NURS 6050 Application of Data to Problem-Solving

Carter-Templeton (2019) describes the crucial role of nursing informatics that uses technology to obtain data that will provide knowledge to improve the clinical processes and clinical judgment, allowing for future innovations to be created. Carter-Templeton (2019) explains that the Alliance for Nursing Informatics (ANI) has plans to transform healthcare through nursing informatics and allowing leadership in the ANI to participate in educational opportunities that allow mentorships for a few years to create members that are skilled in communication, networking, negotiation, leadership, and managing. Conduent Health Healthcare Provider Solutions (2017) has created Midas’s online care management system that outlines data into information used to improve performance.

Conduent Health Healthcare Provider Solutions (2017) gives examples of their abilities, as quality improvement and risk reduction among patients, case management, and reducing central line infections. Conduent Health Healthcare Provider Solutions (2017) expresses that it is the largest provider in business processes services with advanced capabilities in analyzing and processing data that is entered into the program to create interventions that directly affect the problem at hand to decrease any adverse risks that are currently occurring in a specific healthcare facility. Midas provides and creates “an individualized patient care plan worksheet that includes goals, outcomes, and interventions to meet Joint commission” (Conduent Health Healthcare Provider Solutions, 2017, para 8).

Having the potential to be a future nurse leader, the Midas program shows significant value in creating interventions and positive outcomes by analyzing certain events or data listed in the program. Midas can create outcomes, but the ability to comprehend the accurate implementation of the outcomes allows a nurse leader to use clinical reasoning and judgment from experience and knowledge. An example of how data could be collected about current healthcare issues that are arising at an all-time high is the nurse-to-patient ratio since there is a shortage of bedside nurses in the field. Paulson (2018) explains a study and the collected results directly related to nurse-patient ratios through nursing informatics. The hypothetical situation, which soon will not be as speculative considering the nursing shortage sweeping through every hospital, is based on using the Midas program to enter in information for when staffing is not met and how that directly influences patient care.

Paulson (2018) stated that current hospitals staff using hours per patient day algorithm calculated by using the average number of patients in a day multiplied per month days or per year, which is three-hundred and sixty-five days. The hour per patient day does not include patient acuity, meaning the number of nurses remains the same whether the acuity is average or higher than usual. Paulson (2018) expressed that if staffing needs were not met on a unit, mortality of patients increased as well as if the majority of nurses have less than two years’ experience, mortality among patients would increase.

This is an essential topic since many experienced nurses have retired, quit, or moved on to take travel contracts during this pandemic; hospitals are left with new nurses and a lack of nurses to staff the hospitals adequately. Midas would be of great use in any hospital to track and monitor mortality rates caused by a nursing shortage and inexperienced nurses. Through Midas, a nurse leader would use clinical judgment and experience to put forth interventions to reduce mortality in the unit and use other resources to ensure that the unit is staffed accordingly.

References

Carter-Templeton, H., & Sensmeier, J. (2019). The Value and Impact of the Alliance for Nursing Informatics Emerging Leaders Program. CIN: Computers, Informatics, Nursing, 37(12), 612–614. https://doi.org/10.1097/CIN.0000000000000603

Conduent Health Healthcare Provider Solutions . (2017). Midas Health Analytics Solutions Care Management – Improving Patient Safety and Quality Management. Retrieved November 27, 2021, from https://downloads.conduent.com/content/usa/en/brochure/midas-care-management.pdf.

Paulson, R. A. (2018, July). Taking Nurse Staffing . Retrieved November 27, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039374/pdf/numa-49-42.pdf.

As a Psych nurse, I feel that there is a significant disconnect between the physical duties of nursing and the documentation process. Many times, documentation feels useless and unproductive. An example where I found data has been collected and assessed that could have made a difference is in suicide prevention.

