INTERACTION BETWEEN NURSE INFORMATICISTS AND OTHER SPECIALISTS
Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.
Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.
In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.
RESOURCES
Be sure to review the Learning Resources before completing this activity.Click the weekly resources link to access the resources.
Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive LeadershipLinks to an external site.. JONA: The Journal of Nursing Administration, 49(11), 543-548.
This criterion is linked to a Learning OutcomeMain Posting
50 to >44.0 pts
Excellent
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. … Supported by at least three current, credible sources. … Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
44 to >39.0 pts
Good
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. … At least 75% of post has exceptional depth and breadth. … Supported by at least three credible sources. … Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
39 to >34.0 pts
Fair
Responds to some of the discussion question(s). … One or two criteria are not addressed or are superficially addressed. … Is somewhat lacking reflection and critical analysis and synthesis. … Somewhat represents knowledge gained from the course readings for the module. … Post is cited with two credible sources. … Written somewhat concisely; may contain more than two spelling or grammatical errors. … Contains some APA formatting errors.
34 to >0 pts
Poor
Does not respond to the discussion question(s) adequately. … Lacks depth or superficially addresses criteria. … Lacks reflection and critical analysis and synthesis. … Does not represent knowledge gained from the course readings for the module. … Contains only one or no credible sources. … Not written clearly or concisely. … Contains more than two spelling or grammatical errors. … Does not adhere to current APA manual writing rules and style.
The term “knowledge worker†was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?
Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.
In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker.
Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.
RESOURCES
Be sure to review the Learning Resources before completing this activity.Click the weekly resources link to access the resources.
Review the concepts of informatics as presented in the Resources.
Reflect on the role of a nurse leader as a knowledge worker.
Consider how knowledge may be informed by data that is collected/accessed.
The Assignment:
Explain the concept of a knowledge worker.
Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.
Include one slide that visually represents the role of a nurse leader as knowledge worker.
Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.
McGonigle, D., & Mastrian, K. G. (2022).Nursing informatics and the foundation of knowledge(5th ed.). Jones & Bartlett Learning.
Chapter 1, “Nursing Science and the Foundation of Knowledge†(pp. 7–17)
Chapter 2, “Introduction to Information, Information Science, and Information Systems†(pp. 21–32)
Chapter 3, “Computer Science and the Foundation of Knowledge Model†(pp. 35–64)
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics SpecialistLinks to an external site.. In J. Murphy, W. Goosen, & P. Weber (Eds.),Forecasting Competencies for Nurses in the Future of Connected Health(212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF
This criterion is linked to a Learning OutcomeDevelop a 5- to 6-slide PowerPoint presentation that addresses the following:· Explain the concept of a knowledge worker.· Define and explain nursing informatics.
25 to >22.0 pts
Excellent
Ably synthesize the literature and course resources to present a clear and accurate explanation of the 2 concepts….The presentation clearly and accurately explains the concept of a knowledge worker….The presentation clearly and accurately defines and explains nursing informatics.
22 to >19.0 pts
Good
Summarize the literature and course resources to present a clear and accurate explanation of the 2 concepts….The presentation explains the concept of a knowledge worker. …The presentation defines and explains nursing informatics.
19 to >17.0 pts
Fair
The presentation is missing one of the concepts or one of the concepts is superficially addressed.
17 to >0 pts
Poor
The presentation is missing two concepts or the concepts are superficially addressed.
25 pts
This criterion is linked to a Learning OutcomeDevelop a graphic visual representation of the role of the nurse leader as a knowledge worker. On the slide, include an explanation of the role.
15 to >13.0 pts
Excellent
The presentation includes a detailed graphic and explanation of the role of the nurse leader as a knowledge worker.
13 to >11.0 pts
Good
The presentation includes a graphic and an adequate explanation of the role of the nurse leader as a knowledge worker.
11 to >10.0 pts
Fair
The presentation includes a graphic, yet the explanation of the role is not addressed or is superficially addressed.
10 to >0 pts
Poor
The presentation is missing a graphic, an explanation of the role, or both the graphic and explanation of the role are missing.
15 pts
This criterion is linked to a Learning OutcomePresent the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data you could use, how the data might be accessed/collected, and what knowledge might be derived from the data. Be sure to incorporate feedback received from your colleagues’ replies.
35 to >31.0 pts
Excellent
The presentation clearly and thoroughly includes the hypothetical scenario originally shared in the Discussion Forum, including a detailed and accurate examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data. …The presentation incorporates peer feedback.
