Last week, you identified challenges related to informatics and recommended strategies for overcoming them. In this Assignment, you address common challenges applied in a specific informatics scenario. Then, you extend your thinking by addressing another common challenge: resistance to change. The rapidly evolving world of informatics means departments and institutions must evolve in ways that make some professionals uncomfortable, and this Assignment focuses on overcoming that real-world circumstance.  

To Prepare For this Assignment, consider the following scenario:

The radiologist at your hospital reports to the administrator that 30 patients have been diagnosed with brain tumors during the past 2 months. The administrator requests a report detailing the number of patients diagnosed with brain tumors during the past 6 months. However, the radiology department uses a free-text entry for their diagnoses, and their system does not communicate with the larger electronic health record (EHR) system installed at the hospital. You recognize an opportunity to address challenges with the EHR system in your hospital and decide to also write a proposal for a solution to improve your hospital’s EHR system.

• Based on this scenario, analyze each of the challenges described below that the hospital may need to address:
  • Vocabulary standards
  • Interoperability
  • Workarounds
  • Patient safety
  • Patient privacy and security when pulling reports
• Reflect on potential solutions to each of the challenges described. 
• Research change theories in the Walden Library (or other academic sources) that might assist in your convincing the institution to implement potential solutions.
• The Walden Library recommends the following resources:
  • SAGE Knowledge: a collection of specialized encyclopedias in several subject areas that includes many types of theories. 
  • Computers and Applied Sciences Complete: journals covering engineering, computer theory and systems, new technologies, and social and professional context.
• Reflect on how an electronic health record system analytic API could help interpret the data found in the scenario.

The Assignment

• Write a proposal for how the hospital in the scenario might overcome each of the following challenges related to the scenario:
  • Vocabulary standards
  • Interoperabiliy
  • Workarounds
  • Patient safety
  • Patient privacy and security when pulling reports
• Recommend a change theory that might assist in your convincing the hospital administration to implement the EHR solution and improvements you propose. Be specific and provide examples.
• Support your proposal by explaining how the EHR solution might benefit data analysis for the promotion of improved health outcomes.
• Note: The title page, introduction, summary, and references are in addition to the required page count.

Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress.

Peer 1

Savannah, Georgia is the oldest city in the state of Georgia and is a popular tourist spot that have a population of 145, 754. Of that population, 38.7 % is Caucasian, 54.4 is African American, 3$ two or more races, 3.92% Asian, Another race, Native American, Native Hawaiian, or Pacific islander. More than half of the population is African Americans. African Americans have a higher prevalence of things such as hypertension which increases a person’s risk for stroke and heart disease. African Americans are also disproportionally affected by Obesity. African Americans are also more likely to have diabetes which can lead to stroke or cardiovascular disease. A lot of these are influenced by modifiable and non-modifiable factors. Yes, I am African American and that’s something that will stick with me for the rest of my life. But on the other hand, I can eat right, exercise, and drink plenty of water so that I won’t get any of these things. As a nurse, I have seen many patients and sometimes a little education goes a long way.

Another population that interests me is the homeless community. Savannah has the second-highest number of homelessness in Georgia. There are over 1000 individuals that are not including the 800 kids that are enrolled at schools throughout Savannah, GA. There are many reasons a person or family may experience losses. I could be because of lost wages or income, substance abuse, domestic violence, low wages, and many more. In savannah, we do have the homeless authority which provides resources to those who are homeless. We have shelters and soup kitchens. One of the things that are going on is the tiny house project. It is something in place to help homeless veterans that not only provides them with a community but also affordable housing. There is something called Tent city, it is a community of homeless people that live in tents in savannah, Ga. My unit in the hospital chose them to do our own separate community outreach. We are doing things like giving them water, and things that will help them as winter is approaching.

References

About Homelessness. (2020, May 06). Retrieved September 22, 2020, from https://www.homelessauthority.org/about-homelessness/

African Americans and Heart Disease, Stroke. (n.d.). Retrieved September 22, 2020, from https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/african-americans-and-heart-disease-stroke

Savannah, Georgia Population 2020. (n.d.). Retrieved September 22, 2020, from https://worldpopulationreview.com/us-cities/savannah-ga-population

Peer 2

When discussing an aggregate, or target population you are pointing out a collection of people who have one or more personal or environmental traits in common (Stanhope & Lancaster, 2020). In my community two targeted populations that are of interest to me are migrant farmworkers in our county and migrant children of migrant farmworkers. My rationale for these targeted populations is primary prevention.

