What are some ethical issues and dilemmas related to Electronic Health Records and patient electronic communication? What are some of the ethical and legal issues related to patient- sensitive health information?

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Discussion Question Fall 2022

To date, the United States has achieved a 95% implementation use of electronic health records as a means to document healthcare delivery in hospitals and private practice settings. Electronic health records (EHRs) do provide benefits for patients, nurses, and collaborative teams, but also raise many ethical questions. Navigating how to provide care in the digital age requires the nurse to assess the impact of the EHR on patient care and the nurse-patient relationship. EHRs should facilitate patient care and, as an essential component of that care, support the nurse-patient relationship, including nurse autonomy, professionalism, and patient privacy and confidentiality. There are studies that postulate EHRs are resulting in unintended ethical consequences concerning nursing clinical decision-making and subsequent patient safety implications.

Consider exploring ethical challenges and concerns for nursing practice and patient care by incorporating your responses to the following questions:

1.What are some ethical issues and dilemmas related to Electronic Health Records and patient electronic communication?

2.What are some of the ethical and legal issues related to patient- sensitive health information?

3.What are some potential concerns that Electronic Health Records (EHRs) bring to nursing care quality?

4.How can an EHR positively impact the quality of nursing care?

5. How does an EHR support teamwork and collaboration?

6.What is confidentiality in nursing ethics?

7. Why is patient confidentiality an ethical issue?

8. What does the Nursing Code of Ethics say about confidentiality?

9.What are some examples of confidentiality and how does the nurse protect patient confidentiality?

10.Could patient confidentiality be compromised with the electronic health record? How?

 

Support your viewpoint with research from a current, peer-reviewed journal article (published within 5 years). Provide the link to the journal article for your classmates to read.

 

Discuss your process. What are some of the policies and/or procedures of your organization that will impact or be impacted by your project? Describe organizational strengths, weaknesses, opportunities, and threats that will influence the direction of your project.

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Week 3 Post

Explore your healthcare organization’s policies, procedures, and processes related to project planning. Assume you will be using your facility for your concluding graduate experience project.

1. Discuss your process.

2. What are some of the policies and/or procedures of your organization that will impact or be impacted by your project?

3. Describe organizational strengths, weaknesses, opportunities, and threats that will influence the direction of your project.

4. What information or data will you need to gather and from whom will you get it?

5. Whom will you engage in the process?

Explain the progressive pathophysiologic relationship between an MI and the development of left ventricular (LV) failure. What factors affect the severity of LV failure?

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Development of left ventricular (LV) failure

Mr. T., a 45-year-old black man employed as a midlevel corporate manager, came to the doctor’s office seeking a physical examination. He appeared somewhat overweight. He denied taking any medications or smoking, but admitted drinking alcohol. His father and older brother have hypertension (HTN) and his paternal grandfather experienced a myocardial infarction (MI) and a CVA at a young age. Mr. T. stated, “A year ago at a health fair my cholesterol was tested. I was told later by mail that my cholesterol was 250 and I had to recheck my blood pressure.” His Bp at the time of his examination was 159/94, HR 96, weight 275, height 5’11 in.

Explain the progressive pathophysiologic relationship between an MI and the development of left ventricular (LV) failure. What factors affect the severity of LV failure?

Next, visit http://www.cdc.gov/ncbddd/dvt/facts.html (Links to an external site.) and access resources about deep vein thrombosis.

Document the manifestations and management of clients with deep vein thrombosis.
Submit a summary of some of the things you learned from this video.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.

Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale.

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The Psychiatric Evaluation and Evidence- Based Rating Scales

To Prepare:(1) Reflect on the insight the learning Resources provided regarding psychiatric assessment and diagnosis.
(2) Consider the elements of the psychiatric interview, history, and examination.
(3) Consider the diagnostic and Statical Manual of Mental Disorders ( DSM-5-TR) assigned assessment tool.

ASSIGNMENT INSTRUCTIONS Are:
(a) Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important.

(b) Explain the psychometric properties of the rating scale.

(c) Explain when it is appropriate to use the rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment.

(d) Support your approach with evidence-based literature.

(e) Answer all parts of the discussion questions in a clear and concise critical analysis with correct grammar with no spelling errors using APA writing rules and style. Provide three references for the Assignment.

(f) Respond to Two Classmates’ Posts by Comparing your assessment tool to theirs. Plrovide Two references each for the Two classmates’ responses. (E) Writer, Please Note: I will upload for you the Two classmates’ posts for your response as soon as they become available, and I will need them ASAP.

Analyze data to identify a health care issue or area of concern. Identify the type of data you are analyzing from your institution or from the Vila Health activity. Explain why data matters. What does data show related to outcomes? Analyze the dashboard metrics. What else could the organization measure to enhance knowledge?

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Data Analysis and Quality Improvement Initiative Proposal

Prepare an 8-10 page data analysis and quality improvement initiative proposal based on a health issue of interest. Include internal and external benchmark data, evidence-based recommendations to improve health care quality and safety, and communication strategies to gain buy-in from all interprofessional team members responsible for implementing the initiative.

