of: -specific information on outcomes and unintended consequences identified through the program or policy evaluation. -the stakeholders involved in the program or policy evaluation. -who would benefit most from the results and reporting of the program or policy evaluation. -whether the program or policy met the original intent and outcomes, and the reasons why or why not. -whether the program or policy should be implemented, and the reasons why or why not. -ways that the nurse advocate could become involved in the evaluation or policy after 1 year of implementation.

50 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas.Sentences are carefully focused– neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. ...Purpose, introduction, and conclusion of the assignment is incomplete or missing.

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1-2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3-4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting:The paper follows correct APA format for title page, font, spacing, parenthetical/in-text citations, and reference list).

5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1-2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3-4) APA format errors.

2 to >0 pts

Poor

Contains many (≥5) APA format errors.

5 pts

journal week 9

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Journal/Overview -The journal document should be 3-4 pages in length. No citations are required, and no specific formatting is needed. Utilize appropriate grammar and mechanics of writing.

Refer to the journal submission you completed in Unit 1 and reflect on the following:

Topic: The use of pharmacology in advanced practice.

1. How has your knowledge of pharmacology changed?

2. Do you find yourself thinking about medication use in your current employment differently? Why or why not?

3. Explain how your appreciation of the advanced practice role changed or did not change?

How do you envision using the knowledge from this course in your future advanced practice role?

You must complete this Journal submission before the Unit 10 Quiz will open.

SOAP note

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SOAP note Lumbar pain

Healthcare Reform

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Healthcare reform is a constantly discussed topic in the U.S. healthcare system. Various influences, including political, societal, and real-time events (think COVID-19) all help to shape the discussion surrounding reform as it relates to the U.S. healthcare system. This link contains a tracker of all pending or introduced reform legislation currently.

Among the biggest talking points relating to the healthcare reform discussion over the past decade has been the Affordable Care Act (ACA) and whether it should remain as it is, be improved upon, or be dismantled and a new system put in its place. Review the most current attempt at modifications to the ACA in this link.

  • Do you feel that the ACA should be left alone as it is, be kept in place and improved upon, or be removed completely and a new set of legislation put in its place?
  • Discuss your reasoning for your conclusion, and why or how it can be accomplished.