Healthcare Data Standardization

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     Case Study

Read the following case study:

A small community hospital in the Midwest has used a homegrown information system for years. The system began in the early 1970s with a financial module. Over time, additional modules were added. A limited number of departments selected a commercial system and interfaces were used to integrate these into the overall functionality of the hospital information system. Except for physicians, most in-house clinical or care-related documentation is online. However, about 15% to 20% of this documentation is done by free text and is not effectively searchable. In addition, the screens, including the drop-down and default values, were built using terms selected by the in-house development team in consultation with clinical staff; thus there is no data dictionary or specific standard language. In the last few years, the hospital has purchased two outpatient clinics (obstetrics and mental health) and a number of local doctor practices. The clinics and doctors’ offices are now being converted to the hospital administrative systems. A few of the clinical applications that are tied directly to the administrative systems such as order entry and results reporting are also being installed. 

A major change is being planned. A new chief information officer (CIO) was hired last year and she has appointed a chief medical information officer (CMIO) and a chief nursing information officer (CNIO). No other significant staff changes were made. With her team in place, one of the CIO’s first activities was to complete an inventory of all applications. Rather than continue to build, a decision was made to switch to a commercial vendor and the hospital selected a commercial system. 

As a member of the clinical staff with informatics education, the CIO has requested that you develop a training and information presentation for the clinical staff that will:

· Identify two or more issues with the existing system

· Provide staff with appropriate “work-around” for using the existing system

· Provide an overview of two of the standard languages used within the new system including discipline or specialty, updating frequency, and available cross-maps

o One standard language should pertain only to nursing 

o One standard language should be multidisciplinary.

· Obtain clinical staff input, using a five-question survey, of specific methods to support transition to the new system; questions should be open-ended.

PowerPoint Presentation

Directions:

1. Review the case study.

2. Download the provided PowerPoint template to create a presentation that includes:

· Your name on the title slide of the presentation

· Identification of two or more issues with existing system

· Identification of “work-a-round” solutions when using existing system

· Overview of standard language used only in nursing

· Overview of multidisciplinary standard language

· Set of five (5) open-ended survey questions for staff input on transitioning to the new system

· Presentation is free of spelling and grammar errors.

2. Submit the Week 10 Assignment via Blackboard by clicking on the “Week 10 Assignment” link. Include the proper file naming convention: 

· CMP105_wk10_assn_jsmith_mmddyyyy.

References

Week 10: Healthcare Data Standardization

[Type your name here]

Type your name where indicated

1

Existing System Issues

[Using the Case Study, type in two or more issues or concerns identified with the existing system]

Identify two or more issues with the existing system

2

Existing System “Work-a-rounds”

[Type in recommendations for improving efficiency using the existing system]

Recommend specific recommendations for improving efficiency using the existing system

3

Overview of Nursing Standard Language

[Type in your overview of a Standard Language used only for nurses]

Choose from one of the following languages:

CCC

ICNP

NANDA-I

NIC

NOC

OS

PPDS

Overview should include a brief description, how frequently it is updated, and available cross-maps]

Type in your overview of a Standard Language used only for nurses]

Choose from one of the following languages:

CCC

ICNP

NANDA-I

NIC

NOC

OS

PPDS

Overview should include a brief description, how frequently it is updated, and available cross-maps

4

Overview of Multidisciplinary Standard Language

[Type in your overview of a multidisciplinary Standard Language Choose from one of the following languages:

LOINC

SNOMED CT

ABC Codes

CPT

Overview should include a brief description, how frequently it is updated, and available cross-maps]

Type in your overview of a multidisciplinary Standard Language Choose from one of the following languages:

LOINC

SNOMED CT

ABC Codes

CPT

Overview should include a brief description, how frequently it is updated, and available cross-maps

5

Staff Survey

[Create a set of 5 open-ended questions designed to obtain feedback from the clinical staff

Focus of questions is ideas and suggestions of specific methods to support transition from existing system to new system

Might include questions related to training, transitioning data from existing system, system downtime, etc.]

Create a set of 5 open-ended questions designed to obtain feedback from the clinical staff

Focus of questions is ideas and suggestions of specific methods to support transition from existing system to new system

Might include questions related to training, transitioning data from existing system, system downtime, etc.

