Explain common issues related to the use of EHR and healthcare fraud.

/in /by

Prior to beginning work on this assignment review Chapters 21, 24, 25 and 27 of Health Informatics: An Interprofessional Approach.

Select two of the case studies located in the course textbook at the end of Chapters 21, 24, 25, or 27, and answer the questions associated with those case studies in a cohesive, APA-formatted paper.

Chapter 21:

  • Recommend where would you start to improve the user experience.
  • Pharmacists are asking for your help due to struggles with non-integrated systems. What methods would you use to examine this issue?
  • Describe how usability should be incorporated as part of the purchasing process for this institution.

Chapter 24:

  • Assuming that you are the clinical content manager leading reporting efforts, recommend the approach you would take to address the reporting problem.
  • Describe how the effort of changing preadmission testing data collection from paper to the Electronic Health Record System (EHR) can be approached.
  • Using Patient Safety and Quality Research Design (PSQRD) methodology, identifying area of quality improvement in the hospital setting, recommend a process plan and identify the expected outcomes.

Chapter 25:

  • Discuss whether the proposed course of action would be permissible under current fraud and abuse regulations.
  • Explain common issues related to the use of EHR and healthcare fraud.
  • Discuss how the proposed EHR could potentially facilitate healthcare fraud.

Chapter 27:

  • Describe the timeline of the program and its potential financial impact on the individual healthcare providers who are involved in meaningful use.
  • Explain the process that providers must complete to avoid payment penalties.
  • Explain the timeframe for the provider to achieve modified stage two and stage three measures.

The Week 4 Case Studies Papers

  • Must be three to four double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center (Links to an external site.)’s APA Style (Links to an external site.) resource for each case study.
  • Must include a separate title page for each case study with the following:
    • Title of paper including the chapter number and case study title
    • Student’s name
    • Course name and number
    • Instructor’s name
    • Date submitted

For further assistance with the formatting and the title page, refer to APA Formatting for Word 2013 (Links to an external site.).

  • Must utilize academic voice. See the Academic Voice (Links to an external site.) resource for additional guidance.
  • Must include an introduction and conclusion paragraph. Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose of your paper.

For assistance on writing Introductions & Conclusions (Links to an external site.) as well as Writing a Thesis Statement (Links to an external site.), refer to the Ashford Writing Center resources.

  • Must use at least two scholarly or credible sources in addition to the course text.
    • The Scholarly, Peer-Reviewed, and Other Credible Sources (Links to an external site.) table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment.
    • To assist you in completing the research required for this assignment, view this Ashford University Library Quick ‘n’ Dirty (Links to an external site.) tutorial, which introduces the Ashford University Library and the research process, and provides some library search tips.
  • Must document any information used from sources in APA style as outlined in the Ashford Writing Center’s Citing Within Your Paper (Links to an external site.)
  • Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center. See the Formatting Your References List (Links to an external site.) resource in the Ashford Writing Center for specifications.

Carefully review the Grading Rubric (Links to an external site.) for the criteria that will be used to evaluate your assignment.

95. Koch S, Westenskow D, Weir C, et al. ICU nurses’evaluations of integrated information integration in displays for ICU nurses on user satisfaction and perceived mental workload; 2012. Paper presented at the Medical Informatics Europe. Pisa, Italy.

96. Koch SH, Weir C, Westenskow D, et al. Evaluation of the effect of information integration in displays for ICU nurses on situation awareness and task completion time: a prospective randomized controlled study. Int J Med Inform. 2013; 82 (8):665–675.

97. Lowry SZ, Quinn MT, Ramaiah M, et al. Technical Evaluation, Testing and Validation of the Usability of Electronic Health Records. Rockville, MD: National Institute of Standards and Technology; 2012.

98. Tullis T, Albert B. Measuring the User Experience: Collecting, Analyzing and Presenting Usability Metrics. New York: Elsevier; 2008.

