Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

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 4 peer-reviewed research articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

• Identify the 4 peer-reviewed research 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.
• In your conclusion, synthesize the findings from the 4 peer-reviewed research articles

Vital Signs
1. You are a nurse caring for a 58-year-old ironworker who has been admitted to your unit with acute hypertension. He became extremely symptomatic at work and was brought to your emergency department (ED) via ambulance. After receiving a report from the ED nurse, he is brought to your unit asymptomatic (other than his BP of 178/106) and seems in good spirits. After completing his admission paperwork, he settles in and awaits his health care provider. Four hours later, you answer his call light and he reports headache (rated 6 on a 0-to-10 scale) and dizziness. 
a. Outline the pertinent information within this case study.
b. How often would you expect to measure the patient’s vital signs based on his history?
c. What would be your first intervention upon his reporting increased symptoms? Include rationale.
d. What is the patient’s pulse pressure?
e. Describe risk factors that could be contributing to your patient’s hypertension.
2. As a nurse in a critical care unit, your newest admission is a 24-year-old victim of a motor vehicle accident (MVA). Report from the OR nurse indicates that the patient has several surgically repaired fractures, a closed head injury, and elevated temperature. Additionally, he has IV fluid running postoperatively and dressing changes scheduled every shift. The patient is intermittently alert and disoriented, with his pain adequately controlled by IV analgesics. 
a. Outline the pertinent information within this case study.
b. What factors could be causing the patient’s elevated body temperature?
c. Why is determining the fever’s cause important?
d. Indicate areas that are important to monitor in a patient with elevated body temperature.
e. Describe cause-specific interventions useful in treating the patient’s elevated body temperature.

PLEASE, answer each question in order and separately. PLEASE,  this is the bibliography( Chapter 29-30).
1.Potter, P.A., &Perry, A. G. (2017). Fundamentals of Nursing: Concepts, Process, and Practice (9th ed.). St. Louis: MO:  Mosby. ISBN: 9780323327404

Formulate one new comment of your own. It must be a logical and thoughtful response that synthesizes the comments of at least 3 classmates into one comment. Be sure to synthesize; do not simply reply to each of the 3 classmates.

1. Ashley Homme posted Sep 24, 2020 5:48 AMSubscribe

The United States is one of many developed countries. Based on the Commonwealth Fund (2017), the US is ranked last on performance and access, even though they spend the most on healthcare each year. The Commonwealth Fund (2017) has also outlined ranking of other countries compared to the US in 5 categories: care process, access, administration efficiency, equity, and health care outcomes. As mentioned above, the United States spends significantly more each year on healthcare. According to data charts, in 2014 the US spent about 16.5% of their yearly budget on healthcare. That same year, Switzerland was a close second with 11.4%, followed by Sweden, France, and then Germany (The Commonwealth Fund, 2017). With 11 countries total, the US ranked 11th for overall healthcare system performance. The top country for overall performance was the United Kingdom followed by Australia. The care process was the first of the five categories. The United Kingdom was ranked first and the United States was ranked at number (The Commonwealth Fund, 2017)5. The US fell last in access to care. The first with the best access was the Netherlands. Administrative efficiency was highest in Australia and the US was the 10 (The Commonwealth Fund, 2017). Equity showed up best in the UK and the US was last. Finally, Australia was first in health care outcomes and the US was, once again, last (The Commonwealth Fund, 2017). In Australia and the UK, healthcare spending was lower while also offering better quality healthcare performance. Even with lower costs, these countries came in first for overall, compared to the US that spent a lot on healthcare with poor quality. This goes to show that spending more on healthcare does not directly correlate to better healthcare rendered to the persons. 

The Commonwealth Fund. (2017). Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. Retrieved September 21, 2020, from https://interactives.commonwealthfund.org/2017/july/mirror-mirror/

2. It is not a shock that the U.S. spends more on healthcare than any other country because of new and emerging technology in the country, but the U.S is currently ranked last in health care system performance and acquires poorer health. Schneider et al. (2014) state that “poor access to primary care has contributed to inadequate prevention and management of chronic diseases, delayed diagnoses, incomplete adherence to treatments, wasteful overuse of drugs and technologies, and coordination and safety problems” (para 2). Overall, the U.K. ranks the highest in system performance, ranking number 1 in the care process and equity, and number 3 in access and administrative efficiency; although it is ranked number 10 in health care outcomes, one less than the U.S. Schneider et al. (2014) mentions, “in contrast to the U.S., over the past decade the U.K. saw a larger decline in mortality amenable to health care (i.e., a greater improvement in the measure) than the other countries studied” and “(the U.S. has had the smallest decline or lowest level of improvement)” (para 22). Thanks to the UK’s National Health Service (NHS), health services are not paid for through insurance premiums and have more government impact on delivering health care, unlike the U.S. The U.S. health care system is unique because the expenditure does not match up to the outcomes in this country, compared to other countries.   

References:

Schneider, E. C., Sharnak, D. O., Squries, D., Shah, A., & Doty, M. M. (2014, July 14). Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. Retrieved September 22, 2020, from https://interactives.commonwealthfund.org/2017/july/mirror-mirror/

3. Research shows that the U.S. spends the most money on health care compared to other high-income countries. Although the United States spends more money, United States citizens’ health quality is lower.

The United States is the lowest ranking for overall quality of health out of the eleven high income countries. Canada is ranked number 9 out of 11. The United States and Canada are similar when comparing aspects of their healthcare system. For example, both countries are ranked below average for access to health care, equity, and health care outcomes. Additionally, Canada and the United States are ranked above average for care processes related to prevention, safety, and engagement from patients and doctors. For administrative efficiency, Canada ranks above the average while the U.S. remains below average. (The Commonwealth Fund 2017)

One major difference between Canada and the United States is that Canada provides universal health care and the U.S. does not. Non-citizens living in the United States may not qualify to receive health care. As for Canada, temporary visitors and immigrants are eligible for limited health care benefits. (American Institute of Medical Sciences & Education 2018)

References

American Institute of Medical Sciences & Education. (2020, June 24). US vs Canadian Healthcare: What Are the Differences? Retrieved September 21, 2020, from https://aimseducation.edu/blog/us-vs-canadian-healthcare-differences

The Commonwealth Fund. (2017). Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. Retrieved September 21, 2020, from https://interactives.commonwealthfund.org/2017/july/mirror-mirror/

Write a full 1-2 page paper with references…

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