NR 599 Nursing Informatics for Advanced Practice Week 3 and 5 Discussion

NR 599 Nursing Informatics for Advanced Practice Week 3 and 5 Discussion

NR 599 Nursing Informatics for Advanced Practice Week 3 and 5 Discussion

Week 3 Discussion EHRs Benefits and Drawbacks

2. Refer to the Stage 3 objectives for Meaningful Use located in this week’s lesson under the heading Meaningful Use and the HITECH Act. Select two objectives to research further. In your own words, provide a brief discussion as to how the objective may impact your role as an APN in clinical practice.  

Generate and transmit prescriptions electronically: this objective strives to ensure all eligible hospitals and critical access hospitals use electronic health record technology to transmit prescriptions to patients (CMS, 2018). Under stage 2 controlled substances were excluded but under stage 3 e-prescribing of controlled substances is included in states where allowable (CMS, 2018). As an Advanced Practice Provider, I will have to be knowledgeable about prescribing restrictions. For example, in my state of Wisconsin, there are restrictions on prescribing controlled substances (Board of Nursing, 2019). Regardless of eligibility under the objective, I will be unable to prescribe any schedule I controlled substance (Board of Nursing, 2019). One of the factors in my ability to meet this objective is the training I receive. Proper training to ensure correct utilization of the organization’s EHR to e-prescribe will be vital. Beykloo, et al. states that use of the EHR for prescribing increases patient safety by reducing risk of errors, but can add to workflow thereby increasing provider frustration (The impact of electronic prescribing, 2019). To decrease workload, reduce steps in the process, and decrease frustration, providers often use workarounds (Beykloo, et al., 2019). Although workarounds can save time, they are not best practice and can lead to adverse events or poor patient outcomes.

Actively engage in public health: this objective requires providers to show active engagement with public health agencies by meeting at least 2 of the 5 different public health measures (Forward Health, 2023). These measures are: immunization registry reporting, syndromic surveillance reporting, electronic case reporting, public health registry reporting, and clinical data registry reporting (Forward Health, 2023). Meeting these public health measures are vital in my future practice to promote the overall health of the community by focusing on the social, economic, and environmental factors that contribute to patient well-being (Bekemeier, et al., 2021). As Advanced Practice Providers, we have the capacity to work in diverse settings such as health departments, nonprofits, and complex care systems in our community. Being able and willing to engage the fore-mentioned public health measures will guide us to provide better care to the patients we serve in our future practice (Bekemeier, et al., 2021).

Aveyard, H., Butcher, D. & Forde-Johnston, C. (2022). An integrative review exploring the impact of electronic health records (HER) on the quality of nurse-patient interactions and communication. JAN, 79(1), 48-67. Retrieved on 03/19/2023 from: https://onlinelibrary.wiley.com/doi/full/10.1111/jan.15484Links to an external site.

Adebowale, A., Amanullah, S. & Gopidasan, B. (2022). Electronic medical records – a review of cost-effectiveness, efficiency, quality of care, and usability. Journal of Psychiatry Spectrum, 1(2), 76-79. DOI: 10.4103/jopsys.jopsys_17_22. Retrieved on 03/19/2023 from: https://journals.lww.com/jops/Fulltext/2022/07000/Electronic_Medical_Records___A_Review_of.2.aspxLinks to an external site.

Bekemeier, B., Johnson, K., Kaneshiro, J., Kuehnert, P., Swider, S. & Zahner, S. (2021). A critical gap: advanced practice nurses focused on the public’s health. Elsevier Public Health Emergency Collection, 69(5), 865-874. doi:10.1016/j.outlook.2021.03.023. Retrieved on 03/19/2023 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092811/Links to an external site.

Beykloo, M., Blandford, A., Franklin, B., Furniss, D., Ma, T., McLeod, M. & Mohsin-Shaikh, S. (2019). The impact of electronic prescribing systems on healthcare professionals’ working practices in the hospital setting: a systematic review and narrative synthesis. BMC Health Services Research, 19. Retrieved on 03/19/2023 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6806498/Links to an external site.

Board of Nursing (2019). Chapter N8. Wisconsin Legislature. Retrieved on 03/18/2023 from: https://docs.legis.wisconsin.gov/code/admin_code/n/8.pdfLinks to an external site.

Bohsali, F., Chisolm, M. & Wolfe, L. (2018). Clinically excellent use of the electronic health record: review. JMIR Human Factors, 5(4). doi: 10.2196/10426. Retrieved on 03/18/2023 from: https://humanfactors.jmir.org/2018/4/e10426/Links to an external site.

