walden nurs6051 all week discussions latest 2016 October

Week 1 discussion

Discussion: The Effects of “To Err Is Human” in Nursing
Practice

The 1999 landmark study titled “To Err Is Human: Building a
Safer Health System” highlighted the unacceptably high incidence of U.S.
medical errors and put forth recommendations to improve patient safety. Since
its publication, the recommendations in “To Err Is Human’ have guided
significant changes in nursing practice in the United States.

In this Discussion, you will review these recommendations
and consider the role of health information technology in helping address
concerns presented in the report.

To prepare:

Review the summary of “To Err Is Human” presented in the
Plawecki and Amrhein article found in this week’s Learning Resources.

Consider the following statement:

“The most significant barrier to improving patient safety
identified in “To Err Is Human” is a “lack of awareness of the extent to which
errors occur daily in all health care settings and organizations (Wakefield,
2008).”

Review “The Quality Chasm Series: Implications for Nursing”
focusing on Table 3: “Simple Rules for the 21st Century Health Care System.”
Consider your current organization or one with which you are familiar. Reflect
on one of the rules where the “current rule” is still in operation in the
organization and consider another instance in which the organization has
effectively transitioned to the new rule.

By Day 3

Post your thoughts on how the development of information
technology has helped address the concerns about patient safety raised in the
“To Err Is Human” report. Summarize how informatics has assisted in improving
health care safety in your organization and areas where growth is still needed.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 2 discussion

Discussion: Nursing Informatics Competencies

Today’s fast-paced health care environment demands nurses to
be skilled not only in their clinical practice or specialty area but in the use
of technology tools that improve practice and lead to better patient care.
Basic and advanced technology competencies are required and expected as
technology increasingly touches and changes the job of every nurse. Numerous
organizations, including the American Nurses Association (ANA), the American
Medical Informatics Association (AMIA), and Healthcare Information and
Management Systems Society (HIMSS), have developed nurse-specific technology
competencies. The challenge for nurses is to identify both needs and training
opportunities.

In this Discussion, you identify the role informatics plays
in your professional responsibilities. You pinpoint personal gaps in skills and
knowledge and then develop a plan for self-improvement.

To prepare:

Review Nursing Informatics: Scope and Standards of Practice
in this week’s Learning Resources, focusing on the different functional areas
it describes. Consider which areas relate to your current nursing
responsibilities or to a position you held in the past. For this Discussion,
identify one or two of the most relevant functional areas.

Review the list of competencies recommended by the TIGER
Initiative. Identify at least one skill in each of the main areas (basic
computer competencies, information literacy competencies, and information
management competencies) that is pertinent to your functional area(s) and in
which you need to strengthen your abilities. Consider how you could improve
your skills in these areas and the resources within your organization that
might provide training and support.

By Day 3

Post the key functional area(s) of nursing informatics
relevant to your current position or to a position you recently held, and
briefly describe why this area(s) is relevant. Identify the TIGER competencies
you selected as essential to your functional area(s) in which you need
improvement. Describe why these competencies are necessary and outline a plan
for developing these competencies. Include any resources that are available to
you within your organization and the ways you might access those resources.
Assess how developing nursing informatics competencies would increase your
effectiveness as a nurse.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different
days using the following approach: Assume the role of a consultant. Respond to
your colleagues as someone who can offer advice on improving their skills on
the competencies they identified as needing improvement.

Week 3 discussion

Discussion: Standardized Coding Systems

As a result of the fragmented nature of the health care
system, professionals in various specialty areas of medicine have developed
their own unique sets of terminology to communicate within that specialty. In
the past, limited attention has been given to codifying practices in order for
them to be understood and utilized across disciplines or through different
information technology systems. The implementation of a federally mandated
electronic medical records system, therefore, poses a challenge to nursing
professionals and others who must be prepared to utilize standardized codes for
the new system. Why are coding standards important for promoting consistent,
high-quality care?

According to Rutherford (2008, para. 15), “Improved
communication with other nurses, health care professionals, and administrators
of the institution in which nurses work is a key benefit of using a
standardized nursing language.” In this Discussion you consider the reasoning
behind and the value of standardized codification.

To prepare

Review the information in Nursing Informatics: Scope and
Standards of Practice. Determine which set of terminologies are appropriate for
your specialty or area of expertise.

Reflect on the importance of continuity in terminology and
coding systems.

