Reflect on your experiences with the integration of new technology. How have these implementations affected the procedures that you perform at work?

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HIT Usability and Design Challenges

 

Reflect on your experiences with the integration of new technology. How have these implementations affected the procedures that you perform at work? As the end user, it can be easy to overlook all of the important decisions that went into the finished product that you see before you. In looking at the final data management screens, you may find yourself at the crossroads of two options. You may either 1) be ecstatic about the needed change that this system brought, or 2) frustrated because you feel the system brings new hurdles into your already busy day. If you have ever experienced the latter option, the comment “I could have implemented a better system than this” may resonate strongly with you. Though research agrees that user input assists HIT designers, the development and implementation of new systems is not as straightforward as it may appear. HIT development teams find themselves in constant phases of trial and error as they strive to meet the needs of all users within the proposed development timeline. Failure to achieve promised usability benefits can lead to increased costs and job complications. Applying effective strategies to overcome usability challenges is essential.
In this week’s Discussion, you move from the standpoint of the “outsider looking in” (end user) and place yourself into a real-world implementation example. To complete this Discussion, you evaluate a case study to determine where the implementation process took a wrong turn. Use this week’s Learning Resources to propose changes that could have put this operation on the road to success.

 

To prepare:

  • Review      the Learning Resources, focusing on the TIGER Usability and Clinical      Application Design Collaborative.
  • Consider      the “Best Practice Exemplars” provided in the course text Nursing      Informatics: Where Technology and Caring Meet.
  • Review      “Case Study 1: A Usability and Clinical Application Design Challenge”      presented on page 238 of the course text Nursing Informatics:      Where Technology and Caring Meet. (see bottom of this page for the      case study)
  • Determine      the causes of the noted usability challenges (i.e., human factors,      ergonomics, human-computer interaction), as well as potential usability      concerns experienced by staff during implementation. Consider the possible      design failures that lead to the usability challenges.
  • What      strategies might you employ to overcome these HIT usability challenges and      concerns?

By tomorrow Tuesday 10/03/17, 5 pm, write a minimum of 550 words essay in APA format with a minimum of 3 references from the list of Required Readings below. Include all level one headings as numbered below:

 

post a cohesive response to the following:

  • Place      yourself in the role of the clinical administrator tasked with      implementing the case study’s new health information technology system.

1) Evaluate the usability challenges that you faced during implementation as well as the factors that caused these challenges.

2) Determine whether these challenges were a result of implementation or design.

3) Formulate strategies for overcoming these usability challenges.

Required Readings

Course Text: Ball, M. J., Douglas, J. V., Hinton Walker, P., DuLong, D., Gugerty, B., Hannah, K. J., . . . Troseth, M. R. (Eds.) (2011). Nursing informatics: Where technology and caring meet (4th ed.). London, England: Springer-Verlag.

  • Chapter      14, “Usability and Clinical Application Design”

This chapter begins by defining the terms usability and application design as they are used in the field of nursing informatics. The authors then describe the literature review and analytic process that the TIGER Collaborative group underwent to positively transform the development of HIT systems.

Gruber, D., Cummings, G. G., LeBlanc, L., & Smith, D. L. (2009). Factors influencing outcomes of clinical information systems implementation: A systematic review. CIN: Computers, Informatics, Nursing, 27(3), 151–163.

The authors analyze the outcomes of prior IT implementations to determine if certain strategies can guarantee success when launching new clinical information systems.

Kaufman, D., Roberts, W. D., Merrill, J., Lai, T., & Bakken, S. (2006). Applying an evaluation framework for health information system design, development, and implementation. Nursing Research, 55(2, Suppl. 1), S37–S42.

This article emphasizes the indispensable role of continuous evaluation throughout the development and real-time application of new information systems into the workplace.

Schlotzer, A., & Madsen, M. (2010). Health information systems: Requirements and characteristics. Studies in Health Technology and Informatics, 151, 156–166.

Use this article to examine the importance of focusing on sound design, interoperability of systems, and fulfillment of user needs when developing an effective database.

