Health care delivery system

Today, Health care delivery system has been increasingly expensive because of the shortage of health care professionals and costs of health care. Not only that, the costs of medical treatment been doubled with in ten years for each individual. The Affordable Care Act intends to resolve the health care problems in the United States and developing the resources to improve the health care delivery system (Abrams et al., 2015).Health care delivery system

ORDER A PLAGIARISM-FREE PAPER NOW

In this situation, The Patient Protection and Affordable Care Act focus on health promotion and disease prevention for the people. The PPACA build the new models to deliver the care that would be essential to the patients and families in low costs. The PPACA plan is to lower the health costs with in ten years. “The major ways that these cost savings will be accomplished are promoting health and preventing disease, decreasing reliance on fee for service, providing cost-effective care, and using the electronic health record (EHR) across settings. Two of the delivery systems highlighted in PPACA are the “Patient Centered Medical Home” (PCMH) and the “Accountable Care Organization” (ACO)” (Hass, 2011). The PPACA established to deliver the care in health system by involving interdisciplinary care team because they can work together to provide most cost effective care and coordinate each other to achieve better outcomes. For example, Electronic health record information is available to entire health care team to share the information and evaluate the care if action needs to be taken. The interdisciplinary care team can monitor the patients if their chronic health problems need to be managed by educating or counseling them. The entire team members can document their notes and it will be easier to access their documentation to the rest of the team who is involved in patient’s care. Not only that, the results would be also available in timely manner to evaluate as well as it reduces the error on documentation. The EHR is reliable tools to use today and it is a great way to deliver the care to the patients to achieve better outcomes. Health care delivery system

Health insurance: healthcare and abortion

Respond to the following on health insurance, healthcare and abortion…

States have been cutting insurance for women to access reproductive health services. This particularly affects low-income families with the overall lack of access to quality reproductive health care. The lack of proper health insurance for women impedes on their reproductive rights as they should be given an opportunity to make their own reproductive choices when it comes to the use of contraceptives and abortions. Health insurance: healthcare and abortion

ORDER A PLAGIARISM-FREE PAPER NOW

This scenario is not different in the state of Florida. As of April 2017, the state only covers abortion under the Affordable Care Act if the woman in question has been raped, is in danger, or if it is an incest case. An abortion may so be performed from week 24 of the woman last menstrual period, but only if the woman’s life is endangered (Jones & Jerman, 2017). Looking at the state’s infant and maternal mortality rates, one can make the connection between bad policies and the consequences. 160 resident pregnancy-associated deaths were recorded in the state January 1, 2015, to December 31, 2015 (Jones & Jerman, 2017). With a pregnancy-related mortality ratio 16.9 per 100,000 live births, it is not hard to associate lack of good reproductive health policies as a major cause attributed to these rates. Of the deaths, approximately 31.6% were non-Hispanic Black women with Hispanic women accounting for 10.5%. It is illustrative of the lack of proper reproductive health insurance. Health insurance: healthcare and abortion

As an advanced practice nurse and nursing leader, it is the individual’s responsibility to advocate for changes in such policies to ensure better health outcomes for women. Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes adequately prepares nurses to collaborate, communicate, and consult with other interprofessional groups in order to manage and coordinate care (American Association of Colleges of Nursing, 2014). Women reproductive health is highly important and as a nurse, one is required to play a leading role to ensure better policies are put in place to insure women requiring reproductive health not only in the state of Florida but all over the country.

References

Jones, R. K., & Jerman, J. (2017). Abortion incidence and service availability in the United States, 2014. Perspectives on Sexual and Reproductive Health, 49(1), 17-27.

American Association of Colleges of Nursing. (2014). The essentials of master’s education in nursing. March 21, 2011. Health insurance: healthcare and abortion

 

ADN and BSN nurses

Discuss current research that links patient safety outcomes to ADN and BSN nurses. Based on some real-life experiences, do you agree or disagree with this research?

A study done in 2011 by Aiken and colleagues revealed that increasing the number of the registered nurses in hospitals is not only the solution to reducing patients’ mortality rate, but rather increasing number of nurses who have a higher educational, and a positive work environment, positively decrease the mortality rate in the hospitals (Cherry & Jacob, 2017). It interesting to know that every 10% increase in number of BSN nurses, decreases the mortality rate to 4% (Cherry & Jacob, 2017) even though 4% seems small, but it is still a great impact to life-saving effort. ADN and BSN nurses

ORDER A PLAGIARISM-FREE PAPER NOW

There is no doubt that knowledge is the key, just like we all are getting our bachelors in nursing, there is a huge difference in the knowledge acquired. I personally have grown in confidence and knowledge through the course of this study and I am excited to be a better nurse clinically and in the community.