In the article, “Standardized Nursing Language: What Does It
Mean for Nursing Practice?” the author recounts a visit to a local hospital to
view its implementation of a new coding system. One of the nurses commented to
her, “We document our care using standardized nursing languages but we don’t
fully understand why we do” (Rutherford, 2008, para. 1). Consider how you would
inform this nurse (and others like her) of the importance of standardized
nursing terminologies.

Reflect on the value of using a standard language in nursing
practice. Consider if standardization can be limited to a specialty area or if
one standard language is needed across all nursing practice. Then, identify examples
of standardization in your own specialty or area of expertise. Conduct
additional research using the Walden Library that supports your thoughts on
standardization of nursing terminology.

By Day 3

Post an explanation of why nurses need to document care
using standardized nursing languages and whether this standardization can be
limited to specialty areas or if it should be across all nursing practice.
Support your response using specific examples from your own specialty or area
of expertise and using at least one additional resource from the Walden
Library.

Read a selection of your colleagues’ responses.

By Day 6

respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 4 discussion

Discussion: Current Information and Communication
Technologies

With so much attention focused on health care reform, it is
important that nurses be given the opportunity to use high-quality technology
tools. These tools can increase access to vital medical information, promote
effective communication among health care professionals, and improve the
patient experience. By actively seeking out and adopting these tools, nurses
can greatly enhance the quality and safety of care that they provide.

This Discussion focuses on identifying quality technology
tools that increase the ability of nurses to provide safe, effective care.

To prepare:

Review the various technology tools described in this week’s
Learning Resources.

Identify a recently adopted information, education, or
communication technology tool in your specialty area. Reflect on how it is used
and how its use impacts the quality of care.

Consider how your identified technology tool might impact
nursing practice if it were more widely used. What are some barriers preventing
increased usage? How could wider implementation be facilitated?

By Day 3

Post a description of a current or new information, education,
or communication technology tool that is being used in your specialty area and
assess its impact on the quality of care. Highlight the effect that increased
use of this technology would have on nursing practice and discuss the barriers
that are slowing or hindering its adoption. Summarize how adoption of the
technology tool could be facilitated.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 5 discussion

Discussion: Electronic Health Records

Electronic health records (EHRs) are at the center stage of
the effort to improve health care quality and control costs. In addition to
allowing medical practitioners to access and record clinical documentation at
much faster rates, EHRs are also positively influencing care delivery and
nurse-patient interaction. Yet despite the potential benefits of EHRs, their
implementation can be a formidable task that has broad-reaching implications
for an entire health care organization.

In this Discussion, you appraise strategies for obtaining
the benefits and overcoming the challenges of implementing and using electronic
health records.

To prepare

Review the Learning Resources focusing on the implementation
of EHRs in an organization. Reflect on the various approaches used.

If applicable, consider your own experiences with
implementing EHRs. What were some positive aspects of the implementation? What
suggestions would you make to improve the process?

Reflect on the reactions of others during the implementation
process. Were concerns handled effectively?

If you have not had any experiences with an EHR
implementation, talk to someone who has and get his or her feedback on the
experience.

Search the Walden Library for examples of effective and poor
implementation of EHRs.

By Day 3

Post an overview of at least three challenges in the
implementation of electronic health records and provide an example of each
challenge. Develop strategies for addressing each challenge based on what has
been demonstrated to be successful. Cite your resources.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 6 discussion

Discussion: Successful Implementation of Electronic Health
Information Technology

Since the inception of the HITECH Act, health organizations
have faced increased pressure to update their health information technology
(HIT) resources. As discussed last week, many believe that the increased use of
electronic health records and the quick and efficient communication afforded by
HIT can lead to improved quality of patient care. Yet there are significant
costs associated with implementing such systems. What can organizations do to
ensure that the correct system is selected and that the system will be
appropriate for those required to use it? Who should be involved in those
decisions?

This week introduces the systems development life cycle and
discusses how it can guide an organization through the complexities of adopting
a new HIT system. In this Discussion, you are asked to consider the role of
nurses in the SDLC process.

To prepare:

Review the steps of the systems development life cycle.

Think about your own organization, or one with which you are
familiar, and the steps the organization goes through when purchasing and
implementing a new HIT system.

Consider what a nurse could contribute to decisions made at
each stage when planning for new health information technology. What might be
the consequences of not involving nurses?

Reflect on your own experiences with your organization
selecting and implementing new technology. As an end user, do you feel you had
any input in the selection or and planning of the new HIT system?

