Part 1 Current Information and Communication Technologies (2 pages)
With so much attention focused on health care reform, it is important that nurses be given the opportunity to use high-quality technology tools. These tools can increase access to vital medical information, promote effective communication among health care professionals, and improve the patient experience. By actively seeking out and adopting these tools, nurses can greatly enhance the quality and safety of care that they provide.
This Discussion focuses on identifying quality technology tools that increase the ability of nurses to provide safe, effective care.
•Review the various technology tools described in this week’s Learning Resources.
•Identify a recently adopted information, education, or communication technology tool in your specialty area. Reflect on how it is used and how its use impacts the quality of care.
•Consider how your identified technology tool might impact nursing practice if it were more widely used. What are some barriers preventing increased usage? How could wider implementation be facilitated?
Post a description of a current or new information, education, or communication technology tool that is being used in your specialty area and assess its impact on the quality of care. Highlight the effect that increased use of this technology would have on nursing practice and discuss the barriers that are slowing or hindering its adoption. Summarize how adoption of the technology tool could be facilitated.
Part 2 Electronic Health Records (2 pages)
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
•Review the Learning Resources focusing on the implementation of EHRs in an organization. Reflect on the various approaches used.
•If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
•Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
•If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
•Search the Walden Library for examples of effective and poor implementation of EHRs.
Post an overview of at least three challenges in the implementation of electronic health records and provide an example of each challenge. Develop strategies for addressing each challenge based on what has been demonstrated to be successful. Cite your resources.
Part 3 Successful Implementation of Electronic Health Information Technology (2 pages)
Since the inception of the HITECH Act, health organizations have faced increased pressure to update their health information technology (HIT) resources. As discussed last week, many believe that the increased use of electronic health records and the quick and efficient communication afforded by HIT can lead to improved quality of patient care. Yet there are significant costs associated with implementing such systems. What can organizations do to ensure that the correct system is selected and that the system will be appropriate for those required to use it? Who should be involved in those decisions?
This week introduces the systems development life cycle and discusses how it can guide an organization through the complexities of adopting a new HIT system. In this Discussion, you are asked to consider the role of nurses in the SDLC process.
•Review the steps of the systems development life cycle.
•Think about your own organization, or one with which you are familiar, and the steps the organization goes through when purchasing and implementing a new HIT system.
•Consider what a nurse could contribute to decisions made at each stage when planning for new health information technology. What might be the consequences of not involving nurses?
•Reflect on your own experiences with your organization selecting and implementing new technology. As an end user, do you feel you had any input in the selection or and planning of the new HIT system?
Post an analysis of the ramifications of an organization not involving nurses in each stage of the systems development life cycle when purchasing and implementing a new HIT system. Give specific examples of potential issues at each stage and how the inclusion of nurses could help avoid such issues.
Part 4: Understanding Workflow Design (2 pages)
As you explored last week, the implementation of a new technology can dramatically affect the workflow of an organization. Newly implemented technologies can initially limit the productivity of users as they adjust to their new tools. Such implementations tend to be so significant that they often require workflows to be redesigned in order to achieve improvements in safety and patient outcomes. However, before workflows can be redesigned, they must first be analyzed. This analysis includes each step in completing a certain process. Some systems duplicate efforts or contain unnecessary steps that waste time and money and could even jeopardize patient health care. By reviewing and modifying the workflow, you enable greater productivity. This drive to implement new technologies has elevated the demand for nurses who can perform workflow analysis.
In this Discussion you explore resources that have been designed to help guide you through the process of workflow assessment.
•Take a few minutes and peruse the information found in the article “Workflow Assessment for Health IT Toolkit” listed in this week’s Learning Resources. •As you check out the information located on the different tabs, identify key concepts that you could use to improve a workflow in your own organization and consider how you could use them.
•Go the Research tab and identify and read one article that is of interest to you and relates to your specialty area.
Post a summary of three different concepts you found in “Workflow Assessment for Health IT Toolkit” that would help in redesigning a workflow in the organization in which you work (or one with which you are familiar) and describe how you would apply them. Next, summarize the article you selected and assess how you could use the information to improve workflow within your organization. Finally, evaluate the importance of monitoring the effect of technology on workflow.
Part 5: Using Health Information Technology as a Source of Evidence-Based Practice (2 pages)
Before the digital revolution, health information technology supplied very limited support for evidence-based practice. If nurses wanted to be informed about cutting-edge research, their best bet was to either subscribe to leading journals or make periodic trips to the library. With the establishment of research databases, however, nurses became empowered to learn about and facilitate interdisciplinary and translational research. Databases are just one example of how health information technology supports evidence-based practice.
•Read the following scenario from the text (McGonigle & Mastrian, 2015, p. 445):
Twelve-hour shifts are problematic for patient and nurse safety, and yet hospitals continue to keep the 12-hour shift schedule. In 2004, the Institute of Medicine (Board on Health Care Services & Institute of Medicine, 2004) published a report that referred to studies as early as 1988 that discussed the negative effects of rotating shifts on intervention accuracy. Workers with 12-hour shifts realized more fatigue than workers on 8-hour shifts. In another study done in Turkey by Ilhan, Durukan, Aras, Turkcuoglu, and Aygun (2006), factors relating to increased risk for injury were age of 24 or less, less than 4 years of nursing experience, working in the surgical intensive care units, and working for more than 8 hours.