On two occasions, I have witnessed patients successfully commit suicide in the hospital. After talking to other staff who had direct contact with these individuals within the days leading, I found two things in common. Both patients were eating and sleeping much less than usual. Ironically, in this facility, we count sleep hours each night and the percent of food consumed. However, these numbers are not available in any assessment to help predict someone for risk of suicide. Instead, the way that we detect a patient’s suicidality is to do a suicide risk assessment. A suicide risk assessment is composed of questions like; Have you ever tried to kill yourself or attempted suicide? Do you have a plan to end your life? Have you made any preparations? (Dueweke, 2018). In an inpatient psychiatric facility, we ask patients these series of questions two times a day for the entire duration of their stay. According to Bolster (2015), the suicide risk assessments were inconclusive in determining the patient’s willingness to commit suicide.

I believe informatics could play a role in this situation by integrating the information from the patient’s assessments. The assessments we fill out as nurses could contain more potency if they were integrated and analyzed through a much larger algorithm better to determine our patient’s mental/physical health. For instance, sleep hours, food intake, body weight changes, medication compliance, PRN requests, suicide risk assessment, and mental status exam scoring could show potential trajectories that a patient’s health could take. These hypothetical trajectories could be shown on an interface as red flags and alerts.

With this data integration, a nurse leader would be more informed on the patient’s overall health. The nurse leader would have access to more information on the patient allowing them to make better decisions on patient care. Had there been an algorithm to detect those patients’ mental health decline, we would have had a better chance of stopping them from taking their own lives.

References

Bolster, C., Holliday, C., Oneal, G., Shaw, M., (2015) “Suicide Assessment and Nurses: What Does the Evidence Show?” OJIN: The Online Journal of Issues in Nursing Vol. 20, No. 1, Manuscript 2.

Dueweke, A. R., & Bridges, A. J. (2018). Suicide Interventions in Primary Care: A Selective Review of the Evidence. Families, Systems, & Health. Advance online publication.http://dx.doi.org/10.1037/fsh000034

In health care, informatics has become a necessary resource for effectively accomplishing the goal of caring for patients.  So the question remains what informatics in healthcare is, and how do they enhance patient care quality?  The article ” Healthcare informatics ” describes healthcare informatics as “the integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information” (Sweeney, 2017, p.1).  Additionally, “healthcare informatics focuses on managing healthcare information through capturing; retrieval; storage; presenting and sharing biomedical information and data to provide care” (Sewell, 2018, p. 5 ).

In my practice, we utilize several forms of informatics to assist in the dispositions of patient care.  Hypothetically, say patient “A” comes into the emergency room they have been sick with flu-like symptoms for several days.  Patient A’s vitals are as follows: blood pressure 90/50, Respirations 32, temperature 100.2, heart rate 123, 6/10 pain with a productive cough, and blood oxygen level of 91 at room air.  Upon arrival, an initial evaluation was conducted.  The provider utilized the electronic medical system to put in medical orders.  He requested a bedside chest x-ray, two liters of oxygen, and various labs, including blood cultures, point-of-care lactate, venous blood gases, and creatinine.

All imaging is conducted, an intervenous line is placed, and the patients are collected and returned and resulted.  It is determined that the patient has bacterial pneumonia and becoming septic.  The center for disease control and prevention (CDC) defines sepsis as sepsis is the body’s extreme response to an infection, and it is a life-threatening medical emergency.  Sepsis happens when a condition you already have in the lungs, bladder, or wounds triggers a chain reaction throughout your body  (Centers for Disease Control and Prevention, 2022).  Moreover, a sepsis protocol is initiated based on the algorithm of the patient’s medical vital signs and labs in the patient’s electronic medical record. The system suggests ordering fluids, repeat labs, and antibiotics to treat the patient.

Various informatic resources such as the electronic medical system, point-of-care lab collections, and imaging are directly communicated and transferred into patient A’s chart for effective and efficient helpmeet in evaluating, diagnosing, and treating patient A appropriately.  Different health professionals could use informatic healthcare resources to assist in care.  Utilizing healthcare informatics as an assistive tool, not a definitive means, can improve positive patient outcomes.

References

Center for Disease Control and Prevention. (2022, August 9). What is Sepsis? cdc.gov. https://www.cdc.gov/sepsis/what-is-sepsis.html#:~:text=Sepsis is the body’s extreme,%2C skin%2C or gastrointestinal tract

Links to an external site.