Recently, hospital position openings are BSN preferred, based on the reports like that of Institute of Medicine which support that nurses who are BSN possess the skills and knowledge needed to produce a better or positive patient outcome (Sherman, 2012). Last year, I attended a job-fair organized my Methodist hospital, and it was an instant offer for the positions available, everyone was qualified except me because I didn’t have a BSN, so that was my instant driving force to enroll in BSN program. ADN and BSN nurses

Based on my experience, I have worked with nurses who have years of work experiences without BSN and Nurses who have BSN but no experience. I personally think that having years’ experience is a big plus in terms of practical nursing. For example, an LPNs/LVNs took me on floor orientation in Nursing home after I was hired, even though she is an LVN, there are things she taught me that I didn’t know as an RN, obviously because she has years of experience, but not a higher education. I strongly believe also that having a higher education in nursing, prepares nurses to assume leadership roles, and exposes nurses to skills and knowledge needed to deliver a high-quality nursing care.

I agree with the aspect of BSN being prepared to assume leadership roles, but I do not believe that ADN nurses contribute to higher mortality role, because all nurses are exposed to the same clinical training in the hospitals. I believe that having a positive work environment, increasing the number of nurses, and a better communication with other health care teams improve a better patient outcome.

If I am in a hiring position, I would refer to hire a registered nurse with ADN who have years of experience over a BSN nurse who has no experience based on the type of position available, leadership positions would go for BSN, while floor position goes to ADN with a higher years of work experience.

References

Cherry, B. & Jacob. S. (2017) Contemporary nursing, issues, trends, & management. St. Louis: Elsevier. Six editions. Retrieved from https://pageburstls.elsevier.com/#/books/978-0-323-101097/cfi/6/8!/4/2/14/4@0:10

Sherman. R (2012) An 80% BSN Prepared Nursing Workforce by 2020? Emerging RN Leader. Retrieved on September 18th. From http://www.emergingrnleader.com/80bsnworkforce2020/

ADN and BSN nurses

 

Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.” Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.
• Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

• Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

ORDER A PLAGIARISM-FREE PAPER NOW

Use of Clinical Systems to Improve Outcomes and Efficiencies

Introduction

Proper clinical systems play an important role in revitalizing the healthcare delivery system worldwide. All primary healthcare professionals need to come together to establish and implement the target clinical systems. The use of evidence-based practices, health information technology and developing clinical systems have been shown to improve patient outcomes and efficiencies. Clinical systems can be used to improve healthcare processes, identify patients at risk, improve efficiency, and advance research in order to improve patient outcomes. Electronic healthcare records (EHR) have been selected as the clinical system. accordingly, this paper will critique five research articles on the application of electronic healthcare records to improve outcomes and efficiencies. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Summary 1

Bowles, K. H., Dykes, P., & Demiris, G. (2015). The use of health information technology to improve care and outcomes for older adults. Research in gerontological nursing, 8(1), 5–10.  doi: 10.3928/19404921-20121222-01.

According to Bowles, Dykes and Demiris, (2015), EHR are vital in improving documentation and billing in the delivery of healthcare. Healthcare organizations implement EHR to improve quality, safety, and efficiency of care. In regard to improving outcomes, Bowles et al (2015), explains that effective application of EHR can improve care outcomes. For instance, the use of EHR systems has been shown to improve documentation of pressure ulcer and fall risk assessments.  Improved documentation using EHR led to a 13% drop in the rates of nosocomial pressure ulcers. These findings clearly indicate the impact of EHR to improve outcomes. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

The study also highlights the key element of documentation and organization, which are very important in the efficient operations of daily processes with healthcare organizations. The study findings indicate that implementation of EHR led to improved teamwork, collaboration and supportive leadership which led to sustained improvement in safety and quality outcomes (Bowles et al., 2015). Bowles et al (2015), further indicate that the use of EHR supported the integration of clinical decisions for personalized treatment plans into the workflow, improving the efficiency of the workflow.