6

Possible meanings of the term "spirituality," and your understanding of the concepts of pluralism, scientism, and postmodernism

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Assignment Details:

Due Date: Sep 08, 2018 23:59:59       Max Points: 100 Details:

Write an 800-1,000 word essay on your personal worldview. Briefly discuss the various possible meanings of the term “spirituality,” and your understanding of the concepts of pluralism, scientism, and postmodernism. Primarily, address the following seven basic worldview questions:

1. What is prime reality?

2. What is the nature of the world around you?

3. What is a human being?

4. What happens to a person at death?

5. Why is it possible to know anything at all?

6. How do people know what is right or wrong?

7. What is the meaning of human history?

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Health care organizations emergence of new policies, to promote quality care and improve patient safety to keeping pace with the rapid growth in knowledge and best practices

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Assignment: Application: Planned Change
in a Department or Unit

Health care organizations are continuously immersed in change from the emergence of new policies, to promote quality care and improve patient safety to keeping pace with the rapid growth in knowledge and best practices. Establishing a solid framework for planning and implementing change is a wise move, as it provides a foundation for the extensive coordination that will be needed to successfully facilitate the change.

For this Assignment, you propose a change at the department or unit level and develop a plan for guiding the change effort.

To prepare:

  • Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it with other classic change models and strategies.
  • Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or area in your organization or one with which you are familiar. Select one issue as a focal point for this assignment, and consider a change that could be made to address the issue.
  • Think about how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.
  • Using one of the change models or strategies discussed in Chapter 8, begin formulating a plan for implementing the change within the department/unit. Outline the steps that you and/or others should follow to facilitate the change effort. Align these steps to the change model or strategy you selected.
  • Determine who should be involved in initiating and managing the change. Consider the skills and characteristics that are necessary to facilitate this change effort.

Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:

  • Identify a problem, inefficiency, or issue within a specific department/unit.
  • Describe a specific, realistic change that could be made to address the issue.
  • Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.
  • Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.
  • Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.
  • Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the change effort.

The importance of recognizing symptoms of asthma and providing immediate treatment, as well as distinguishing minor symptoms from serious, life-threatening symptoms

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Complications of asthma can be sudden. Consider the case of Bradley Wilson, a young boy who had several medical conditions. He appeared in good health when he went to school, returned home, and ate dinner. However, when he later went outside to play, he came back inside wheezing. An ambulance took him to the hospital where he was pronounced dead (Briscoe, 2012). In another case, 10-year-old Dynasty Reese, who had mild asthma, woke up in the middle of the night and ran to her grandfather’s bedroom to tell him she couldn’t breathe. By the time paramedics arrived, she had passed out and was pronounced dead at the hospital (Glissman, 2012). These situations continue to outline the importance of recognizing symptoms of asthma and providing immediate treatment, as well as distinguishing minor symptoms from serious, life-threatening symptoms. Since these symptoms and attacks are often induced by a trigger, as an advanced practice nurse, you must be able to help patients identify their triggers and recommend appropriate treatment options. For this reason, you need to understand the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation.

To Prepare

· Review “Asthma” in Chapter 27 of the Huether and McCance text. Identify the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Consider how these disorders are similar and different.

· Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of both disorders. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

· Review the “Mind maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Consider the epidemiology and clinical presentation of both chronic asthma and acute asthma exacerbation.

To Complete

Write a 2- to 3-page paper that addresses the following:

· Describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Be sure to explain the changes in the arterial blood gas patterns during an exacerbation.

· Explain how the factor you selected might impact the pathophysiology of both disorders. Describe how you would diagnose and prescribe treatment for a patient based on the factor you selected.

· Construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

Professional issues and leadership challenges for the graduate registered nurse and argue for realistic and achievable actions and goals

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Your task for this piece of assessment is to critically discuss professional issues and leadership challenges for the graduate registered nurse and argue for realistic and achievable actions and goals. 

 1. Analyse the WIKI discussion forum contributions (in relation to self-awareness, identity development and mentoring) and using the literature as a point of reference, discuss the significance of one of these professional development strategies in relation to transition to practice for the graduate registered nurse (GRN). 1. 2. Drawing from national and international literature, critically discuss the implications of the chosen professional development strategy for the graduate registered nurse working in a clinical environment in relation to achieving a work-life balance and developing a resilient approach to practice. 3. Referring to your critical discussion in Step 2, develop 2 SMART goals (one that aims to achieve work-life balance and the other a resilient approach to practice). Advocate/argue for how the realistic SMART goal actions (to achieve a work-life balance and a resilient approach to practice) would enhance your transition to clinical practice as a GRN. 