DISCUSSION QUESTIONS

1. Discuss critical user experience issues in your own organi- zation. Describe one example in more detail.

2. Outline how to apply the heuristic evaluation technique to analyze where the major violations exist for a selected health IT product.

3. Search the internet for current policies on the user experience in health IT by searching the Centers for Medicare and Med- icaid (CMS), the Office of the National Coordinator for Health Information Technology, and the National Institute of Standards and Technology websites. Analyze how one of these current policies will affect your organization.

4. Outline a usability test for one module of your current EHR. Include the elements discussed in the chapter in your proposed usability test. Describe why you chose the methods you did.

5. Your organization is planning to purchase new physiologic monitors for the adult ICUs. You are the clinical/informat- ics person assigned to this project. Describe how you would include usability in the purchase process. Outline participants, methods, and tasks to be tested.

CASE STUDY

A tertiary care center in the western United States has an installed base of EHRs supported by Cerner Corporation for inpatient areas and by Epic for outpatient areas. Other technol- ogy includes a suite of about 300 different applications sup- ported by the IT department. The current environment, while including robust capabilities such as computerized pro- vider order entry, is “siloed” with information. Healthcare pro- viders complain that they have difficulty obtaining the “big picture” of the patient across systems and they have to remem- ber information located in disparate systems. They are bur- dened with integrating information themselves. Not only is this time consuming; it is potentially prone to error. Providers have developed numerous workarounds to the different sys- tems in ambulatory and inpatient areas, including “ shadow” files for patients they see frequently. Nurses complain that they have to “jump around” the inpatient system to find information they need for activities such as patient handoffs. The organization responds by developing a vision for the future that centered on the concept of knowledge manage- ment (KM). This concept is defined as the systematic process

of identifying, capturing, and transferring information and knowledge that people can use to create, compete (with other organizations), and improve. A crucial aspect of KM is improving the user experience. As the leaders in the organi- zation begin to address KM and improve the user experience, they are employing the same tactics described in this chapter.

Discussion Questions 1. Assume that you are the leader for UX for your discipline

in your organization. Where would you start to improve the user experience?

2. Pharmacists supporting the ICUs are asking for your help to improve their situation (their user experience) because they are forced to use nonintegrated systems. What methods would you use to examine this issue?

3. The institution is in the process of purchasing new phys- iologic monitors for their step-down unit. Describe how usability should be incorporated as part of the purchasing process. Design a brief usability test to support the pur- chasing process.

369CHAPTER 21 Improving the User Experience for Health Information Technology

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Analyze processes related to cardiovascular and respiratory disorders

/in /by

Using the below listed case scenario you are to create a 1-2 page paper (excluding the title page and reference page). It is important that you review the APA sample paper and APA requirements for writing your paper.

11-year-old boy complains of wheezing and difficulty “getting enough air.” Notices it more when he is playing baseball and symptoms improve when exercise activity stops. He says that the symptoms are getting worse and the symptoms are even occurring at rest. Mother says the child is allergic to cat dander and his next-door neighbor in their apartment building recently began sheltering cats for the local humane society. Auscultation demonstrates wheezes on forced expiration throughout all lung fields.

Be sure that you are addressing the following within the body of your paper:

  • Analyze processes related to cardiovascular and respiratory disorders
  • Analyze alterations in the cardiovascular and respiratory systems and the resultant disease processes
  • Analyze racial/ethnic variables that may impact physiological functioning
  • Evaluate the impact of patient characteristics on disorders and altered physiology

Make sure that you are following APA guidelines for writing your paper, in-text citation and references.

Conceptual Relationships And Assumptions

/in /by

In Weeks 3 and 4, you conducted a concept analysis. As Walker and Avant (2019) explain, “concepts allow us to classify our experiences in a meaningful way both to ourselves and others….The ability to express a relationship between two or more concepts is even more useful and efficient” (p. 63). In this Discussion, you create statements about the relationships between two or more concepts, which are critical for developing your theoretical foundation for a program of research.