Case Study 1: A Usability and Clinical Application Design Challenge 

A medical center implemented an EMR with orders, clinical documentation, and results retrieval to improve efficiencies and enhance patient safety in the perinatal units of a small medical center, including Labor and Delivery (L& D), NICU, and Newborn Nursery Selection process The system was installed elsewhere in this integrated delivery network The executives wanted a fast 6-month installation at the maximum Usability challenges Existing order sets and documents from other sites were not uploaded and tailored to this site. Clinicians were asked to input individual orders (not acceptable). Needed computer terminals were ordered late and arrived the day of go-live. Clinicians competed for working terminals at the nurses’ stations Workflow among units was not considered or tested. Shared information such as mother’s blood type and L& D information was not available to NICU or Newborn Nursery, causing confusion about potential patient safety issues Generic training was given because the site tailoring was not done. On go-live, users did not know where to locate information before it had changed in the lag between training and go-live Outcomes The clinicians had to endure an unnecessarily painful implementation and its potential patient safety impacts Working out usability issues took months after go-live

The system was tested/ validated for usability, design, and practice needs Education included practice changes along with how to use the system Developed a methodology to respond rapidly to end users Outcomes Standardized practice in three different acute care hospitals in 15 months Significant improvement in core measures and nurse-sensitive outcomes.

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It is important to identify health issues or concerns that may impact an individual or family in any setting.  This identification can help the nurse to address health promotion and disease prevention.

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Home Safety Assessment

It is important to identify health issues or concerns that may impact an individual or family in any setting.  This identification can help the nurse to address health promotion and disease prevention.

To complete this activity, you must complete the Family Support Assessment activity.  Click on Enter Sentinel City®.  Once in the city, click on the map to locate the apartment dwelling in Nightingale Square.  Approach the door next to the laundromat and enter the apartment.  Here you will complete the Home Safety Assessment by noting any health, safety, and environmental hazards in the apartment.  Note as many of the hazards that you observe.  Select and prioritize the top two hazards for health, safety, and environmental areas for a total of six hazards that the healthcare professional should address first:

  1. #1 = most serious hazard-life threatening
  2. #2 = second most important-potential to affect the most people or cause long-term injury

Try to avoid prioritizing the same hazard in multiple categories.  Provide an evidence-based rationale and a recommendation for addressing the top two hazards in each category.  Click the “Family Support Assessment” tab at the top of the screen and review the information on the form.

Reading and Resources

Chapter 16 pages 297-316, Chapter 23 pages 395-404, Chapter 20 pages 367-375, Chapter 26 pages 439-447 in Fundamentals of Case Management Practice.

Review clinical guidelines of the AHRQ

Clinical Guidelines and Recommendations

Evidence-based research provides the basis for sound clinical practice guidelines and recommendations. The datab…

Additional Instructions:

  • All submissions should have a title page and reference page.
  • Utilize a minimum of two scholarly resources.
  • Adhere to grammar, spelling and punctuation criteria.
  • Adhere to APA compliance guidelines.
  • Adhere to the chosen Submission Option for Delivery of Activity guidelines.

**Family Support Assessment Required

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Dashboard Analysis and Nursing Plan

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Week 5 Assignment: Dashboard Analysis and Nursing Plan

 

Alexis Nicole Runge

 

Walden University

 

NURS 4005/NURS 4006: Topics in Clinical Nursing

 

May 12, 2017

 

 

 

 

 

 

 

 

 

 

 

Dashboard Analysis and Nursing Plan

 

In order for health care facilities to enhance and improve the care they deliver to their patients, they rely on data collected within their facility and from surveys sent out to patients. The information collected is formatted into a quarterly dashboard where goals are set for each quality indicator and then interpreted if the facility met those goals. Through the use of dashboards and quality indicators proactive decisions can be made based on actual events occurring, rather than changing the plan of care based on assumptions. The dashboard is effective in determining particular areas in which improvements would be beneficial to not only the care of the patient but the overall morale of the health care facility. The dashboard is also helpful in strategic planning, where the assessment of performance can be undertaken (Tomlinson, Hewitt, & Blackshaw, 2013). The overall objective of this paper is to analyze areas where the facility excels, and determining a plan of action to improve negative performance by utilizing evidenced based practice.

After carefully analyzing the data presented in this week’s dashboard, communication between the nurses and the patients excels. Nurses develop a good rapport with the majority of their patients and give thorough explanations of the care provided. However, their promptness and attention to detail needs to be an area addressed to improve patient outcomes. Thus, could also be the result of negative data reflected on the dashboard that represents patient safety measures such as falls, pressure ulcers, mislabeled specimens and uncontrolled pain. Patient safety is crucial in the plan of care and if not carefully addressed could lead to adverse events and outcomes.