On average, the level of education completed by a migrant farmworker is 6th grade (Student Action with Farmworkers, 2020). This tells me that education needs to take priority about prevention of diseases and what they can be taught about it. Migrants face a higher rate of urinary tract infections, heat stress, tuberculosis and other illnesses, as their children have higher rates of dental diseases and malnutrition (Student Action with Farmworkers, 2020).

If migrants are taught about health promotion services they can utilize in the community that can reduce the risk of disease, it could give them a sense of empowerment. Having the knowledge and control over their own health may entice them to educate others about what they can do. Primary prevention is the first step that should be made in order to begin care for not just this aggregate group, but for any aggregate.

References

Stanhope, M. & Lancaster, M.S.J. (2020). Public health nursing: Population-centered health care in the community. (10th ed.). St. Louis, MO: Elsevier.

Student Action with Farmworkers. (2020). United States farmworker fact sheet. Retrieved from https://saf-unite.org/content/united-states-farmworker-factsheet

Zero Plagiarism

5 references

While cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) have many similarities, they are distinctly different therapeutic approaches. When assessing clients and selecting one of these therapies, you must recognize the importance of not only selecting the one that is best for the client, but also the approach that most aligns to your own skill set. For this Assignment, as you examine the similarities and differences between CBT and REBT, consider which therapeutic approach you might use with your clients.

Learning Objectives

Students will:

Compare cognitive behavioral therapy and rational emotive behavioral therapy

Recommend cognitive behavioral therapies for clients

To prepare:

Review the media in this week’s Learning Resources.

Reflect on the various forms of cognitive behavioral therapy.

The Assignment

In a 1- to 2-page paper, address the following:

Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar.

Explain at least three differences between CBT and REBT. Include how these differences might impact your practice as a mental health counselor.

Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature.

I need these questions answered in about 120 words each, with references

1. If there are gaps in a published literature, what evidence might be able to be used?

2. Can you provide an example of a statistically significant finding but not clinically significant?

Click on the following link and read the article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061635/
Arabi, A., Rafii, F., Cheraghi, M., & Ghiyasvandian, S. (2014, May). Nurses’ policy influence: A concept analysis. 
1. Look up your local nursing state organizations in this case New York.
3. Find out what policies they are working on  
4. choose a policy of your choice pertaining to the nursing field and write a 200-300 words post about the policy that you are interested in learning more about.
APA format, with intext citation and citing the source. Please use the above link for the a for references and plagiarism free. DO NOT TURNITIN.

 types of Variables 

Discussion: Searching Databases

When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems.

The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format.

In this Discussion, you will transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently. You will share this PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question.

To Prepare:

• Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
• Review the Resources for guidance and develop a PICO(T) question of interest to you for further study.

By Day 3 of Week 4

Post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. Then, describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples.

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 2, “Asking Compelling Clinical Questions” (pp. 33–54)
Chapter 3, “Finding Relevant Evidence to Answer Clinical Questions” (pp. 55–92)

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80. https://doi.org/10.18438/B8WS5N
Note: You will access this article from the Walden Library databases.

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. doi:10.1097/01.NAJ.0000368959.11129.79
Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58
Note: You will access this article from the Walden Library databases.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e
Note: You will access this article from the Walden Library databases.

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981

Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/jbisearchhelp

Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/medlinesearchhelp

Walden University Library. (n.d.-h). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing? Retrieved September 6, 2019, from https://academicanswers.waldenu.edu/faq/72670

Walden University Library. (n.d.-i). Systematic review. Retrieved January 22, 2020, from https://academicguides.waldenu.edu/library/healthevidence/types#s-lg-box-1520654

Required Media

Laureate Education (Producer). (2018). Searching the Evidence [Video file]. Baltimore, MD: Author.

3 sources for this discussion

REPLY 1

The health care profession can experience a difficulty and can become frustrated with the possible reservations of Sister Mary. There are other things to consider with the plan of care and possibility of introducing different care approaches with the results of diagnostic procedures performed on Sister Mary.

An example of a common religious practice discrepancy that you may encounter is that although most Catholics generally don’t support the use of birth control, many Catholics do use contraceptives. Because some Catholic patients use contraceptives, when providing discharge instructions after childbirth or during the first 6-week check-up, you may want to ask if the patient wishes to discuss birth control options.

