Tag: Clinical-Nursing

  • NURS 6051S week 4 Assignment: The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies

    Project Proposal:

    Decreasing Interruptions in Medication Administration

     

    The proposed project seeks to decrease interruptions in medication administration by applying a bottom-up approach. The problem addressed by the project is the concern that interruptions during medication administration lead to a significant proportion of medication errors. Despite the best efforts to safely manage medication administration, mistakes occur within the health care setting (Mortaro et al., 2019). In fact, about 7,000 patients die every year from preventable medication errors. Although there is limited research on this subject, evidence suggests that reducing interruptions would reduce medication errors. In addition, it is noted that medication administration is a routine activity with a skill-based and repetitive nature thereby increasing the risk of distractions (Stanhope & Lancaster, 2020). To address this concern, the project will apply a pre-and post-intervention observational study approach that is based on direct observation. The intervention will involve adequately training nurses on the risks related to interruptions during medication administration. The bottom-up approach is expected to tailor the intervention and concurrently act as the training instrument tool (Snipes, 2016). During the project, the participating nurses will be observed for total medication dispensing rounds reported for the pre-intervention and post-intervention periods. Observations will note the raw number of interruptions per patient rate during drug rounds with the expectation that the project will result in reduced interruption rates during medication administration (Harris et al., 2016).

     

     

     

     

    Identify the stakeholders impacted by this project.

    The project is focused on addressing medication safety. Five stakeholders have been identified as impacted by this project. Firstly, patients/consumers whose lives are risked when medication errors occur. They have become more informed and are no longer passive about their healthcare. Patients are now active customers who ask questions about their medication and are not intimidated by the disposition of medication personal. They should be informed about the project since it has implications for their health care outcomes. Secondly, academia would be interested in the project. The results of the project can be weaved into current medication safety concepts throughout the curriculum thus ensuring that medical personnel is able to develop the critical thinking skills required to manage medication administration safety (Zaccagnini & White, 2017). Thirdly, external health care stakeholders who include licensing, accrediting and regulatory bodies who would use the project results to develop safety standards. Also, the project results would be useful for providing oversight and ensuring that medical organizations fully implement medication administration safety standards. Fourthly, health care organizations, and leaders who would need to incorporate the concepts presented in the project into their patient safety goals and mission statement while upholding practice issues. Their affirmation that patient safety is a significant concern should be accompanied by genuine commitment and action to safe medication administration. The leaders would be interested in transforming the project results into practice standards and protocols then communicating them to all levels of the organization. Finally, medical practitioners would be interested in the project as it presents them with current information bout patient safety. Also, the information allows them to maintain competencies and make necessary changes in practice to improve patient safety (Zaccagnini & White, 2017).

     

    Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur.

    The project seeks to reduce interruptions during medication administration with the expectation of a reduced proportion of medication errors. The project will train selected nurses on the risks related to interruptions during medication administration. The information is expected to enable nurse personnel to be more aware of the risks associated with medication errors. In addition, it is expected to enable nurses to develop better strategies and protocols for eliminating or handling interruptions so that they do not interfere with medication administration and they are not distracted. Besides that, it will enable organization leadership to work alongside frontline medical personnel to guide a bottom-up approach in identifying and applying tailored interventions alongside training instrument tools. Ultimately, the project seeks to improve patient safety and care outcomes by reducing incidences of medication errors (Snipes, 2016).

     

    Identify the technologies required to implement this project and explain why.

    This project will require three technologies. The first technology is training material that will inform medical personnel about the risks related to interruptions during drug administration. The training material will include a trainer, notes, posters, and presentations. The second technology is access to the electronic medical records (EMR) system. This will offer access to data on incidences of medication errors as well as data on other variables. The final technology is a data analysis software that will determine the correlation between variables to identifying areas in which interventions would present the most benefits (Harris et al., 2016).

     

     

     

    Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

    The project team has three members. The first member is a project manager who would be responsible for coaching the project team through the project life cycle, coordinating with the organization’s management, and ensuring the overall success of the implementation to include meeting deadlines and requirements such as performance and function. In addition, this individual links the implementation phases (planning, design, development, implementation, and testing phases) so that they run seamlessly and are able to communicate. The second member is a training analyst who is responsible for linking the concepts and ideas that are presented as the training requirements. The expertise required of the training analyst is the technical knowledge of continuous training applications. The role requires excellent interpersonal and communication skills, the ability to relay information to others and elicit their needs, and analytical skills. This individual should understand that medication administration needs of the organization and should have a clinical background (Bemker & Schreiner, 2017). The final member is a nurse informaticist who will be responsible for managing all data needs of the project. This will include identifying the project’s data needs in terms of which variables inform on medication errors. In addition, this individual will be responsible for evaluating the project data and communicating the results to the project leader and other stakeholders with a focus on noting implications for the organization (McGonigle & Mastrian, 2018).

     

    References

    Bemker, M., & Schreiner, B. (Eds.) (2017).
    The DNP Degree & Capstone Project: A Practical Guide
    . DEStech Publications, Inc.

    Harris, J., Roussel, L., Thomas, P., & Dearman, P. (2016).
    Project Planning & Management: A Guide for Nurses and Interprofessional Teams
    . Jones & Bartlett Learning, LLC.

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

    Mortaro, A., Pascu, D., Pancheri, S., Mazzi, M., Tardivo, S., Bellamoli, C., … & Moretti, F. (2019). Reducing interruptions during medication preparation and administration: An improvement project.
    International Journal of Health Care Quality Assurance
    , 32(6), 941-957.
    https://doi.org/10.1108/IJHCQA-12-2017-0238

    Snipes, C. (2016).
    Project Management for the Advanced Practice Nurse
    . Springer Publishing Company.

    Stanhope, M., & Lancaster, J. (2020).
    Public Health Nursing: Population-Centered Health Care in the Community
    . Elsevier, Inc.

    Zaccagnini, M., & White, K. (Eds.) (2017).
    The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing
    (3
    rd
    ed.). Jones & Bartlett Learning, LLC.

    Assignment: The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies

    In the Discussion for this module, you considered the interaction of nurse informaticists with other specialists to ensure successful care. How is that success determined?

    Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is measured. Measuring patient outcomes results in the generation of data that can be used to improve results. Nursing informatics can have a significant part in this process and can help to improve outcomes by improving processes, identifying at-risk patients, and enhancing efficiency.

    To Prepare:

    Review the concepts of technology application as presented in the Resources.

    Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

    The Assignment: (4-5 pages not including the title and reference page)

    In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

    Describe the project you propose.

    Identify the stakeholders impacted by this project.

    Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.

    Identify the technologies required to implement this project and explain why.

    Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

    Use APA format and include a title page and reference page.

    Use the Safe Assign Drafts to check your match percentage before submitting your work.

  • Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post

    Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post

    Nursing informatics is a modern high-level technical operation of nurses. Nursing informatics require computer skills, information technology, and data each day to successfully  evaluate systems, patient care practices, and healthcare initiatives. They analyze data to determine what is working effectively and what is not while using established findings to propose advancements, lead programs, and necessary changes (Mosier et al., 2019).  Nursing informatics should work jointly with other professionals in the medical fields, for example doctors, other nurses, occupational therapist, and psychologists, to ensure the quality of care (McGonigle &Mastrain, 2015). Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post.  Such interactions should be improved by ensuring that nursing informatics provide healthcare to patients in different settings, units, and departments while working with all medical professionals to guarantee successful patient-centered care.