In this Discussion, you also examine assumptions that may influence your program of research. Assumptions are another type of statement; these statements are considered true, even when they have not been tested. They often go unrecognized because they are deeply embedded in thinking and behavior, so it is important to engage in critical reflection to identify them.

In addition, during this Discussion you consider how nursing’s metaparadigm relates to the theoretical foundation you are developing.

To prepare
  • Continue to review the literature that features concepts related to your phenomenon of interest. As you read each article, consider the relationships between and among concepts. Also identify assumptions that are implicit or explicit in the research.
  • Select one article from your literature review and apply the seven steps of statement analysis that Walker and Avant (2019) present in Chapter 11 of their text. What insights does this give you about the relationships described in the article, as well as for your own work?
  • Think more deeply about the conceptual relationships that may distinguish the theoretical foundation for your future program of research. Also, analyze assumptions that may influence your research (McEwen and Wills, 2019, p. 81).
  • Review the information on nursing’s metaparadigm in McEwen and Wills (2019, pp. 41–45). Consider how the metaparadigm concepts of patient, health, nurse, and environment relate to your theoretical foundation.

By Day 3

Post a synopsis of an article that features conceptual relationships related to your phenomenon of interest, and explain the insights you gained by applying Walker and Avant’s steps for statement analysis. Compare the information in the article with your current thinking about your own theoretical foundation for research, including relationships between and among concepts, and assumptions. Describe implications of nursing’s metaparadigm for your theoretical foundation.

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

· Review Chapter 8, “Frameworks” (pp. 138-154)

McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.) Philadelphia, PA: Wolters Kluwer Health.

· Review Chapter 2, “Overview of Theory in Nursing”

· Section, “Nursing’s Metaparadigm” (pp. 41–45)

· Review Chapter 4, “Theory Development: Structuring Conceptual Relationships in Nursing” (pp. 72–92)

Nursing’s metaparadigm, described in Chapter 2, presents four core concepts (i.e., patient, health, nurse, and environment), which you consider in this week’s Discussion. Chapter 4 presents information on conceptual relationships and assumptions.

Walker, L. O., & Avant, K. C. (2019). Strategies for theory construction in nursing (6th ed.). Upper Saddle River, NJ: Prentice Hall.

· Chapter 5, “Statement Derivation” (pp. 88-98)

· Chapter 8, “Statement Synthesis” (pp. 127-148)

· Chapter 11, “Statement Analysis” (pp. 194-206)

· Review Chapter 13, “Assessing the Credibility and Scope of Nursing Knowledge Development: Concepts, Statements, and Theories” (pp. 237-239)

Compare and contract legal and ethical issues.

/in /by

Chapter 4—Ethical Issues

1. Compare and contract legal and ethical issues.

2. What determines how a person approaches and solves ethical dilemmas

3. Define moral indifference—provide an example

4. Define moral uncertainty—provide an example from your own healthcare experience

5. Moral distress—provide an example from your own health care experiences

6. What is an ethical dilemma? Give an example

7. Describe deontological approach to ethical decision making? What does this mean?

8. Describe a teleological approach to ethical decision making? What does this mean?

9. Compare and contrast the 4 different frameworks for ethical decision making

10. What is autonomy—give an example from your experience

11. Define the following terms—how have you used/understood these principles in your nursing practice?

12. Beneficence

13. Paternalism

14. Utility

15. Justice

16. Veracity

17. Fidelity

18. Confidentiality

19. What is the MORAL decision-making model—how does this work?

20. Name important strategies to promote ethical behavior in healthcare.

Chapter 5—Legal and Legislative Issues

1. Define civil law and what is involved in civil cases

2. What are the reasons that nurses are at increased risk for legal liability in nursing practice?

3. What does the term Standard of Care mean in nursing? Why is this so important?

4. Define malpractice and the term professional negligence (the 5 criteria needed to fulfill this definition)….provide examples of each criteria to deepen your understanding