•Consider how the resources identified in the scenario above could influence an organization’s practice.
•Select an issue in your practice that is of concern to you. Using health information technology, locate at least three evidence-based practice resources that address your concern and that could possibly inform further action.
Post a description of your practice concern. Outline how you used health information technology to locate evidence-based practices that address this concern. Cite and include insights from the resources. Analyze how health information technology supports evidence-based practice.
Part 6: HITECH Legislation (2 pages)
In order for organizations to receive the incentives offered through the HITECH legislation, they must be able to demonstrate that they are using the technology in meaningful ways. The following criteria for meaningful use must be evident to qualify for EHR incentives (U.S. Department of Health & Human Services, 2012). The technology must:
•Improve quality, safety, and efficiency, and reduce health disparities
•Engage patients and families
•Improve care coordination
•Improve population and public health
•Ensure adequate privacy and security protections for personal health information
For this Discussion you consider the impact of the meaningful use criteria of the HITECH legislation on the adoption of health information technology.
•Review the Learning Resources on the HITECH legislation and its primary goals.
•Reflect on the positive and negative impact this legislation has had on your organization or one with which you are familiar.
•Consider the incentives to encourage the use of EHRs. Focus on the definition of meaningful use and how it is measured.
•Reflect on how the incentives and meaningful use impact the quality of patient care.
•Find an article in the Walden Library dealing with one of the criteria to qualify for meaningful use and how it has been successfully met.
Post a description of how HITECH legislation has positively or negatively impacted your organization. Address how its related incentives influence the adoption of health information technology in health care and impact the quality of patient care. Provide a summary of the article you identified and explain how it demonstrates the ability of health information technology to meet the requirements of meaningful use.
Part 7: Security of Health Care Records (2 pages)
With the increase of health information technology used to store and access patient information, the likelihood of security breaches has also risen. In fact, according to the Canadian Medical Association Journal (CMAJ):
In the United States, there was a whopping 97% increase in the number of health records breached from 2010 to 2011… The number of patient records accessed in each breach has also increased substantially, from 26,968 (in 2010) to 49,394 (in 2011). Since August 2009, when the US government regulated that any breach affecting more than 500 patients be publicly disclosed, a total of 385 breaches, involving more than 19 million records, have been reported to the Department of Health and Human Services.
A large portion of those breaches, 39%, occurred because of a lost, stolen, or otherwise compromised portable electronic device—a problem that will likely only get worse as iPads, smartphones, and other gadgets become more common in hospitals. (CMAJ, 2012, p. E215).
Consider your own experiences. Does your organization use portable electronic devices? What safeguards are in place to ensure the security of data and patient information? For this Discussion you consider ethical and security issues surrounding the protection of digital health information.
•Review the Learning Resources dealing with the security of digital health care information. Reflect on your own organization or one with which you are familiar, and think about how health information stored electronically is protected.
•Consider the nurse’s responsibility to ensure the protection of patient information. What strategies can you use?
•Reflect on ethical issues that are likely to arise with the increased access to newer, smaller, and more powerful technology tools.
•Consider strategies that can be implemented to ensure that the use of HIT contributes to an overall culture of safety.
Post an analysis of the nurse’s responsibility to protect patient information and the extent that HIT has made it easier or more difficult to protect patient privacy. Comment on any security or ethical issues related to the use of portable devices to store information. Assess the strategies your organization uses to safeguard patient information and how these promote a culture of safety. Describe an area where improvement is needed and one strategy that could address the situation.
Part 8: Health Literacy (2 pages)
In order to effectively manage their own health, individuals need to have competencies in two areas—basic literacy and basic health literacy. What is the difference? Basic literacy refers to the ability to read, even simple language. Health literacy is defined as, “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (National Coalition for Literacy, 2009). Unfortunately, according to a Department of Education report on health literacy, only 12% of adults aged 16 and older are considered to have a proficient level of health literacy (U.S. Department of Education, 2006). Acquiring health literacy skills has become more complicated with the explosion of online health information, some credible and some misleading.
In this Discussion, you focus on how to help individuals find credible information on the Internet and develop strategies nurses can use to increase the health literacy of their patients.
•Think about the nurse’s role in improving the health literacy of patients.
•Consider the many ways patients access health information, including blogs, social media, patient portals, websites, etc.
•Reflect on experiences you have had with patients who self-diagnose using online medical sources.
•Using the Internet, the Walden Library, or other trustworthy sources, identify a resource that you could introduce to patients to help them evaluate the credibility of health information found online.
•What are some strategies you could employ to improve the health literacy of patients?
Post your assessment of the nurse’s role in improving the health literacy of patients. Then, identify the resource you would recommend to patients for evaluating online health information and why it would be beneficial. Describe additional strategies for assisting patients in becoming informed consumers of online health information