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    Nursing informatics are involved in analyzing  data to improve patient care and enable healthcare facilities to establish novel and useful expertise. They research, suggest, and employ new technology while training other health professionals to use such knowledge in answering questions, providing care to patients, and monitoring results (Ng et al., 2018).  Contrary to nurses’ traditional tasks that centered only on providing one-on-one care to patients, nursing informatics advocate steps that should be taken to improve patient safety and outcomes in a given department, units, facility, or the entire healthcare system.

    Some of the projects that could help nursing informatics to improve outcomes and effectiveness in healthcare organizations include enabling all stakeholders to have enhanced access to electronic records, diagnostics, and patient care plans. Some significant nursing informatics projects’ influential stakeholders include all nurses doctors, patients and their family members, the nursing association, lawmakers, and all medical professionals. Enhanced collaboration and communication among stakeholders make it simple to tackle healthcare work flows, facilitate coordination, and improve patient outcomes (McGonigle & Mastrain, 2015). Facilitation of data access will necessitates system integration, which will make information and analysis essential. Another project would be the improvement of clinical strategies, protocols, practices and procedures. Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post

    Nurse informaticists should regularly gauge and assess how particular care delivery segments are performing while focusing on patient outcomes. They could advocate changes and improvement in poorly performing practices to guarantee positive patient outcomes. Moreover, nurse informaticists should provide training and learning anchored on unbiased data. They should train other health professionals on technology-based aspects and employ data to identify rampant problems in health institutions while consulting on the most successful means of resolving underlying issues (Ng et al., 2018). This will enable nurse informatics to generate highly targeted programs to address existing gaps between capacity and provider anticipations.

    Projects undertaken by nursing informatics improve healthcare delivery outcomes by enhancing the selection and testing of new health devices that can offer vast quantities of patients’ medical data. Nursing informatics are characteristically positioned to fathom actual worth of data and give suggestions on the best practices of recording, accessing, and using it to ensure quality of care. Engaging them in the choice of valuable health devices will make sure that medical professionals have an added advantage in understanding how technological gadgets can improve diagnostics, care plans, and eventually, patient outcomes.  Nursing informatics projects also assist in the reduction of medical errors and unnecessary costs (McGonigle & Mastrin, 2015). Collaboration among nursing informatics, patients and their relatives, doctors, and other health professionals ensures a vast pool of decisions that make all stakeholders well-informed, which helps avoid mistakes. Additionally, the incorporation of regular staff training and development, process enhancement, and application of best practices will ensure the quality of care and prevent patient risks. Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post

    References

    McGonigle, D., & Mastrian, K.G. (Eds). (2015). Nursing informatics and the foundation of knowledge (3rd ed.) Jones &Bartlett Publishers

    Mosier, S., Roberts, W.D., & Englebright, J. (2019). A systems-level method for developing nursing informatics solutions: The role of executive leadership. JONA: The Journal of Nursing Administration, 49 (11), 543-548.

    https://doi.org/10.1097/NNA.0000000000000815 Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post

    Ng, Y.C., Alexander, S., & Frith, K. H. (2018). Integration of mobile health application in health information technology initiatives: Expanding opportunities for nurse participation in population health. CIN: Computers, informatics, Nursing, 36 (5), 209-213. https://doi.org/10.1097/CIN.0000000000000445

     

     

    Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post sample 2

    At a level 1 trauma center, communication is exceedingly important.  In many circumstances, a maximum response time of 30 minutes from hospital entry to operating room table is necessary for a good outcome.  The data for incoming  traumas is recorded and protocol is adjusted to ensure a smooth transition from department to department.  This is the area where patient care communication is often dropped; the possibilities are not relayed to the involved teams causing  unnecessary uncertainty, and confusing delays.  Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post Following a patient physically prior to entry, and then throughout the assessment as well as testing areas would be beneficial to all.  Just as with the HIT initiative cell phone technology is recognized as playing a major role in improving  health care delivery.   Alexander, Ng, & Frith  (2018) There are many real time applications that can be utilized to improve patient care.

    The greatest area for improvement that I see daily, is the actual “following” of a patient upon arrival.  When a trauma arrives  a beeper goes off to signal the severity of the injuries and then nothing is communicated unless it is sought.  This is where the cell phone technology would be beneficial.  When a patient left the ER to go for testing or to the SICU for observation, those waiting for possible interventions should be informed.  There are many studies trying to integrate continuity of care within the hospital; one being the HANDS care model.  Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post ” Underpinning the HANDS Method is a model which includes concepts adapted from the literature on high reliability organizations, such as nuclear power plants, air traffic control towers, and hospitals.”  Park, Murray, Delaney, Keenan, Yakel, & Marriott. (2006) With all of the technology of today the immediate hand-off information could be relayed to the appropriate parties. Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post

    .     There needs to be an efficient way for nursing and supporting staff to be made aware of changes in patient care decisions.  Currently there is a “hurry-up and wait” style of communication without any end to the loop of information unless the operating room or other departments hunt down information for themselves.  If management could see the potential cost-saving measures that would not only create greater efficiency, but avoid near misses, and improve continuity of care that would have a much greater success in emergent care situations.   Studies to determine the points in which specific patient information should be shared with particular areas where there may be a  need for intervention, type of care, or termination of readiness.   “These data can potentially affect the productivity, efficiency, performance, effectiveness, cost, and value of nursing care when properly collected and used.”   Mosier, Sammie, Roberts, et al. (2019) Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post

     

    References:

    Alexander, S., Ng, Y. C., & Frith, K. H. (2018). Integration of Mobile Health Applications in Health Information Technology Initiatives: Expanding Opportunities for Nurse Participation in Population Health. 
    CIN: Computers, Informatics, Nursing
    , 
    36
    (5), 209–213. Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post

    Mosier, Sammie, DHA, MA, BSN, NE-BC, CMSRN, BC, Roberts, Wm., Dan PhD, RN, et al. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. Journal of Nursing Administration, 49, 543-548. https://doi.org/10.1097/NNA.0000000000000815

    Park, H.-A., Murray, P., Delaney, C., Keenan, G., Yakel, E., & Marriott, D. (2006). HANDS: A Revitalized Technology Supported Care Planning Method to Improve Nursing Handoffs. 
    Studies in Health Technology & Informatics
    , 
    122
    , 580. Interaction Between Nurse Informaticists and Other Specialists Sample Discussion Post

  • Interaction Between Nurse Informaticists and Other Specialists Discussion Essay

    Interaction Between Nurse Informaticists and Other Specialists Discussion Essay

    Nursing informatics is a formal specialty that is recognized by the American Nurses Association (Laureate education, 2018). Nursing informatics is the synthesis of nursing science, information science, computer science, and cognitive science for the purpose of managing and enhancing healthcare data, information, knowledge, and wisdom to improve patient care and the nursing profession(ANA) Interaction Between Nurse Informaticists and Other Specialists Discussion Essay.