5. What does the term “under ordinary circumstances” means as it relates to professional negligence?

6. Define these legal terms that are pertinent to nursing practice—be sure you can relate these term to nursing practice

1. Stare decisis

2. Liability

3. tort

4. respondeat superior

5. vicarious liability

6. product liability

7. res ipsa loquitur

7. Define intentional torts and give as many examples as you can related to nursing practice

8. What are some common reasons nurses are sued (claims filed against them)

9. BON—Board of Nursing—what is their responsibility to the public?

10. Define the Nurse Practice Act and its role in your ability to practice nursing?

11. Define, compare and contrast the three forms of consent:

1. Informed consent

2. Implied consent

3. Express consent

12. What is HIPAA and what is its importance to healthcare/your nursing practice?

13. What are the parameters of Good Samaritan Immunity?

14. Describe the Patient Self-Determination Act (PSDA) of 1991 and how it changed healthcare

15. List the common causes of nursing license revocation

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NURSING LEADERSHIP AND MANAGEMENT I

Nursing Leadership and Management REVIEW MODULE EDITION 8.0

Contributors Honey C. Holman, MSN, RN

Debborah Williams, MSN, RN

Sheryl Sommer, PhD, RN, CNE

Janean Johnson, MSN, RN, CNE

Brenda S. Ball, MEd, BSN, RN

Terri Lemon, DNP, MSN, RN

Consultants Tracey Bousquet, BSN, RN

Julie Traynor, MSN, RN

INTELLECTUAL PROPERTY NOTICE ATI Nursing is a division of Assessment Technologies Institute®, LLC.

Copyright © 2019 Assessment Technologies Institute, LLC. All rights reserved.

The reproduction of this work in any electronic, mechanical or other means, now known or hereafter

invented, is forbidden without the written permission of Assessment Technologies Institute, LLC. All of the

content in this publication, including, for example, the cover, all of the page headers, images, illustrations,

graphics, and text, are subject to trademark, service mark, trade dress, copyright, and/or other intellectual

property rights or licenses held by Assessment Technologies Institute, LLC, one of its affiliates, or by

third parties who have licensed their materials to Assessment Technologies Institute, LLC.

 

 

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II CONTENT MASTERY SERIES

IMPORTANT NOTICE TO THE READER Assessment Technologies Institute, LLC, is the publisher of this publication. The content of this publication is for

informational and educational purposes only and may be modified or updated by the publisher at any time. This

publication is not providing medical advice and is not intended to be a substitute for professional medical advice,

diagnosis, or treatment. The publisher has designed this publication to provide accurate information regarding the

subject matter covered; however, the publisher is not responsible for errors, omissions, or for any outcomes related to

the use of the contents of this book and makes no guarantee and assumes no responsibility or liability for the use of the

products and procedures described or the correctness, sufficiency, or completeness of stated information, opinions, or

recommendations. The publisher does not recommend or endorse any specific tests, providers, products, procedures,

processes, opinions, or other information that may be mentioned in this publication. Treatments and side effects described

in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect

that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by

the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice,

and government regulations often change the accepted standard in this field. When consideration is being given to use

of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the

drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations

on dose, precautions, and contraindications and determining the appropriate usage for the product. Any references

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and a patient’s physical condition can vary widely from one emergency to another. Nor is it intended that this book

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These models do not necessarily endorse, represent, or participate in the activities represented in the images. THE

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Director of content review: Kristen Lawler

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NURSING LEADERSHIP AND MANAGEMENT USER’S GUIDE III

User’s Guide Welcome to the Assessment Technologies Institute® Nursing Leadership and Management Review Module Edition 8.0. The mission of ATI’s Content Mastery Series® Review Modules is to provide user-friendly compendiums of nursing knowledge that will:

● Help you locate important information quickly. ● Assist in your learning efforts. ● Provide exercises for applying your nursing knowledge. ● Facilitate your entry into the nursing profession as a

newly licensed nurse.