31 to >27.0 pts
Good
The presentation includes the hypothetical scenario originally shared in the Discussion Forum, including an accurate examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data. …The presentation incorporates peer feedback.
27 to >24.0 pts
Fair
The presentation includes the hypothetical scenario originally shared in the Discussion Forum; one or two of the criteria are not addressed or are superficially addressed.
24 to >0 pts
Poor
The presentation is missing the hypothetical scenario originally shared in the Discussion Forum or three or more of the criteria are not addressed or are superficially addressed.
35 pts
This criterion is linked to a Learning OutcomePowerPoint presentation:The presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.
5 to >4.0 pts
Excellent
The presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.
4 to >3.0 pts
Good
Eighty percent of the presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.
3 to >2.0 pts
Fair
Sixty to seventy nine percent of the presentation follows these guidelines: presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.
2 to >0 pts
Poor
Less than sixty percent of the presentation follows these guidelines: presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.
5 pts
This criterion is linked to a Learning OutcomeResources
10 to >8.0 pts
Excellent
Presentation includes: 3 or more peer-reviewed articles and 2 or more course resources.
8 to >7.0 pts
Good
Presentation includes: 2 peer-reviewed articles and 2 course resources.
7 to >6.0 pts
Fair
Presentation includes: 1 peer-reviewed article and 1 course resource.
6 to >0 pts
Poor
Presentation includes: 1 or no resources.
10 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards:Correct grammar, mechanics, and proper punctuation
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.5 pts
Good
Contains a few (1-2) grammar, spelling, and punctuation errors.
3.5 to >3.0 pts
Fair
Contains several (3-4) grammar, spelling, and punctuation errors.
3 to >0 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – APA:The reference list and image attribution list follow correct APA format
I work in a freestanding emergency department. We are fairly new to our area coming up on three years this summer. Because our corporation was unsure of how our numbers, volume and acuity were going to be, they didn’t allot for much staff on a given shift. We start with two 7a nurses, another comes in at 11a and the next three nurses come in at 7p. Now, however, we have generated enough numerical data to justify adding another 7a/7p nurse at the very minimum. My facility will not approve it. This puts us in dangerous situations sometimes where we don’t have enough hands to manage more than one emergency at a time. Or even just the amount of patients we have in the ER at any given time.
Data and collection
“Nursing is an information-intensive profession. The steps of using information, applying knowledge to a problem, and acting with wisdom form the basis of nursing science practice” (McGonigle & Mastrian p.8 (2022). For starters, there are a few freestanding ER’s in our area and our corporation could have contacted these facilities and asked questions about their staffing needs. Most of the other freestanding’s start with between five to seven 7a nurses. For concrete data, they can now pull our numbers on a monthly basis to see the volume and acuity we are serving. We see anywhere from 70-95 patients a day. Our main hospital ER sees nearly the same and they are staffed with at least 9-13 nurses at a time. One cardiac arrest coming in to our facility requires all hands on deck, so normally all 3 nurses are involved. This means the patients coming in the front doors don’t receive care until we are done, nor do the patients in rooms, or the patients coming in via EMS. There have been times that we have had a STEMI sitting in the lobby for longer than 15 minutes because the lack of staff didn’t allow for anyone to be available to get to the patient.
Pulling our numbers will show the percentage of high acuity patients and volume of patients versus the number of staff present on a shift. The data reports can also review average wait times for patients including how long it took us to be able to get a high acuity patient from the lobby to an exam room if there were no beds or staff available. The data will speak for itself and provide all the justification we need to be able to add at least one other nurse.
Formation of knowledge
When we apply our knowledge, we are making our collected data functional (McGonigle, D., & Mastrian, K. G. p.9 (2022). After evaluating the data regarding the acuity and volume of patients versus the number of RN’s on shift, more staff can easily be justified. Many times when I have asked about more staff, I am told it is not in the budget. My response every time is a lawsuit when someone dies is not in the budget either and it would be a lot cheaper to just have at least one more RN. Living in the most up to date data era, implementing nursing informatics ultimately improves patient care (Zareshahi & Nasiriani (2022).
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
A patient calls their primary care doctor for a yearly follow-up visit, but they are currently on a travel nurse assignment across the country. They also need their prescriptions refilled during the follow-up visit. The nurse makes an appointment for a telemedicine follow-up visit.