By Day 3

Post an analysis of the ramifications of an organization not
involving nurses in each stage of the systems development life cycle when
purchasing and implementing a new HIT system. Give specific examples of
potential issues at each stage and how the inclusion of nurses could help avoid
such issues.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 7 discussion

Discussion: Understanding Workflow Design

As you explored last week, the implementation of a new
technology can dramatically affect the workflow of an organization. Newly
implemented technologies can initially limit the productivity of users as they
adjust to their new tools. Such implementations tend to be so significant that
they often require workflows to be redesigned in order to achieve improvements
in safety and patient outcomes. However, before workflows can be redesigned,
they must first be analyzed. This analysis includes each step in completing a
certain process. Some systems duplicate efforts or contain unnecessary steps
that waste time and money and could even jeopardize patient health care. By
reviewing and modifying the workflow, you enable greater productivity. This
drive to implement new technologies has elevated the demand for nurses who can
perform workflow analysis.

In this Discussion you explore resources that have been
designed to help guide you through the process of workflow assessment.

To prepare:

Take a few minutes and peruse the information found in the
article “Workflow Assessment for Health IT Toolkit” listed in this week’s
Learning Resources.

As you check out the information located on the different
tabs, identify key concepts that you could use to improve a workflow in your
own organization and consider how you could use them.

Go the Research tab and identify and read one article that
is of interest to you and relates to your specialty area.

By Day 3

Post a summary of three different concepts you found in
“Workflow Assessment for Health IT Toolkit” that would help in redesigning a
workflow in the organization in which you work (or one with which you are
familiar) and describe how you would apply them. Next, summarize the article
you selected and assess how you could use the information to improve workflow within
your organization. Finally, evaluate the importance of monitoring the effect of
technology on workflow.

Read a selection of your colleagues’ responses. Focus
particularly on questions raised for which you can add comments based on your
experiences or situations. Consider how your colleagues’ postings reflect
and/or differ from your own perceptions and opinions. Review the Learning
Resources for any clarification needed before responding.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 8 discussion

Discussion: Using Health Information Technology as a Source
of Evidence-Based Practice

Before the digital revolution, health information technology
supplied very limited support for evidence-based practice. If nurses wanted to
be informed about cutting-edge research, their best bet was to either subscribe
to leading journals or make periodic trips to the library. With the
establishment of research databases, however, nurses became empowered to learn
about and facilitate interdisciplinary and translational research. Databases
are just one example of how health information technology supports evidence-based
practice.

To prepare:

Read the following scenario from the text (McGonigle &
Mastrian, 2015, p. 445):

Twelve-hour shifts are problematic for patient and nurse
safety, and yet hospitals continue to keep the 12-hour shift schedule. In 2004,
the Institute of Medicine (Board on Health Care Services & Institute of
Medicine, 2004) published a report that referred to studies as early as 1988
that discussed the negative effects of rotating shifts on intervention
accuracy. Workers with 12-hour shifts realized more fatigue than workers on
8-hour shifts. In another study done in Turkey by Ilhan, Durukan, Aras,
Turkcuoglu, and Aygun (2006), factors relating to increased risk for injury
were age of 24 or less, less than 4 years of nursing experience, working in the
surgical intensive care units, and working for more than 8 hours.

Consider how the resources identified in the scenario above
could influence an organization’s practice.

Select an issue in your practice that is of concern to you.
Using health information technology, locate at least three evidence-based
practice resources that address your concern and that could possibly inform
further action.

By Day 3

Post a description of your practice concern. Outline how you
used health information technology to locate evidence-based practices that
address this concern. Cite and include insights from the resources. Analyze how
health information technology supports evidence-based practice.

Read a selection of your colleagues’ responses. Focus
particularly on those questions raised to which you can add comments based on
shared experiences or situations. Consider how your colleagues’ postings
reflect and/or differ from your own perceptions and opinions. Review the
Learning Resources for any clarification needed before responding.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 9 discussion

Discussion: HITECH Legislation

In order for organizations to receive the incentives offered
through the HITECH legislation, they must be able to demonstrate that they are
using the technology in meaningful ways. The following criteria for meaningful
use must be evident to qualify for EHR incentives (U.S. Department of Health
& Human Services, 2012). The technology must:

Improve quality, safety, and efficiency, and reduce health
disparities

Engage patients and families

Improve care coordination

Improve population and public health

Ensure adequate privacy and security protections for
personal health information

For this Discussion you consider the impact of the
meaningful use criteria of the HITECH legislation on the adoption of health
information technology.

