A local hospital publicly reported organization discharge data. The data were risk adjusted to control for pre-existing comorbidities to level the playing field with data reported from other hospitals. The report notes little risk adjustment for stroke mortality. Recently, the hospital received stroke center designation for following best practice protocols for stroke management. The DNP scholar and data analyst track stroke mortality data and note a spike in mortality for a given quarter, which explains why the state public report is unsatisfactory. Drilling into the data to examine the numerator deaths due to stroke, denominator and total patient population. The data analysts determines that the risk mortality has a score of one to four, with one being a minor risk of mortality. This explains why the hospital did not risk adjust well, because these patients did not appear to have risks associated with severe illness that would reasonably explain the associated mortalities. Next, the data analyst drills further into the detailed subject oriented data of actual patient records and then completes a full chart review to obtain the sweet spot to inform quality improvement. 

Consider the scenario above to address the following.

• Do you recommend that the data analyst examine aggregate data, detailed data, or both, to investigate this quality issue? Please explain your rationale.
• Do you recommend that the data analyst use a retrospective data warehouse, clinical data store, or both, to investigate the mortality rate? Please explain your rationale.
• What type of tools or analytic approaches is relevant for use by this analyst? Please explain your rationale.

Now, conduct a search for evidence. Select three scholarly sources of information describing the challenges of utilizing data in the clinical setting.

• Provide a brief overview of the findings of each source of evidence.

Instructions:

Use an APA 7 style and a minimum of 200 words. Provide support from a minimum of at least three (3) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 years), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply. Include the Doi or URL link.

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be used.

Respond to your colleagues’ posts by sharing your thoughts on their specialty, supporting their choice or offering suggestions if they have yet to choose. 

At least 2 references in each peer responses!

           Growing up, I played “nurse” with my pets, wrapping them in bandages while they patiently accepted their fate of being practice patients. This trend of care taking animals developed into having that same love of care taking for people. As long as I could remember, I knew I would be in a profession where I would dedicate my life to the wellbeing of humans and alleviation human suffering. In nursing school, I was torn between psych and pediatrics, and conveniently I was hired as a youth behavioral health nurse, combining my passions. Working as a nurse in psych has solidified my choice of nursing specialty in that I am focused on becoming a Psychiatric Mental Health Nurse Practitioner (PMHNP).

2.6 million youth between 12 and 17 have had a major depressive episode, with 3.3 million receiving treatment for behavioral disturbances (Ramirez, 2016). This statistic only represents a fraction of individuals of all ages suffering from mental illness. I have first-hand seen on numerous occasions, patients having to reside in the emergency department waiting for a bed. I did not struggle with the decision to pursue the PMHNP path because seeing the lack of providers has been a motivating factor, as well as my passion for psych nursing. A significant concern for individuals with mental health diagnosis is accessing mental health care providers that have the skills and knowledge to primarily address mental health, including medication management and psychotherapy (Ramirez, 2016). This lack of adequate services is where PMHNP is poised to fill this gap for these individuals obtaining sufficient care as well as making a significant difference in behavioral health care delivery (Chapman, Phoenix, Hahn, & Strod, 2018, p. S243).

To support my efforts in becoming a PMHNP, the American Psychiatric Nurse’s Association promotes personal enrichment as a psychiatric nurse practitioner who, in turn, elevates the quality of care provided to individuals (American Psychiatric Nurses Association, 2019a). Becoming a member involves paying a membership fee, but the membership includes networking, continuing education, and personal growth opportunities (American Psychiatric Nurses Association, 2019b).

The decision to become a nurse was instinct, but the decision to pursue the specialty of PMHNP is motivated by the undue suffering I see as a psych nurse with individuals not receiving adequate services due to stigma and lack of providers.

Select 3 (three) of the following information systems:

• Radiology
• Emergency
• Surgical
• Dental
• Pharmacy

Create a 10- to 15-slide Microsoft® PowerPoint® presentation with speaker notes describing the informational systems selected.

Include the following for each system in your presentation:

• Define the information system.
• Discuss its purpose and use.

Create a 1-page handout to accompany your presentation.

Cite a minimum of 1 outside source such as a textbook or required reading article.

Module 04 Content

1. Provide your answers to the following questions in a 2-page paper. Use APA Editorial Format for all citations and references used.
   
   1. What should the “culture and environment of safety” look like when preparing and administering medications?
   2. Discuss a common breach of medication administration.
   3. Identify three (3) factors that lead to errors in documentation related to medication administration.
   4. What can I do to prevent medication errors?
   5. Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.
      Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:
      Jstudent_exampleproblem_101504

Use this space to build your submission.

You can add text, images, and files.Add Content

Answer the following questions with evidence-based research: (Modules 2-7 Discussions must have citations and references) 

How do we know this is a problem or issue?

Who needs the information about the problem or issue?

What are possible solutions?

How will dissemination of this researched information impact behavior?

Post another article synopsis; defining key words and how article relates to chosen area of interest.

Post your initial response by Wednesday 2359. Reply to at least two of your colleagues’ posts by Saturday 2359 of Module 3.

Flott, E. A., & Linden, L. (2016). The clinical learning environment in nursing education: a concept analysis. Journal of Advanced Nursing, 72(3), 501-513. 

 Xu, J. H. (2016). Toolbox of teaching strategies in nurse education. Chinese Nursing Research, 3(2), 54-57. 

 Raymond, C., Profetto-McGrath, J., Myrick, F., & Strean, W. B. (2018). Balancing the seen and unseen: Nurse educator as role model for critical thinking. Nurse education in practice, 31, 41-47.