NURS 6050 Application of Data to Problem-Solving

Carter-Templeton (2019) discusses the critical role of in obtaining data that will provide knowledge to improve clinical processes and clinical judgment, allowing for future innovations. Carter-Templeton (2019) explains that the Alliance for Nursing Informatics (ANI) has plans to transform healthcare through nursing informatics and to allow ANI leadership to participate in

educational opportunities that allow mentorships for a few years in order to create members who are skilled in communication, networking, negotiation, leadership, and managing. Conduent Health Healthcare Provider Solutions (2017) developed Midas, an online care management system that converts data into information that can be used to improve performance.

Conduent Health Healthcare Provider Solutions (2017) cites quality improvement and risk reduction among patients, case management, and reducing central line infections as examples of their capabilities. According to (2017), it is the largest provider of business process services with advanced capabilities in analyzing and processing data that is entered into the program in order to create interventions that directly affect the problem at hand in order to reduce any adverse risks that are currently occurring in a specific healthcare facility. Midas offers and develops “an individualized patient care plan worksheet that includes goals, outcomes, and interventions to meet Joint Commission standards” (Conduent Health Healthcare Provider Solutions, 2017, para 8).

Having the potential to be a future nurse leader, the Midas program shows significant value in creating interventions and positive outcomes by analyzing certain events or data listed in the program. Midas can create outcomes, but the ability to comprehend the accurate implementation of the outcomes allows a nurse leader to use clinical reasoning and judgment from experience and knowledge. An example of how data could be collected about current healthcare issues that are arising at an all-time high is the nurse-to-patient ratio since there is a shortage of bedside nurses in the field. Paulson (2018) explains a study and the collected results directly related to nurse-patient ratios through nursing informatics. The hypothetical situation, which soon will not be as speculative considering the nursing shortage sweeping through every hospital, is based on using the Midas to enter in information for when staffing is not met and how that directly influences patient care. Paulson (2018) stated that current hospitals staff using hours per patient day algorithm calculated by using the average number of patients in a day multiplied per month days or per year, which is three-hundred and sixty-five days.

Because the hour per patient day does not take into account patient acuity, the number of nurses remains constant whether the acuity is average or higher than usual. According to Paulson (2018), if a unit’s staffing needs are not met, patient mortality increases, and patient mortality increases if the majority of nurses have less than two years of experience. This is an important topic because many experienced nurses retired, quit, or moved on to take travel contracts during the pandemic, leaving hospitals with new nurses and a nursing shortage. Midas would be extremely useful in any hospital for tracking and monitoring nursing shortages and inexperienced nurses’ mortality rates.

NURS 6050 Application of Data to Problem-Solving References

Carter-Templeton, H., & Sensmeier, J. (2019). The Value and Impact of the Alliance for Nursing Informatics Emerging Leaders Program. CIN: Computers, Informatics, Nursing, 37(12), 612–614.

Conduent Health Healthcare Provider Solutions . (2017). Midas Health Analytics Solutions Care Management – Improving Patient Safety and Quality Management. Retrieved November 27, 2021, from .

Paulson, R. A. (2018, July). Taking Nurse Staffing . Retrieved November 27, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039374/pdf/numa-49-42.pdf.

THE APPLICATION OF DATA TO PROBLEM-SOLVING

In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.

Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.

In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

To Prepare:

Reflect on the concepts of informatics and knowledge work as presented in the Resources.
Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

BY DAY 3 OF WEEK 1

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

BY DAY 6 OF WEEK 1

Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.

*Note: Throughout this program, your fellow students are referred to as colleagues.

NURS 6050 Application of Data to Problem-Solving

Few professions in the modern era do not rely on data to some extent. Stockbrokers rely on market data to provide financial advice to their clients. Meteorologists use weather data to forecast weather conditions, while realtors use data to advise on property purchases and sales. In these and other cases, data not only aids in problem solving but also contributes to the practitioner’s and discipline’s body of knowledge.