Data Used, Collected, and Accessed
Health services that are delivered virtually are becoming more common worldwide. Virtual care is when a patient encounters a medical professional remotely using information or communication technologies. Telemedicine has been used to perform remote assessments, diagnoses, and medical consultations through peripheral devices and computers (Nagle et al., 2017). A doctor can do a remote assessment with computer technologies via a camera. Direct-to-consumer (DTC) telemedicine must have uncomplicated usability for diverse public users to interact with the website effortlessly and communicate with doctors virtually (Campbell & Monkman, 2021). Mobile apps are evolving; patients can track their records better when talking with their providers during telemedicine visits (Walden University, LLC, 2018).
Clinical Reasoning and Judgment
The nurse leader would assess the patient’s knowledge using the telemedicine website while making the appointment. The nurse would then use their judgment on the data they have collected on the patient’s competence for using the telemedicine website. The nurse is a knowledge worker. If the patient does not understand, the nurse will disseminate knowledge on how to work the patient portal (McGonigle & Mastrian, 2022).
References
Campbell, J. L., & Monkman, H. (2021). The Application of a Novel, Context Specific, Remote, Usability Assessment Tool to Conduct a Pre-Redesign and Post-Redesign Usability Comparison of a Telemedicine Website…Medical Informatics Europe, Public Health and Informatics Conference (Virtual), 29-31 May, 2021. Studies in Health Technology & Informatics, 281, 911–915. https://doi.org/10.3233/SHTI210311Links to an external site.
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). p.9-12. Jones & Bartlett Learning.
Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving Role of the Nursing Informatics Specialist. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REFLinks to an external site.
Walden University, LLC. (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.
NURS 6501-Advanced pathophysiology case study discussion.
Question: The role of genetics in Rheumatoid Arthritis.Response: It is believed that genetics(the hereditary factor) plays a role in the occurrence of RA(Rheumatoid Arthritis) mostly in persons with existing HLA-DR1 and HLA -DR4 gene(most common susceptible genes causing RA). “Environmental factors also play a role in the occurrence of Rheumatoid Arthritis but People with susceptible genes tend to have a higher occurrence rate””(ACR, 2024).Therefore, the advanced nurse needs to perform an in-depth patient assessment and proper history taking to identify genetic factors/ environmental factors involved which will facilitate the basis for patient / family / employer education current treatment and prophylaxis for the future.
Question: Why the patient is presenting with the symptoms outlined; Pain at the joints 5/10 edema of the 4th and 5th PIP, decreased grip strength bilaterally, low grade fever T 100.1 BP120/80mmHg P78bpm and R16 .Response: An autoimmune response emanates from the body of the patient due to an interaction between the gene and the environmental factors (stress and ergonomics at work)resulting into an inflammatory reaction.The patient presented in the case study scenario appears to be at Stage 1-The initial inflammatory phase (Collection of the signs listed in the scenario-joint pain stiffness and swelling) is a result of the alterations in the cellular activity which can either be hyperplasia, metaplasia, atrophy hypertrophy or death. “Cellular alterations either result into adaptation or death”(Michelle, 2024).In response to the auto immune process, the hyperplastic cells in the synovial membrane release cytokine, prostaglandins and free radicals into the surrounding tissues causing erosion of the surfaces of the ligament cartilage and the articular capsule. The process causes dilatation of the vessels in the area causing loss of fluid and blood from the intracellular space to interstitial space and decreased movement of fluid to the capillaries leading to warmth at the area and edema while a compression of the fluid- edematous area on the nerve endings leads to pain/ tenderness and decreased grip strength .The leucocytes are activated to wall-off(defense) the inflammatory process while the release of the cytokines alter the basal body temperature causing low-grade to increased body temperature noted in the patient.
Question: Physiologic response and the cause.Response: The release of the mast cells as a result of an interaction between the genetic (autoimmune response) causing a release of mast cells and cell mediators causing an inflammatory of the lining causing swelling pain and decreased grip strength. This knowledge enables the advanced practice nurse to effectively educate the patient on the pain relieve measures need to eh-engage the services of the occupational therapy and the avoidance of precipitating factors like poor ergonomics, stress or exposure to a cold environment at home/ work.
Question: The cells involved in the disease process.Response: The mast (immune) cells located in the connective tissue(bone joints) and epithelial surfaces begin the inflammatory process in response to the reaction between the genetic(susceptible gene of the patient ) and environmental factor( stress work environment temperature and ergonomics) .
Question: How another characteristic (gender/genetic )would change the response.