    I work in an adolescent psychiatric unit and we use Meditech as software for electronic health record. An electronic health record (HER) is a digital version of a patient’s chart. Electronic health records are real time, patient-centered records that make information available instantly and securely to authorized users (healthit.gov). Meditech is friendly user software if you are trained in a proper way. The entire pertinent patient’s information is stored in the system. After being hired at the hospital, the nurse informaticist will spend a couple of days with any new hire to go over the details and to explain how to navigate the system. The nurse informaticist is very important for a new hire to stay on the job. It is fundamental for the new hire to be curious, vigilant and inquisitive. The nurse informacist provides so much information during orientation that you feel lost. The nurse informaticist makes sure that the new hire masters those skills that will enable him/her to perform his/her task adequately. The nurse informaticist will teach all shortcuts, tricks and eventual glitches you might encounter in real life situation.  The nurse informaticist is the heart of the system and their presence on the floor is reassuring. The nurse informaticist trained all types of personnel from administrators, doctors, nurses, kitchen aid and housekeepers how to enter data for their respective work. This is reassuring knowing that the nurse informaticist is present on the floor to answer any pertinent questions that you might have. The nurse informaticist supports nurses, consumers, patients, the interprofessional healthcare team, and other stakeholders in their decision making in all roles and settings to achieve desired outcomes (Sipes, 2016)

    One of the new technologies that we had issues with was a new glucometer that was required by the state for reimbursement. A lot of my colleagues tried to use it and could not. The system was complicated and caused a lot of stress on the unit. Sometimes, we have to check a patient’s blood sugar and we could not. We had to call the nurse informaticist to come to the floor for a review. You scanned everything and followed all the steps and the data did not go to the system. The computer sent you messages and asked you to take the blood sugar that was already past due. With time, staff mastered the techniques how to manipulate the machine and we had no issues afterwards.

    The nurse informaticist has a pivotal role in healthcare organizations. The nurse informaticist interacts with other professionals at the hospital via email. Email is the number one means of communication and cellular phone is second. The nurse informacist is reliable and responds promptly and gently to any request made by the healthcare team. The combination of clinical insight and technological skills possessed by nurse informaticists enables this highly trained group to make significant contributions in the design and deliver of mental health applications (Ng, Y.C & all, 2018). With the Covid-19 pandemic and the existence of new means of communication, telehealth is a good way for patients and providers to be in touch. In today’s technologically savvy healthcare environment, patients are being prescribed applications for their smartphones instead of medications in some clinical practices. Patient’s smartphones are being used to interact with them in new ways and to monitor and assess their health in some cases. With applications and add-ons, for example, a provider can see the patient’s ECG immediately, or the patient can monitor his or her ECG and send it to the provider as necessary (McGonigle and Mastrian, 2017) Interaction Between Nurse Informaticists and Other Specialists Discussion Essay. New technologies are revolutionized the healthcare system. The nurse informaticist will be at the forefront of those changes. With their combination of clinical and technological expertise, nurse informaticists are poised to integrate mental health applications in clinical practice and connect patients and health care providers in ways that are compatible with life, work, and the health of populations (Ng, Y.C, 2018). Technology is great and it does not help us collect meaningful data and generate knowledge about our patient situations, but equally important is the need to collect the human-to-human data that become available only when we step away from technology and interact authentically with our patients (McGonigle and Mastrian, 2017) Interaction Between Nurse Informaticists and Other Specialists Discussion Essay

     

    References:

    American Nurses Association (ANA). (2008). Nursing informatics: Scope and standards of practice. Springfield, MD: Nursesbooks.org

    https://www.healthit.gov/faq/what-electronic-health-record-ehr

    Laureate Education (Producer). (2018). The Nurse Informaticist [Video File]. Baltimore, MD: Author.

    McGonigle, D; & Mastrian, K. G. (2017). Nursing Informatics and the foundation of knowledge (4
    th
    ed). Burlington, MA: Jones & Barlett Learning Interaction Between Nurse Informaticists and Other Specialists Discussion Essay

    Ng, Y.C., Alexander, S., & Frith, K. H. (2018). Integration of Mobile health Applications in Health Information Technology Initiatives: Expanding Opportunities for Nurse Participation in Population Health. CIN: Computers, Informatics, Nursing, 36(5), 209-213.

    Sipes, C. (2016). Project management: Essential skill of nurse informaticists. Studies in Health Technology and Informatics, 225, 252-256. Interaction Between Nurse Informaticists and Other Specialists Discussion Essay

  • Interaction Between Nurse Informaticists and Other Specialists

    Nursing informatics is a formal specialty that is recognized by the American Nurses Association (Laureate education, 2018). Nursing informatics is the synthesis of nursing science, information science, computer science, and cognitive science for the purpose of managing and enhancing healthcare data, information, knowledge, and wisdom to improve patient care and the nursing profession(ANA).

    I work in an adolescent psychiatric unit and we use Meditech as software for electronic health record. An electronic health record (HER) is a digital version of a patient’s chart. Electronic health records are real time, patient-centered records that make information available instantly and securely to authorized users (healthit.gov). Meditech is friendly user software if you are trained in a proper way. The entire pertinent patient’s information is stored in the system. After being hired at the hospital, the nurse informaticist will spend a couple of days with any new hire to go over the details and to explain how to navigate the system. The nurse informaticist is very important for a new hire to stay on the job. It is fundamental for the new hire to be curious, vigilant and inquisitive. The nurse informacist provides so much information during orientation that you feel lost. The nurse informaticist makes sure that the new hire masters those skills that will enable him/her to perform his/her task adequately. The nurse informaticist will teach all shortcuts, tricks and eventual glitches you might encounter in real life situation.  The nurse informaticist is the heart of the system and their presence on the floor is reassuring. The nurse informaticist trained all types of personnel from administrators, doctors, nurses, kitchen aid and housekeepers how to enter data for their respective work. This is reassuring knowing that the nurse informaticist is present on the floor to answer any pertinent questions that you might have. The nurse informaticist supports nurses, consumers, patients, the interprofessional healthcare team, and other stakeholders in their decision making in all roles and settings to achieve desired outcomes (Sipes, 2016)

    One of the new technologies that we had issues with was a new glucometer that was required by the state for reimbursement. A lot of my colleagues tried to use it and could not. The system was complicated and caused a lot of stress on the unit. Sometimes, we have to check a patient’s blood sugar and we could not. We had to call the nurse informaticist to come to the floor for a review. You scanned everything and followed all the steps and the data did not go to the system. The computer sent you messages and asked you to take the blood sugar that was already past due. With time, staff mastered the techniques how to manipulate the machine and we had no issues afterwards.

    The nurse informaticist has a pivotal role in healthcare organizations. The nurse informaticist interacts with other professionals at the hospital via email. Email is the number one means of communication and cellular phone is second. The nurse informacist is reliable and responds promptly and gently to any request made by the healthcare team. The combination of clinical insight and technological skills possessed by nurse informaticists enables this highly trained group to make significant contributions in the design and deliver of mental health applications (Ng, Y.C & all, 2018). With the Covid-19 pandemic and the existence of new means of communication, telehealth is a good way for patients and providers to be in touch. In today’s technologically savvy healthcare environment, patients are being prescribed applications for their smartphones instead of medications in some clinical practices. Patient’s smartphones are being used to interact with them in new ways and to monitor and assess their health in some cases. With applications and add-ons, for example, a provider can see the patient’s ECG immediately, or the patient can monitor his or her ECG and send it to the provider as necessary (McGonigle and Mastrian, 2017). New technologies are revolutionized the healthcare system. The nurse informaticist will be at the forefront of those changes. With their combination of clinical and technological expertise, nurse informaticists are poised to integrate mental health applications in clinical practice and connect patients and health care providers in ways that are compatible with life, work, and the health of populations (Ng, Y.C, 2018). Technology is great and it does not help us collect meaningful data and generate knowledge about our patient situations, but equally important is the need to collect the human-to-human data that become available only when we step away from technology and interact authentically with our patients (McGonigle and Mastrian, 2017)

     

    References:

    American Nurses Association (ANA). (2008). Nursing informatics: Scope and standards of practice. Springfield, MD: Nursesbooks.org

    https://www.healthit.gov/faq/what-electronic-health-record-ehr

    Laureate Education (Producer). (2018). The Nurse Informaticist [Video File]. Baltimore, MD: Author.