CMS (2018). Medicare promoting interoperability program stage 3 eligible hospitals, critical access hospitals, and dual-eligible hospitals attesting to CMS objectives and measures for 2018. Department of Health and Human Services. Retrieved on 03/18/2023 from: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/MedicareEHStage3_Obj2.pdfLinks to an external site.

Dyrbye, L., Melnick, E., Nedelec, L., Shanafelt, T., Sinsky, C., Trockel, M., Tutty, M. & West, C. (2019). The association between perceived electronic health record usability and professional burnout among US physicians. Mayo Clinic Proceedings, 95(3), 476-487. Retrieved on 03/18/2023 from: https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0025619619308365?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0025619619308365%3Fshowall%3Dtrue&referrerLinks to an external site.=

Eltair, S., Faber, K. & Pagulayan, J. (2018). Use the nursing process to take advantage of EHR’s capabilities and optimize patient care. The American Nurse Journal. Retrieved on 03/18/2023 from: https://www.myamericannurse.com/documentation-electronic-health-record/Links to an external site.

Forward Health (2023). Promoting interoperability program: meaningful use of certified EHR technology. Department of Health Services. Retrieved on 03/19/2023 from: https://www.forwardhealth.wi.gov/WIPortal/Subsystem/KW/Print.aspx?ia=1&p=1&sa=15&s=11&c=637&ntLinks to an external site.=

Purpose

The ideas and beliefs underpinning the discussions 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 ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

Contribute level-appropriate knowledge and experience to the topic in a discussion environment that models professional and social interaction (CO4)

Actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty (CO5)

Requirements:

Post a written response in the discussion forum to EACH threaded discussion topic:

As discussed in the lesson and assigned reading for this week, EHRs provide both benefits and drawbacks. Create a “Pros” versus “Cons” table and include at least 3 items for each list. Next to each item, provide a brief rationale as to why you selected to include it on the respective list.

Refer to the Stage 3 objectives for Meaningful Use located in this week’s lesson under the heading Meaningful Use and the HITECH Act. Select two objectives to research further. In your own words, provide a brief discussion as to how the objective may impact your role as an APN in clinical practice.

Adhere to the following guidelines regarding quality for the threaded discussions in Canvas:

Application of Course Knowledge: Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings.

Scholarliness and Scholarly Sources: Demonstrates achievement of scholarly inquiry for professional and academic decisions using valid, relevant, and reliable outside scholarly source to contribute to the discussion thread.

Writing Mechanics: Grammar, spelling, syntax, and punctuation are accurate. In-text and reference citations should be formatted using correct APA guidelines.

Direct Quotes: Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category.

For each threaded discussion per week, the student will select no less than TWO scholarly sources to support the initial discussion post.

NR599 Nursing Informatics for Advanced Practice

Week 5 Discussion

Clinical Decision Support Systems

Purpose

The ideas and beliefs underpinning the discussions 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 ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

Contribute level-appropriate knowledge and experience to the topic in a discussion environment that models professional and social interaction (CO4)

Actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty (CO5)

Requirements:

Post a written response in the discussion forum to EACH threaded discussion topic:

This week we learned about the potential benefits and drawbacks to clinical decision support systems (CDSSs). Create a “Pros” versus “Cons” table with a column for “Pro” and a separate column for “Con”. Include at least 3 items for each column. Next to each item, provide a brief rationale as to why you included it on the respective list.

The primary goal of a CDSS is to leverage data and the scientific evidence to help guide appropriate decision making. CDSSs directly assist the clinician in making decisions about specific patients. For this discussion thread post, you are to assume your future role as an APN and create a clinical patient and scenario to illustrate an exemplary depiction of how a CDSS might influence your decision. This post is an opportunity for you to be innovative, so have fun!

Adhere to the following guidelines regarding quality for the threaded discussions in Canvas:

Application of Course Knowledge: Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings.

Scholarliness and Scholarly Sources: Demonstrates achievement of scholarly inquiry for professional and academic decisions using valid, relevant, and reliable outside scholarly source to contribute to the discussion thread.

Writing Mechanics: Grammar, spelling, syntax, and punctuation are accurate. In-text and reference citations should be formatted using correct APA guidelines.

Direct Quotes: Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category.

For each threaded discussion per week, the student will select no less than TWO scholarly sources to support the initial discussion post.