Discussion: Application of Data to  Problem-solving

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Discussion: Application of Data to  Problem-solving

RE: Discussion – Week 1

The Application of Data to Problem Solving

Informatics and technological innovations are important in improving healthcare changes on policies and processes. In recent years, technological changes have led to improvements in medical diagnosis.  According to the National Academies Institute of Medicine, diagnostic errors leads to over 10% of deaths and 17% of hospital complication. The increased error rate has been identified to be due to inefficient collaboration and integration of patient information, inefficient communication, and inadequate system that supports diagnostics (Watson et al., 2019). With an increasing number of patients due to old age, there is a need for a greater combination of care and medicine, which points to the importance of data tracking for formulating prescriptions and diagnoses of illnesses. to help keep up with rising healthcare needs, many healthcare stakeholders have turned to the latest technological breakthrough such as artificial intelligence in management and preventing chronic illnesses such as cancer(Dzobo et al., 2020). AI has been found to connect the vast healthcare data to its true potential to healthcare professionals.

The care coordination platform, for example, aggregates large sums of data of patient entire medical history, which allow the physician to easily access the data and every detail on patient case history at a glance. These innovations also suggest treatment options because it has inputted data point and adaptive algorithm, which help in decision-making and improve patient outcome. The performance analytics of some of the platforms allow patients access the most cost-effective treatment because they combine the claim, clinical processes, and socio-economic data. Healthcare stakeholders, therefore, can be assured of over 80% accuracy on the diagnosis and even up to 98% success rate thus reducing misdiagnosis for the patient at care facilities (Ahmadi-Assalemi et al., 2020). Healthcare professionals are also likely to solve many healthcare problems including misdiagnosis that has been the largest healthcare challenge. Insurers are also likely to benefit from the use of data derived from patient history by knowing that they are paying the correct care of their clients.

Nurse leaders can also benefit from the applications of data-solving tools for patient outcomes. They are likely to make a correct diagnosis and as well have reduced burnout due to reducing time taken on reviewing patient medical records. Nurses can use new technologies that will allow them to galvanize their knowledge to make an efficient and correct diagnosis. The current technologies also can integrate important data that allow nurses to gather information and formulate treatment for the patient’s problems. Nursing informatics allows nurses to acquire knowledge, generate, disseminate and process information and as well receive feedback regarding their decision, which drives the current healthcare model (Watson et al., 2019). Access to vast medical data allows for easy resolution of healthcare problems and administration of correct medication to their patients. With health information and data, the nurse leaders can meet and discuss the problems arising from their units, and development a framework for improving patient outcomes.

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT:  Discussion: Application of Data to  Problem-solving  

Discussion: Application of Data to Problem-solving

Discussion: Application of Data to  Problem-solving

Question Description
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.

To Prepare:

Reflect on the concepts of informatics and knowledge work as presented in the Resources.
Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.
BY DAY 3 OF WEEK 1
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?

Scenario is early ambulation in post surgical to prevent post operative problems ( example: DVT, Pneumonia, Pain, etc.)

APA format and minimum of 3 citations. intext and references.

I will provide 2 sources, one website and one PDF file and then you can use whichever ones you would like.

https://www.himss.org/library/healthcare-informati…

RE: Discussion – Week 1
Collapse
As a nurse in an NICU, central lines are a common finding. Central lines although life-saving, come with the risk of central line-associated bloodstream infections (CLABSI), which for a pre-term infant increases the risk of mortality and morbidity lengthening hospital stays and increasing complications and associated costs (Oh et al., 2020). A not so hypothetical scenario that could occur in any healthcare environment with central lines, could be an increase in the number of CLABSIs. As a nurse leader, gathering data and investigating potential reasons for the increase in CLABSIs would greatly help to reduce their incidence, improve patient care and better outcomes for patients.

Nursing informatics blends nursing, computer, and information science to create useful data to inform practice (McGonigle & Mastrian, 2017). As a nurse leader, through the collection of data on your unit and through the benchmarking of other similar units, data could be analyzed and assessed to investigate areas for improved practice in regard to CLABSIs. In Ontario, there is the Critical Care Information System (CCIS) which collects data from all patients in level 2 and 3 critical care units across Ontario (Criticall Ontario, n.d.). A nurse leader could access data for the benchmarking process from CCIS to assess other center’s rate of CLABSIs. From there, strategies can be implemented for prevention and reduction measures. For example, the NICU in which I work saw an increase in CLABSIs and implemented the use of the 3M Curos disinfecting caps for line hubs. The cap contains “70% isopropyl alcohol” and requires just one minute to provide disinfection (3M, n.d.). The cap can stay in place for up to one week. There was sufficient clinical evidence to support the use of these caps in practice in reducing CLABSIs, therefore the Curos caps were widely implemented in NICU settings in Ontario.