Paying attention to details is important for avoiding errors, maintaining efficiency, preventing injuries, making a good impression and analyzing information. Attention to detail improves accuracy in performing tasks. Preventing errors is valuable when providing care to all patients. Careful management of details contributes to overall efficiency and success in the healthcare facility. Reducing errors also contributes to patient satisfaction. By developing a nurse-patient relationship you are able to address needs and concerns of the patient, as well as pick up on detail-oriented cues that will need implemented for each individual patient in order to maintain a balance of trust and communication during the patients stay.

Attention of detail leads to patient safety. Patient safety throughout the hospital should be developed by the leadership. Leadership assumes a role in establishing a culture of safety that minimizes hazards and patient harm by focusing on processes of care. The leaders of the organization are responsible for fostering an environment through their personal example; emphasizing patient safety as an organizational priority; providing education to medical and hospital staff regarding the commitment to reduction of medical errors; supporting proactive reduction in medical/health care errors; and integrating patient safety priorities into the new design and redesign of all relevant organization processes, functions and services (IHI, 2017).

There are many quality indicators that fall into the category of patient safety such as: medication errors or adverse events, pressure ulcers, falls, restraint use, nosocomial infections, VTE, etc. Various tools can be set in place to ensure adequate monitoring of these areas to protect the patients and the facility. Conducting a thorough head-to-toe physical examination on admission is a high priority. Patients come into the hospital and we treat their presenting symptoms, however many times there may be an underlining problem that needs addressed to ensure an optimal outcome and patient experience. A full physical assessment gives you a thorough picture of the patient’s condition.

Best practice would be to conduct a fall risk assessment and a skin risk assessment on each patient every shift or as needed if there has been a change in the patient’s condition. With a fall risk assessment, it can determine what interventions need put in place to ensure patients are free from physical injury while in our care. The fall risk assessment we use at our facility is similar to the one presented by John Hopkins, called the JHFRAT (Hopkins Medicine, 2017). The fall risk assessment tool addresses various patient safety indicators such as: age, history of falls within 6 months, elimination of bowel and bladder (incontinence, urgency or frequency), medications (PCA/opiates, anticonvulsants, antihypertensive, diuretics, hypnotics, laxatives, sedatives, psychotropic, etc.), use of patient care equipment (IV infusion, chest tube, indwelling catheter, SCDs, etc.), mobility (unsteady gait or needs assistance), sensations (decrease in hearing, vision, etc.), and cognition (impulsive behavior, sedation, or altered mental status). If the patient scores greater than 6 then they are required to wear fall risk socks, fall risk bracelet, and bed/chair alarms are put in place. This is a great tool as we can reassess it multiple times throughout the day to ensure the safety of the patient and decrease the rate of falls on our dashboard to improve quality indicators. It also shows the patients that we are concerned for their safety and are putting all measures of safety in place to ensure a positive outcome.

Another best practice tool we can utilize would be the skin risk assessment to prevent and manage pressure ulcers. The Braden Scale for predicting pressure sore risk is a clinically validated tool that allows nurses and other health care providers to reliably score a patient/client’s level of risk for developing pressure ulcers. It measures functional capabilities of the patient that contribute to either higher intensity and duration of pressure or lower tissue tolerance for pressure. Lower levels of functioning indicate higher levels of risk for pressure ulcer development (NLM, 2013). The Braden Scale uses various categories to determine the patient’s skin risk such as: sensory perception (ability to respond meaningfully to pressure-related discomfort), moisture (degree to which skin is exposed to moisture), physical activity (degree of physical activity), mobility (ability to change and control body positions), nutrition (usual food intake pattern), and friction and shear risk. A score of 18 or below alerts the nurse that the patient may be at risk for pressure areas, a score 9 or less determines that the patient is high risk. Interventions should be put in place to prevent pressure ulcers for at risk patients. The nurses should be required to inspect patients skin each shift, manage moisture on the skin, conduct a skin risk assessment each shift or as needed if there is a change in the patient’s condition, minimize pressure to bony prominence by reposition patient every 1-2 hours, increasing nutrition intake and hydration (if the patient is unable to consume these orally then intravenous methods need to be implemented). By completing each of these steps for all patients it will prevent secondary diagnosis and prolonging of patient stay. Maintaining skin integrity will increase the patient’s outcome and satisfaction.