 1200 words +/-10%. Word length excludes in-text referencing, your reference list, direct quotes and appendices. Please note: markers will not mark beyond the work limit.  Suggested (not mandatory) word count structure. Introduction (100 words) 1.Discuss significance for the GRN (300 words) 2.Critically discuss in relation to work life balance and resilience (400 words) 3.Advocate for realistic actio 

Professional Standards for Nursing Leadership

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Theories in Leadership

Theories in Leadership Case Study 1

approx 30 min

The study described in the Research Perspective (Hauck, Winsett, & Kuric, 2012) was about the introduction of evidence-based practice for a hospital. Rogers’s theory of diffusion of innovation served as the theoretical framework for that study. However, other theoretical perspectives are present. Based on situational-contingency theory, describe factors that the nurse researcher, as the leader of the implementation team, would need to consider. Consider the following:

Question 1

What considerations come into play that are outside of the group targeted for the change initiative? Are there any external stakeholders? What are the internal factors that would drive or limit change from being successful?

Question 2

How do people behave individually and in groups when it comes to adopting a practice-based change? Is there a difference between individual and group behaviors? If so, why does this occur?

Question 3

What should the nurse leader do to plan for and address potentially negative attitudes of staff regarding the implementation of evidence-based practice? How should the nurse leader use nurses with positive attitudes toward the implementation of evidence-based practice?

Question 4

How can previous interactions with the nurse leader impact the success or failure of implementing evidence-based practice?

Question 5

What are the resource requirements? What are the regulatory requirement

Influence and Diplomacy Case Study 2

approx 30 min

Ryan graduated from his BSN program about 18 months ago and has been working on a surgical unit in a large Magnet™ hospital. He belongs to his state nurses association and the Academy of Medical-Surgical Nurses (AMSN).

He recently moved to another town for graduate school and took a job in a small community hospital. The new chief nursing officer is trying to create a shared governance structure. The nursing staff seems disinterested in participating in such a governance structure. Some of them complain that they do not want to “think” about nursing beyond what they have to do at the bedside.

Ryan served on the practice council at the hospital where he worked after graduation. The nurses he works with now are discouraging him from volunteering to serve on one of the new councils being formed to implement shared governance. He is frustrated by his colleagues’ lack of interest in participating in decision making about nursing care. He wonders if this is the right place for him to work while in his graduate program. Although this hospital is closely affiliated with the school of nursing where he is a graduate student, the nurses on his unit openly challenge the wisdom of his decision to pursue a graduate degree.

Question 1

What resources should Ryan use to gain support for his desire to participate in the new shared governance structure?

Question 2

If Ryan wants to test the job market to find a position in a more positive nursing work environment, what resources can he use?

Question 3

Ryan has been subjected to a lot of questions and negative comments by some of the senior staff nurses about his graduate studies. They tend to negate the importance of advancing one’s nursing education. How can he redirect their comments?

Evolution of the Nurse Leader Case Study-3

approx 30 min

Margaret Compton, RN, is 52 years old and recently widowed. Her husband died a week after traumatic injuries from a serious fall on a hiking expedition.

Margaret has been out of the work force for 23 years, electing to stay at home and take care of her three children while her husband worked. Her youngest is in his third year of college, and Margaret has realized that she needs to return to the workforce.

During her husband’s hospitalization, Margaret realized that she missed nursing and eagerly looks forward to returning to active practice. She kept her license active all these years, but during her husband’s hospitalization, Margaret saw that much has changed since she left her last nursing position.

Question 1

What specific challenges does Margaret face in returning to the nursing workforce after 23 years?

Question 2

What has changed in health care that will make her work different now?

Question 3

What do you think is the same in nursing over time?

Professional Standards for Nursing Leadership Case Study 4

approx 30 min

You are the nurse manager of a busy operating room in a large metropolitan hospital, serving both adult and pediatric clients. A case is scheduled involving a child who will have a hip arthroplasty. The surgical technician usually scheduled for the pediatric cases is unavailable to assist with this case, so you schedule a surgical technician who has assisted with multiple hip arthroplasties but has never performed one on a younger child. After the procedure, the child has permanent damage to his sciatic nerve, and his parents have filed a lawsuit against the surgical technician, you as the nurse manager, and the hospital.

Question 1

How do you suspect that the court will react to such a case?

Question 2

What would their findings likely be in such an instance and why?

Question 3

What could you have done to prevent this outcome?

