se the theory that you developed in week two.  Improve it by using the information you have obtained in the intervening weeks.  Use the Conceptual – Theoretical – Empirical Model (CTE) to link the operational definitions with the empirical indicators with the theoretical concepts and the conceptual model components.  Post your revised theory and explain how you would measure the concepts and proposition in a research study.

Expectations

Initial Post:

• Due 5/22/21
• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA from within the last 5 years

POST 1

Lolade

Briefly identify your practice setting and the information technology initiative you selected. Provide a rationale for your selection

            My practice setting is a psychiatric unit. The proposed technology initiative that I select for use in my unit is mHealth for treating and managing patients with chronic mental health problems. The need for the technology is attributed to the fact that treatment adherence among patients with chronic mental health problems is always a challenge. In addition, the effective management of mental health problems requires close follow-up for patients, which can be achieved using mHealth. The psychiatric unit has been trying to implement solutions to address the above issues in the management of chronic mental health problems. Therefore, mHealth is a solution that may be considered. 

Evaluate the potential barriers to implementing your hypothetical initiative

            One of the potential barriers that may be experienced in implementing the hypothetical initiative is resistance to change. The healthcare providers may resist implementing the initiative in their practice due to fear of the unknown outcomes of the change or lack of involvement. The other potential barrier that may be experienced is the lack of institutional support. The organization may not provide the needed financial, human resources and material support for the project (Saba & McCormick, 2021). Therefore, responsive interventions will be adopted to address the above issues. 

Identify the change management strategies that you would use to facilitate a successful implementation & Appraise the leadership strategies 

            The change management strategies that I will need for the successful implementation of the initiative include open communication, active stakeholder involvement, provider training, and leading the implementation of change. The key resources that I will need for the implementation will include time, money, skilled workforce, mobile tablets, and internet infrastructure. The leadership strategies that I will embrace include openness in communication, teamwork, honesty and transparency, delegating to empower, and commitment to promote the educational development of the staffs (Singh & Ramdeo, 2020). 

References

Saba, V. K., & McCormick, K. A. (2021). Essentials of Nursing Informatics, 7th Edition. McGraw-Hill Education.

Singh, R., & Ramdeo, S. (2020). Leading Organizational Development and Change: Principles and Contextual Perspectives. Springer Nature.

POST 2

Victoria

Information Systems and Changing Organizational Culture

Health information technology enables nurse executives to ensure that nursing care is safe, efficient, and of high quality. The Technology Informatics Guiding Education Reform TIGER initiative summit created a vision for the future of nursing with information technology through strategies to implement technology and informatics within the nursing profession and to empower a revolutionary leadership that will transform healthcare through technology (Ball et al., 2011).

Practice Setting

Chronic diseases management (CDM) such as heart disease, asthma, COPD and diabetes reduce the incidence of preventable hospitalizations and adverse events by more effectively and comprehensively managing the health of patients with chronic conditions. Many disease management organizations are implementing health information technology (H IT) to facilitate their chronic disease management programs.

                            Technology Initiative

Telehealth applications that remotely connect providers and patients in co-management of chronic diseases. Remote monitoring devices and electronic health records are components that extend traditional Telehealth networks to provide enhanced CDM functions for patients and providers. Telemedicine can enable providers to deliver health services to patients at remote locations, by conducting virtual visits through videoconference or phone. During a telemedicine visit, a patient may see providers in real time and telemedicine can also enable remote interactions and consultations between providers (CDC,2020).

Evaluate the potential barriers to implementing your hypothetical initiative.

The implementation of health information technology involves strategic planning and organizational changes as the systems may not fit the usual workflows. Selecting a system should be both fit for organizational purpose and fit for clinical practice. Implementing a telehealth system in a CDM organization requires significant financial and workforce investment, which may be more difficult for smaller or less-resourced practices (Gajarawala, and Pelkowski,2021). Another barrier is that telehealth includes legal and regulatory issues at state and federal levels. Providers or institutions who utilize telehealth should keep risk management strategies in mind and familiarize themselves with potential telehealth legal risks and implications to ensure best practices for patient care to avoid licensure or litigation issues as Patient’s privacy and confidentiality during telemedicine encounters are more vulnerable to privacy and security risks (Gajarawala, and Pelkowski,2021).

Change Management Strategies That Would Facilitate a Successful Implementation Identify key resources that you would need to promptly overcome potential barriers.