In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

To Prepare for NURS 6050 Application of Data to Problem-Solving:

Reflect on the concepts of informatics and knowledge work as presented in the Resources.
Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

By Day 3 of Week 1 of NURS 6050 Application of Data to Problem-Solving

I currently work in the emergency department where they use data in many ways to improve the flow and outcomes of the department to enhance patient care. My suggestion for them would be to collect a “door to disposition time”, as stated in the Society for Academic Emergency Medicine (2018) “a good clinician thinks about patient disposition from the moment he or she enters the room.” First, a goal should be set to be able to determine if the desired outcome was achieved. For example, a goal door to disposition time could be 3 hours. This time clock can start from the time of a patient’s registration to the time the physician decides to admit or discharge a patient. This would mean counting how long it takes the department to get a patient triaged, see a doctor, complete any imaging or lab work, treat, and decide the final plan of care for the patient. This clock can also be available for all providers to access and see in the patient’s electronic medical record chart.

“Leadership is defined as the art of influencing others to achieve their maximum potential to accomplish any task, objective, or project” (Specchia et al., 2021) A nurse leader could use the data collected from the door to disposition time clock to determine what the delays are in getting a patient admitted or discharged. Is there a delay in being seen by a doctor? Is there a delay in collecting blood work or urine samples? Is there a delay in administering medications? These questions could all be answered by a nurse leader using clinical reasoning and the knowledge they have gained from the door to disposition time to evaluate where the delays are coming from so that they can develop a plan to make any necessary improvements to get a patient discharged or admitted sooner. As Gruppen (2017) stated, “most educational interventions that focus on clinical reasoning are also (perhaps implicitly) conveying knowledge in critical areas of medicine and it is this knowledge acquisition that fosters better performance.” A nurse leader can then reevaluate the success of their improvements by analyzing the door to disposition time and make any further adjustments as necessary. The nurse leader can then continue the process of clinical reasoning until they reach their goal door to disposition time.

References:

Gruppen L. D. (2017). Clinical Reasoning: Defining It, Teaching It, Assessing It, Studying It. The western journal of emergency medicine, 18(1), 4–7.

Society for Academic Emergency Medicine (2018). Disposition of the Emergency Department Patient. Society for Academic Emergency Medicine.

Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership Styles and Nurses’ Job Satisfaction. Results of a Systematic Review. International journal of environmental research and public health, 18(4), 1552.

By Day 6 of Week 1 of NURS 6050 Application of Data to Problem-Solving

*Note: Throughout this program, your fellow students are referred to as colleagues.

Elizabeth, Great discussion. Healthcare and nursing informatics are vastly growing fields within the medical field and continuously incorporate new and evolving technology (Sweeney, J., 2017). The steps of using information, applying knowledge of the data to a problem, and acting with wisdom are the basis of a nursing science practice (McGonigle, D., & Mastrian, K. G., 2022). How do you think these practices will grow to further monitor ED practices to allow for growth, better care for the patients, and improve disposition time? Do you see growth will help the patient and nurse have better outcomes in the ED?

References:

McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.

Sweeney, J. (2017). Healthcare Informatics. Online Journal of Nursing Informatics, 21(1).

I believe that growth will help the patient and nurse have better outcomes in the emergency department. Nursing is always changing with new evidence-based practices providing us with many options to improve our nursing skills. So yes, I believe these practices will grow to better monitor these ED patients in a positive way.

One challenge the nurse leader might experience could be implementing the changes that have been created to meet the overall goal. One problem involved with implementing change is short staffing in not only the emergency department but also in the lab department, imaging department, environmental services, and registration. All these departments are working together to make a successful visit for each patient but, if they don’t have the staff to be successful then the appropriate changes might not take effect. Some of our staff have been replaced by travelers who might only be with us for eight weeks so having consistency with regular staff who can maintain these changes could also become troublesome.

Another challenge within the knowledge model could be obtaining the knowledge. If the data cannot be consistently collected that could skew the results and the goal might not be appropriately met. The emergency department is open 24/7, 7 days a week, 365 days a year. The number of patients that arrive in the department can be very different when comparing daytime vs nighttime, weekends vs weekdays, holidays, etc. Data should be collected with the knowledge of these various factors to be able to overcome this challenge.

Hello Elizabeth,

I agree that implementing changes when the unit is short-staffed can be challenging. According to Saxton & Nauser (2020), ED nurses are the most difficult to retain, and it is estimated that 20% of RNs leave within the first year of hire while 33% leave within two years of hire. Nurses leave their jobs based on factors such as a lack of administrative support, unhealthy work environments and inappropriate staffing, all of which can be frustrating barriers to effective care delivery (Delgado, 2021). Shortage in other departments does not help implement changes either as staff continues to quit the healthcare career altogether. The hiring process can be lengthy because the applicants may not fit the position requirements when the department implements changes. To attract high-quality employees that do their best work requires the organization to use information technology.