References

3M (n.d.). 3M disinfecting port protectors. Retrieved on December 2, 2020. https://www.3m.com/3M/en_US/company-us/all-3m-products/~/All-3M-Products/Health-Care/Medical/Curos/?N=5002385+8707795+8707798+8711017+8717585+3294857497&rt=r3

Criticall Ontario (n.d.). Critical care information system. Retrieved on December 2, 2020. https://www.criticall.org/Article/Critical-Care-Information-System

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning

Oh, Y., Oh, K.W., & Lim, G.L. (2020, October). Routine scrubbing reduced central line associated bloodstream infection in NICU. American Journal of Infection Control, 48(10), 1179-1183. https://doi.org/10.1016/j.ajic.2020.02.011

As an intensive care nurse for nearly a decade, I’ve seen plenty of ICU readmissions.  Whenever it happens, I can’t help but feel that we’ve failed the patient. Studies have shown that readmission to the intensive care unit can result in higher mortality rate and increasing hospital cost (Ponzoni et., 2017).  This story is all too familiar—a post-op patient gets discharged from the ICU to the general floor.  Within hours to days, a rapid response is activated for early signs of clinical deterioration such as tachycardia, hypotension, dyspnea, and change in level of consciousness.  That patient is readmitted to the ICU, which usually means decreased activity and sleep, inadequate nutrition, and delayed home discharge.  It’s a sad reality but I wonder what factors contribute to ICU readmission and if collecting and applying data could aid us decrease readmissions.

Analyzing the data could shed light into risk factors for readmissions.  I’ve noticed that patients that have had a long surgery and had required ICU care tend to be readmitted. Our liver failure population are frequently admitted and readmitted with hepatic encephalopathy.  I’ve seen plenty of readmissions within hours of ICU discharge. Are we rushing the patients out of the ICU because of ICU bed shortage? Should we institute an ICU discharge score? Can we be proactive about the lack of sleep, activity, and appetite? What would that look like?

What I’ve observed and these questions can be addressed not from anecdotal information, but from collecting the right data. For example, we can collect time a discharging provider spends with the patient the day of discharge.  Less time may show a connection to readmissions.  We can also isolate specific surgeries that result in readmissions. These are just two examples of the kind of data that can lead to tangible change, hopefully resulting in less ICU readmissions.

Reference

Discussion: Application of Data to  Problem-solving

Discussion: Application of Data to  Problem-solving

Ponzoni C.R., Correa T.D., Filho R.R., Pardini A, Schettino G.P. 2017. Readmission to the Intensive Care Unit: Incidence, Risk Factors, Resource Use, and Outcomes. A Retrospective Cohort Study. doi: 10.1513/AnnalsATS.201611-851OC. PMID: 28530118.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_5051_Module01_Week01_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_5051_Module01_Week01_Discussion_Rubric

COLLAPSE
Good Afternoon Lynne

I really enjoyed reading your post. I benefited from your discussion of how data from devices like EKGs prompts the provision of timely and appropriate care. The use of remote monitoring devices that detect changes in physiologic parameters is rapidly advancing. These devices will become integrated in our daily lives and will alert patients and providers of deteriorations in real-time For instance, there is a device built for smartphones, KardiaMobile and there is a band for the Apple Iwatch, KardiaBand: http://www.alivecor.com/home

FDA-cleared, clinical grade personal EKG monitor. Kardia captures a medical-grade EKG in 30 seconds anywhere, anytime.
Know instantly if your heart rhythm is normal or if atrial fibrillation is detected, and email your EKG to yourself or your doctor.
Used by the world’s leading cardiac care medical professionals and patients. More than 30 Million EKGs recorded.
Take unlimited EKGs, track your weight and blood pressure in one app.
In the Fall of 2018, Apple released the Apple Watch Series 4 which can complete an EKG and was cleared by the FDA. “Apple Watch can now screen your heart rhythm in the background and it sends you a notification if it detects an irregular rhythm that appears to be atrial fibrillation,” Williams said. “Now it won’t catch every instance of a-fib, but this is going to help a lot of people who didn’t realize they had an issue.” Williams also announced that the Watch will alert users to low heart rates in addition to high ones. But the far bigger news is the ECG, which is accomplished by adding electrodes to the digital crown and the back of the Watch.

“In addition to an optical heart sensor there is a new, Apple-designed electrical heart sensor that allows you to take an electrocardiogram, or ECG, to share with your doctor, a momentous achievement for a wearable device,” designer Johnny Ives said in a prerecorded video played at the event. “Placing your finger on the digital crown creates a closed circuit with electrodes on the back, providing data that the ECG app uses to analyze your heart rhythm.”

It takes about 30 seconds for a user to take an ECG, which is then stored in Apple’s Health app. This means, via Apple Health Records, some users will also be able to send readings directly to their doctors. “It’s amazing the same watch that you wear every day to make phone calls and respond to messages can now take an ECG,” Williams said. https://www.healthcareitnews.com/news/apple-unveils-watch-series-4-fda-approved-ecg

I believe mobile applications and devices with remote monitoring capabilities have the potentially to radically alter the delivery of healthcare, improve patient outcomes, and reduce costs. The Kardia devices cost less than $100. This is a fraction of the costs of traditional ECGs. Costhelperhealth provides the following data on ECGs http://health.costhelper.com/ecg.html

Typical costs:

Typically, there are two costs associated with an EKG — the cost of the procedure itself and the cost of the analysis of the readout.
Patients with medical insurance that covers a portion of the cost of the EKG, can expect to pay $30-$100 in copays for both the test and the analysis of the test. For example, Harvard Pilgrim Health Care[1] , which serves patients in Massachusetts, charges its members $32-$54 for an EKG and interpreting the results.
Uninsured patients can expect to pay $500-$3,000 total for an EKG. An EKG averages $1,500, according to NewChoiceHealth.com[2] , but some locations charge as high as $2,850. Typically, prices are higher for services in metropolitan areas, than in smaller rural communities.
These devices can alert both patients and cardiologists to abnormal ECGs which can result in faster treatment and better patient outcomes. There is also tremendous potential for cost savings. The ability to detect health issues 24/7, in real-time has so many tremendous benefits. Thanks for your thoughtful post, Dr. Reilly

 

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