Sewell, J. (2018). Introduction to Nursing Informatics: Managing healthcare information. In Informatics and nursing (6th ed., p. 5). LWW.

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1), 1.

Detailed information is comprised of individual units. There are various types of data, each of which is formatted in a specific way. Defining a phenomenon or entity by its data determines its quality or quantity.

Data collection involves gathering demographics, social context, disease status, medical history, and drug history of the patient.

A description of the data collection methods;

Methods of collecting data can be divided into two categories:

A direct interview is the primary method of collecting data, in which questions are posed directly to subjects or researchers. An example would be an interview with the patient directly.

Information from previously collected data is used in secondary data collection. This data is collected from patients’ previous health reports.

Physiological, psychological, sociological, and spiritual data are gathered during data assessment.

Identifying patient care needs is the first step in nursing assessment.

The ability to reason clinically and to judge; the ability to judge and to think clinically.

As nurses, we use clinical reasoning and decision-making to classify patient issues according to evidence and choose between options before making nursing diagnoses or selecting nursing outcomes and treatments.

Along with observation, medical judgment allows the nurse to associate data items, evaluate them, make connections to established evidence, and examine and interpret the data from the standpoint of both vitality and logic.

Work Cited 

Banning, M. (2008). Clinical reasoning and its application to nursing: concepts and research studies. Nurse education in practice, 8(3), 177-183.

Sapsford, R., & Jupp, V. (Eds.). (2006). Data collection and analysis. Sage.

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The evolution of nursing informatics has been a momentous advancement regarding the safety of patients in the healthcare environment. According to McGonigle & Mastrian, The American Nurses Association (ANA) describes nursing informatics as a specialty that incorporates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom within the nursing practice (McGonigle & Mastrian, 2018). With the direct utilization of informatics, the healthcare environment has converted entirely into a technological system where the patient’s data is collected and mainstreamed for healthcare professionals to obtain patient data concurrently. Healthcare professionals can gain a perspective of the patient’s electronic healthcare records and work collectively to provide a greater quality of patient care and safety outcomes. Information technology enhances various conditions of healthcare nurses to involve significant communication of patient medical information involving clinicians, expeditious access to policy and protocol when necessary, comfort in assembling data, and even giving notice when a task has not been performed. Acquiring an integrated system in one spot allows professional nurses and leaders to examine issues or problems in the current practice setting and ways to improve. (Laureate Education, 2018).

References

Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health (Video file). Baltimore, MD: Author.

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge. (4^th ed.) Burlington, MA: Jones & Bartlett Learning.

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You provided a detailed post on ways to collect data in nursing informatics to achieve desired outcomes. As we have studied nursing informatics this week, it further defined my understanding of its importance. According to Zytkowski, “Nursing informatics plays an essential role in the future directions of healthcare by defining the relationship between nurses and information technology as well as the knowledge that can be gained when these domains work together” (2003). There are many ways to incorporate this information into nursing education so that nurses are more equipped to be involved in this process. According to Darvish et al.,

“The NACNEP recommended to prepare nurses to adopt intelligent and quality-based information technology use in patient care by implementing five strategies: providing core informatics courses to nursing schools, educating nurses specialized in informatics skills who are able to solve related issues, offering more powerful nursing care through the implication of telecommunication projects, preparing more nursing faculties in the informatics field to facilitate students skills enhancement and enhancing collaboration to advance informatics” (2014).

Equipping students who are becoming a part of the healthcare field is one way to promote the appropriate application and understanding of nursing informatics. How have you seen the application of nursing informatics in your role as a healthcare provider?

References

Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science, 6(6), 11–18. https://doi.org/10.5539/gjhs.v6n6p11

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Links to an external site.

Zytkowski, M. E. (2003). Nursing Informatics: The Key to Unlocking Contemporary Nursing Practice. Advanced Practice in Acute and Critical Care, 14(3), 271–281. https://aacnjournals.org/aacnacconline/article-abstract/14/3/271/14046/Nursing-InformaticsThe-Key-to-Unlocking

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Currently, most organizations are involved in the use of data to solve different problems in the operational processes. In the healthcare system, the knowledge work of nurses is data intensive (You et al., 2018). With the technological innovation and applications in the healthcare system, healthcare institutions use complex information systems, networks and other technologies to enhance the management of financial, clinical, and epidemiological activities that must always be integrated in a meaningful way (Tekieh & Raahemi, 2015).