Introduction
Health care providers are perpetually striving to improve care quality and patient safety. To accomplish enhanced care, outcomes need to be measured. Next, data measures must be validated. Measurement and validation of information support performance improvement. Health care providers must focus attention on evidence-based best practices to improve patient outcomes.

Health informatics, along with new and improved technologies and procedures, are at the core of all quality improvement initiatives. Data analysis begins with provider documentation, researched process improvement models, and recognized quality benchmarks. All of these items work together to improve patient outcomes. Professional nurses must be able to interpret and communicate dashboard information that displays critical care metrics and outcomes along with data collected from the care delivery process.

For this assessment, use your current role or assume a role you hope to have. You will develop a quality improvement (QI) initiative proposal based on a health issue of professional interest. To create this proposal, analyze a health care facility’s dashboard metrics and external benchmark data. Include evidence-based recommendations to improve health care quality and safety relating to your selected issue. Successful QI initiatives depend on the support of nursing staff and other members of the interprofessional team. As a result, a key aspect of your proposal will be the communication strategies you plan to use to get buy-in from these team members.

Preparation
To develop the QI initiative proposal required for this assessment, you must analyze a health care facility’s dashboard metrics. Choose Option 1 or 2 according to your ability to access dashboard metrics for a QI initiative proposal.

Option 1
If you have access to dashboard metrics related to a QI initiative proposal of interest to you, complete the following:

Analyze data from the health care facility to identify a health care issue or area of concern. You will need access to reports and data related to care quality and patient safety. For example, in a hospital setting, you would contact the quality management department to obtain the needed data. It is your responsibility to determine the appropriate resource to provide the necessary data in your chosen health care setting. If you need help determining how to obtain the needed information, consult your faculty member for guidance.
Include in your proposal basic information about the health care setting, size, and specific type of care delivery related to the identified topic. Please abide by Health Insurance Portability and Accountability Act (HIPAA) compliance standards.

Option 2
If you do not have access to a dashboard or metrics related to a QI initiative proposal:

Use the hospital data set provided in Vila Health: Data Analysis. (ATTACHED) You will analyze data to identify a health care issue or area of concern.
Include in your proposal basic information about the health care setting, size, and specific type of care delivery related to the identified topic.
Instructions
Use your current role or assume a role you would like to have. Choose a quality improvement initiative of professional interest to you. Your current organization is probably working on quality improvement initiatives that can be evaluated, so consider starting there.

To develop your proposal you will:

Gather internal and external benchmark data on the subject of your quality improvement initiative proposal.
Analyze data you have collected.
Make evidence-based recommendations about how to improve health care quality and safety relating to your chosen issue.

Remember, your initiative’s success depends on the interprofessional team’s commitment to the QI initiative. Think carefully about these stakeholders and how you plan to include them in the process, as they will help you develop and implement ideas and sustain outcomes. Also, remember how important external stakeholders, such as patients and other healthcare delivery organizations, are to the process. As you are preparing this assessment, consider carefully the communication strategies you will employ to include the perspectives of all internal and external stakeholders in your proposal.

The following numbered points correspond to the grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your proposal addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels related to each grading criterion.

Analyze data to identify a health care issue or area of concern.
Identify the type of data you are analyzing from your institution or from the Vila Health activity.
Explain why data matters. What does data show related to outcomes?
Analyze the dashboard metrics. What else could the organization measure to enhance knowledge?
Present dashboard metrics related to the selected issue that are critical to evaluating outcomes.
Assess the institutional ability to sustain processes or outcomes.
Evaluate data quality and its implications for outcomes.&
Determine whether any adverse event or near-miss data needs to be factored in to outcomes and recommendations.
Examine the nursing process for variations or performance failures that could lead to an adverse event or near miss.
Identify trends, measures, and information needed to critically analyze specific outcomes.
Specify desired outcomes related to prevention of adverse events and near misses.
Analyze which metrics indicate future quality improvement opportunities.
Develop a QI initiative proposal based on a selected health issue and supporting data analysis.
Determine benchmarks aligned to existing QI initiatives set by local, state, or federal health care policies or laws.
Identify any internal existing QI initiatives in your practice setting or organization related to the selected issue. Explain why they are insufficient.
Evaluate external national or international QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and nongovernmental bodies on quality improvement.
Define target areas for improvement and the processes to be modified to improve outcomes.
Propose evidence-based strategies to improve quality.
Analyze challenges that meeting prescribed benchmarks can pose for a health care organization and the interprofessional team.
Communicate QI initiative proposal based on interdisciplinary team input to improve patient safety and quality outcomes and work-life quality.
Define interprofessional roles and responsibilities relating to data and the QI initiative.
Explain how to ensure all relevant interprofessional roles are fully engaged in this effort.
Identify how outcomes will be measured and data used to inform interprofessional team performance related to specific tasks.
Reflect on the impact of the proposed initiative on work-life quality of the interprofessional team.
Describe how the initiative enhances work-life quality due to improved strategies supporting efficiency.
Determine communication strategies to promote quality improvement of interprofessional care.
Identify interprofessional communication strategies that will help to promote and ensure the success of the QI initiative.
Identify communication models, such as SBAR and CUS, to include in your proposal.
SBAR stands for Situation, Background, Assessment, Recommendation.
CUS stands for “I am Concerned about my resident’s condition; I am Uncomfortable with my resident’s condition; I believe the Safety of the resident is at risk.”

