In 500 words or more discuss one of the roles of the informatics specialist described in the readings. (chapter 16 Sewell, J. (2016). Informatics & nursing: Opportunities & challenges (5th ed.) Lippincott, Williams & Wilkins: Philadelphia.). Look for a nursing informatics organization on the Internet and discuss information from the site about the nurse informatics role.

Please reference the book   and internet source APA style

Sewell, J. (2016). Informatics & nursing: Opportunities & challenges (5th ed.) Lippincott, Williams & Wilkins: Philadelphia.

Reading Assignment

 Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 1, “The History and Interviewing Process”This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.

Chapter 5, “Recording Information”This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–29)

Deckx, L., van den Akker, M., Daniels, L., De Jonge, E. T., Bulens, P., Tjan-Heijnen, V. C. G., … Buntinx, F. (2015). Geriatric screening tools are of limited value to predict decline in functional status and quality of life: Results of a cohort study. BMC Family Practice, 16, 1–12.  https://doi-org.ezp.waldenulibrary.org/10.1186/s12875-015-0241- x 

Wu, R. R., & Orlando, L. A. (2015). Implementation of health risk assessments with family health history: Barriers and benefits. Postgraduate Medical Journal, (1079), 508–513. 

Lushniak, B. D. (2015). Surgeon general’s perspectives: Family health history: Using the past to improve future health. Public Health Reports, (1), 3. 

Jardim, T. V., Sousa, A. L. L., Povoa, T. I. R., Barroso, W. K. S., Chinem, B., Jardim, L., … Jardim, P. C. B. V. (2015). The natural history of cardiovascular risk factors in health professionals: 20-year follow-up. BMC Public Health, 15(1111), 1–7. https://doi-org.ezp.waldenulibrary.org/10.1186/s12889-015-2477-8 

Shadow Health Support and Orientation Resources

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

Frey, C. [Chris Frey]. (2015, September 4). Student orientation [Video file]. Retrieved from https://www.youtube.com/watch?v=Rfd_8pTJBkY

Shadow Health. (n.d.). Shadow Health help desk. Retrieved from https://support.shadowhealth.com/hc/en-us 

Document: Shadow Health. (2014). Useful tips and tricks (Version 2) (PDF)

Document: Shadow Health Nursing Documentation Tutorial (Word document)

Optional Resource

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw- Hill Medical.
Chapter 2, “History Taking and the Medical Record” (pp. 15–33)

Required Media (click to expand/reduce)

Discussion: Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

• By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
• How would your communication and interview techniques for building a health history differ with each patient?
• How might you target your questions for building a health history based on the patient’s social determinants of health?
• What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
• Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
• Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
• Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

Case Study

16-year-old white pregnant female living in an inner-city neighborhood

• How would your communication and interview techniques for building a health history differ with each patient?

     The interview process has to be adjusted pending on the age group, gender, financial status, culture, and language barrier of the individual being assessed. One must provide a private area and be close to the patient during the interview to provide comfort. Use of laymen’s terms helps the individual to understand healthcare information clearly. Making eye contact is especially important unless there is a cultural factor involved. Taking notes should be minimal and if using a computer; it should be positioned so the patient can see the screen as well. Introduce one’s self to the patient and others present and use their names to build a friendly trustworthy environment.

reluctant to talk and have a clear need for confidentiality (Stewart, 2019).

     When speaking with my adolescent patient I would emphasize that our discussion is confidential with limitations if there is a danger to her or others. We will speak privately unless she wants someone else present. She will be given the opportunity to discuss whatever topics she feels comfortable discussing.

• How might you target your questions for building a health history based on the patient’s social determinants of health?

     There are several areas to concentrate on to build a history based on social determinants of health. One should enquire about the individual’s personal status, sexual history, living conditions, occupation, environment, military record, and social needs.

     According to the information provided my patient lives in an inner city neighborhood. This may be an indication of poverty and limited resources. One would inquire if housing, clothing, food, and access to medical care are adequate. If they are not, community resource information would be provided and a social worker referral to aide her. Also, one must ascertain if she is in an abusive relationship or being abused at home.