From this article, we learn that EHR can be used to improve assessment of adverse events such as documentation of pressure ulcer and fall risk assessments. For example, organizations should ensure all patient data is stored electronically in order to facilitate easy assessment for patients at risk of adverse events.

Summary 2

Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018). The use of Electronic Health Records to Support Population Health: A Systematic Review of the Literature. Journal of medical systems, 42(11), 214. doi: 10.1007/s10916-018-1075-6. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

According to Kruse, Stein, Thomas and Kaur (2018), EHRs are among the clinical systems that improve the quality of care and efficiency of healthcare.  Regarding outcomes, this study found out that implementation of EHRs led to improved delivery and integration of the recommended preventative care into care practices, leading to improved care outcomes. In addition, according to Kruse et al (2018), implementation of EHRs in the ICU significantly lower central line-associated bloodstream infections and mortality rates within the surgical ICU. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

EHRs facilitate the provision of patient-centered care and more coordinated care improving efficiency. EHRs also facilitate the provision of secure access to patients’ information which leads to better outcomes in regard to the quality of care and productivity (Kruse et al., 2018). EHR systems are applied in the management of chronic diseases such as diabetes and regular utilization of the EHRs can decrease data fragmentation and hence improve continuity of care between healthcare professions if healthcare providers engage in health information exchanges. In addition, EHRS within the emergency department improves the decision-making process when utilizing a decision tree and hence improves the quality of life for the patients and is also cost-effective (Kruse et al., 2018) Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

From this article, it is evident EHRs facilitate safe continuity of care. For example, with EHRs, human errors likely to occur during handover using manual paper are eliminated.

Summary 3

Manca D. P. (2015). Do electronic medical records improve quality of care? Yes. Canadian family physician Medecin de famille canadien, 61(10), 846–851. doi: 10.14236/jhi. v18i1.751

Manca (2015) explains various ways that EHRs improve outcomes and efficiency. According to Manca (2015), EHRs improve the management of chronic disease, and screening and prevention of disease, which leads to improved quality of care and outcomes. EHRs can provide treatment goals and notifications to remind healthcare providers when specific preventative and screening planned activities are due or outdated. The EHRs also facilitates access to important information and resources necessary to handle various health conditions which leads to better outcomes (Manca, 2015) Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

The structured EHRs data provide access to point-of-care information which can be utilized in informing practice and conducting research. With meaningful use, the EHR data provides healthcare providers with vital practice-level information that can be utilized for practice-level interventions like identification of patients who missed screening for specific diseases. Such data provides important feedback to the healthcare providers regarding the quality of care (Manca, 2015). Manca (2015) also explains that the use of point-of-care EHR data can provide important information regarding the efficacy of specific medications and other treatment modalities. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

It is therefore evident that EHRs improve disease outcomes. For instance, screening of patients with hypertension using an EHR intervention facilitates provision of the appropriate/specific lifestyle modification education to the target group and hence improves disease outcome, for example reduces blood pressure for the patients.

Summary 4

Selvaraj S, Fonarow G, Sheng S, Matsouaka R, DeVore A, Heidenreich A, Hernandez A, Yancy W & Bhatt D. (2018).  Association of Electronic Health Record Use with Quality of Care and Outcomes in Heart Failure: An Analysis of Get with the Guidelines—Heart Failure. Journal of the American Heart Association, 7(7), pii: e008158. doi: 10.1161/JAHA.117.008158. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Selvaraj, Fonarow, Sheng, Matsouaka, DeVore, Heidenreich, Hernandez, Yancy and Bhatt (2018) provide that implementation of the EHRs leads to improved coordination of care and thus improves efficiency during care provision. Similarly, EHRs have been demonstrated to be effective in decreasing medical errors and hence improve the quality of care and outcomes. However, the findings of this study indicate that the use of EHRs was not attributable to improved quality of care and did not have a significant impact on heart failure-related outcomes (Selvaraj et al., 2018).

From this article, it is evident that use of EHRs alone may not be sufficient in improving heart failure-related outcomes. Therefore, other interventions such as monitoring patient adherence to treatment and patient education should be integrated in patients’ treatment plan.

