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Application-Design-Considerations-and-Workarounds
/in Questions Uploads /by adminWhen nurse informaticists are tasked with identifying the most appropriate technology to meet a specific need within a health care setting, there are many questions that must be asked.
Consider the following scenario:
Riverdale Hospital has come under recent scrutiny for their medication procedures. Many times, paper medication records are not up to date or have been misplaced. As a result, patients have increasingly received their medications at the wrong times. Though each nurse is performing to the best of his or her ability, the fast pace of the hospital has caused some to ineffectively manage patient records.
The lead nurse informaticist, Nancy, has decided that a bar code scanner could help streamline the documentation process while also improving patient quality and safety. Nancy knows that when selecting a bar coding system she must not only examine the hardware and software of the system but also consider the various human factors that can positively and/or negatively affect the outcomes of the system implementation. As such, Nancy asked three of the most reputable bar code vendors to bring sample systems to Riverdale Hospital.
In evaluating each system, Nancy role plays the process of scanning a patient’s bar code. She rolls the coding cart into the room to begin her mock demonstration. First, Nancy scans her identification card to gain access to the medication screen. To scan the patient’s bar code identifier, Nancy then pulls the medication cart to the patient so that the attached scanner reaches the bar code on the patient’s wristband. When the scan is complete, the computer displays a screen that houses the patient’s personal information. By navigating the screens, Nancy finds that she can use the computer to track medication administration. In addition, Nancy is able to view applicable vitals and medication history. As Nancy continues to examine this system, she reflects on the other hardware and software facets she should be sure to consider. She also thinks about how human factors will affect this and other vendor systems.
In this Assignment, you consider how hardware, software, and human factors can impact the implementation of an informatics system.
To prepare:
- Review Chapter 30, “The Role of Technology in the Medication-Use Process,†in the course text, Essentials of Nursing Informatics. When examining computerized prescriber order entry (CPOE) systems and bar code-enabled technologies, what hardware, software, and human factors did the authors identify?
- Consider how each of these factors can negatively impact patient safety and quality of care.
- How might these factors translate to the usability, implementation, and outcomes of other informatics technologies?
- Review the media presentation Selecting New Technologies in this week’s Learning Resources. How did presenter Dr. Patricia Button take the above factors into consideration when selecting an informatics technology for her health care setting?
- When planning and selecting a new informatics system, what steps should informaticists take to ensure the system will address the needs of their health care setting? In addition, how can informatics leaders encourage all nurses to commit to using a new technology?
To complete:
Submit a 3- to 5-page paper that addresses each part of this Assignment:
- Part 1: Design Considerations
- Identify two major design considerations associated with each of the following: hardware, software, human factors. (6 considerations in total)
- Describe why informaticists should play close attention to each of these considerations when evaluating an informatics technology. In your description, include the potential dangers each of these pose to patient safety and quality of care.
- Identify two major design considerations associated with each of the following: hardware, software, human factors. (6 considerations in total)
- Part 2: Employee Workarounds
- Even with a carefully thought out design and implementation, nurses and other health care employees may adopt workarounds. With this reality in mind:
- What benefits and/or consequences do you associate with workarounds?
- When selecting an informatics technology, would you opt to purchase a system that mitigates the opportunity for workarounds; or do you believe that workarounds are sometimes necessary? Justify your response.
- Even with a carefully thought out design and implementation, nurses and other health care employees may adopt workarounds. With this reality in mind:
Note: Your responses should focus on informatics technologies in general, not just bar code scanners as portrayed in the scenario. You may, however, use specific examples such as bar code scanners and other informatics technologies to justify your responses.
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Soap-Notes
/in Questions Uploads /by adminCan you please write 6 soap notes Following the example below You can use some of the wording from the example ( All the bolded areas from the example can be use if ertains to the case) and change to what is appropriate to each case please elaborate on what is pertaining to each case only a page per case. Thank you
1) Patient 11-year-girl , ( in for immunizations Hpv first dose,and meningococcal),
2) Patient 36y/o with abdominal pain Female (Constipation)
3) Patient 40y/o Male with bronchitis and history of ASTHMA for the past 11 years smoker for 25 years;
4) Pt 20 y/o Female Tension headache
5) pt. 46 y/o female hyp0thyroidism
6) Pt 34 y/o R Ankle pain (hx of 2 past surgeries on his foot)
SOAP Sample
S:
Chief Complaint: “I have no energy.â€
HPI:25 y/o Caucasian male presents to the clinic today with complaint of lethargy and feeling progressively more tired and lethargic. He stopped taking his thyroid medication six months ago.The patient discontinued his thyroid medication because he didn’t feel like he needed it any longer. He reports general lethargy increasing in frequency to daily over the past six months. He describes a feeling of “fog†in his head, falling asleep at work, and lasting from the time he wakes up until he goes to bed.Patient also reports weight gain of 20 pounds over the past six months.Reports pain 0/10 on 0-10 scale.He reports nothing makes the feeling of being tired any better. He states he has been using caffeine and energy drinks to help him feel better without success.The lethargy occurs daily and has begun to interfere with his job and his social life.
Medications: None Noted.
Allergies:NKDA.No food, insect or environmental allergies noted.
Personal/Social History:Denies using alcohol; denies tobacco use; denies illicit drug use; able to complete all ADL’s without difficulty; able to complete all IADL’s without difficulty; does not exercise and eats a lot of fast food.
O: T 97.7, BP 140/82, HR 75, RR 18, SpO2 98%, BMI 34.9.Neuro: A&Ox4, Balance and gait intact.Respiratory: Symmetric chest wall, RR clear with no distress noted.Lung fields intact to palpation.No rales, rhonchi, wheezes or rubs.Cardiovascular: RR intact, S1 and S2 intact with no S3 or S4, no clicks, rubs or murmurs.Capillary refill <2 seconds.No edema noted to BLE. Thyroid: No thyromegaly or nodules.
A:Patient presents to clinic with complaints of tiredness, lethargy and weight gain.
ICD-10:E03.9 Acquired Hypothyroidism, R53.83 Fatigue, Z68.34 BMI, Adult 34.0-34.9
P:Labs Ordered:CBC with differential, CMP, TSH, FREE T3, FREE T4, LIPID PANEL TODAY.
RTC for f/u in 1 week to discuss lab results. Levothyroxine will be restarted if thyroid levels are out of range at f/u, dosage to be determined at f/u.Educated patient on s/s of hypothyroidism, disorders.Educated patient on healthy lifestyle choices, diet, exercise and adequate sleep. Patient voiced understanding of teaching provided.
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Mathematics-of-Voting-Proves-Eye-opening
/in Questions Uploads /by adminfirst read the article from Harvey Mudd College. Then pick three of the questions from the list below, answer them the best you can.
https://www.hmc.edu/about-hmc/2012/11/07/mathemati…
Students’ claimed they learned the answers to the following questions from taking a course about The Mathematics of Voting:
- How can the outcome of any given election depend on the procedures used to tally the votes?
- What is the current U.S. voting system for presidential elections?
- What constitutes a reasonable voting system?
- What does it really mean for a voting system to represent the will of the voters?
- Under what conditions are voting systems vulnerable to manipulation and arbitrariness?
- What are some ways of using voting systems other than for political elections?
- What kinds of informal voting do you do 1) in the family; 2) at work or 3) elsewhere?
- What are the pros and cons of the various voting systems?
- What’s the contrast between an election using a simple popular vote and one using a top-two primary?
- Why is it that ANY voting system will exhibit one or more undesirable characteristics, and who worked out the math to prove this statement?
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