NURS 6051 Discussion The Application of Data to Problem-Solving Sample

References

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

Nursing Informatics Career & Salary. (2020). Retrieved from https://nursejournal.org/nursing-informatics/nursing-informatics-career-outlook/

A Sample Answer 5 For the Assignment: NURS 6051 Discussion The Application of Data to Problem-Solving Sample

Title: NURS 6051 Discussion The Application of Data to Problem-Solving Sample

These are great points. I would have to agree that I also have a love / hate relationship with electronic additions to the health care world especially due to the lack of nurses’ input. I remember when my hospital implemented another policy to continue the decrease in medication errors. As an ICU nurse, I give the majority of medications via IV. Due to our new policy; now I must scan the patient’s wrist band (after asking name and date of birth), scan the medication, verify which IV access will be used, and then scan the medication pump that will be used. After that, the computer will ask that all the information is correct: patient, medication, route, IV access, pump, rate, dosage along with any extra information that is needed such as vital signs. Once I confirm all of that information, I send the data from the computer to the IV pump. While I walk across the room to double check the IV pump, I pray the computer and IV pump actually communicated correctly the first time. If the data is all correct on the IV pump, then I can hit accept. The IV pump will start administering the medication at that time. But as I walk back across the room, I pray that the IV pump and the computer communicated correctly again. If so, the computer will then document that the medication has been administered and the medication is “linked”.

This is an amazing tool when everything is working correctly. However, I am sure you can begin to imagine how this process can begin to fall apart. Sometimes the scanners are not working. Sometimes the barcodes on the medications, the patient’s wrist band, or the IV pump are not working. Did I mention the scanners are NOT wireless? Sometimes there are family members or co-workers in the way. Sometimes the MD is doing a sterile procedure at bedside. Sometimes the patient is coding and IV drips get stopped and new ones are started and they have not been “linked”. Sometimes, the IV tubing is switched to another port or IV access entirely without being “linked”.

As I stated prior, this technology is great when everything works correctly. However, if it does not, it can make my job more difficult and time consuming.

When everyone (including nurses) sits at the table and is able to give their input, that is when amazing things happen.

I have spent the last 10 years working in emergency rooms as a staff nurse. One of the biggest challenges that my department faces regularly is delays with getting admitted patients out of the ED and onto their assigned units. These delays negatively impact the patients waiting for emergency treatment in the lobby and hallway stretchers. There are a number of factors that can prolong ED length of stay. Some of these include lack of bed availability due to hospital overcrowding, treatment delays such as loss of IV access, and delays caused by hospital personnel during the handoff report process (Paling et. al, 2020). Some of these factors, such as hospital overcrowding, are unavoidable and difficult to work around, which is why it is important for hospitals to assess which factors they can control to expedite patient flow out of the emergency room.

For my hospital’s scenario, the emergency department would collect data about admission delays that are specifically caused by disruptions in the nursing telephone report process. In my current workplace, there is not a standardized electronic handoff form, despite the fact that several studies have demonstrated the efficiency and increased patient safety outcomes associated with the transition to standardized electronic nursing report (Wolak et al., 2020). Instead, the ED nurse calls the receiving unit on the telephone, gives a verbal patient care handoff, and then transfers the patient to their hospital room. By collecting data about where in the handoff process delays are occurring, the ED could try to streamline the handoff process with the medical floors.

The emergency department nurses would collect quantitative data about the length of time between the first attempt to call report to the medical floor, and the time of the patient’s actual departure from the ED. The data would be recorded in the section of the EMR called “time to disposition” for each patient that is admitted. The ED leadership team could then pull a certain number of charts per month (or all the admission charts, if time allowed) and assess how long it takes on average for patient transfer to happen after report. Generally, most hospitals set their goals for disposition time for handoff and transfer within a 30-minute window (Potts et. al., 2018). If there are frequent delays causing transfer time to take greater than 30 minutes, the ED leadership team or unit-based council could meet with leadership from the floors where patient transfer takes the longest. By demonstrating the hard numbers associated with patient care delays, the teams could better understand the factors that lead to admission delays and work together to find solutions that expedite the admissions process.

References:

Paling, S., Lambert, J., Clouting, J., González-Esquerré, J., & Auterson, T. (2020). Waiting times in emergency departments: Exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data. Emergency Medicine Journal. https://doi.org/10.1136/emermed-2019-208849

Potts, L., Ryan, C., Diegel-Vacek, L., & Murchek, A. (2018). Improving patient flow from the emergency department utilizing a standardized electronic nursing handoff process. JONA: The Journal of Nursing Administration, 48(9), 432–436. https://doi.org/10.1097/nna.0000000000000645

Wolak, E., Jones, C., Leeman, J., & Madigan, C. (2020). Improving throughput for patients admitted from the Emergency Department. Journal of Nursing Care Quality, 35(4), 380–385. https://doi.org/10.1097/ncq.0000000000000462

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A Sample Answer 6 For the Assignment: NURS 6051 Discussion The Application of Data to Problem-Solving Sample

