The Dual Nature of Informatics

 

Informatics can be used for improving health outcomes not only for individual patients, but also for whole groups of patients with similar conditions. This is often referred to as the dual nature of informatics. Technologies, such as electronic health records (EHRs) and clinical decision support (CDS) systems, can provide insights and guidance for health care professionals at the point of care. In addition, data warehousing and mining allow health care organizations to use the vast amount of information stored in EHRs to make predictions and diagnoses for other patients with similar conditions.

 

In this Discussion, you examine the dual nature of informatics. First, you review a scenario and consider the patient information to be collected and recorded at the point of care. Then, you decide how this information could be aggregated for population health and future use.

 

Consider the following scenario:

 

Mrs. Jones has come into your office stating that she has been experiencing frequent dizzy spells. She also reports that she has been unable to eat anything substantial over the last few days due to extreme nausea. The last time Mrs. Jones was in your office, the physician had suggested she start walking around the block or bicycling around the neighborhood to get her activity level up. Mrs. Jones admits that she did very little of that after a “ flip-flop” feeling of her heart scared her. You know that her symptoms could be a result of many conditions. Following the prompts on your informatics system, you begin to gather more specific information about Mrs. Jones’ symptoms and health history.

 

To prepare:

 

• Based on the scenario, what information would you want to immediately gather about Mrs. Jones?  
• With that in mind, compile a list of patient questions you would like an EHR documentation screen to have.
• How might the information derived from these questions help you provide high-quality care to Mrs. Jones?
• Once this information is collected, what alerts might be critical to the evaluation of Mrs. Jones?
• Review this week’s media presentation, Dual Nature of Informatics Systems, and reflect on the movement towards more transparent data and meaningful use. How might the data entered about an individual patient help to build preventative care and treatment for whole populations?
• Refer back to your list of patient questions. Of these questions, which would generate data that could be aggregated for use with a larger group of patients? (Note: When developing your questions, consider the whole patient.)

 

Post on Tuesday 06/06/2016 a minimum of 550 words in APA format with 4 references

 

1) A description of the ideal EHR documentation screen that you would like to have at the point of care for all patients and why.

 

2) Explain how information gathered at the point of care with an individual patient can be aggregated to help provide high quality care to a larger population of patients.

 

 

Readings

 

• Saba, V. K., & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York, NY: McGraw-Hill.

  • Chapter 1, “Historical Perspectives of Nursing Informatics”

    In this chapter, the authors explain the transition from paper-based records to electronic records. The chapter provides an overview of the historical events that contributed to the rise of electronic health records.

• Liaw, S.-T., & Boyle, D. I. R. (2010). Primary care informatics and integrated care. Studies in Health Technology and Informatics, 151, 255–268.
  Retrieved from the Walden University databases.

  This article discusses how the health care field can be reformed by increasing access to information across organizations and professionals. The authors of the article justify the need for this reform and provide guidance on how it can be achieved.

• Mitchell, J. K. (2011). Nursing informatics 101: Using technology to improve patient care. ONS Connect, 26(4), 8–12.
  Retrieved from the Walden Library databases.

  The emergence of nursing informatics in health care is the main topic of this article. New trends in informatics are discussed, as well as the certification process, nurse education, and the implementation of new systems to support patient care.

• Morath, J. (2011). Nurses create a culture of patient safety: It takes more than projects. Online Journal of Issues in Nursing, 16(3).
  Retrieved from the Walden Library databases.

  The author of this article emphasizes the need for nurses to develop skills for improving care and embracing new health care innovations. The author also describes the connection between individual nursing practice and the system-wide success of informatics.

• Reiner, B. I. (2011). Improving healthcare delivery through patient informatics and quality centric data. Journal of Digital Imaging, 24(2), 177–178.
  Retrieved from the Walden Library databases.

  In this article, the author analyzes the impact of the movement towards digitized medical data on patient care. The author discusses how this movement places more responsibility and empowerment on the patient.

  Media

• Laureate Education, Inc. (Executive Producer). (2012b). Dual nature of informatics systems. Baltimore: Author. 

  Note: The approximate length of this media piece is 7 minutes.

  In this week’s media presentation, Gail Latimer, Dr. Patricia Button, and Dr. Roy Simpson discuss one of the most important aspects of informatics: the collection and aggregation of health information. The electronic health record (EHR) is discussed, as well as the nurse’s roles in working with EHR systems.

   

   

   

   

 

 

• Select a complex case study to focus on for this discussion (below).
• Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.
• You will pick 1 case to discuss for your initial post during week 9. Then complete 2 response posts during week 10; be sure to discuss both cases.

Post a description of your patient’s health needs from the patient case study you selected. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including specific medications. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

You must make at least a reference to course materials and two outside sources in your initial posting (At least 3 sources for initial posts). You will respond to your colleagues’ posts in Week 10.

 

CASE STUDY 2

A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms.  She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms.  She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms.  She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90.  She has regular monthly menstrual cycles. Her LMP was 1 month ago.

 

APA Format

 1) Minimum 5  full pages (No word count per page)- Follow the 3 x 3 rule: minimum three paragraphs per page

2)¨******APA norms

         All paragraphs must be narrative and cited in the text- each paragraph

         Bulleted responses are not accepted

         Don’t write in the first person 

         Don’t copy and paste the questions.

         Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 6  references (APA format) per part not older than 5 years  (Journals, books) (No websites)

All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed.

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

__________________________________________________________________________________

Topic:  Margaret Newman’s Theory of Health

1.  Introduction ( 1/2 page)

a. Identification of theorist 

b. Make a brief background of the theorist (accomplishments, career, accolades, research efforts) 

2.  Analysis of basic components/concepts and major relationships in the theory. (1 page)

3. Discuss the theory’s core concepts  and their apply in nursing today (1 /2 page)

4.  Relevance to healthcare and the client discussed. Also, (1/2 page)

a. Connect the theory to healthcare today 

5. Application to research and/or practice provided. Also, (1 page)

a. Connect the theory to current research/practice

6. Describe two peer-reviewed/research articles that detail the nursing theory being applied in clinical practice/research. Also, (1 page)

a. Summarize key findings of both articles

b. Summarize results 

c. Summarize implications for future practice. 

 

7.  Summary: Include theory strengths and limitation in the summary  ( 1/2 page)

 

Directions*** week 9 and 10 are separate assignments and each need their own reference list. At least 2 references requires for each week. APA format. No certain page requirement as long as it covers the topics

 

Week 9 Journal

 

An advance directive is a legal document that defines a patient’s wishes for medical care. This document is a way for patients to share their wishes with family members and health care providers when their illness or mental capacity prevents them from making decisions. As an advanced practice nurse who has care discussions with patients and their families, you need to not only be familiar with the process of completing an advance directive, but also understand how this document might impact your role in patient care and treatment.

 

Journal Entry Part 1

 

For the first part of your journal entry, reflect on the Five Wishes presented on the Five Wishes website and PDF and complete your Five Wishes. Explain your state’s requirements for advance directives, including whether your Five Wishes can be turned into a formal document. (**I will message you the state i live in) Then, explain how your experience of completing your Five Wishes advance directive will help you guide discussions with patients and their families. Finally, explain how you might apply the Five Wishes advance directives to your nursing practice. Include how this advance directive might benefit patients in decision making for specialized areas of care.

 

** Five wishes reference https://class.waldenu.edu/bbcswebdav/institution/USW1/201750_27/MS_NURS/NURS_6540/readings/USW1_NURS_6540_fiveWishSample_Week%209.pdf

 

 

 

Journal Entry Part 2

 

For the second part of your journal entry, reflect on geriatric patients from your practicum site with disorders related to specialized areas of care, such as oncology, nephrology, urology, gynecology, and neurology. Describe a case of a frail elder patient who must make decisions related to specialized areas of care. Then, explain potential patient outcomes and include whether treatments would be beneficial and how they would impact the patient’s quality of life. Finally, describe the patient’s wishes in terms of treatments and interventions for the disorder (Was there an advanced directive?) and how the patient might want to spend any remaining time. Include how environmental factors, such as family, caregivers, ethnicity, culture, religion, and/or personal values, might impact decision making for treatments and interventions. If you did not have an opportunity to evaluate a patient with this background during the last 9 weeks, you can select a related case study or reflect on previous clinical experiences.

 

 

 

Week 10 Journal

 

Elder abuse is any intentional or negligent behavior that results in physical, sexual, emotional, pharmacological, and/or financial abuse. Unfortunately, abuse is sometimes difficult to identify, and elders are often hesitant or unable to report abuse themselves (Administration on Aging, n.d.). This makes it important for health care providers to regularly monitor for signs of abuse and react according to local and state laws.

 

Journal Entry Part 1

 

For the first part of your journal entry, select and describe one of the following types of elder abuse: physical, sexual, mental/emotional/verbal, pharmacological, or financial. Explain strategies for identifying this abuse. Then, explain how you would proceed based on your local and state laws once you have identified this abuse in a patient. Describe resources in your community that assist victims of this type of abuse and explain how you, as the advanced practice nurse, might apply these resources for abused elders who are identified in the clinical setting.

 

Journal Entry Part 2

 

For the second part of your journal entry, reflect on the different cultures—ethnic, religious, regional, or generational—of the elder patient population at your practicum site. Describe the cultures you have observed and explain the influence of these cultures on the prevalence and detection of elder abuse. Then, explain how culture might impact the way you would implement resources for preventing or addressing abuse.

 

 

 

 

 

  

Answer Critical Thinking Question 2 for Chapter 10 on page 297 and Clinical Application Question 3 for Chapter 11 on page 329. Answers should be submitted in a word document with any associated references used.

Answer Critical Thinking Question 2 for Chapter 10 on page 297

Describe the use of a DNA probe and PCR for:

a) Rapid identification of an unknown bacterium.

b) Determining which of a group of bacteria are most closely related

Clinical Application question 3 for chapter 11 on page 329

A Woman complaining of lower abdominal pain with a temperature of 39  degree C gave birth soon after to a stillborn baby. Blood cultures from the infant revealed gram-positive rods. The woman had a history of eating unheated hot dogs during her pregnancy. Which organism is most likely involved