Professional Standards for Nursing Leadership Case Study 5 

approx 30 min

Joe Rodriquez, 19, presents to the hospital Emergency Department with a diagnosis of West Nile virus. He has a fever of 102° F, chills, and generalized aching in all his muscles. He reports that he was recently hiking in a wooded portion of the state and was bitten repeatedly by mosquitoes, despite the fact that he used an insect repellent. He and his parents are informed about this condition, including the need for immediate hospitalization and the treatment plan. Joe refuses to be hospitalized, stating that he will follow all medical recommendations at home. He asks to be assigned a home healthcare nurse to assist with his medical treatment. His parents are totally torn between honoring their son’s wishes and forcing the admission of their son, so that he can receive the needed medical and nursing care.

Question 1

You are the nurse manager for the emergency department, and staff members approach you about this patient. How would you begin to resolve this dilemma?

Question 2

What type of direction would you give staff members to allow them to come to a satisfactory conclusion?

Question 3

How does the Code of Ethics for Nurses (ANA, 2001) provide guidance in reaching needed decisions?

Questions that you would like to ask the advanced practice clinician or non-clinician

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Professional Practice Paper

Based on the AP role of the person that you interviewed in W1 Project, in a 3- to 5-page paper (excluding the title page, references, and appendices) describe the role, the type of organization, and address all the interview questions, and include:

  • -List the type of organization. For example: Primary care office, ED, Specialty, cardiology GI etc.
  • -List the type of and how many clients it serves. FP would see all ages. Research in your area the number of visits in a local office per year or # of visits seen local ED, specialty office etc. 
  • the professional fit for advanced nursing role. “Fit” refers to the Qualifications in order to be an AP provider at that agency/organization. What license, credentialing (accrediting agency, and other expectations NPI, CMS)?
  • -Include a brief job description
  • -Discuss board of nursing NPA or scope of practice of the state. Include what the NPA in the state allows and restrictions.
  • -Answer the questions one by one, do not just answer them in general.
  • -The questions must be answer on one specific Family Nurse Practitioner(just imagine that you are interviewing a real Family Nurse Practitioner).
  • -Focus the paper on a Primary Practice clinic like a doctors office and talk primary about the Family Nurse Practitioner.

Ten questions that you would like to ask the advanced practice clinician or non-clinician

1. What would you do if a patient is not responding positively to prescribed medication and requests more than the allowable amount?

2. Explain a scenario where you went above and beyond to provide exceptional patient care.

3. Do you prefer to work alone or as part of a nursing team?

4. How would you handle a patient who complains due to wrong medical prescription?

5. Would you advance your career to become a doctor?

6. What is the most difficult aspect of being a nurse practitioner?

7. Why should the company hire you?

8. Explain how failure has helped you become a better professional?

9. How do you contribute to a patient’s experience?

10. What do you do when a patient requests unnecessary antibiotics?

Values and principles that guide the nursing profession; the organization’s mission, vision, and values; the leadership and management competencies

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Assignment: Application: Taking a Stand

Effective leaders have a high degree of self-awareness and know how to leverage their strengths in the workplace. Assessments are a valuable tool that professionals can use to learn more about themselves and consider how their temperament and preferences influence their interactions with others.

As you engage in this learning process, it is important to remember that everyone—regardless of temperament type or related preferences—experiences some challenges with regard to leadership. The key to success is being able to recognize and leverage your own strengths while honoring differences among your colleagues.

At some point in your leadership career, you will encounter an ethical or moral dilemma that requires you to take a stand and defend your position.

For this Assignment, you evaluate an issue and consider how you could act as a moral agent or advocate, facilitating the resolution of the issue for a positive outcome.

To prepare:

· Consider the examples of leadership demonstrated in this week’s media presentation and the other Learning Resources.

· To further your self-knowledge, you are required to complete the Kiersey Temperament as indicated in this week’s Learning Resources. Consider your leadership style, including your strengths for leading others and include your results from Kiersey Temperament Sorter to describe potential challenges related to your leadership style.

· Mentally survey your work environment, or one with which you are familiar, and identify a timely issue/dilemma that requires you to perform the leadership role of moral agent or advocate to improve a situation (e.g., speaking or acting on behalf of a vulnerable patient, the need for appropriate staffing, a colleague being treated unfairly).

· What ethical, moral, or legal skills, dispositions, and/or strategies would help you resolve this dilemma? Define the differences between ethical, moral, and legal leadership.

· Finally, consider the values and principles that guide the nursing profession; the organization’s mission, vision, and values; the leadership and management competencies addressed in this course; and your own values and reasons for entering the profession. What motivation do you see for taking a stand on an important issue even when it is difficult to do so?

To complete:

Write a 4 to 5 page paper (page count does not include title and reference page) that addresses the following:

· Introduce the conceptual frameworks of the ethical constructs of ethics, moral, or legal standards and the purpose of the paper.

