Client Questions

Explore the technology systems offered by Nanthealth, a provider of “telehealth” and health management services via the following link: http://nanthealth.com/ Prepare a brief (8-10 slides) PowerPoint presentation in which you do the following: Identify at least two technology innovations to connect patients, providers, and insurers across the care continuum. Describe how the technologies work to provide patients and providers with data necessary for health care decision making. Discuss how the real-time data encourages outcome-focused planning. Predict what impact the technology will have on future health care delivery. Provide rationale and examples. Presentations must include speakers’ notes on each slide, as well as references for the presentation. A minimum of three academic references from credible sources are required for this assignment. The slide count (8-10 slides) does not include the introduction and References slide(s). Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

In a perfect world, research studies would be flawless however, that is not typically the case.  Inherently, flaws exist related to study design, how the study is conducted, and also the manner in which research is reported.  “Given that research is not perfect, users of research must learn to carefully evaluate research reports to determine their worth to practice through critical appraisal” (Melnyk & Fineout-Overholt, 2015, p. 92-93).  Factors that need to be assessed when critically appraising quantitative studies include validity, reliability and applicability (Melnyk & Fineout-Overholt, 2015).          The validity of a study relates to obtaining results from utilizing sound methods which are scientific.  Bias and confounding variables can compromise validity of a study.  Bias can occur at any stage of the process but while assessing the reliability of the results one must look at if the study was systematic, grounded in theory, and criteria was followed for all of the processes.  If so, then the study, more than likely, is valid and reliable.  Clinicians need the ability to interpret the results so they can implement EBP into their practice (LoBiondo-Wood & Haber, 2014).  “Whether we are interpreting the research studies of others, or designing our own, we need a good understanding of research design and an ability to recognize weaknesses in intervention studies which may reduce the reliability of study findings” (Ebbels, 2017, p. 229).      Although each factor is important to quality research, I feel the most important factor is the applicability to practice.  Having the ability to appraise research, which is evidence-based, and implement EBP interventions with our patients is essential in promoting optimal patient outcomes.    References Ebbels, S. H. (2017). Intervention research:  Appraising study designs, interpreting findings and creating research in clinical practice. International Journal of Speech-Language Pathology, 19(3), 218-231. https://doi.org/https://doi-org.arbor.idm.oclc.org/10.1080/17549507.2016.1276215 LoBiondo-Wood, G., & Haber, J. (2014). Nursing research:  Methods and critical appraisal for evidence-based practice (8th ed.). St. Louis, MO: Mosby Elsevier. Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare:  A guide to best practice (3rd ed.). Retrieved from Amazon Kindle App

Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies. Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking. In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings. To Prepare: Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery. Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.” Identify and select 5 peer-reviewed articles from your research. The Assignment: (4-5 pages) In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following: Identify the 5 peer-reviewed articles you reviewed, citing each in APA format. Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples

Write a 175- to 265-word response to the following questions: How is the landscape of health care changing today? As a manager, how can you address change? Choose one current issue and provide an example of how you might deal with it. Describe current and potential challenges with the health care system. Identify health care cost for consumers.

Respond using one or more of the following approaches: Ask a probing question, substantiated with additional background information, and evidence. Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. Validate an idea with your own experience and additional sources. Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings. Expand on your colleagues’ postings by providing additional strategies for addressing barriers to EBP based on readings and evidence.                                                         Main Post                                          Introduction/PICOT Question Pain is the most common complaint of people who present to the emergency department (ED).  It is estimated that 75% of all patients use the ED for pain related complaints (Bergman, 2012).  Patient satisfaction survey results emphasize the importance of adequate pain management (Bergman, 2012). With this in mind, nurses have a responsibility to evaluate, assess, and be advocates for a patient’s pain control.  Studies have shown when an ED department has pain management protocols and delegates these to the nurses there is a reduction in patient’s pain (Hadorn, Comte, Foucault, Morin, & Hugli, 2016).  Discovering patient expectations for pain management allows healthcare workers and patients to understand each other.  Once understanding has taken place, we can evaluate essential questions related to the patient’s pain management.  As healthcare workers are we expected to base pain management protocols solely on self-reported pain by the patient?  If so then an important question to answer is: When patients present with pain in the ED, how does a nurses’ perception of the pain influence the level of pain management the patient receives?  Evidence-Based Practice               Currently, in the ED I work in pain guidelines and protocols are in place for the nurse to initiate as needed.  Hadorn et al. (2016) state, “guidelines or protocols are generally used to facilitate the transfer of compelling evidence into clinical practice” (p. 81).  This evidence-based pain management protocol is available for the nurse to initiate based on the patient’s self-reported pain, nursing assessment, and observational data.  At times, nurses evaluate pain based on vital signs, facial expressions such as grimacing, restlessness, self-report, and chief complaint (Hazelett, Powell, & Androulakakis, 2002).  In our organization, the policies and procedures for pain management support the adoption of evidence-based practices.  By using the set protocol for pain, nurses are better able to treat pain promptly.  Nurses have a crucial role in delivering evidence-based healthcare in order to have the best outcomes and treatments for their patients (Majid et al., 2011). Barriers        Studies noted a barrier to effective pain management is the nurses’ perception of the individual.  Some patients frequent the ED over exaggerating or making up complaints to seek pain medications (Hazelett et al., 2002).  This repetitive drug seeking over time creates a barrier to compassionate care.  The ED is a vulnerable place for drug abuse, especially by patients attempting to get narcotics or other pain medications (Bergman, 2012).  Emergency department nurses and staff have a culture within their units that influence everyday practices.  There is often a vast age range in the nursing staff which highlights differences in work ethic, attitudes, and professionalism.  The culture of our ED hinders the initiation of evidence-based practices due to stressed out, overworked, and underappreciated nurses.  With this in mind, it is vital that as an organization we provide opportunities for nurses to have adequate rest and find ways to show appreciation for all their hard work.              Proper access and initiation of the pain management protocol increases the likelihood of adequate pain control for patients.  By discovering the expectations of patients and barriers to providing appropriate care we can eliminate miscommunication regarding pain control.  References Bergman, C. (2012). Emergency nurses’ perceived barriers to demonstrating caring when managing adult patients’ pain. Journal of Emergency Nursing, 38(3), 218-225. http://dx.doi.org/10.1016/j.jen.2010.09.017  Hadorn, F., Comte, P., Foucault, E., Morin, D., & Hugli, O. (2016). Task-shifting using a pain management protocol in an emergency care service: Nurses’ perception through the eye of the roger’s diffusion of innovation theory. Pain Management Nursing, 17(1), 80-87. http://dx.doi.org/10.1016/j.pmn.2015.08.002 Hazelett, S., Powell, C., & Androulakakis, V. (2002). Patients’ behavior at the time of injury: Effect on nurses’ perception of pain level and subsequent treatment. Pain Management Nursing, 3(1), 28-35. http://dx.doi.org/10.1053/jpmn.2002.29012 Majid, S., Foo, S., Luyt, B., Zhang, X., Thong, Y., Chang, Y., & Mokhtar, I. (2011). Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229-236. http://dx.doi.org/10.3163/1536-5050.99.3.010