Consult this resource for additional information about these fundamental evidence-based tools to improve interprofessional team communication for patient handoffs:
Agency for Healthcare Research and Quality (AHRQ). (n.d.). Module 2: Communicating change in a resident’s condition. https://www.ahrq.gov/professionals/systems/long-term-care/resources/facilities/ptsafety/ltcmod2ap.html

Communicate QI initiative proposal in a professional, effective manner, writing clearly and logically, with the correct use of grammar, punctuation, and spelling.
Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.

What is your approach to solving this problem? Using a specific motivational theory (McClelland’s theory), describe how you would create a healthful work environment within that organization. Describe at least three theory-based strategies you will use to create this environment you described

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Week 4: Motivation within Organizational Structures.

Nurse leaders, whether at the unit or organizational level, play a pivotal role within any given organizational structure in creating a healthy, motivating work environment. These environments are ones that encourage workers to perform their best and continue to develop professionally. The underlying belief about motivation is that behaviors and actions of individuals are driven by internal and external factors. They possess these in varying degrees and are not the same for everyone. Motivational theory provides the foundation for creating strategies for motivating people to perform well and be satisfied in their jobs.

Consider this scenario:

You are the nurse administrator of a medium sized health system with a multigenerational workforce. Over the past year, there has been a noticeable decrease in employee satisfaction scores, presence of low morale, and attrition has begun. Attrition has not met the critical point and you are taking action to prevent it getting worse.

  1. What is your approach to solving this problem?
  2. Using a specific motivational theory (McClelland’s theory), describe how you would create a healthful work environment within that organization.
  3. Describe at least three theory-based strategies you will use to create this environment you described

 

How many DNP-level nursing employees are working there? In what roles? Is what they do different than other nurses with similar titles? Have the DNPs within Kings County Hospital Center had their roles changed since becoming a DNP?

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kings county hospital

The DNP Entrepreneur – Zaccagnini & White, Chapters 8 & 9

Kings County Hospital Center is a municipal hospital located in the East Flatbush neighborhood of Brooklyn, New York City. It is owned and operated by NYC Health + Hospitals, a municipal agency that runs New York City’s public hospitals. 451 Clarkson Ave, Brooklyn, NY 11203.

Presentations: DNP Roles and Responsibilities – Findings within Kings County Hospital Center.

Topic: Leadership & Personal Mastery
• Mission, Vision & Values
• Agency Organization and Committee Structure
• Organizational * Proactivity & Advocacy: Agency Strategic Plan
• IHI & AHRQ
• Nurses on Boards Initiative: Committee Implications?

Provide a copy of Kings County Hospital Center’s current chart and committee structures within the agency.

1. How many DNP-level nursing employees are working there? In what roles?
2. Is what they do different than other nurses with similar titles?
3. Have the DNPs within Kings County Hospital Center had their roles changed since becoming a DNP?
4. What are their current initiatives or plans for leading change to make an impact within their organization?

Describe two studies that used the theory as a framework for their study, including a description of how they operationalized the concepts. How could you use the theory to research a phenomenon in your area of clinical practice? How would you operationalize the concepts?

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Application of Theoretical Concepts to Research

Background: contains two subsections, which includes a brief description of the theorist and the phenomenon of concern in the theory.

Theory Description: a description of each of the concepts in the theory, a diagram of the theory, and a description of how the concepts are related.

An Evaluation of the Theory: a description of the theory’s weaknesses and how the metaparadigms are described in the theory.

Application of the Theory:
Describe two studies that used the theory as a framework for their study, including a description of how they operationalized the concepts.
How could you use the theory to research a phenomenon in your area of clinical practice? How would you operationalize the concepts?

You MUST use the attached template here to complete your paper.

Complete the Flashcard Template (Word). It is important that you remember to include three sources for references.

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HYPERNATREMIA

Once your topic is selected, you will complete the Flashcard Template (Word). It is important that you remember to include three sources for references.

My topic is HYPERNATREMIA, the below file is the flashcard template that needs to be filled out. Three sources for references is needed. it must have the disease process for Hypernatremia, the pathophysiology, risk factors , major signs and symptoms, and diagnostic testing.

Disease Process:

Pathophysiology:

Risk factors:

Major signs and symptoms:  (image if you can find one)

Diagnostic testing:

 

References

 

 

 

Describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs?

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Discussion: Organizational Policies and Practices to Support Healthcare Issues

Discussion: Organizational Policies and Practices to Support Healthcare Issues

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy.

Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.