    McGonigle, D; & Mastrian, K. G. (2017). Nursing Informatics and the foundation of knowledge (4
    th
    ed). Burlington, MA: Jones & Barlett Learning

    Ng, Y.C., Alexander, S., & Frith, K. H. (2018). Integration of Mobile health Applications in Health Information Technology Initiatives: Expanding Opportunities for Nurse Participation in Population Health. CIN: Computers, Informatics, Nursing, 36(5), 209-213.

    Sipes, C. (2016). Project management: Essential skill of nurse informaticists. Studies in Health Technology and Informatics, 225, 252-256.

  • Interaction Between Nurse Informaticists and Other Specialists

    Interaction Between Nurse Informaticists and Other Specialists

    Nurse informaticists routinely make sure all systems are maintained, and able to be utilized properly (McGonigle & Mastrian, 2017, p. 313). Within the Washington Health System, the nurse informaticists help with the orientation of new staff members. All workers who will be utilizing the computers go through their orientation. This orientation helps workers learn the computer system utilized and how to log on to the computer. They provide direct supervision while the staff performs tasks on the computer. There is a packet of step-by-step instructions on how to access and chart in the Sunrise computer system. These individuals interact directly with those who will be using the computers for their job. When the organization implements new technology nurse informaticists are on the floor, directly showing nurses how it operates. This direct observation helps nurses feel more comfortable with new technology and provides resources for questions. Nurse informaticists are focused on creating solutions to improve overall patient care (Mosier et al., 2019). They are responsible for making technology user friendly and without errors. Interaction Between Nurse Informaticists and Other Specialists

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    One new technology advancement that we have had issues with is the ViTrac. When staff calls the technical support for the hospital, they try to address the issue over the phone. It would be easier if we could show them the issues we are experiencing. Having a person come over in person is less frustrating and many individuals feel heard. This is one strategy to improve the relationships between the different departments.

    Technology is always changing. Healthcare especially, is seeing advancements in technology to help better care for the patient. The use of mobile phone and telehealth is becoming more common. Health apps are being utilized to help lower readmission rates for designated diseases (Ng et al., 2018). Nursing informaticists play a key role in the development and execution of healthcare-based technology. This specialty is becoming more essential every year as technology advances. We need these individuals to help advance technology services we can provide to patients. As new technology is developed every year, this role is crucial. I believe the advancement of new technologies will expand the current professional interactions. It will allow for physicians to remotely connect with other professionals to better care for the patient. The evolution of this role allows for more professional interactions to occur. It will also cause many professional interactions to occur remotely. While this aspect can be positive in many ways, the lack of actual in person communication is lost. Especially during these times, many people need some form of human interaction after quarantining for months. Nurse informaticists are a great tool for advancing healthcare and improving care for patients.

    References

    McGonigle, D., & Mastrian, K. G. (2017).
    Nursing informatics and the foundation of knowledge
    (4th ed.). Jones & Bartlett Learning.

    Mosier, S., Roberts, W. D., & Englebright, J. (2019). A system-level method for developing nursing informatics and solutions: The role of executive leadership.
    The Journal of Nursing Administration,
    49(11), 543-548.

    10.1097/NNA.0000000000000815

    Ng, Y. C., Alexander, S., & Frith, K. H. (2018). Integration of mobile health applications in health information technology initiatives: Expanding opportunities for nurse participation in population health.
    Computers, Informatics, Nursing
    , 36(5), 209-213.
    10.1097/CIN.0000000000000445

     

    response post

    I agree that nursing informatics is a necessary tool for the advancement of the quality of care and the nursing profession in its’ entirety. Recently, we have seen a huge shift in the healthcare with telehealth coming to the forefront due to the Affordable Care Act and more recently the coronavirus pandemic. There are several advantages to providing services remotely such as: convenience, cost savings, the ability to provide care to those who are immunocompromised or with mobility issues, and accessibility for those that live in rural areas.

    According to Harvard Health, almost three-quarters of Americans surveyed said the pandemic has made them more eager to try virtual care, and one in four Americans over the age of 50 have had a virtual health visit during the first three months of the pandemic (2020). Telehealth is an umbrella term that covers telemedicine and a variety of nonphysician services, including telenursing and telepharmacy (Weinstein et al., 2014). Telehealth fundamentally changes the way patient care is delivered. Telephonic or virtual nursing allows nurses to monitor and deliver care to patients remotely. Nurse informaticists combine clinical and technical expertise to determine how to best meet the needs of the patient and organization. Nurse informaticists are critical in the success of telehealth as they play a significant role in the design and implementation of the systems utilized as well as the education of healthcare workers regarding the technology and biometric data that is used in order to treat patients virtually. As the population’s life expectancy continues to grow, the role of telehealth will become increasingly important as will the ability to utilize the technology in order to assess, communicate, and provide care for out patients virtually.

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    references

    Harvard Health. (2020).
    Telehealth: The advantages and disadvantages
    . https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-and-disadvantages. Interaction Between Nurse Informaticists and Other Specialists

    Weinstein, R. L., Lopez, A. M., Jospeh, B., Erps, K., Holcomb, M., Barker , G., & Krupinski, E. (2014, March).
    Telemedicine, Telehealth, and Mobile Health Applications That Work: Opportunities and Barriers
    . The American Journal of Medicine . http://scholar.google.com/scholar_url?url=http://www.academia.edu/download/42581191/Applications_that_work.pdf&hl=en&sa=X&ei=m43bX7j2GY-Ny9YPt6-10Ac&scisig=AAGBfm31zNtLDXJT_2-7S7hftARrTGuYww&nossl=1&oi=scholarr. Interaction Between Nurse Informaticists and Other Specialists

     

    Discussion: 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. Interaction Between Nurse Informaticists and Other Specialists

    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. Interaction Between Nurse Informaticists and Other Specialists

    To Prepare:

    Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.

    Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization.

    By Day 3 of Week 3

    Post
    a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions. Interaction Between Nurse Informaticists and Other Specialistsv

    By Day 6 of Week 3

    Respond
     to at least 
    two
     of your colleagues
    * on two different days
    , offering one or more additional interaction strategies in support of the examples/observations shared or by offering further insight to the thoughts shared about the future of these interactions.

     

    Interaction Between Nurse Informaticists and Other Specialists Sample 2

    Information about Covid-19 is being intensely scrutinized throughout not only the healthcare organization that I work for, but also throughout the world, in an attempt to coordinate a massive response to try to contain the spread of the disease.  Data is being gathered by multiple professions and disciplines and analyzed with the intention of sharing the resulting knowledge with people and agencies responsible for making decisions regarding steps to take to protect the public from the disease.  Data that is being collected and shared on a regular basis at my place of work includes results from weekly staff and patient Covid-19 testing, daily staff and patient symptom reports, daily bed counts, and patient temperatures and vital signs each shift.  Interaction Between Nurse Informaticists and Other Specialists The information is gathered by nurses on the inpatient unit, it is shared verbally and electronically with doctors, administrators, building supervisors, and public health officials to make decisions regarding patient care and staffing.

