DNP 805 Full Discussion Essay Papers

DNP 805 Full Discussion Essay Papers

DNP 805 Full Discussion Essay Papers

DNP 805 Topic 1 Discussion 1

Select a specific health care technology-related regulation, law, statute, or ethical standard that applies to informatics. Provide a summary of your example and a statement describing your reasoning either in support of the example you select, or in opposition to it.

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DNP 805 Topic 1 Discussion 2

Select one informatics theory from the areas of Communication Theories, Change Theories, or Human Factors. Discuss how the application of the theory you select can guide the use of technology in advanced practice. What strengths does the theory possess that would make it useful to the DNP-prepared nurse? What weaknesses does the theory present that might prevent its use?

DNP 805 Topic 2 Discussion 1

Discuss the usefulness of the electronic health record (EHR) and its impact on patient safety and quality outcomes. Describe strengths and limitations that might apply to its usage.

SAMPLE SOLUTION APPROACH – TOPIC 2 DISCUSSION 1

Topic 2 DQ 1

Discuss the usefulness of the electronic health record (EHR) and its impact on patient safety and quality outcomes. Describe strengths and limitations that might apply to its usage.

During the last decade, healthcare has witnessed the development and implementation of electronic health records (EHRs). The initial theory was that EHRs would improve patient safety and quality outcomes.  Silverman (1998) stated that some of the obvious advantages to an EHR would have included and were not limited to the ease of access and immediate availability of patient information, history, and treatment plans in routine or emergency situations.  He stated the potential to decrease adverse outcomes such as missed diagnoses, unnecessary or repeated treatments and procedures, international drug interactions and contraindicated treatments.  If all EHRs were connected, one could also have a complete and up to date medical record always immediately available to caregivers.

Reimbursement incentives to increase the use of EHRs were put into place by the Health Information Technology for Economic and Clinical Health Act in 2009.  This Act allocated $27 billion of reimbursement for the demonstration of the meaningful use of EHRs.  Clinical decision support rules that are specialty specific were expected to be implemented in the EHR to guide professional practice at the point of care with a purpose of improving overall patient safety and quality outcomes (Moja et al, 2014).

The impact of the EHR on the mortality, morbidity and costs of healthcare has been examined by several researchers throughout the years. Moja et al. (2014), conducted a systematic review of computerized decision support systems (CDSSs) that provided guidance messages such as “diagnostic test ordering and interpretation, treatment planning, therapy recommendations, primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, or chronic disease management” to identify the impact of CDSSs on patient safety and quality outcomes.   The researchers compared systems with CDSSs to those without access to CDSSs, those that did not generate advice for care and those that did not have evidence based advice for care (Moja et al., 2014).

The results of 28 randomized control trials was surprising as it  indicated little evidence for a difference in mortality.  The small differences were primarily identified in particular settings with specific diseases and circumstances only. However, most studies were considered too short to prove or exclude a mortality effect.  Morbidity outcomes of the studies were found to be too diverse and limited to make inferences.  However, there was a 10% to 18% decrease of morbidity due to CDSSs linked to EHRs.  This indicates that some studies showed an improvement in the health outcomes and quality of patient care as it pertained to the overall morbidity of patients. Finally, the differences observed for cost and utilization of health services among the studies was found to be small between the study groups (Moja et al, 2014).

While this study had several limitations such as not including the processes of different facilities or the level of compliance of practice professionals to guideline recommendations, the study indicates that there are several advantages to the use of CDSSs within an EHR to improve patient safety and quality of care.  Although more research is needed to prove the benefits of CDSSs within EHRs, several advantages have been observed.

However, disadvantages have also been observed in relation to EHRs.  There is concern for the privacy of medical record information and the accuracy of information entered into permanent medical records (Thede, 2010). The implementation of information technology systems is expensive, time consuming and at times is perceived as disruptive to the care being delivered by healthcare professionals. The adoption of a universal electronic health record is still yet to be achieved and the use of the EHR by some practice professionals still seems daunting and time consuming (Kreidler, 2019).