Summary 5

Campanella P, Lovato E, Marone C, Fallacara L & Mancuso A. (2015). The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. European Journal of Public Health, 1(5), 60-4. doi: 10.1093/eurpub/ckv122

Campanella, Lovato, Marone, Fallacara and Mancuso (2015) explore the impact of EHRs on the quality of care. The study explains that the EHR leads to reduced medical errors and thus improves the quality of care and health outcomes. In addition, EHR has been shown to improve time inefficiency and also reduces healthcare costs and thus EHR has led to improved efficiency. Campanella et al (2015) further explain that EHR has been an effective method to reduce healthcare costs and thus improve the quality of care and reduce harm to patients. The availability of the stored computerized enables computerized quality assessment and automated chart review, which is cost-effective and also a time-saving process. Evidence indicates that EHR systems improve the quality of care and outcomes by improving time efficiency and decreasing medication errors (Campanella et al., 2015). Therefore, the implementation of EHR systems significantly improves health outcomes and efficiencies of healthcare processes.

The article demonstrates that by use of EHRs, medical errors and the consequent adverse events can be avoided. For example, EHR technologies can assist in preventing medication errors by flagging possible adverse reactions and/or drug interactions. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

Conclusion

Clinical systems such as EHR systems have been shown to improve outcomes, efficiency, and effectiveness in health care. All the selected studies indicated that EHRs improve outcomes by reducing the rate of medical errors, improve documentation, and facilitating the provision of coordinated care: this significantly contributes to improved outcomes. On the other hand, EHRs improve efficiency by promoting teamwork and collaboration among healthcare providers which improves the efficiency of care. In addition, EHR systems save time and reduce costs further indicating the efficiency of EHRs in the healthcare system. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

 

References

Bowles, K. H., Dykes, P., & Demiris, G. (2015). The use of health information technology to improve care and outcomes for older adults. Research in gerontological nursing, 8(1), 5–10.  doi: 10.3928/19404921-20121222-01.

Campanella P, Lovato E, Marone C, Fallacara L & Mancuso A. (2015). The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. European Journal of Public Health, 1(5), 60-4. doi: 10.1093/eurpub/ckv122 Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018). The use of Electronic Health Records to Support Population Health: A Systematic Review of the Literature. Journal of medical systems, 42(11), 214. doi: 10.1007/s10916-018-1075-6.

Manca D. P. (2015). Do electronic medical records improve quality of care? Yes. Canadian family physician Medecin de famille canadien, 61(10), 846–851. doi: 10.14236/jhi. v18i1.751.

Selvaraj S, Fonarow G, Sheng S, Matsouaka R, DeVore A, Heidenreich A, Hernandez A, Yancy W & Bhatt D. (2018).  Association of Electronic Health Record Use with Quality of Care and Outcomes in Heart Failure: An Analysis of Get with the Guidelines—Heart Failure. Journal of the American Heart Association, 7(7), pii: e008158. doi: 10.1161/JAHA.117.008158. Nurs 6051 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

Portfolio Assignment: The Role of the Nurse Informaticist in Systems Development and Implementation

Introduction

Advancement in technology and its integration in healthcare to improve safety and efficiency has influenced additional roles and responsibilities to nurses in the field of informatics. A perfect example is the role of a nurse Informaticist who assists system developers to analyze problems and propose solutions in SDLC. The SDLC (Systems Development Life Cycle) describes the steps followed by system developers in designing, troubleshooting and implementing a system.

The entire process requires a systematic problem-solving approach that will provide solutions to an existing problem. As highlighted by McGonigle & Mastrian, (2018), the primary issue addressed by most nurse informacists in healthcare organizations is developing a documentation system that addresses the challenges of nursing documentation. Nurses are the majority in the health workforce and spend most of their time with patients. Therefore, they should be actively involved in developing the information systems used in healthcare organizations for more successful outcomes.

Steps of the SDLC (Systems Development Life Cycle)

The steps of an SDLC vary based on a type of a system being developed. However, the development of a system that supports nursing documentation has five major steps namely: planning and requirements definition, analysis, design, implementation, testing and maintenance (post-implementation) (McGonigle & Mastrian, 2018). Every stage of the cycle must involve nurses to improve chances for success since they are well-informed on the required output. For instance, nurse leaders can guide system developers in each stage of development and ensure that plans developed to identify and address organizational needs. On the other hand, to determine the most appropriate inputs to start development with, a system developer may consider using a reverse system development approach. A nurse informacist can identify and communicate any workflow issues witnessed in the system.