    One way to improve the efficient distribution of the information that is gathered on the inpatient unit would be to ensure that information is shared between disciplines and professions with compatible organizational approaches (Nordsteien & Bystrom, 2018).  Nursing on the inpatient unit needs to be aware of what specific information is being requested, and it must be reported in a manner that is accessible and easily understood by those requesting it.  Providing unnecessary information will only slow the analysis of information and delay effective interventions (Skiba, 2017) Interaction Between Nurse Informaticists and Other Specialists.

    As nursing informatics continues to evolve into a nursing specialty, nurse’s interactions with other professionals will take on a collaborative role in the quest for improved patient outcomes.  Knowledge will be created from data, analyzed, shared among professions, and incorporated into the practice of multiple disciplines (McGonigle & Mastrian, 2017).

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    References

    McGonigle, D., & Mastrian, K. (2017).
    Nursing informatics and the foundation of knowledge
    (4th ed.). Jones & Bartlett Learning. Interaction Between Nurse Informaticists and Other Specialists

    Nordsteien, A., & Bystrom, K. (2018). Transitions in workplace information practices and culture: The influence of newcomers on information use in healthcare.
    Journal of Documentation
    ,
    74
    (4), 827–843.
    www.emeraldinsight.com/0022-0418.htm

    Skiba, D. J. (2017). Nursing informatics education: From automation to connected care. In
    Forecasting informatics competencies for nurses in the future of connected health
    (pp. 9–19). IMIA; IOS Press.
    https://doi.org/10.3233/978-1-61499-738-2-9  
     Interaction Between Nurse Informaticists and Other Specialists

  • NRNP 6565 Week 1 Knowledge Check

    Question 1

    PhRMA will allow pharmaceutical companies to buy meals for clinicians if:

    As often as desires at any time of day

    Every other week during lunchtime

    Dinner time only

    Occasional basis during lunchtime NRNP 6565 Week 1 Knowledge Check.

    1 points

    Question 2

    There are several titles for NPs, and some are based on the state requirement. What does ARNP stand for?

    Adult Registered Nurse Practitioner

    Advanced Registered Nurse Practitioner

    Acute Registered Nurse Practitioner

    Advanced Registered Nurse Provider

    1 points

    Question 3

    At what level of government is the role of the nurse practitioner defined?

    By the county in which the NP practices

    By the state in which the NP practices

    By the federal government

    1 points

    Question 4

    A well-accepted change theory is the transtheoretical model (TTM), which conceptualizes the process of change in five stages. Pick the answer that lists the five stages in the correct order NRNP 6565 Week 1 Knowledge Check.

    Preparation; precontemplation; contemplation; action; maintenance

    Precontemplation; contemplation; preparation; action; maintenance

    Action; maintenance; precontemplation; contemplation; preparation

    Preparation; contemplation; action; maintenance; precontemplation

    1 points

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    Question 5

    Release of information (ROI) to third parties requires authorization by the patient or his or her legal representative. True or False?

    True

    False

    1 points

    Question 6

    It is vital for an NP to obtain a family history because

    Teaches you to have biases about your care

    Indicate need for Genetic testing

    Guide the decision for Diagnostic testing

    B and C correct

    All of the above

    1 points

    Question 7

    All states require NPs to take and pass a national certification exam. True or False?

    True

    False

    1 points

    Question 8

    Private email affords the security mandated by HIPAA to transmit personal health information. True or False?

    True

    False

    1 points

    Question 9

    Health insurers can use genetic information to make enrollment or coverage decisions

    True

    False

    1 points

    Question 10

    It is vital for an NP to obtain a family history because

    Teaches you to have biases about your care

    Indicate need for Genetic testing

    Guide the decision for Diagnostic testing

    B and C correct

    All of the above

    1 points NRNP 6565 Week 1 Knowledge Check

  • The Quality of Well-Being (QWB) scale Essay

    The Quality of Well-Being (QWB) scale Essay

    The Quality of Well-Being Scale

    The Quality of Well-Being (QWB) scale, developed in the 1970’s, is a validated and well established tool used to calculate a comprehensive measure of a health-related quality of life and it can help estimate the quality adjusted life years (QALYs) as an expression of health outcome
     
    (Pickles, et al., 2019). 
     
    The QWB can be used for The concept of the term, quality of life, is described as one’s own understanding of his/her lifestyle in the context of their social environment, the culture he/she lives in, and the desires in which suites their mental state
     
    (Moudjahid & Abdarrazak, 2019). 
     
    An individual’s quality of life can change with a variety of reasons including social, environment, economic, physical etc The Quality of Well-Being (QWB) scale Essay.

    The Quality of Well-Being Scale Psychometric Properties

    Psychometric properties of the QWB include testing the impact of mode of administration on overall scores along with test-retest reliability
     
    (Kaplan, Ganiats, Sieber, & Anderson, 1999). 
     
    QWB can be utilized before and after a treatment or intervention and can be described in terms of the QALYs that it produces or saves
     
    (Seiber, Groessl, David, Ganiats, & Kaplan, 2008).
     
     The QWB measure consists of segments for mobility, physical and social activity, and it is comprised of symptoms and problems, which allows for the scoring placement of each client on a continuum of wellness ranging from 0 to 1.0, for dead to asymptomatic
     
    (Seiber, Groessl, David, Ganiats, & Kaplan, 2008).
     
     The QWB scale can be used for population monitoring, descriptive studies of patient populations, cost effective analysis, societal perspective, and clinical trials to name a few.

    The Quality of Well-Being Scale and the Efficacy of Psychopharmacologic Medications

     
    It is well known that mental health is an important component to an individual’s well-being. 
     
    There are several studies on testing the validity of a mental health subscale for the QWB.
     
     One study in particular shows that it is extremely difficult to test the efficacy of a psychopharmacologic medication for several reasons stemming from the fact that the QWB does not have a mental health subscale. 
     
    This scale could be configured to be utilized regarding the symptoms of some mental health diagnoses; however, it appears that these symptoms are secondary to a primary illness ie: AIDS and depression.

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    Supporters of the QWB believe that even though there is not a mental health subscale, it can still be used to measure the quality of well-being in those with mental health disorders.
     
     There are studies that have shown similarities in scores when comparing the QWB with the Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS), and the Global Severity Index (GSI); however, this study was completed on patients with AIDS and who were also suffering from depression. 
     
    Which came first, the chicken or the egg-depression or AIDS? 
     
    All in all, while the QWB is an evidenced based practice scale and is widely used, it would be very difficult to test the efficacy of a psychopharmacologic medication The Quality of Well-Being (QWB) scale Essay.

    Thank you,

    Jen

    References

    Kaplan, R. M., Ganiats, T. G., Sieber, W. J., & Anderson, J. P. (1999). The quality of well-being
     
    scale: Critical similarities and   differences with SF-36.
     
    International Journal for Quality
     
    in Health Care, 10
    (6), 509-520.

    Moudjahid, A., & Abdarrazak, B. (2019). Psychology of quality of life and its relation to psychology.
     
