NR-361 Week 5 Discussion: Documentation and Reimbursement
NR-361 Week 5 Discussion: Documentation and Reimbursement
NR-361 Week 5 Discussion: Documentation and Reimbursement
One standardized terminology that is very crucial in healthcare is the term Interoperability. Hebda, Hunter, and Czar define interoperability as “the ability to exchange information across systems” (Hebda, Hunter, & Czar, 2019, p. 156). I believe this especially important when caring for patients in a hospital setting, because so many members of the healthcare team need to document on the care provided. Many disease processes require multidisciplinary teams to treat and care for those patients. One example of this is the care for a stroke (CVA) patient. Once on an inpatient unit, members of the care team include attending physician, Neurology physician, nurses, pharmacist, physical therapist, occupational therapist, speech language pathologist, case manager, and possibly operating room nurses and Neurosurgeons or interventional radiology physicians and nurses (Clarke & Foster, 2015). At my hospital for example, all of these disciplines do not use the same program for charting. My hospital uses Cerner as their EMR system, but each discipline uses their own version. PT, OT, and SLP all use different forms for their charting, which are all accessible for nursing staff to view, but it is not as streamline as one would hope. The forms that PT, OT, and SLP use all include ICD coding, that us nurses are not taught to identify. OR and IR nurses use different charting programs that do not easily cross-over to inpatient nursing documentation. For this reason, many nursing interventions done in the OR or IR are not properly documented, such as new IV placements and indwelling catheter insertions. I believe interoperability in healthcare informatics definitely has room for improvement. The shift to all electronic medical records has greatly enhanced the outcomes for patients. Making all this documentation easy to read and more streamline would help inpatient nurses like me to connect the dots when doing research on my patients. Understanding what each discipline is doing will help the healthcare team members work better together.
References
Clarke, D. J., & Foster, A. (2015). Improving post-stroke recovery: the role of the multidisciplinary health care team. Journal of multidisciplinary healthcare, 8, 433-442. https://doi.org/10.2147/JMDH.S68764
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Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses & healthcare professionals (6th ed.). Pearson.
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.
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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.
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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.
Participation: RN-to-BSN
In discussions, you, as a student, will interact with your instructor and classmates to explore topics related to the content of this course. You will be graded for the following.
1. Attendance
Discussions (graded): Discussions are a critical learning experience in the online classroom. Participation in all discussions is required.
2. Guidelines and Rubric for Discussions
PURPOSE: Threaded discussions are designed to promote dialogue between faculty and students, and students and their peers. In the discussions students:
- Demonstrate understanding of concepts for the week
- Integrate scholarly resources
- Engage in meaningful dialogue with classmates
- Express opinions clearly and logically, in a professional manner
Participation Requirement: You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday.
Participation points: It is expected that you will meet the minimum participation requirement described above. If not:
- You will receive a 10% point deduction in a thread if your response to the initial question is not posted by 11:59 p.m. MT on Wednesday
- You will also receive a 10% point deduction in a thread if you do not post at least three (3) times in each thread on at least two (2) separate days.
3. Threaded Discussion Guiding Principles
The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
4. Participation Guidelines
You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday. Discussions for each week close on Sunday at 11:59 p.m. Mountain Time (MT). To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. For courses with Week 8 graded discussions, the threads will close on Wednesday at 11:59 p.m. MT. All discussion requirements must be met by that deadline.
5. Grading Rubric
Discussion Criteria | A (100%) Outstanding or highest level of performance |
B (87%) Very good or high level of performance |
C (76%) Competent or satisfactory level of performance |
F (0) Poor or failing or unsatisfactory level of performance |
---|---|---|---|---|
Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week. 16 points |
Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.16 points | Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.14 points | Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.12 points | Minimally addresses the initial discussion question(s) or does not address the initial question(s).0 points |
Integrates evidence to support discussion. Sources are credited.* ( APA format not required) 12 points |
Integrates evidence to support your discussion from:
Sources are credited.* 12 points |
Integrates evidence to support discussion from:
Sources are credited.* 10 points |
Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.Sources are credited.*
9 points |
Does not integrate any evidence.0 points |
Engages in meaningful dialogue with classmates or instructor before the end of the week. 14 points |
Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.14 points | Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.12 points | Responds to a classmate and/or instructor but does not further the discussion.10 points | No response post to another student or instructor.0 points |
Communicates in a professional manner. 8 points |
Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).8 points | Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).7 points | Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).6 points | Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).0 points |
PARTICIPATION: Response to initial question: Responds to initial discussion question(s) by Wednesday, 11:59 p.m. M.T. |
0 points lost
Student posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT. |
-5 points
Student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT. |
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PARTICIPATION Total posts: Participates in the discussion thread at least three times on at least two different days. |
0 points lost
Posts in the discussion at least three times AND on two different days. |
-5 points
Posts fewer than three times OR does not participate on at least two different days. |
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NOTES: * Credited means stating where the information came from (specific article, text, or lesson). Examples: Our text discusses…. The information from our lesson states…, Smith (2010) claimed that…, Mary Manners (personal communication, November 17, 2011)…. APA formatting is not required. |
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** Assigned readings are those listed on the syllabus or assignments page as required reading. This may include text readings, required articles, or required websites. | ||||
*** Scholarly source – per the APA Guidelines in Course Resources, only scholarly sources should be used in assignments. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Wikipedia, Wikis, .com website or blogs should not be used as anyone can add to these. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. Outside sources do not include assigned required readings. | ||||
NOTE: A zero is the lowest score that a student can be assigned. |