Respond  by offering one or more additional mitigation strategies or further insight into your colleagues’ assessment of big data opportunities and risks.

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      Big data provides knowledge, insight, ideas and the potential to expand opportunities within an organization (McGonigle & Mastrian, 2018, p. 478).  Considerable amounts of data have been collected through the EMR over the past decade creating a challenge for nurse scientist to find nuggets of information in tsunami of data (Gephart, Davis, & Shea, 2017). The amount if big data can be difficult for those required to examine and retrieve information. Despite the overwhelming amounts of big data, it does come with benefits, challenges and risk associated with its use.

     A benefit to using big data is the ability to communicate with a large group of patients at one time. For instance, a physician can send a message out to a large group of patients in a short period of time with the use of big data (Laurete Education, 2018).  A physician’s office can remind large group of patients of appointment reminders, lab appointments or alert them to call the md office with abnormal lab results.  This cost effective and convenient as it allows consistent measures to monitor the practice.

     A potential challenge of using big data is the fine line of deciding who owns and who can use the data (Shanthagiri, 2014). For example, the data sources include the patient’s private health information which could now be potentially shared with labs, pharmacies, social media in addition to their physician (Shanthagiri, 2014).  The enforcement of privacy of PHI and HIPPA is strict. The potential for error with big data is a high risk.

     Working with the VA medical center, I observe strict monitoring and firewalls ensuring safety of patient’s PHI. The vulnerability of exposure of personal health information to social media or social networks is a constant threat.  The EMR not only stores health data but also houses the patient’s personal information such as social security numbers, addresses, and birthdays. A strategy to combat this potential problem is a strong malware and security system monitored 24 hours a day 7 days a week. The VA medical center monitors all information going in and going out of the EMR with it’s own security department specific for data protection.  Each user is tagged to this information and can be traced.  The VA will immediately terminate privileges should a user of the EMR violate any firewall in the system. They monitor everything as they should.

      As a bedside nurse I am aware of my contribution to this data however, I am not exposed to the cumbersome job of disentangling this information or protecting it. I know the potential benefit of collecting this information is to provide information as it relates to quantifying and qualifying illness, providing evidence for practice.  That being said, big data will continue to grow as we knowledge workers continue to contribute and technology advances.

References

Gephart, S., Davis, M., & Shea, K. (2017, December 13, 2017). Perspectives on Policy and the Value of Nursing Science in a Big Data Era. SAGE Journals.         https://doi.org/https://doi-org.ezp.waldenulibrary.org/10.1177/0894318417741122

Laurete Education. (2018).  Health Informatics and Population Health: Analyzing Data for Clinical Success [Video file]. Retrieved from                                       https://class.waldenu.edu/bbcswebdav/institution/USW1/201950_27/MS_NURS/NURS_5051_WC/USW1_NURS_5051_module03.html?course_uid=USW1.1425.201950&service_url=https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/wslinks&b2Uri=https%3A%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN#resources

McGonigle, D., & Mastrian, K. G. (2018). Nursing Informatics and the Foundation of Knowledge (4 ed.). Burlington, MA: Jones & Bartlett Learning.

Shanthagiri, V. (2014). Big Data in Health Informatics [Video file]. Retrieved from https://www.youtube.com/watch?v=4W6zGmH_pOw

 Describe what specific resources or federal agencies that you will utilize to remain informed and current in public health trends and practices.

  What does your textbook have to say on the topic? 

References

• Nickitas, D., Middaugh, D., & Aries, D. (2016). Policy and Politics for Nurses and Other Health Professionals ,2nd. Jones and Bartlet: Burlington, MA  ISBN# 9781284053296
• Porche, D. (2012). Health Policy: Application for Nurses and Other Health Care Professionals. Jones & Bartlett. ISBN: 9780763783136

The incorporation of a model when making practice changes is very important for several reasons. Dearholt and Dang (2012, p. 33) indicate that using an appropriate model can help ensure projects better align with the organization where they are being implemented.  Selecting an appropriate model to use is an important step in the process.  Buckwalter et al. (2017, p. 181) discuss that the Iowa Model may be especially useful for healthcare providers trying to make evidence-based practice changes because it can help users to identify current research and focus on the results from a patient perspective.   Melnyk and Fineout-Overholt (2015, p. 278) explain that the use of models can help clarify and guide changes throughout the process which should ultimately lead to better patient care.

Effort and Benefit

           The use of a change model requires both time and effort.  However, the risks of not using a change model are significant and could potentially lead to a less than optimal result.  Helping to ensure the success of a project that will benefit health outcomes for patients is worth the effort.  Dearholt and Dang (2012, p. 60) explain, that questions being addressed by EBP projects are important and the use of a model can help ensure that the time and energy are not wasted.  

Conclusion

           Careful selection of a change model is an important step when undertaking EBP projects.  As nurses, we have a responsibility to work toward improving patient outcomes as well as working to further nursing research.  The use of change models can help accomplish both goals and therefore is vital to the process.

References

Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., Rakel, B., … 

           Tucker, S. (2017). Iowa Model of Evidence-Based Practice: Revisions and 

           validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. doi:

           10.1111/wvn.12223

Dearholt, S. L. & Dang, D. (2012). Johns Hopkins Nursing evidence-based practice: Models and

           guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International.

Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and 

           healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Wolters Kluwer Health

Hi, I’m looking for a professional writer that can write a 500 word essay on why I want to pursue a nursing at Elms College. Elms College is a private college located in Chicopee, Massachusetts. I’ve been rejected from my previous school (Goodwin College) which sucks because I’ve worked so hard trying to achieve my goal in getting accepted into the nursing program . I need a writer who is going to write an effective and efficient essay that entails excellent grammar, proper word choice, and professional college written work.

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A 43-y.o. female presents with the complaint of weight gain and fatigue over the past 4 mo. She states that she is always cold and just can’t get warm. She states that she is sleeping really well through the night but does not wake feeling refreshed. She denies shortness of breath, chest pain, or dyspnea on exertion.

1. What additional questions should you ask the patient and why?
2. What should be included in the physical examination at this visit?
3. What are the possible differential diagnoses at this time?
4. What tests should you order and why?
5. How should this patient be managed?