    International Journal of Inspiration & Resilience Economy, 3
    (2), 58-63.

    Pickles, K., Lancsar, E., Seymour, J., Parkin, D., Donaldson, C., & Carter, S. M. (2019). Accounts from developers of generic health state utility instruments explain why they produce different QALYs: A qualitative study.
     
    In Social Science & Medicine, 240
    .

    Seiber, W. J., Groessl, E. J., David, K. M., Ganiats, T. G., & Kaplan, R. M. (2008).
     
    Quality of Well Being Self-Administered (QWB-SA) Scale.
     
    Retrieved from ucsd.edu: https://hoap.ucsd.edu/qwb-info/qwb-manual.pdf The Quality of Well-Being (QWB) scale Essay

  • NRNP 6552 Taking / Building a Health History: Asking Difficult Questions

    NRNP 6552 Taking / Building a Health History: Asking Difficult Questions

    Module 1 Assignment: Taking a Health History: Building a Health History: Asking Difficult Questions

    Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.

    Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations NRNP 6552 Taking / Building a Health History: Asking Difficult Questions.

    For this Assignment, you will develop a script to be used to interview a volunteer serving in the role of patient.

    To prepare:

    Review the Ewing (2004) questionnaire found in this week’s Learning Resources and consider the difficult questions you might have to ask when you take a patient’s health history.

    Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.

    Review the media programs related to a vaginal exam, pap test, and breast exam.

    Review the health history guide presented in Chapter 7 of the Schuiling & Likis (2022) text and consider how you would create your own script for building a health history. (
    Note:
     You will also find the Health History Form in Chapter 7)

    Describe the components of a complete gynecologic health history.  Include  considerations for special populations such as  LGBTQ+ individuals.

    What health maintenance guidelines should be  included for initial and follow up  might be needed for follow-up assessments?  (i.e., bone density test, Gardasil vaccine, shingles, etc.)?

    What questions would you consider in your patient’s assessment? For example

    What is your patient’s living situation?

    Do they have stairs?

    Do they live by themselves?

    Do they have a working refrigerator?

    Create your own script for building a health history and use the Health History Template for guidance (consider the type of language you would use to help your patient be more comfortable). As you create your script, consider the difficult questions you want to include in your script NRNP 6552 Taking / Building a Health History: Asking Difficult Questions.

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    Assignment: 
    (1- to 2-page reflection)

    In addition to your script for building a health history for this assignment, include a separate section called “Reflection” that includes the following:

    A brief summary of your experiences in developing and implementing your script during your health history.

    Explanations of what you might find difficult when asking these questions. What you found insightful and what would you say or do differently.

    Reminder:
    The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting NRNP 6552 Taking / Building a Health History: Asking Difficult Questions.

  • The Hamilton Rating Scale for Depression Essay

    The Hamilton Rating Scale for Depression Essay

    The Hamilton Depression Rating Scale

    The Hamilton Depression Rating Scale is the most widely used provider administered depression assessment scale. This assessment scale for treatment is the oldest and efficient form of clinical treatment for depression (Rohan, Rough & Vacek 2017). The rating scale has been proven to be useful in rating the patient’s depression level before, during, and after treatment. The Hamilton Depression Rating Scale, also known as that Ham-D, has a 17- original item to measure the patient’s level of depression. A later 21-item version added four items to intend the subtype of the depression. This discussion will describe the Hamilton Depression Rating Scale’s psychometric properties and the best time to use the treatment.
     

    Psychiatrist Dr. Max Hamilton created The Hamilton Rating Scale for Depression in the 1950s (Sharp, 2015). It was initially designed for inpatient hospitals with melancholic and physical symptoms of depression. It is also used to determine the performance of psychiatric medication, especially the first group of antidepressants. Over 40 years, the assessment was used to evaluate the patient’s mental status and assist diagnosing patients experiencing moderate to severe depression for a week or more. The patient’s interview should take 15 to 20 minutes, containing 17-21 items, and scored on a point system from 0-4. The first 17 items on The Hamilton Depression Rating Scale measures the depression symptoms. The additional four items for the 21-point scale measures factors that may be related to depression, but not known as severe, such as obsession, compulsive, and paranoia symptoms. The scoring system is based on the 17-item scale, the suggested ranges consist of 0-7 normal, 8-16 mild depression, and 17-23 moderated depression and scores over 24 are suggested severe depression The Hamilton Rating Scale for Depression Essay.

    Hamilton’s depression scale is used to rate depression in patients that are taking antidepressants. This form of assessment helps determine the outcome of the medication. It also helps determine if the dose should be increased or changed to a new medication. Besides, The Hamilton Depression Rating Scale provides proof to healthcare providers that mental illnesses are treatable and not indefinite (Worbys, 2013). A study conducted to evaluate further discrimination between placebo and active drugs to prove a dose-response relationship in patients with severe depression has caused concern when treating a patient with mental illnesses (Bech, 2010).

    An improvement in the Hamilton Depression Scale Score during an assessment trial does not indicate that antidepressant has improved the patient medical status. The form of assessment is not statistically proven. Many statistical versus clinical significance problems occur when analyzing placebo-controlled trials, including dose-response relationships (Bech, 2010). The insufficient statistical data makes it challenging to determine if the Hamilton Depression Scale is efficient in evaluating the patient’s response when prescribed an antidepressant.

    Despite the lack of statistical data, The Hamilton Depression Rate Scale has proven to determine patients’ effects from depression (Bech, 2010). Psychotherapy is a great way to evaluate the patient’s mental status further. As a PMHNP, not to base the final assumption based on the patient’s score after completing the Hamilton Depression Rating Scale but instead, us the scale to further treat the patient’s mental status.
     

    Reference

    Bech, P. (2006). Rating scales in depression: limitations and pitfalls. Dialogues in clinical neuroscience, 8(2), 207–215.

    Worboys, M. (2013). The Hamilton Rating Scale for Depression: The making of a “gold standard” and the unmaking of a chronic illness, 1960-1980. Chronic illness, 9(3), 202–219. https://doi.org/10.1177/1742395312467658

    Sharp, R. (2015). The Hamilton Rating Scale for Depression, Occupational Medicine, Volume 65, Issue 4, June 2015, Page 340, https://doi.org/10.1093/occmed/kqv043 The Hamilton Rating Scale for Depression Essay

     

    Rohan, K., Rough, J., Vacek, P.(2018).A Protocol for the Hamilton Rating Scale for Depression: Item Scoring Rules, Rater Training, and Outcome Accuracy with Data on its Application in a Clinical Trial .J affects order, 200(6),111-118.

    Discussion: Assessment Tools

    Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy.

    Learning Objectives

    Students will:

    Analyze psychometric properties of assessment tools

    Evaluate appropriate use of assessment tools in psychotherapy

    Compare assessment tools used in psychotherapy

    Note:
     By Day 1 of this week, the Course Instructor will assign you to an assessment tool that is used in psychotherapy.

    To prepare:

    Review this week’s Learning Resources and reflect on the insights they provide.

    Consider the assessment tool assigned to you by the Course Instructor.

    Review the Library Course Guide in your Learning Resources for assistance in locating information on the assessment tool you were assigned.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking 
    Submit!