Through the use of quality indicators and data collection we have the ability to improve our patient satisfaction and the care we deliver on a daily basis. By utilizing best practices to maintain patient safety and recognizing the needs and concerns of our patients we can achieve high standards. We must realize though that perfect scores across the dashboard is unrealistic. Health care and evidenced-based practices are always changes and the care we are providing is becoming more acute. By continuing our education and having our patient’s safety as our number one priority we will continue to excel in the health care continuum.

 

 

 

 

 

Reference

Tomlinson, P., Hewitt, S., & Blackshaw, N. (2013). Joining up health and planning: How Joint Strategic Needs Assessment (JSNA) can inform health and wellbeing strategies and spatial planning. Perspectives In Public Health, 133(5), 254-262. Retrieved from: http://dx.doi.org/10.1177/1757913913488331

Institute for Healthcare Improvement. (2017). Patient Safety Plan. St. Francis Health System: St. Joseph Medical Center. Bloomington, Illinois. Retrieved from: http://www.ihi.org/resources/Pages/Tools/PatientSafetyPlan.aspx

Hopkins Medicine. (2017). Fall Risk Assessment: JHFRAT. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. Retrieved from: http://www.hopkinsmedicine.org/institute_nursing/models_tools/fall_risk.html

National Library of Medication. (2013). Braden Scale. National Institutes of Health, Health & Human Services. Retrieved from: https://www.nlm.nih.gov/research/umls/sourcereleasedocs/current/LNC_BRADEN/

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COMM 1034 – Professional Correspondence Assignment (20%) Due WEEK 4 – Sept.28 (b

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COMM 1034 – Professional Correspondence Assignment (20%)
Due WEEK 4 – Sept.28 (by 11:59:59pm). Submit on Blackboard
Please note: late assignments are subject to a 10% per day late penalty (up to one week,
after which assignments will not be graded). Please see the missed assignment policy.
Academic Policy violations (i.e. plagiarism) will be awarded a grade of zero.
Instructions:
The purpose of this assignment is to evaluate your ability to understand your audience and
purpose, as well as select the right approach. Working individually, you will write two concise,
appropriate emails. You will be evaluated on your tone, content, format, and writing skills.
You will submit this assignment through Blackboard. If you have any questions about submitting
assignments through Blackboard, please ask for help.
Situation:
As a manager in your department, you have organized an important conference in Toronto that
will be attended by film industry professionals from across North America. As a gesture, you have
invited and paid for five department interns to attend the conference.
However, a few weeks before the conference, you noticed at a department luncheon that several
of your interns were acting inappropriately. Specifically, some were holding a loud conversation
that included lewd, unprofessional jokes about several co-workers. You also noticed that their
clothing is consistently sloppy, and at lunch one day, you saw one intern lift his bowl to his lips to
slurp his soup while another belched loudly and laughed.
You have become increasingly concerned that your interns will act inappropriately at the
conference events and will damage your reputation.
Thus, you’ve decided to organize an etiquette workshop for your entire department to not only
improve the interns’ behaviour in the workplace, but also to ensure your entire department is
prepared for acting professionally at the conference.
You did some research and discovered a company called Decorum Business Training. Decorum
runs workshops on a variety of areas pertaining to business etiquette, including everything from
dress to elocution.
You need to write two emails: one to Decorum’s business contact, Lucinda Leplastrier, to
inquire about arranging a workshop for your department; you also need to send a second email
to your department making them aware of the upcoming workshop.
Step One: Plan
In your department, discuss what the content of your e-mails should include.
For the first email, what kind of specific questions will you need to ask Lucinda Leplastrier? What
kind of information will she need to provide? What tone should you use in your email?
For the second email, what will your employees need to know about the etiquette workshops?
What kind of information do you need to provide for them? What information should you
exclude? What tone should you use?
Step Two: Write
Email One: Write an email to Lucinda Leplastrier asking specific questions about Decorum’s
services. Be sure to provide information that will allow her to understand your department’s
needs. Remember to choose your questions carefully; phrase your questions to be as specific as
possible to help ensure you receive all the information you require. Invent details as necessary.
Email Two: Based on your correspondence, Lucinda Leplastrier has designed a workshop for
teaching workplace etiquette to your department. She’ll be leading the workshop on a date prior
to the conference. Now, you need to email your department and let them know about the
upcoming workshop. Be sure to be specific when you provide them with all the information
they’ll need to attend. Invent details as necessary.
Use Microsoft Word to type your assignment (just format the page it as if it were an email).

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Due WEEK 4 – Sept.28 (b appeared first on homework handlers.