This newest edition of the Review Modules has been redesigned to optimize your learning experience. We’ve fit more content into less space and have done so in a way that will make it even easier for you to find and understand the information you need.

ORGANIZATION Chapters in this Review Module use a nursing concepts organizing framework, beginning with an overview describing the central concept and its relevance to nursing. Subordinate themes are covered in outline form to demonstrate relationships and present the information in a clear, succinct manner. Some chapters have sections that group related concepts and contain their own overviews. These sections are included in the table of contents.

ACTIVE LEARNING SCENARIOS AND APPLICATION EXERCISES

Each chapter includes opportunities for you to test your knowledge and to practice applying that knowledge. Active Learning Scenario exercises pose a nursing scenario and then direct you to use an ATI Active Learning Template (included at the back of this book) to record the important knowledge a nurse should apply to the scenario. An example is then provided to which you can compare your completed Active Learning Template. The Application Exercises include NCLEX-style questions (multiple- choice and multiple-select items), providing you with opportunities to practice answering the kinds of questions you might expect to see on ATI assessments or the NCLEX. After the Application Exercises, an answer key is provided, along with rationales.

NCLEX® CONNECTIONS To prepare for the NCLEX, it is important to understand how the content in this Review Module is connected to the NCLEX test plan. You can find information on the detailed test plan at the National Council of State Boards of Nursing’s website, www.ncsbn.org. When reviewing content in this Review Module, regularly ask yourself,

“How does this content fit into the test plan, and what types of questions related to this content should I expect?”

To help you in this process, we’ve included NCLEX Connections at the beginning of each unit and with each question in the Application Exercises Answer Keys. The NCLEX Connections at the beginning of each unit point out areas of the detailed test plan that relate to the content within that unit. The NCLEX Connections attached to the Application Exercises Answer Keys demonstrate how each exercise fits within the detailed content outline.

These NCLEX Connections will help you understand how the detailed content outline is organized, starting with major client needs categories and subcategories and followed by related content areas and tasks. The major client needs categories are:

● Safe and Effective Care Environment ◯ Management of Care ◯ Safety and Infection Control

● Health Promotion and Maintenance ● Psychosocial Integrity ● Physiological Integrity

◯ Basic Care and Comfort ◯ Pharmacological and Parenteral Therapies ◯ Reduction of Risk Potential ◯ Physiological Adaptation

An NCLEX Connection might, for example, alert you that content within a chapter is related to:

● Management of Care ◯ Advance Directives

■ Provide clients with information about advance directives.

 

 

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IV USER’S GUIDE CONTENT MASTERY SERIES

QSEN COMPETENCIES As you use the Review Modules, you will note the integration of the Quality and Safety Education for Nurses (QSEN) competencies throughout the chapters. These competencies are integral components of the curriculum of many nursing programs in the United States and prepare you to provide safe, high-quality care as a newly licensed nurse. Icons appear to draw your attention to the six QSEN competencies.

Safety: The minimization of risk factors that could cause injury or harm while promoting quality care and maintaining a secure environment for clients, self, and others.

Patient-Centered Care: The provision of caring and compassionate, culturally sensitive care that addresses clients’ physiological, psychological, sociological, spiritual, and cultural needs, preferences, and values.

Evidence-Based Practice: The use of current knowledge from research and other credible sources, on which to base clinical judgment and client care.

Informatics: The use of information technology as a communication and information-gathering tool that supports clinical decision-making and scientifically based nursing practice.

Quality Improvement: Care related and organizational processes that involve the development and implementation of a plan to improve health care services and better meet clients’ needs.

Teamwork and Collaboration: The delivery of client care in partnership with multidisciplinary members of the health care team to achieve continuity of care and positive client outcomes.