    By Day 3

    Post
    an explanation of the psychometric properties of the assessment tool you were assigned. Explain when it is appropriate to use this assessment tool with clients, including whether the tool can be used to evaluate the efficacy of psychopharmacologic medications. Support your approach with evidence-based literature The Hamilton Rating Scale for Depression Essay.

    Read
     a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues by comparing your assessment tool to theirs.

    response 1

    I enjoyed reading your post about the Hamilton Depression Rating Scale. Your scale has been around for about 70 years, and it is still used to this day. I was given the MMSE tool that was created about 25 years after your tool in 1975. The Mini‐Mental State Examination (MMSE) is one of the most known and used short screening tools for providing an overall measure of cognitive impairment in clinical, research, and community settings (Arevalo-Rodriguez et al., 2015). This test can assess a person’s memory, attention, and language (Alzheimer’s Society, (n.d.)). However, unlike your tool, it can not be used to assess the efficacy of psychopharmacologic medications because this test measures a person’s mental abilities. Since there is no cure for dementia, practitioners treat patients intending to attempt to slow the progression of dementia. However, your tool can determine how well medication works because it can track if a patient is getting better, remaining the same, or getting worse. With dementia, we can only try to slow the deterioration, but they will not get better.

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    References

    Alzheimer’s Society. (n.d.). The MMSE test. Retrieved September 09, 2020, from

    https://www.alzheimers.org.uk/about-dementia/symptoms-and-
    diagnosis/diagnosis/mmse-test

    Arevalo-Rodriguez, I., Smailagic, N., Roqué I Figuls, M., Ciapponi, A., Sanchez-Perez, E.,

    Giannakou, A., Pedraza, O. L., Bonfill Cosp, X., & Cullum, S. (2015). Mini-Mental State Examination (MMSE) for the detection of Alzheimer’s disease and other dementias in people with mild cognitive impairment (MCI). The Cochrane database of systematic reviews, 2015(3), CD010783. https://doi.org/10.1002/14651858.CD010783.pub2 The Hamilton Rating Scale for Depression Essay

     

    response 2

         Thank you for your post this week. While I was aware of the existence of the Hamilton Depression Rating Scale (HAM-D) I did not realize that there are different versions of the HAM-D available. The HAM-D17 and a short HAM-D6 are both available, and according to Kieslich da Silva et al. (2019), the HAM-D6 is helpful in identifying depressive symptoms that fall outside of MDD, such as bipolar depression and bipolar depression with mixed features. A benefit according to the same study, was that the HAM-D6 is a much more brief assessment tool than the HAM-D17.

         The assessment tool that I was assigned was the Mini-Mental State Exam (MMSE), which is a tool that was developed to help quickly assess the basic cognitive function by assessing the patient’s orientation, registration, calculation, and attention, as well as recall and language in a short 5-10 minute exam (Folstein et al., 1975).  While the MMSE is not meant to replace a full mental status examination, it is a tool that gives providers some insight into the cognitive function of a client which may better direct the provider by giving a baseline impression before completing a full mental status examination.

         Of note, according to Folstein et al. (1975) the score on the MMSE can be impacted by someone dealing with depression for whom cognitive function has declined in relation to the depression. The MMSE presents a tool that could be administered at multiple appointments to help assess whether pharmacologic or psychotherapeutic interventions for the depression has impacted the cognitive abilities. In this scenario, both the HAM-D and the MMSE could both be utilized to help assess changes to the client’s depressive symptoms. It is helpful to be aware of these different tools that are available not only for assessment and diagnosis purposes, but they also offer means by which we can measurably compare the progress of a patient over time The Hamilton Rating Scale for Depression Essay.

                                                                                                    References

    Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive

           state of patients for the clinician. 
    Journal of psychiatric research, 12
    (3), 189-198.

    Kieslich da Silva, A., Reche, M., Lima, A. F. da S., Fleck, M. P. de A., Capp, E., & Shansis, F. M. (2019). Assessment of the

           psychometric properties of the 17- and 6-item Hamilton Depression Rating Scales in major depressive disorder,

           bipolar depression and bipolar depression with mixed features. 
    Journal of Psychiatric Research
    ,
     108, 84–89.

           https://doi-org.ezp.waldenulibrary.org/10.1016/j.jpsychires.2018.07.009

    response 3

    Depression is a significant problem among elderly patients. The main issue is that depression is often overlooked as a normal aging process of underdiagnosed in the older adult population (Wheeler, 2014). Therefore, it is crucial to choose the right instruments for screening and diagnosing depression in the elderly clients. The Hamilton Depression Rating Scale (HDRS or HAM-D), which you have explored in your discussion, is one of the depression assessment tools widely used in geriatric settings. The Geriatric Depression Scale (GDS), which I presented in my discussion post, is another frequently used tool for evaluating depressive episodes in the elderly. Both the HDRS and GDS assess depressive symptoms in clinical populations. However, the GDS is a self-reported global tool for measuring depression in older adults while the HDRS rates the client’s level of depression before, during, and after treatment. As such, the GDS assesses depressive symptoms in the elderly while the HDRS moves further by quantifying the severity of depression (Rohan et al., 2018; Stone et al., 2019).

    You have raised a critical issue in your discussion about evaluating the effectiveness of psychotherapy. I agree with you that the HDRS rates depression in clients taking antidepressants, which allows healthcare providers to assess the effectiveness of the therapy. The GDS has also proven effective in assessing the clinical severity of depression, as well as monitoring the complex and emotional responses of patients to therapy. However, personal review of research evidence has shown that the HAM-D and Beck Depression Inventory (BDI) are the best validated tools that quantitatively assess patient’s response to treatment. Furthermore, I found a paucity of research evidence that had validated the use of both the short and long versions of the GDS in assessing the efficacy of psychopharmacologic medications (Stone et al., 2019). A key takeaway from the discussion is that the GDS is suitable for screening while the HAM-D is useful in assessing the effectiveness of treatment The Hamilton Rating Scale for Depression Essay.

    References

    Rohan, K., Rough, J., Evans, M., Ho, S.-Y., Meyerhoff, J., Roberts, L. M., & Vacek, P. (2018). A protocol for the Hamilton Rating Scale for Depression: Item scoring rules, rater training, and outcome accuracy with data on its application in a clinical trial. 
    Journal of Affective Disorders, 200
    (6),111-118. https://doi.org/10.1016/j.jad.2016.01.051

    Stone, L. E., Granier, K. L., & Segal, D. L. (2019). Geriatric Depression Scale. In D. Gu & M. Dupre (eds) 
    Encyclopedia of Gerontology and Population Aging
    . Springer.

    Wheeler, K. (Ed.). (2014). 
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
    (2nd ed.). Springer Publishing Company The Hamilton Rating Scale for Depression Essay

  • NRNP 6552 Different Roles of the Nurse Practitioner Discussion essay

    NRNP 6552 Different Roles of the Nurse Practitioner Discussion essay

    Discussion: Different Roles of the Nurse Practitioner

    The term ‘history” is broad in meaning. Within that broad framework archeologists tend to focus their careers on various specialties and areas of interest, such as specific historical eras or geographical areas.

    So it is with nurses. Within the broad framework of healthcare, nurse practitioners focus their careers on various roles. These roles may in part be based on narrower areas of interest such as women’s health. Careers also focus on selected technical nursing specialties NRNP 6552 Different Roles of the Nurse Practitioner Discussion essay.