To prepare:

Review the Learning Resources on the HITECH legislation and
its primary goals.

Reflect on the positive and negative impact this legislation
has had on your organization or one with which you are familiar.

Consider the incentives to encourage the use of EHRs. Focus
on the definition of meaningful use and how it is measured.

Reflect on how the incentives and meaningful use impact the
quality of patient care.

Find an article in the Walden Library dealing with one of
the criteria to qualify for meaningful use and how it has been successfully
met.

By Day 3

Post a description of how HITECH legislation has positively
or negatively impacted your organization. Address how its related incentives
influence the adoption of health information technology in health care and
impact the quality of patient care. Provide a summary of the article you
identified and explain how it demonstrates the ability of health information technology
to meet the requirements of meaningful use.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 10 discussion

Discussion: Security of Health Care Records

With the increase of health information technology used to
store and access patient information, the likelihood of security breaches has
also risen. In fact, according to the Canadian Medical Association Journal
(CMAJ):

In the United States, there was a whopping 97% increase in
the number of health records breached from 2010 to 2011… The number of patient
records accessed in each breach has also increased substantially, from 26,968
(in 2010) to 49,394 (in 2011). Since August 2009, when the US government
regulated that any breach affecting more than 500 patients be publicly
disclosed, a total of 385 breaches, involving more than 19 million records,
have been reported to the Department of Health and Human Services.

A large portion of those breaches, 39%, occurred because of
a lost, stolen, or otherwise compromised portable electronic device—a problem
that will likely only get worse as iPads, smartphones, and other gadgets become
more common in hospitals. (CMAJ, 2012, p. E215).

Consider your own experiences. Does your organization use
portable electronic devices? What safeguards are in place to ensure the
security of data and patient information? For this Discussion you consider
ethical and security issues surrounding the protection of digital health
information.

To prepare

Review the Learning Resources dealing with the security of
digital health care information. Reflect on your own organization or one with
which you are familiar, and think about how health information stored
electronically is protected.

Consider the nurse’s responsibility to ensure the protection
of patient information. What strategies can you use?

Reflect on ethical issues that are likely to arise with the
increased access to newer, smaller, and more powerful technology tools.

Consider strategies that can be implemented to ensure that
the use of HIT contributes to an overall culture of safety.

By Day 3

Post an analysis of the nurse’s responsibility to protect
patient information and the extent that HIT has made it easier or more
difficult to protect patient privacy. Comment on any security or ethical issues
related to the use of portable devices to store information. Assess the
strategies your organization uses to safeguard patient information and how
these promote a culture of safety. Describe an area where improvement is needed
and one strategy that could address the situation.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or research.

Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional
research.

Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 11 discussion

Discussion: Health Literacy

In order to effectively manage their own health, individuals
need to have competencies in two areas—basic literacy and basic health
literacy. What is the difference? Basic literacy refers to the ability to read,
even simple language. Health literacy is defined as, “the degree to which
individuals have the capacity to obtain, process, and understand basic health
information and services needed to make appropriate health decisions” (National
Coalition for Literacy, 2009). Unfortunately, according to a Department of
Education report on health literacy, only 12% of adults aged 16 and older are
considered to have a proficient level of health literacy (U.S. Department of
Education, 2006). Acquiring health literacy skills has become more complicated
with the explosion of online health information, some credible and some
misleading.

In this Discussion, you focus on how to help individuals
find credible information on the Internet and develop strategies nurses can use
to increase the health literacy of their patients.

To prepare:

Think about the nurse’s role in improving the health
literacy of patients.

Consider the many ways patients access health information,
including blogs, social media, patient portals, websites, etc.

Reflect on experiences you have had with patients who
self-diagnose using online medical sources.

Using the Internet, the Walden Library, or other trustworthy
sources, identify a resource that you could introduce to patients to help them
evaluate the credibility of health information found online.

What are some strategies you could employ to improve the
health literacy of patients?

By Day 3

Post your assessment of the nurse’s role in improving the
health literacy of patients. Then, identify the resource you would recommend to
patients for evaluating online health information and why it would be
beneficial. Describe additional strategies for assisting patients in becoming
informed consumers of online health information.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different
days using one or more of the following approaches:

Ask a probing question, substantiated with additional
background information, evidence or

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