In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.
Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.
In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.
i’m going to send you an example of what my classmates submitted so you have an idea. thank you very much!!15 hours agoTonya Lyles
RE: Discussion – Week 1
When a patient presents to the emergency room, the nurses and physicians often have minutes to decide which care path to choose for the patient. A very common emergency room complaint is “altered mental status”. This simple complaint can lead to at least three high priority, timed treatment options. The patient could be having an ischemic stroke in which tPA would need to be administered within 3 hours of last know well (McDermott, 2018). The patient could be suffering from sepsis and need fluids and antibiotics within an hour of arrival (Society of Critical Care Medicine, n.d.). Predictive analytics can help in this scenario through the analysis of the patient’s electronic health record to review past medical history and current medications to determine which scenario is more likely and where initial efforts should be placed.
John Edwards (2019) reports that predictive analytics is the data analysis “aimed at making predictions about future outcomes based on historical data and analytics techniques”. Most high priority emergency conditions have predictive factors such as age and previous medical history. Using this knowledge from research along with the data from the electronic health record can predict for the emergency room providers which condition is the most likely cause.
This type of program could also be used by healthcare leaders to predict future healthcare needs. Nurse leaders would use a program such as this to drive patient specific healthcare based on current symptom information combined with previous healthcare data.
Edwards, J. (2019, Aug 16). What is predictive analytics? Transforming data into future insights.
Retrieved from https://www.cio.com/article/323114/what-is-predictive-analytics-transforming-data-into-future-insights.html
McDermott, M.L. (2018, May 9). 2018 AHA/ASA stroke early management guidelines.
Retrieved from https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2018/01/29/12/45/2018-guidelines-for-the-early-management-of-stroke
Society of Critical Care Medicine. (n.d.). Surviving sepsis campaign: hour-1 bundle. Retrieved
This is another example!!
Main Discussion Post
The electronic health record (EHR) serves as a health biography for patients. The data found in a medical record can be utilized to develop an efficient patient-focused plan of care for a patient (Office of the National Coordinator for Health Information Technology [ONC], 2017a). According to Nagle et al. (2017), electronic health records have resulted in more accurate patient documentation. One valuable piece of information located in the EHR is the patient’s medication list. However, a recent study conducted to evaluate the accuracy of the medications listed in a patient’s health record revealed that many patients were taken less than half of the medications listed in their medical records (Ryan et al., 2017). The study also revealed that a third of the medications prescribed to the patients in the study were not listed in their medical records (Ryan et al., 2017). These results indicate that there is a need for improving the process of documenting a patient’s medication list.
I currently work as an emergency room (ER) nurse. I encounter several charts with inaccurate medication documentation. When a patient comes to the ER, the medication list is usually completed or updated during the triage process. If they are admitted, a medication reconciliation should be conducted during the admission process. The problem that arises is that some nurses feel they get too busy to bother with the medications list (Al-Hashar et al., 2017). A study conducted by Al-Hashar et al. (2017) noted that 99% of the nurses surveyed agreed that it was important to have an accurate medication list in the patients.
One way to improve the accuracy of the medication list would be to provide multiple opportunities for data collection. During the registration process, patients are given access to the patient portal. The patient portal is a password-protected site that allows a patient to access their medical records (ONC, 2017b). Instead of merely giving patients access to their medical records, provide them with the authority to make edits to their medical history. The items eligible for edit can include address changes, new diagnoses, any pertinent health history initially omitted, and medications. Another opportunity to collect data from a patient would be during the admission process. According to Nagle et al. (2017), information collected during the admission process tends to be more accurate.
Patients often visit more than one provider, and this can lead to medication list inaccuracies (Ryan et al., 2017). Information submitted by the patient can be verified for accuracy before being added to the patient’s charts. For example, if a patient logs in to update a new provider, then the patient will have to list the provider’s information. That provider will then be contacted for verification. Requiring the patient to list their pharmacy or prescribing doctor when they add a new medication will help ensure accuracy. In a clinical setting, a pharmacist can conduct a medication reconciliation to improve the efficiency of a patient’s medication list (Ryan et al., 2017).
A nurse leader could use the new accurate data collected to improve patient outcomes. Patient education can be added to the medication list on the patient portal to help improve the patients knowledge about the medications they are prescribed. Follow up with staff should also be conducted to ensure that the medications are being documented accurately. An accurate medication list is an important patient safety tool that can be used to prevent medication errors (Al-Hashar et al., 2017). Creating multiple ways of collecting data and verifying it can improve the accuracy of the data. Applicable knowledge has to be accurate (McGonigle & Mastrian, 2019). An accurate medication list can improve patient care, reduce admissions, and reduce the risk of a patient having an adverse reaction to a medication (Agency for Healthcare Research and Quality [AHRQ], 2019). An accurate medication list can also help to reduce patient knowledge deficits. An accurate medication list can be made available for the patient to access through the patient portal. It can also improve the overall accuracy of the chart. If a patient has a medical condition not listed in the chart, an accurate medication list can help identify medical conditions not listed in the patient’s record.
Agency for Healthcare Research and Quality. (2019). Medication Reconciliation. Retrieved from https://psnet.ahrq.gov/primer/medication-reconciliation
Al-Hashar, A., Al-Zakwani, I., Eriksson, T., & Al Za’abi, M. (2017). Whose responsibility is medication reconciliation: Physicians, pharmacists or nurses? A survey in an academic tertiary care hospital. Saudi Pharmaceutical Journal : SPJ : The Official Publication of the Saudi Pharmaceutical Society, 25(1), 52–58. doi:10.1016/j.jsps.2015.06.012
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212–221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Ryan, T. P., Morrison, R. D., Sutherland, J. J., Milne, S. B., Ryan, K. A., Daniels, J. S., & Daly, T. M. (2017). Medication adherence, medical record accuracy, and medication exposure in real-world patients using comprehensive medication monitoring. PLOS ONE, 12(9). https://doi-org.ezp.waldenulibrary.org/10.1371/journal.pone.0185471
The Office of the National Coordinator for Health Information Technology. (2017a). Benefits of EHRs. Retrieved from https://www.healthit.gov/topic/health-it-basics/benefits-ehrs
The Office of the National Coordinator for Health Information Technology. (2017b). What is a patient portal? Retrieved from https://www.healthit.gov/faq/what-patient-portal
Remember i work in ICU floor with adult patients.
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