· Consider  an ethical, moral, or legal dilemma that you have encountered in your work environment and describe it.

· Analyze the moral, ethical, and legal implications utilized in this situation. Describe your role as a moral agent or advocate for this specific issue.

· Consider your leadership styles identified by your self-assessment and determine if they act as a barrier or facilitation during this dilemma. 

Process for the development of nursing standards of practice and how the standards of practice influence the nursing process for your areas of specialty

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A). Outline the process for the development of nursing standards of practice for  Illinois state, including discussion of the entities involved   in developing the standards of practice and how the standards of   practice influence the nursing process for your areas of specialty.
B). Outline the concept of professional accountability as it pertains to   nursing. Provide examples of how a nurse demonstrates professional   accountability in clinical expertise, the nursing process, and   evidence-based practice.
C). 

Review the Institute of Medicine’s 2010 report “The Future of   Nursing: Leading Change, Advancing Health.” Write a 750-1,000   word paper discussing the influence of the IOM report on nursing   practice. Include the following:

  1. Summarize the four messages outlined in the IOM report and     explain why these are significant to nursing practice.
  2. Discuss the direct influence the IOM report has on nursing     education and nursing leadership. Describe the benefits and     opportunities for BSN-prepared nurses.
  3. Explain why it is     important that a nurse’s role and education evolve to meet the needs     of an aging and increasingly diverse population.
  4. Discuss     the significance of professional development, or lifelong learning,     and its relevance in caring for diverse populations across the life     span and within the health-illness continuum.
  5. Discuss how     nurses can assist in effectively managing patient care within an     evolving health care system.

Prepare this assignment according to the guidelines found in the APA   Style Guide.

The established metaparadigms and metatheories of the discipline

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Instructions

Concept Synthesis Paper on Personal Nursing Philosophy

You are required to submit a scholarly paper in which you will identify, describe, research, and apply the concepts that underlie your personal philosophy for professional nursing practice.

This will help you identify your own values and beliefs about the established metaparadigms and metatheories of the discipline. It will also help you identify and articulate concepts relevant to your specific practice. This paper is intended to be an exercise in clarification and organization of your professional foundation. You are also required to provide a list of assumptions from personal nursing practice that illustrate the concepts and framework of your theory.

Your paper should follow a format that includes:

  • Nursing Autobiography: A brief (1 page) discussion of your background in nursing.
  • The Four Metaparadigms: Identification, discussion, and documentation from the literature of your perspective on the basic four metaparadigms/concepts of patient, nurse, health, and environment.
  • Two Practice-Specific Concepts: Identification, discussion, and documentation from the literature of your perspective on at least two other concepts specific to your own practice.
  • List of Propositions: A numbered list of at least five propositions or assumption statements that clearly connect the concepts described.

Each week, you will complete various segments of your Concept Synthesis Paper and submit it to the Submissions Area for facilitator feedback when necessary. Your paper should integrate these discrete elements and reflect your personal nursing philosophy.

Your Concept Synthesis Paper on your Personal Nursing Philosophy is due in Week 3. However, it is recommended that you begin working on your paper from Week 1 onwards and complete the various components related to the paper week wise as you progress through the course. The suggested tasks for each week are:

Week 1: Nursing Biography and The Four Metaparadigms of Nursing
Week 2: Two Practice-specific Concepts, and List of Propositions/Assumptions
Week 3: Due: Concept Synthesis Paper on Personal Nursing Philosophy

Consider the following questions as you complete your various tasks related to this assignment.

1.

How do I define and employ the four basic metaparadigms of nursing theory in my professional practice?

2.

What are the major concepts I employ that are unique to my professional practice?

3.

What philosophies and theories from the literature of nursing and other disciplines/domains are consistent with these concepts?

4.

How are the concepts of transcultural nursing, the health promotion model, skill acquisition, role theory, and change theory specifically integrated into  my philosophy and practice?

5.

What research supports these theories and concepts?

6.

How do I integrate role and change theory into my professional practice and how may these theories be applied to the organization in which I practice?

The paper is to be thoroughly researched and well documented, with relevant material from the nursing theorists presented incorporated into the paper. Use the current edition of the APA Manual throughout the paper. Sources should focus on references from nursing theory but may also include conceptual and theoretical material from other professional domains. The paper, excluding references or appendices, is to be limited to 6-10 pages. Writing should be succinct and well organized, as it is impossible for the facilitator to evaluate form and content separately.

Your philosophy/framework is to be given a title that is appropriate to its content and emphasis.