References

Delgado, S. (2021). Nurse staffing: A reason to leave and a reason to stay. American Association of Critical- Care Nurses. https://www.aacn.org/blog/nurse-staffing-a-reason-to-leave-and-a-reason-to-stay

Saxton, R., & Nauser, J. (2020). Students’ experiences of clinical immersion in operating room and emergency department. Nurse Education in Practice, 43 doi:http://dx.doi.org/10.1016/j.nepr.2020.102709

Elizabeth, I did some further research on the technology the emergency department is bringing in recently to help with workflow. The use of I pads is becoming increasingly popular with results showing a decrease in the use of PPE and decreased patient wait times, and decreased exposure to infectious disease for patients and staff (Wittbold et. al., 2020). I agree with your statements on effective and positive leadership. Leaders who display effective leadership focus on the needs and wishes of patients along with cooperative from other interdisciplinary team members (Weiss et. al., 2019). They share common goals and work together to reach those goals.

References

Weiss, S. A., Tappen, R. M., & Grimley, K. (2019). Essentials of nursing leadership & management. FA Davis.

Wittbold, K. A., Baugh, J. J., Yun, B. J., Raja, A. S., & White, B. A. (2020). iPad deployment for virtual evaluation in the emergency department during the COVID-19 pandemic. The American Journal of Emergency Medicine, 38(12), 2733.

Good day, Elizabeth.

Thank you for taking the time to share your thoughts with us this week.

In many ways, healthcare technology and innovation can help us improve our work flow in hospitals and health-care facilities.

Remote patient monitoring and wearable technology

In both inpatient and outpatient settings, healthcare wearables are increasingly being used to promote patient involvement.

Wearable technology can assist in obtaining a comprehensive picture of a patient’s vital signs, including pulse, temperature, respiration, blood pressure, and heart rate.

Instead of manually monitoring and documenting vital signs once or twice a day, the information is automatically logged throughout the system, supporting data-driven decision making.

Mobile apps are being used to increase patient involvement.

Consider anything you might need, and chances are you’ll be able to find an app for it. So, what’s the deal with healthcare delivery lagging behind? Mobile health apps are proven to be a viable technique for increasing patient involvement and improving the hospital experience. From medication reminder apps to mobile patient portals that provide you an overview of the therapy being administered in the palm of your hand, mobile apps in the healthcare field are here to stay.

Patients can also get automatic reminders to refill their prescriptions, which will improve their health.

Hesham,

You may be aware of the HillRom hospital beds’ ability to continuously monitor heart rate and respiratory rate via a contact-free method while patients are in bed. This is great because we only get vital signs on an interval basis. Heart rate isn’t continuously monitored on a regular ward unless the patient is on telemetry. There isn’t always a need for telemetry, but even patients without cardiac history can deteriorate. Unless we are in their room constantly, we may not be aware until it is too late. “Despite the Q4 standard for vitals, intervals between vitals can be eight hours or longer…Unrecognized patient deterioration may occur during these intervals.”(210721-en-r2_centrella-bed-hr-rr_brochure-hr.pdf, 2021) The beds don’t transmit to the EMR, the ones at my hospital don’t, but they have an audible alarm for when the heart rate and respiratory rate are out of range. We have only been using this function for two months, and it has alerted me on two occasions to deterioration of my patient. Both times, the patient was stabilized before they got worse.

Another remote monitoring technology that has advanced recently monitor pacemakers. Patients now have the ability to interrogate their devices at home. They used to be able to do a basic check on the device by placing their phone over their pacemaker, but now they can do so much more. It is amazing how technology can positively impact healthcare.

References

210721-en-r2_centrella-bed-hr-rr_brochure-hr.pdf [PDF]. (2021). Retrieved March 4, 2022, from

Read Also:

RE: Discussion – Week 1

As a Psych nurse, I believe there is a significant disconnect between nursing’s physical duties and the documentation process. Documentation can often feel pointless and ineffective. Suicide prevention is an example of where I discovered data that could have made a difference that was collected and assessed.