When providing care for an observant Catholic patient, be aware that birthing techniques, the use of pain management drugs during child birth, breastfeeding, circumcision, and immunizations are all issues that the Catholic Church leaves to the discretion of the parents.

If a patient is N.P.O., get permission from the healthcare provider before the patient is offered communion. The patient may want to keep a crucifix or rosary beads with him or her during surgery or a medical procedure if possible.

Most Catholics believe that if patients perceive that they risk death during a medical procedure, they or their family may request sacraments, last rites, and blessings to be performed by a Catholic priest. Baptism may be requested, especially for an infant who may be dying,

No special preparation of the body is required after death. The Catholic Church endorses burial as opposed to cremation, but no longer forbids the practice. The church requires that cremated remains not be scattered, kept at home, or subdivided into other containers because this would be considered desecration. Burial at sea is permitted if the remains stay in a heavy, sealed container.

Reference:

Falvo, D. (2011) Effective Patient Education: A guide to Increased Adherence. Retrieved from https://viewer.gcu.edu/RQBKXW

REPLY2

Patients come from diverse backgrounds with different cultures, traditions, values, and religious practices. Healthcare professionals require cultural knowledge to meet the social, cultural, and spiritual needs of patients. In the given case scenario, the patient is a Roman Catholic nun. Thus, a healthcare professional working with Sister Mary can show uncertainty due to the religious beliefs and preferences of the patient and need the assistance of practicing Roman Catholic in handling Sister Mary.

The primary concern when working with Sister Mary is religious differences. Healthcare professionals must consider the religious beliefs of the patient and their impact on the care process (Balzer-Riley, 2020). Patients practicing the Roman Catholic religion keep sacred objects, such as a rosary, on them. Sister Mary will need to remove the items when undergoing tests. A healthcare professional with adequate Roman Catholic information will ensure the objects are kept near the patient during testing. One without awareness will keep the religious pieces away from the patient, which might influence the caring process.

Notably, Sister Mary must have a physical assessment. The process will require the inspection of various body parts of the patient. A healthcare professional might be reluctant to evaluate Sister Mary due to perceived barriers, such as modesty and gender differences, to physical testing (Potter, Perry, Stockert, & Hall, 2020). Thus, they will need to ask and receive confirmation from Sister Mary before proceeding with the examination.

Healthcare professionals working with Sister Mary can receive assistance from Roman Catholic colleagues, Sister Mary’s family, and fellow nuns. The team helps the healthcare team understand the religious beliefs and needs of the patient, which is essential in providing patient-focused and culturally competent care (Kersey-Matusiak, 2013). Moreover, they will offer emotional and psychological support to promote the wellbeing of the patient. Therefore, psychosocial support helps the patient feel more comfortable, lessens anxiety, and improves care quality and outcomes.

Balzer-Riley, J. (2020). Communication in nursing (9th ed.). St. Louis, MO: Elsevier.

Kersey-Matusiak, G. (2013). Delivering Culturally Competent Nursing Care, Second Edition. New York, NY: Springer.

Potter, P., Perry, A., Stockert, P., & Hall, A. (2020). Fundamentals of nursing (10th ed.). St. Louis, MO: Elsevier.

Please provide proper APA citation of your references. DO NOT COPY WORD FOR WORD (this includes both text book and all other forms of media- paraphrase and cite your reference). Remember to include a reference sheet with you references list IN ALPHABETICAL ORDER.

1. In your own words explain the purpose for using theory to develop community based health interventions. (This is not a one or two sentence answer. I am looking for a solid explanation, utilizing references, of why we use theory).

2. In your own words, describe the relationship between theoretical constructs and intervention activities. (This is not a one or two sentence answer. I am looking for a complete discussion of the interactions of theoretical constructs and intervention activities).

3. In your own words discuss the difference between primary and secondary data. (This is not a one or two sentence answer. Your response should demonstrate a complete understanding of the terms and must include examples… DO NOT USE EXAMPLES FROM THE TEXT BOOK!!!).

4. State and describe a specific priority population for whom an internet-based survey would be appropriate (notice I said describe not simply list). Why do you think it would work with this group (be complete in your response)? What research and/or statistics support your claim (this can be addressed with a simple web search. Do not forget to reference)? I am looking for a logical response to this question. Do not simply put something down without having firm evidence to support.

Each answer must contain 150 word answer minimum.

due in 8 hours

 Using this template, complete one SOAP note from a patient in your current NSG6440 clinical experience. The completed note should be submitted to the Submissions Area.