    Photo Credit: Getty Images/Blend Images

    For this Discussion, you will explore your professional interests and those interests are addressed in specific guidelines and competencies. You also examine the different nurse practitioner roles related to women’s health and how these roles might impact the way you work.

    To prepare:

    Review the modular structure of this course and reflect on how each module defines the specific skills needed as an advanced Nurse Practitioner (NP).

    Review the ANA guidelines, NP competencies, and the Ethic resources found in this week’s Learning Resources and consider how they impact the work of the NP.

    By Day 3

    Post a brief explanation about the differences in roles related to a CRNP, a CNM, and a PA and how each of these roles might impact the how you practice as a FNP. Be specific and provide examples.

    Read
     a selection of your colleagues’ responses.

    By Day 6

    Respond to at least 
    two
     of your colleagues’ posts on 
    two different days 
    and
     
    provide additional insight to your colleagues related to issues and topics they may want to also consider. Use the Learning Resources and/or the best available evidence from current literature to support your explanation NRNP 6552 Different Roles of the Nurse Practitioner Discussion essay.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Main Discussion

    The role of the mid-level practitioner varies based on their scope of practice, and this can differ state by state. Certified Registered Nurse Practitioners (CRNP) and Certified Nurse Midwives (CNM) are recognized roles as Advanced Practice Registered Nurses (APRN) (ANA, 2021). Nurse Practitioners (NP) select a population focus, with specialty tracks guiding the type of care they will deliver within the community. In the United States, a CNM graduates from a nurse-midwifery program with a goal to promote health and provide care to all women throughout their lifespan (Zhou and Lu, 2018). A Physician Assistant’s education entails a comprehensive approach to general medicine, formed under a medical model that is designed to complement medical doctors (AAPA, 2021). When looking at the utilization of costs for complex patients, as a primary care provider (PCP), NPs and PAs were associated with lower healthcare costs and less use of acute care services; however, there can be different clinical approaches to management that may stem from their educational models (Morgan et al., 2019). Following evidence-based practice is imperative regardless of the approach to the treatment and plan of care NRNP 6552 Different Roles of the Nurse Practitioner Discussion essay.

    Observing these different roles can provide insight and impact the practice of a Family Nurse Practitioner (FNP) student. Educational backgrounds and practical experience can provide an excellent learning platform. Nurse Practitioners are often primary care providers, and in states with independent practice, this is often promoted within the healthcare organization (Poghosyan et al., 2017). Specialties, such as a preceptorship with a CNM, can provide an excellent opportunity to hone women’s health skills, such as contraception counseling, preventative care including PAP smears, clinical breast exams, prenatal and postpartum care. Learning from a PA can provide greater insight into general medicine. Every encounter offers a learning opportunity, and each preceptor can teach you something if you keep an open mind and are willing to learn.

    References

    American Academy of Physician Assistants (AAPA). (2021). How are Pas different from nurse practitioners (NPs)? https://www.aapa.org/what-is-a-pa/

    American Nurses Association (ANA) (2021). Recognition of a nursing specialty, approval of a specialty nursing scope of practice statement, acknowledgment of specialty nursing standards of practice, and affirmation of focused practice competencies. 
    https://www.nursingworld.org/~49d755/globalassets/practiceandpolicy/scope-of-practice/3sc-booklet-2021-june.pdf

    Morgan, P., Smith, V., Berkowitz, T., Edelman, D., VanHoutven, C., Woolson, S., Hendrix, C., Everett, C., White, B., Jackson, G. (2019). Primary care: impact of physicians, nurse practitioners, ad physician assistants on utilization and costs for complex patients. 
    Health Affairs
    , 
    38
    (6), 733–739. 
    https://pubmed.ncbi.nlm.nih.gov/31866788/

    Poghosyan, L., Liu, J., & Norful, A. A. (2017). Nurse practitioners as primary care providers with their own patient panels and organizational structures: A cross-sectional study. 
    International journal of nursing studies
    , 
    74
    , 1–7. 
    https://doi.org/10.1016/j.ijnurstu.2017.05.004

    Zhou, N., & Lu, H. (2018). A review and comparison of midwifery management and education in five representative countries. 
    International journal of nursing sciences
    , 
    5
    (1), 10–14. 
    https://doi.org/10.1016/j.ijnss.2017.12.007

     

    sample 2

    There are several specialized roles that an Advanced Practice Nurse (APRN) can select for clinical practice.  When it comes to women’s health, there are 3 roles to choose from which include Certified Professional Midwife/CPM, Certified Nurse Midwife/CNM, or a Certified Midwife. Each of these roles can provide women with holistic services (Winter et al., 2020).

    The scope of practice for each discipline is designated in the APRN’s practicing state (Yang, 2020). The role of the Certified Professional Mid-Wife (CPM) is unique because the APRN must have experience in the field. In addition, the nurse is certified by a midwifery credentialing agency (Marzalik, Feltham, Jefferson, & Pekin, 2018). If you work as a CPM, you could be in a position of providing services to patients in their homes until her child is born NRNP 6552 Different Roles of the Nurse Practitioner Discussion essay.

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    A Certified Nurse Midwife or CNM is also an APRN’s who graduates with at least with a master’s level degree from a school with an approved Nurse-Midwife nursing program (Marzalik, Feltham, Jefferson, & Pekin, 2018). The candidate must pass the national Certified Nurse Midwife Examination and maintain continuing education credits required by his/her State

    Licensure Organization. As a CNM, you can work in various venues such as hospitals, birthcenters, OB/GYN practices and/or health clinics while providing care throughout a patient’s lifespan.

    The credentials to become a Certified Midwives are somewhat different due to the fact that the certification can be achieved by a person who does not have a nursing background. Then the candidate will need a graduate level degree which is certified by the American Midwifery Certification Board. With this delegation, you could provide services to patients from adolescent to menopause in either a hospital, health clinics, OB/GYN office, homes and/or a birth center (Marzalik, Feltham, Jefferson, & Pekin, 2018).

    Regardless of the medical specialty practice the Advanced Practice Registered Nurse achieves, the goal of care remains the same. The APRN must ensure that each patient is counseled on health promotion, and that health determinants to care are minimized, and make sure the patient receives quality of care by putting the patient first.  Additionally, it is important that the patient has an opportunity to ask sensitive questions during her examination.

    References

    American Nurses Association (ANA). (n.d.). View the code of ethics for nurses with interpretive statements. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of ethics-for-nurses/ NRNP 6552 Different Roles of the Nurse Practitioner Discussion essay

    Marzalik, P. R., Feltham, K. J., Jefferson, K., Pekin, K. (2018). Midwifery education in the U.S. Certified Nurse-Midwife, Certified Midwife and Certified Professional Midwife, 
    Midwifery
    , 
    (60)
    , 9-12. 
    https://doi.org/10.1016/j.midw.2018.01.020

    Winter, S., Chapman, S. A., Chan, G. K., Duderstadt, K., & Spetz, J. (2020). Nurse Practitioner role and practice environment in primary and in nonprimary care in California. 
    Medical Care 
    Research and Review
    .  
    https://doi.org/10.1177/1077558720942706

    Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2020). State Nurse Practitioner Practice Regulations and U.S. Health Care Delivery Outcomes: A Systematic Review. 
    Medical Care Research and Review 
    https://doi.org/10.1177/1077558719901216 NRNP 6552 Different Roles of the Nurse Practitioner Discussion essay