ICONS Icons are used throughout the Review Module to draw your attention to particular areas. Keep an eye out for these icons.

This icon is used for NCLEX Connections.

This icon indicates gerontological considerations, or knowledge specific to the care of older adult clients.

This icon is used for content related to safety and is a QSEN competency. When you see this icon, take note of safety concerns or steps that nurses can take to ensure client safety and a safe environment.

This icon is a QSEN competency that indicates the importance of a holistic approach to providing care.

This icon, a QSEN competency, points out the integration of research into clinical practice.

This icon is a QSEN competency and highlights the use of information technology to support nursing practice.

This icon is used to focus on the QSEN competency of integrating planning processes to meet clients’ needs.

This icon highlights the QSEN competency of care delivery using an interprofessional approach.

This icon appears at the top-right of pages and indicates availability of an online media supplement (a graphic, animation, or video). If you have an electronic copy of the Review Module, this icon will appear alongside clickable links to media supplements. If you have a hard copy version of the Review Module, visit www.atitesting.com for details on how to access these features.

FEEDBACK ATI welcomes feedback regarding this Review Module. Please provide comments to comments@atitesting.com.

As needed updates to the Review Modules are identified, changes to the text are made for subsequent printings of the book and for subsequent releases of the electronic version. For the printed books, print runs are based on when existing stock is depleted. For the electronic versions, a number of factors influence the update schedule. As such, ATI encourages faculty and students to refer to the Review Module addendums for information on what updates have been made. These addendums, which are available in the Help/FAQs on the student site and the Resources/eBooks & Active Learning on the faculty site, are updated regularly and always include the most current information on updates to the Review Modules.

 

 

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NURSING LEADERSHIP AND MANAGEMENT TABLE OF CONTENTS V

Table of Contents

NCLEX® Connections 1

CHAPTER 1 Managing Client Care 3

Leadership and management 3

Critical thinking 4

Assigning, delegating, and supervising 7

Staff education 10

Quality improvement 11

Performance appraisal, peer review, and disciplinary action 13

Conflict resolution 14

Resource management 17

NCLEX® Connections 21

CHAPTER 2 Coordinating Client Care 23

NCLEX® Connections 33

CHAPTER 3 Professional Responsibilities 35

Client rights 35

Advocacy 35

Informed consent 36

Advance directives 37

Confidentiality and information security 38

Information technology 40

Legal practice 40

Disruptive behavior 45

Ethical practice 45

 

 

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VI TABLE OF CONTENTS CONTENT MASTERY SERIES

NCLEX® Connections 49

CHAPTER 4 Maintaining a Safe Environment 51

Culture of safety 51

QSEN competencies in nursing programs 52

Handling infectious and hazardous materials 52

Safe use of equipment 53

Specific risk areas 53

Home safety 55

Ergonomic principles 58

NCLEX® Connections 63

CHAPTER 5 Facility Protocols 65

Reporting incidents 65

Disaster planning and emergency response 65

Security plans 71

References 75

Active Learning Templates A1 Basic Concept A1

Diagnostic Procedure A3

Growth and Development A5

Medication A7

Nursing Skill A9

System Disorder A11

Therapeutic Procedure A13

Concept Analysis A15

 

 

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NURSING LEADERSHIP AND MANAGEMENT NCLEX® CONNECTIONS 1

NCLEX® Connections

When reviewing the following chapter, keep in mind the relevant topics and tasks of the NCLEX outline, in particular:

Management of Care ASSIGNMENT, DELEGATION AND SUPERVISION Evaluate delegated tasks to ensure correct completion of activity.

Evaluate effectiveness of staff members� time management skills.

CASE MANAGEMENT: Practice and advocate for cost effective care.

CONCEPTS OF MANAGEMENT Manage conflict among clients and health care staff.

Identify roles/responsibilities of health care team members.

ESTABLISHING PRIORITIES Apply knowledge of pathophysiology when establishing priorities for interventions with multiple clients.