I have witnessed patients successfully commit suicide in the hospital on two occasions. After speaking with other staff members who had direct contact with these individuals in the days preceding, I discovered two things in common. Both patients ate and slept much less than usual. In this facility, we count sleep hours each night as well as the percentage of food consumed. These numbers, however, are not available in any assessment to help predict someone’s risk of suicide. Instead, we conduct a suicide risk assessment on each patient to detect suicidality. A suicide risk assessment includes questions such as, “Have you ever attempted suicide or attempted to kill yourself?” Do you intend to end your life? Have you started making plans? Dueweke (2018) In an inpatient psychiatric facility, we ask these questions twice a day for the duration of the patient’s stay. The suicide risk assessments, according to Bolster (2015), were inconclusive in determining the patient’s willingness to commit suicide.

I believe informatics can help in this situation by integrating data from the patient’s assessments. The assessments we complete as nurses could be more effective if they were integrated and analyzed by a much larger algorithm to determine our patients’ mental/physical health. Sleep hours, food intake, body weight changes, medication compliance, PRN requests, suicide risk assessment, and mental status exam scoring, for example, can all indicate potential health trajectories. These hypothetical trajectories could be displayed as red flags and alerts on an interface.

A nurse leader would be better informed about the patient’s overall health with this data integration. The nurse leader would have more information about the patient, allowing them to make better patient care decisions. We would have had a better chance of preventing those patients from committing suicide if there had been an algorithm to detect their mental health decline.

References

Bolster, C., Holliday, C., Oneal, G., Shaw, M., (2015) “Suicide Assessment and Nurses: What Does the Evidence Show?” OJIN: The Online Journal of Issues in Nursing Vol. 20, No. 1, Manuscript 2.

Dueweke, A. R., & Bridges, A. J. (2018). Suicide Interventions in Primary Care: A Selective Review of the Evidence. Families, Systems, & Health. Advance online publication.http://dx.doi.org/10.1037/fsh000034

Name: NURS_5051_Module01_Week01_Discussion_Rubric

	Excellent	Good	Fair	Poor
Main Posting	Points Range: 45 (45%) – 50 (50%) 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.	Points Range: 40 (40%) – 44 (44%) 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.	Points Range: 35 (35%) – 39 (39%) 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.	Points Range: 0 (0%) – 34 (34%) 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.
Main Post: Timeliness	Points Range: 10 (10%) – 10 (10%) Posts main post by day 3.	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) Does not post by day 3.
First Response	Points Range: 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	Points Range: 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	Points Range: 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	Points Range: 0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%)	Points Range: 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.

Total Points: 100

Name: NURS_5051_Module01_Week01_Discussion_Rubric

The procurement, assimilation, and interpretation of data in the nursing profession are paramount to problem-solving and achieving evidence-based outcomes (Deckro et al., 2021). One area in my daily practice to which this approach can be applied is understanding the rate of staff turnover after one year of employment. The cause of staff turnover can be multifaceted and result from many differing views of the employees and their feelings about professional advancement and job satisfaction. Knowing the staff’s mindset regarding these two topics in the early stages of their careers can assist the nurse leader in maintaining retention and overall positive morale.

The information needed to make necessary changes can come from sources such as surveys, dropbox suggestions, and individual staff performance evaluations. Anonymous data from surveys or a breakroom box can be used to establish nonbiased data that can then be used for application to the presenting inquiry. Personal staff performance evaluations can allow the nurse leader to explore any current employee dissatisfactions and possible solutions during the face-to-face interaction.

Having knowledge of departmental or educational discrepancies that result in post-one-year employment turnover can assist with policy and program changes which can improve employee satisfaction and retention. Being a knowledge worker, the nurse leader can then cause a change in employment outcomes by knowledge generation and dissemination (McGonigle & Mastrian, 2018).

References

Deckro, J., Phillips, T., Davis, A., Hehr, A., & Ochylski, S. (2021). Big Data in the Veterans Health Administration: A Nursing Informatics Perspective. Journal Of Nursing Scholarship, 53(3), 288-295.

McGonigle, D., & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones and Bartlett Learning.

NURS 6050 Application of Data to Problem-Solving

NURS 6050 Application of Data to Problem-Solving References

THE APPLICATION OF DATA TO PROBLEM-SOLVING

RESOURCES

BY DAY 3 OF WEEK 1

BY DAY 6 OF WEEK 1

NURS 6050 Application of Data to Problem-Solving

Name: NURS_5051_Module01_Week01_Discussion_Rubric

Name: NURS_5051_Module01_Week01_Discussion_Rubric

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