Change management is the process by which an organization gets to its future state, its vision. Some technology applications fail because of sabotage by users who like the old ways in which things were done. Therefore, it is important to address the natural resistance to change during the planning phase before implementation and helping to convert that resistance into commitment and enthusiasm. New systems should enhance the quality of work and increase responsibility and enthusiasm. For change management to be successful, project managers should understand the reasons for the change and are able to communicate the vision and solve problems (HealthIT,2018).

  the implementation of telemedicine services often poses challenges, successful telemedicine services require significant organizational and practice changes intended to facilitate and guide the implementation of the technology. Some change management strategies include aligning the goals of the telehealth system with the mission of the organization, conducting a needs assessment, developing a clear simple vision, engaging stakeholders, developing organizational protocols, adequate funding and support for the technology and user training plans. As with other IT implementations, thorough security protocols and routine audits should be put in place to guard against the real-time exposure of protected health information (PHI). Providers must remain up to date on the regulations governing telemedicine services to ensure regulatory compliance and proper eligibility for reimbursement (HealthIT,2018).

Leadership Strategies to Establish a Culture That Supports the New Information Technology Initiative with Reference to the TIGER Informatics Competencies

With reference to the TIGER competency of Information Literacy, and implementation strategies, nurse leaders must  develop and demonstrate  specific informatics competencies to provide meaningful leadership and support ongoing transformation of the healthcare system(TIGER,2011).

                                  References

Ball, M. J., Douglas, J. V., Hinton Walker, P., DuLong, D., Gugerty, B., Hannah, K. J., . . . Troseth, M. R. (Eds.) (2011). Nursing informatics: Where technology and caring meet (4th ed.). London, England: Springer-Verlag.

Centers for Disease Control and Prevention. (2020). Telehealth Interventions to Improve Chronic Disease https://www.cdc.gov/dhdsp/pubs/telehealth.htm

Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth Benefits and Barriers. The Journal for Nurse Practitioners, 17(2), 218–221. https://doi-org.ezp.waldenulibrary.org/10.1016/j.nTurpra.2020.09.013

Health IT. (2018). Change Management in EHR Implementation https://www.healthit.gov/resource/change-management-ehr-implementation

Technology Informatics Guiding Education Reform. (2011). Informatics competencies collaborative team.https://web.archive.org/web/20150910131244/http://www.thetigerinitiative.org/docs/tigerreport_informaticscompetencies.pdf

POST 3

Kelly

Quantitative data provides information regarding quantities or numbers, whereas qualitative data is concise and regards to concepts (McLeod, 2019). Qualitative data collects, analyzes, and interprets the data (McLeod, 2019). The research can be used to understand an individual’s perceptions. Qualitative data is not numerical. The data is collected using interviews, and using theory (McLeod, 2019). Quantitative data is inherently more rigorous. Quantitative researchers aim to establish laws of behavior and concepts across different settings/contexts (McLeod, 2019). Statistics help drive the quantitative data into meaningful information that will assist with the decision making. Statistics are used to summarize the data, describing patterns, relationships, and connections (McLeod, 2019). Quantitative data is useful for testing and validating constructed theories (McLeod, 2019). 

A qualitative study was completed to explore nurses’ perceptions and experiences of patient involvement that was relevant to patient safety (Skagerstrom et al., 2017). A qualitative design was completed using semi-structured interviews (Skagerstrom et al., 2017). Interviews were conducted with registered nurses (11) and nurse assistants (8) (Skagerstrom et al., 2017). The analysis resulted in four categories. The respondents conveyed that patient involvement can lead to safer care and benefits for individual patients (Skagerstrom et al., 2017). The study completed did not require rigor. The study completed was conducted by interviewing 19 subjects regarding the perceptions. The quantity of subjects is small. The study should be expanded to include the patients’ perceptions. The analysis was completed in one setting. The setting could also be expanded to the entire healthcare organization or multiple healthcare organizations. The study could have reviewed adverse events reported in comparison to the survey. 

References:

McLeod, S. A. (2019). Qualitative vs Quantitative Research. Simple Psychology. Retrieved

            from: https://www.simplypsychology.org/qualitative-quantiative.html

Skagerstom, J., Ericsson, C., Nilsen, P., Ekstedt, M., & Schildeijer, K. (2017). Patient 

            Involvement for improved patient safety: A qualitative study of nurses’ perceptions and 

            experiences. US National Library of Medicine National Institutes of Health 4(4): 230-

            239. https://doi:10.1002/nop2.89

POST 4

Jelda

According to Davidson Reynolds (1971), rigor is the ‘use of logical systems that are shared and accepted by relevant scientists to ensure agreement on the predictions and explanations of the theory’ (Ryan-Nicholis & Will, 2009). Rigorous research uses logic and accepted systems, and therefore strengthens the arguments researchers make when attempting to demonstrate the significance of findings (Ryan-Nicholis & Will, 2009). As Morse (2004) argues, when ‘compared’ with predictive research designs that ‘are usually focused on measurement and are meticulously organized around notions of equivalence… qualitative inquiry appears downright sloppy’ (Ryan-Nicholis & Will, 2009). Per (Claydon, 2014), qualitative research uses a wide range of methods, such as interviews, focus groups and case studies to collect narrative data to gain an understanding of a topic and generate theory. It is based on interpretivism, the philosophical concept that there is not just one truth but multiple truths or realities (Claydon, 2014). Quantitative research is explanatory and deductive with numerical data being collected to test a theory, whereas qualitative is exploratory and inductive, with narrative data being collected to generate themes that may be used to develop a theory (Claydon, 2014). Regardless of method, it is important that the research is peer reviewed (Claydon, 2014). In my opinion, depending on results post peer review, that is when rigor can be determined. Therefore, I don’t feel that either method is more rigorous than the other; it depends on the quality of the research as a whole. 