Title: NURS 6051 Discussion The Application of Data to Problem-Solving Sample

Health informatics provides important data that can prevent errors. While allowing nurses to assist with coordination of care and improving patient outcomes. Nurses are often on the front lines of ensuring that their patients are kept safe and preventing medication errors, misdiagnoses, falls, and other problems. Health informatics provides important data that can prevent these errors; for example, an electronic record can provide information about a possible dangerous medication interaction or allergy that might not otherwise be immediately apparent. Armed with data, nurses can make quick decisions that keep their patients safe.” (Harness , 2021)

Scenario

I work in the rural area, and we are the only hospital in the county that offers Labor and Delivery services. I had an active high risk labor patient show up in active labor. She was seen by our providers in clinic and was told to establish care with a Level three facility due to a fetal cardiac anomaly noted on ultrasound. She was a poor historian and had a history of methamphetamine use. Our hospital uses Cerner for charting and the providers use Athena for outpatient clinical care. At one time we did not have access to the patients’ medical records. We voiced our concerns of not having access to their computer system and having the need to duplicate procedures without having access to the patient’s history and physical. Access to Athena allowed us to transport this patient to the correct facility in a timely manner. This allowed the patient to have continuity care with the perinatologist that managed her care during her pregnancy.

Leadership

“The healthcare environment is fast-paced, and nurses must be prepared to inspire, innovate, and lead healthcare transformation as the healthcare sector continues to evolve in the application use and support of delivery of care”. (Garcia-Dia, 2021)

In this modern era, almost all professions, including the nursing profession, depend on data for their Day-to-day operations and to perform efficiently. Collecting data not only assists in solving problems but is vital to the practitioner’s and the discipline’s body of knowledge. Data is part of the first step in the nursing process. Problems but adds to the practitioner’s and the discipline’s body of knowledge. The field of nursing informatics aims to ensure nurses have access to the appropriate data to solve healthcare problems, make decisions in the interest of patients, and add to knowledge (Walden University, 2018). According to McGonigle and Mastrian (2021), “Nurses must possess the technical skills to manage equipment and perform procedures, the interpersonal skills to interact appropriately with people, and the cognitive skills to observe, recognize, and collect data; analyze and interpret data, and reach a reasonable conclusion that forms the basis of a decision”.

Scenario

The scenario that would rely on informatics within the healthcare system involves patient care management. The scenario involves a patient on the postpartum patient unit who delivered vaginally  10 hours ago on admission, suddenly complained of sharp chest pain and rates the pain as 10 out of 10 on a scale of 1-10, with 10 being the highest pain. The patient also complained of shortness of breath (SOB) and heart palpitation. The rapid Response Team (RT) called. While waiting for the RT to arrive, the patient is connected to a continuous pulse oximeter machine to check his oxygen level. The MD was also made aware by the charge nurse. The pulse oximeter machine showed oxygen of 83% on room air and a heart rate of 140 bpm.

The nurse immediately administered oxygen at 3 L/min via nasal cannula and elevated the head of the bed. The nurse also used the EKG machine to confirm the patient’s heart rhythm. The RT arrived and connected the patient to a defibrillator machine to check for heart rhythm, which will guide the treatment plan. The machine shows sinus tachycardia with a heart rate of 120, Blood Pressure of 175/92, and Respiration of 30. A physical exam shows the patient is distressed due to SOB, rapid heartbeat, and hyperventilation. The patient states she is very anxious. The nurse administered morphine 4mg IV, and STAT labs were drawn to check cardiac markers to rule out heart disease. The patient felt relieved after 15mins of morphine administration, and vitals became stable. The patient was connected to a continuous heart monitor. The data used in the scenario include objective data from the nurse, subjective data from

The patient has data from a continuous pulse ox, EKG, defibrillator machine, and continuous heart monitor. Objective data enabled the nurse to know that the patient may need oxygen due to distress from an SOB. Subjective data informs the nurse that the patient’s symptoms might be due to anxiety. Data from the pulse ox machine confirms that the patient has anxiety and SOB and needs oxygen. The EKG and defibrillator machine confirm the patient’s sinus tachycardia. The heart monitor provides continuous heart rhythm that directs the nurse on the appropriate intervention based on changes in rhythm. The cardiac markers lab results will inform the nurse if the patient chest pain is related to a heart problem or not. All patient information is documented in the patient’s electronic health record (EH) for continuity of care by other providers. A nurse leader in the above scenario will rely on clinical reasoning and judgment by collecting and processing information regarding the patient’s condition before implementing any treatment plan. The managerial level requires the interpretation and modification of information and data for better decision-making processes within the information system(Sweeney, 2017). Virtual health services are becoming a trend globally (Nagle et al., 2017). These efforts will ensure the patient in the above scenario gets the proper diagnoses and treatment and thus obtain the best health outcomes based on evidence-based practice.

References

McGonigle, D., & Mastrian, K. G. (2021). Nursing informatics and the foundation of knowledge (5th ed.).

Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. Forecasting Competencies for Nurses in the Future of Connected Health, 212–221. Retrieved November 29, 2022, from https://doi.org/doi:10.3233/978-1-61499-738-2-212Links to an external site.

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 4–1.

Walden University. (2018). Health Informatics and Population Health: Trends in Population Health [Video].