To Prepare: Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics. Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA). Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study. The Assignment: (1 page) Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following: Briefly and generally explain the policy or regulation you selected. Address the impact of the policy or regulation you selected on system implementation. Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow. Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

t is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format (6th Ed.). Classroom Participation Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature. All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation. Discussion Prompt [Due Wednesday] Select ONE of the questions listed below and provide a substantive posting by Wednesday. Please include the question number you selected in the title of your post (e.g. Question 1 Contraceptives). Respond to a classmate who initially posted to the opposite question.  What are the clinical criteria for selection of contraceptives, including emergency contraception? What resources would you utilize in your decision-making? Include the domains of the gynecologic and obstetric history in your response. Identify two evidence-based interventions which increase compliance and successful utilization of contraceptives? What are the clinical, ethical, social, and economic consequences of unintended pregnancy? Why is it important for advance practice nurses to remain cognizant of this information?

Evidence-Based PICOT Question The purpose of this assignment is to draft an appropriate and effective PICOT question that can be related to your DNP project. Keep in mind your project will continue to evolve and take more specific shape as you move through your program. That is expected. It is important to begin with a workable PICOT question in mind so that you start off on the right track and can continue to refine your area in subsequent courses. Consider an advanced practice nursing care problem or issue related to your intended DPI Project. Conduct a search in the GCU Library using CINAHL, The Cochrane Library, the Joanna Briggs Institute (JBI), OVID, or Sage Research Methods databases to find appropriate empirical resources regarding applicable nursing intervention research. General Requirements: • Doctoral learners are required to use Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is not required. • You are not required to submit this assignment to LopesWrite. • Review the “PICOT Decision Pathway” and “PICOT Selection Guidelines” resources. NOTE: PROPOSED PICOT QUESTION “Are families, nurses, and the organizations responsible for the medication administration errors within the pediatric care units?” This question is based on the literature review of the article by Albara Alomari and his colleague. The targeted population is the pediatric patients of ages 4 years. Directions: • Utilizing your feedback you have received on your draft PICOT question from Topic 2 DQ1, create a draft PICOT question specifically related to your project. This PICOT will be revised and in Topic 8 will be submitted for approval by the college. • Use the “PICOT Decision Pathway” to determine if your PICOT question is appropriate and can be supported with substantial research. • Using the “PICOT Question Template”, formulate an evidence-based practice (EBP) question that pertains to your project focus. • In addition to your evidence-based practice PICOT question, prepare a brief abstract about your topic. Include a rationale for why you have selected this topic and why you believe it is in line with the PICOT selection guidelines. If you have selected a route that advises caution on the “PICOT Decision Pathway” explain how you think you might mitigate complications that could occur to ensure you are able to successfully accomplish your project in a timely manner.

To Prepare: Review the concepts of informatics as presented in the Resources, particularly Rutherford, M. (2008) Standardized Nursing Language: What Does It Mean for Nursing Practice? Reflect on the role of a nurse leader as a knowledge worker. Consider how knowledge may be informed by data that is collected/accessed. The Assignment: (4-5 pages) In a 2- to 3-page paper, address the following: Explain how you would inform this nurse (and others) of the importance of standardized nursing terminologies. Describe the benefits and challenges of implementing standardized nursing terminologies in nursing practice. Be specific and provide examples. Be sure to support your paper with peer-reviewed research on standardized nursing terminologies that you consulted from the Walden Library.

Why is the concept of family health important? Consider the various strategies for health promotion. How does a nurse determine which strategy would best enable the targeted individuals to gain more control over, and improve, their health?