There are different scenarios in the healthcare system where data can be applied to enhance healthcare delivery. Nurse to patient ratio has been a problem in most healthcare institutions (Gupta & Rokade, 2016). The problem is always attributed to the increase in the number of patients in the healthcare system as well as the lack of enough healthcare professionals. The application of data in this case can enhance the management of influx of patients in disaster situations and during the normal operational processes.

The data collected in the above case may involve recording number of patients who visits a healthcare facility at a given time, the reason for visits (diseases and complications), whether the patients are inpatients or outpatients, time of visit, and number of nurses and other healthcare professionals at a particular time (Chen et al., 2019). The data collected can be used to establish the rates of inflow of patients and the number of patients in the hospital at a given time, the information can then be applied in the establishment appropriate nurse to patient ratio to ensure effective patient outcome (Coviello, Avitabile, & Florio, 2020).

In the above case, data can be collected through the electronic medical record (EMR) systems. With the EMR system, the data is always captured at the point of admission, during diagnosis, treatment processes, and discharge (Qureshi et al., 2019). The data are then stored safely in the databases and can be analyzed at any given time to provide information on the status of healthcare system and the adjustments that needs to be undertaken (Lang et al., 2017).

The knowledge that can be derived from the data include the number of patients, types of medication required by most patients, the number of nurses, and finally, the nurse to patient ratio. Nurse leaders can apply clinical reasoning and judgement in the establishment of accurate nurse to patient ration to enhance the management of patients. In other words, nurse leaders can apply the knowledge of nurse to patient ration obtained from data analysis to establish enough nurses and other healthcare workers in the management of patients.

In health care, informatics has become a necessary resource for effectively accomplishing the goal of caring for patients. So the question remains what informatics in healthcare is, and how do they enhance patient care quality? The article ” Healthcare informatics ” describes healthcare informatics as “the integration of healthcare sciences, computer science, information science, and cognitive science to assist in the management of healthcare information” (Sweeney, 2017, p.1). Additionally, “healthcare informatics focuses on managing healthcare information through capturing; retrieval; storage; presenting and sharing biomedical information and data to provide care” (Sewell, 2018, p. 5 ).

In my practice, we utilize several forms of informatics to assist in the dispositions of patient care. Hypothetically, say patient “A” comes into the emergency room they have been sick with flu-like symptoms for several days. Patient A’s vitals are as follows: blood pressure 90/50, Respirations 32, temperature 100.2, heart rate 123, 6/10 pain with a productive cough, and blood oxygen level of 91 at room air. Upon arrival, an initial evaluation was conducted. The provider utilized the electronic medical system to put in medical orders. He requested a bedside chest x-ray, two liters of oxygen, and various labs, including blood cultures, point-of-care lactate, venous blood gases, and creatinine.

All imaging is conducted, an intervenous line is placed, and the patients are collected and returned and resulted. It is determined that the patient has bacterial pneumonia and becoming septic. The center for disease control and prevention (CDC) defines sepsis as sepsis is the body’s extreme response to an infection, and it is a life-threatening medical emergency. Sepsis happens when a condition you already have in the lungs, bladder, or wounds triggers a chain reaction throughout your body (Centers for Disease Control and Prevention, 2022). Moreover, a sepsis protocol is initiated based on the algorithm of the patient’s medical vital signs and labs in the patient’s electronic medical record. The system suggests ordering fluids, repeat labs, and antibiotics to treat the patient.

Various informatic resources such as the electronic medical system, point-of-care lab collections, and imaging are directly communicated and transferred into patient A’s chart for effective and efficient helpmeet in evaluating, diagnosing, and treating patient A appropriately. Different health professionals could use informatic healthcare resources to assist in care. Utilizing healthcare informatics as an assistive tool, not a definitive means, can improve positive patient outcomes.