Response: If the patient does not possess the RA susceptible gene the advanced practice nurse will need to perform an in-depth assessment to facilitate the use on differential diagnosis like osteoarthritis or trauma.Also women tend to be more susceptible to RA than men due to the effect of estrogen (Estrogen is involved in the development of B cells that are responsible for the body’s immune response .”Women are more susceptible to developing Rheumatoid Arthritis and the severity of the symptoms / effects”(Barhum, 2022).However the B cells also cause a dysfunction of the immune system in people susceptible to auto immune disorders.Gender based roles ( pulling lifting cooking laundry housekeeping or carrying infants/ kids or groceries.Women also tend to receive more vaccinations to stay healthy which may trigger immediate release of cell mediators in response to reactions between genetic and environmental factors .Post -menopausal effects like osteoporosis may also lead to thinning/erosion of the synovial lining leading to an inflammatory process in people with susceptible genes to RA the above listed factors could worsen the signs and symptoms presented in the patient leading to prolonged pain and disability and cause other cellular dysfunction / musculoskeletal disorders.Other responses are fatigue depression anxiety, insomnia loss of job relationship problems or financial strain.
Barhum, L. (2022, November 15). How rheumatoid arthritis affects the genders. Verywell Health https://www.verywellhealth.com/rheumatoid-arthritis-gender-differences-5070797 .
Michelle, R. (n.d.). Learning resources. Walden University. https://waldenu.lecturio.com/#/lecture/h/88725/187962 .
There is a myriad of inflammatory joint diseases that attack the human body. After review of the case study, one would focus on the repetitive work the patient does on the computer at his job creating the joint issues to the fingers. Yet, the prospective for the practitioner must shift focus away from only the possibility of carpal tunnel syndrome when the patient reports increased fatigue over several months, loss of some mobility in hands, a low-grade fever, extra synovial rheumatoid nodules or swelling to 4th and 5th PIP as well as a family history of rheumatoid arthritis.
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory autoimmune disease that can affect organs but particularly affects small joints such as the hands and feet. It has long been acknowledged that having a family history of RA increases an individual’s likelihood of developing the disease and the heritability of RA has been estimated to be around 60%. Over the years, many gene studies have been completed in the attempt to isolate the genes involved in immune function. The most significant genetic risk factors for RA are variations in Human leukocyte antigen (HLA) genes, particularly the HLA-DRB1 gene.
The patient is presenting with these symptoms due to the pathologic events mediated by antibodies against self-antigens and the inflammatory cytokines (CD4+T cells that promote inflammation). When acting together, T cells produce cytokines that stimulate other inflammatory cells and promote tissue injury. Amino acids become enzymatically modified into other amino acids called citrulline. This changes the structure and function of the protein. The inflammatory cytokines convert the synovium into a thick abnormal layer of granulated tissue. This tumor or pannus acts like a locally invasive tumor. In turn, the immune system activates leukocytes out of the circulation and into the synovial membrane causing a damaging effect. Neutrophils and macrophages ingest the immune complexes. During this process, releasing powerful enzymes that degrade the synovial tissue and articular cartilage. Understanding the genetic basis of RA is a predictor of disease severity, prognosis, and response to varying treatment.
It is essential to rule out infections. RA can have various infectious mimics. That is why it is imperative that the clinician is not narrowly focused on what is “visible†and takes time to obtain a thorough psychical and history from a patient especially if they are new to your office/unit. When misdiagnosed with RA, the therapies utilized to treat RA (immunosuppressive agents), can aggravate the underlying infections. Numerous bacterial, mycobacterial, and viral infections often present with musculoskeletal manifestations such as arthralgia and arthritis. Examples include but are not limited to: Parvovirus B19 infection in the pediatric population may present with febrile illness with “slapped cheekâ€, aplastic anemia and bone marrow suppression in adults. Also, enquire about foreign travel as well as sexual history. Brucellosis can be spread by the consumption of unpasteurized dairy products. The chronic phase of this is characterized by fever, fatigue, and various osteoarticular manifestations.
References
Dedmon, L. (2020). The genetics of rheumatoid arthritis. Rheumatology, 59(10), 2661-2670. doi:https://doi.org/10.1093/rheumatology/keaa232
Hopkins, L., Smallheer, B., & McCance, K. (2019). Alterations of Musculoskeletal Function. In K. McCance, & S. Huether, Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th ed., pp. 1450-1454). Elsevier.
Sharma, V., & Sharma, A. (2022). Infectious mimics of rheumatoid arthritis. Best Practice and Research Clinical Rheumatology, 36(1). doi:https://doi.org/10.1016/j.berh.2021.101736