Kreidler, M. L. (2019). Health Care and Information Technology. Salem Press Encyclopedia. Retrieved from

https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=ers&AN=89163746&site=eds-live&scope=site

Moja, L., Kwag, K. H., Lytras, T., Bertizzolo, L., Ruggiero, F., Brandt, L., … Bonovas, S. (2014). Effectiveness of computerized decision support systems linked to electronic health records: A systematic review and meta-analysis. American Journal of Public Health, (12), e12. https://doi-org.lopes.idm.oclc.org/10.2105/AJPH.2014.302164

Silverman, D. D. (1998). The electronic medical record system: Health care marvel or morass? Physician Executive, 24(3), 26. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=bth&AN=619793&site=eds-live&scope=site

Thede, L. (2010). Informatics: Electronic Health Records: A Boon or Privacy Nightmare? Online Journal of Issues in Nursing, 15(2), 8.

https://doi-org.lopes.idm.oclc.org/10.3912/OJIN.Vol15No02InfoCol01

DNP 805 Topic 2 Discussion 2

You are now a DNP-prepared nurse in a new leadership position in clinical practice. Analyze your new practice workflow to incorporate seeing patients and in regards to communication with the health care team and the infusion of the EHR into your practice. What elements do you need to consider if this position is in a magnet acute-care hospital in a busy metropolitan area? How might your practice change if the setting was a rural regional clinic system?

DNP 805 Topic 3 Discussion 1

Describe how CPOE and CDSS embedded in the EHR can be useful towards a specific patient population of your choice. Identify one element of either the CPOE or CDSS you would improve that could enhance the effectiveness of the system for that patient population.

DNP 805 Topic 3 Discussion 2

Select a particular medication or clinical problem. Describe how the CPOE and/or CDSS technologies support care decisions in this area.

DNP 805 Topic 4 Discussion 1

Select a defined patient population and list elements that you think will be valuable in a database. What elements are required and why? What elements are optional and why?

DNP 805 Topic 4 Discussion 2

In the prior discussion question in this topic, you selected a defined patient population and listed elements that you think will be valuable in a database. Of those elements you identified to be valuable in a database, which are structured and unstructured? Explain.

DNP 805 Topic 5 Discussion 1

Select a specific clinical problem and post a clinical question that could potentially be answered using data mining. Identify data mining techniques you would apply to this challenge, and provide your rationale. Are there any specific data mining techniques you would not use? Support your decision.

DNP 805 Topic 5 Discussion 2

Using the clinical question you identified from above, determine the individual components to that question and pinpoint the location in the hypothetical database where the information you require will be extracted.

DNP 805 Topic 6 Discussion 1

A patient of your choice is being discharged to home and will use telehealth technology. Post the technology your patient will use at home and how will you connect with the patient using this technology.

DNP 805 Topic 6 Discussion 2

Consider current telehealth strategies and alternatives. Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons. Identify a particular practice area (e.g., clinic, hospital, primary care site) and discuss how you as a health care leader might you implement a similar strategy in that area?

DNP 805 Topic 7 Discussion 1

Describe one technology that you use on a daily basis that you thoroughly like or appreciate. What features or elements does that technology provide to you that make it easy, enjoyable, or necessary to use? Name one element of the technology you would change to improve its functionality for your needs?

DNP 805 Topic 7 Discussion 2

Describe one technology that you use on a daily basis that you dislike or that is dissatisfying in some manner. What features or elements of that technology make it difficult, frustrating, or not enjoyable to use? Name one element of the technology you would change to improve its functionality for your needs?

DNP 805 Topic 8 Discussion 1

For a specific patient population, select one application or a technology that could effectively increase patient engagement and patient outcomes for your future practice area or work focus. What elements of this application or technology are the most valuable to you? How could you improve this technology?

DNP 805 Topic 8 Discussion 2

Describe how you can apply the spectrum of health care technology options to develop a plan to manage your patient from acute care to home care and then into the community. What organizational, societal, cultural, or other factors might impact your plan, and how could you address these?

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