Planning and Requirements Definition

Planning is the most essential tool that guarantees high chances of a successful outcome of any program or operation. In the system development cycle, the lead nurse is responsible for giving a healthcare plan to the system developers. The information provided is used to plan the best approaches for system development. In the requirements definition, a nurse identifies the requirements for formulating specific outputs, which are incorporated into the system (Schoville & Titler, 2015). The system developer will later make plans on how to code the inputs provided.

Analysis

In the analysis stage, the system’s processes and workflows are established. A determination to ascertain whether the requirements provided are met and an evaluation of the processes for potential changes is done. In this phase, nurses can be useful in explaining and discussing the components that were working in the previous system with the system developer (Yen et al., 2017). This will help to determine components that need to be done-away-with or added. Besides, a nurse informacist can discuss with a system developer how to meet these requirements.

Design of the New System

In the design stage, the general look of the system is established. The implementation team makes several decisions including the required type of data. The team generates reports, prototypes, mockups, and screenshots to determine potential hitches that are likely to occur (Thomas, Seifert & Joyner, 2016). In this phase, a nurse Informaticist can scrutinize the developed flowcharts to ensure that they follow the appropriate performance path and display the expected output.

ORDER A PLAGIARISM-FREE PAPER NOW

Implementation

A student nurse who has basic knowledge in programming can apply the five-step approach by Everett Rogers to facilitate adoption and implementation of the system in the following phases: knowledge, persuasion, decision, implementation, and confirmation (Ronquillo, Currie & Rodney, 2016). Since implementation incorporates the use of a specific coding language to code designs, the nurse student can also check the coded flowcharts and assist to troubleshoot the system in case it provides an incorrect output. He/she can also: organize for meetings with staff, obtain feedback from nurses, identify potential facilitators and barriers of the system, make modifications on techniques to evaluate processes, use positive reinforcements to encourage other staff to adhere to the system requirements, track and monitor the rate at which staff comply with the new system and measure outcomes. Ronquillo, Currie & Rodney (2016) suggest that, in the implementation phase, a nurse manager can plan for appropriate training of staff to ensure a successful transition in the implementation of a new system.

Post-Implementation Support

The final phase incorporates testing and maintenance. The system should be tested before its delivery. Testing purposes to ensure that the system provides the appropriate output and solves all the issues it is required to solve. A nurse informaticist can help to ensure that the output given by the system aligns with the requirements of the health system. The system should be able to assist in nursing documentation in roles such as capturing and storing information. A nurse informacist should also organize training to educate other nurses about the system and its usage. As emphasized by McGonigle & Mastrian (2018),  the nurse informaticist should oversee the process of integration into the organization. As a maintenance role, the nurse Informaticist will notify the system developer on required changes where needed.

Conclusion

In today’s highly diverse and well-developed health sector, information technology has an integral role. Ensuring adequacy in nursing processes such as documentation requires a well-developed system that guarantees efficiency. This system should be able to address issues related to the maintenance of nursing processes such as nursing documentation. Steps in SDLC have addressed the burdensome process where nurses were required to manage information manually. When developing a system for nursing documentation or other nursing processes, it is advisable to involve nurses since they are informed on the issues that should be addressed and the expected solutions.

 

References

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

Ronquillo, C., Currie, L. M., & Rodney, P. (2016). The evolution of data-information-knowledge-wisdom in nursing informatics. Advances in nursing science, 39(1), E1-E18. DOI: 10.1097/ANS.0000000000000107

Schoville, R. R., & Titler, M. G. (2015). Guiding healthcare technology implementation: a new integrated technology implementation model. CIN: Computers, Informatics, Nursing, 33(3), 99-107. doi: 10.1097/CIN.0000000000000130

Thomas, T. W., Seifert, P. C., & Joyner, J. C. (2016). Registered nurses leading innovative changes. OJIN: The Online Journal of Issues in Nursing, 21(3). DOI: 10.3912/OJIN.Vol21No03Man03

Yen, P. Y., Phillips, A., Kennedy, M. K., & Collins, S. (2017). Nursing informatics competency assessment for the nurse leader: instrument refinement, validation, and psychometric analysis. JONA: The Journal of Nursing Administration, 47(5), 271-277. https://doi.org/10.1097/NNA.0000000000000478