NURS 6051 Transforming Nursing and Healthcare Through Technology

NURS 6051 Week 1 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: The Effects of “To Err Is Human” in Nursing Practice Discussion, you will review these recommendations and consider the role of health information technology in helping address concerns presented in the report.Discussion: The Effects of “To Err Is Human” in Nursing Practice

To prepare for Discussion: The Effects of “To Err Is Human” in Nursing Practic:

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

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

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

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NURS 6051 Week 4 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.

NURS 6051 Week 3 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.

NURS 6051 Week 2 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.

NURS 6051 Week 4 Assignment: Using the Data/Information/Knowledge/Wisdom Continuum

Have you ever gone online to search for a journal article on a specific topic? It is amazing to see the large number of journals that are available in the health care field. When you view the library in its entirety, you are viewing untapped data. Until you actually research for your particular topic, there is little structure. Once you have narrowed it down, you have information and once you apply the information, you have knowledge. Eventually, after thoughtful research and diligent practice, you reach the level of wisdom—knowledge applied in meaningful ways.

Are there areas in your practice that you believe should be more fully explored? The central aims of nursing informatics are to manage and communicate data, information, knowledge, and wisdom. This continuum represents the overarching structure of nursing informatics. In this Assignment, you develop a research question relevant to your practice area and relate how you would work through the progression from data to information, knowledge, and wisdom.

To prepare:

Review the information in Figure 6–2 in Nursing Informatics and the Foundation of Knowledge.

Develop a clinical question related to your area of practice that you would like to explore.

Consider what you currently know about this topic. What additional information would you need to answer the question?

Using the continuum of data, information, knowledge, and wisdom, determine how you would go about researching your question.

Explore the available databases in the Walden Library. Identify which of these databases you would use to find the information or data you need.

Once you have identified useful databases, how would you go about finding the most relevant articles and information?

Consider how you would extract the relevant information from the articles.

How would you take the information and organize it in a way that was useful? How could you take the step from simply having useful knowledge to gaining wisdom?

By Day 7 of Week 4

Write a 3- to 4-page paper that addresses the following:

Summarize the question you developed, and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific.

Identify the databases and search words you would use.

Relate how you would take the information gleaned and turn it into useable knowledge.

Can informatics be used to gain wisdom? Describe how you would progress from simply having useful knowledge to the wisdom to make decisions about the information you have found during your database search.

Your paper must also include a title page, an introduction, a summary, and a reference page

NURS 6051 Week 5 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.

NURS 6051 Week 6 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.

NURS 6051 Week 6 Assignment: Application: Adoption of New Technology Systems

As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.

Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:

Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.

Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.

Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.

Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.

Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.

Note: You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.

For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.

To prepare

Review the Learning Resources this week about successful implementations of EHRs.

Consider how you would present the new EHR system to the nurses to win their approval.

Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success?

By Day 7 of Week 6

Write a 3- to 5-page paper which includes the following:

Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting with the nurses. Be specific as to the types of information or activities you could provide to address each area and include how you would respond to resistance.

Analyze the role of nurses as change agents in facilitating the adoption of new technology.

NURS 6051 Week 7 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.

NURS 6051 Week 8 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, 2011, p. 482):

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