Article Analysis

A 2021 article titled, NICU and postpartum nurse perspectives on involving fathers in newborn care: A qualitative study, discussed a study that was done to better understand the attitudes, beliefs, and behaviors of healthcare providers that may encourage and engage fathers, or alternatively alienate and discourage them (Buek & al, 2021). The study involved structured interviews with ten NICU and postpartum nurses from hospitals in two large Texas cities (Buek & al, 2021). The interview protocol was designed to elicit descriptive information about nurses’ attitudes and beliefs, sense of efficacy and intention for working with fathers, as well as their father-directed behaviors (Buek & al, 2021). Nurses were recruited for the study using a purposive sampling approach. Interviews were conducted by telephone and lasted approximately 25 to 35 min (Buek & al, 2021). Data were analyzed using a qualitative descriptive approach. The study resulted that nurse attitudes and practices that place mothers in the role of primary caregiver may be interpreted by fathers as excluding or disregarding them (Buek & al, 2021). Further research is needed to validate the results of this small-scale study, and to assess whether and how provider attitudes impact their practices in educating and engaging fathers in newborn care (Buek & al, 2021). Therefore, I believe this study did not do a great job in promoting rigor.

References

Buek, K. W., & al, e. (2021). NICU and postpartum nurse perspectives on involving fathers in newborn care: A qualitative study. BMC Nursing, 20(35), 1-9.

Claydon, L. S. (2014). Rigour in quantitative research. Nursing Standard, 29(47), 43-48.

Ryan-Nicholis, K. D., & Will, C. I. (2009). Rigour in qualitative research: Mechanisms for control. Nurse Researcher, 16(3), 70-85.

  

Outline the steps involved in completing each of the following procedures 

1. Assisting a person to don anti-embolic stockings

2. Caring for drainage tube systems associated with tubes and drains inserted into the body

3. Emptying and changing ostomy bag

4. Emptying and changing a urinary drainage bag

5.  Providing care of suprapubic catheter

6.  Inserting and removing indwelling catheters (IDC) including insertion for male and female genitourinary anatomy

7. Applying isolation nursing practices

8.  Inserting and removing nasogastric tubes (NG)

9.  Feeding through nasogastric tubes (NG) and percutaneous feeding tube

Performing blood specimen collection (venepuncture) 

 

Competency

Explain care for the client with lower respiratory disorders.

Instructions

Read the scenarios below and answer the questions. If you use sources, site them using APA format.

Case # 1

An elderly woman comes into the ER with severe dehydration after spending the day at the beach. The client is weak and feels like she is going to faint. An IV is started, and the RN hangs 0.9% Normal Saline. There are no IV pumps available. The client begins to feel better after 500 mL’s are infused, and the rest of the IV bag is infused. The client begins to have difficulty breathing. Auscultation of the lungs reveals crackles to ½ of the lower lung fields. The provider diagnoses pulmonary edema, and the client is treated with Lasix. She is stabilized but needs to be admitted to the ICU.

Question # 1: What nursing action could have prevented the client from having pulmonary edema? (5-10 sentences)

Question # 2: What makes this client at risk for pulmonary edema? (5-10 sentences)

Case # 2 

A 22-year-old special-needs client comes to the ER with fever and difficulty breathing. The client weighs 66 LBS. The client is admitted with pneumonia and IV fluids, antibiotics, and respiratory treatments are started. The client is dehydrated, so she receives several bags of IV fluids over three days. On the third day, the client has worsening shortness of breath, and an X-ray is ordered which shows pulmonary edema. An echocardiogram is ordered. It shows normal cardiac function. The client is given Lasix, and the shortness of breath resolves.

Question # 3: How did the client’s size (body weight) put her at risk for pulmonary edema? (5-10 sentences)

Question # 4: How could pulmonary edema have been prevented in this client? (5-10 sentences)

Case # 3

A 32-year-old male with a history of cardiomyopathy is admitted to the medical-surgical floor with a diagnosis of flu. The client has a high fever and receives multiple bags of 0.9%NS. One day into the admission the client develops severe shortness of breath. An X-ray shows pulmonary edema.

Question # 5: What puts this client at risk for pulmonary edema? (5-10 sentences)

Format

• Standard American English (correct grammar, punctuation, etc.)
• Logical, original, and insightful
• Professional organization, style, and mechanics in APA format
• Submit document through Grammarly to correct errors before submission.