• What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?

     Assessing an individual’s health risks is very important in determining what potential health problems one may face. “One of the main goals of documenting the social history (SH) of the patient is to identify factors outside of past or current medical conditions that may influence the patient’s overall health or behaviors that create risk factors for specific conditions” (Sullivan, 2018). Asking what their eating habits are, do they exercise, how much alcohol do they consume, do they smoke cigarettes, do they use recreational drugs, what are their sleeping habits, do they take their medications as prescribed, do they practice unsafe sex, and what is their family history of medical problems. Also, inquiring about their family history of mental illness is important. Religion and culture can affect how the individual’s treatment plan will be developed.

    One would obtain the young lady’s family health history at this time to determine if she is at risk for familial issues during her pregnancy. This would be a great opportunity to provide prenatal education and stress the importance of continuity of care during pregnancy.

• Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

     Adolescent girls are more likely to die during childbirth than women in their twenties or older.  If a pregnancy is unplanned, the mother may not be getting the prenatal care she and her baby need or may not even be healthy enough to carry a child to term.

• Teens are often unprepared for the realities involved in parenting an infant. Often, complex relationships and financial burden combined with balancing school and parenting are stressful and can put a newborn at risk.
• Teens who are pregnant or raising a baby have a hard time finishing school. Only 3 percent of teens who have a baby receive their college diploma before the age of 30.
• Many teen parents are single. Being a single parent can have financial and emotional stressors and a stressed parent puts a baby at risk.
• Parents often need resources to help them navigate their child’s well-being and development. Teens may not be aware of this type of assistance. (Heuristic, 2016)

References

Heuristic. (2016). Risks of Teen Pregnancy. Retrieved from: (nationwidechildrens.org)

Stewart, B.S.J.B.J.F.J.D. R. (2019) Seidel’s Guide to Physical Examination. [VitalSource

Bookshelf]. Retrieved from https://bookshelf.vitalsource.com/#/books/9780323481953/

Sullivan, D. D. (2018). Guide to Clinical Documentation. [VitalSource Bookshelf]. Retrieved

from https://bookshelf.vitalsource.com/#/books/9780803694194/

Photo Credit: Getty Images/Caiaimage

 Scenario

The scarcity of health resources continues to negatively affect communities across the country. Deciding how to allocate scarce resources creates significant ethical challenges for local policymakers and other stakeholders within the community.

You represent a local non-profit community health organization in Chicago. Your organization is compiling data to conduct a needs assessment in order to determine the feasibility of a new community-based mobile health clinic. You have been asked to review the most recent strategic plan for the city of Chicago.

The mobile clinic would offer free preventive care, urgent care, and chronic disease management services to vulnerable citizens of Chicago, who may not otherwise have the financial resources to access quality healthcare services. Your executive summary will be used in the development of a needs assessment for the project.

Your targeted population is an urban, low income community disenfranchised by current health reform policies, high unemployment, a shortage of primary care physicians, and divisive partisan attitudes regarding entitlement programs. The goal of the community-based clinic is to work collaboratively with local health facilities to reduce costs, improve access, and to enhance the quality of care for underserved communities.

Instructions

Review the community health needs assessment linked here

that was conducted by the Health Impact Collaborative of Cook County. Pages 37 – 49 of the report highlight challenges facing the city with respect to costs, access, and quality of care issues.

Write an executive summary addressing the following questions:

What are some of socio-economic factors that affect access to care based on the findings in the report?

What are the critical focus areas identified in the report?

Based on the report’s content, how might the use of a mobile health clinic address the critical focus areas?

What are some of the potential barriers to success for a mobile health clinic?

APA formatting for the reference list, and proper grammar, punctuation, and form are required. 

Minimum of 350 words with at least 2 peer review reference in 7th edition apa style

1. Compare and contrast theories of organizational behavior and leadership. 
2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. 
3. Differentiate attributes of effective leaders and followers in influencing healthcare. 

Topic: Reflection

What do you believe about the influences of theory on nursing practice? What value do you place on using a model for practice as an advanced practice registered nurse? Has your philosophy of advanced practice nursing changed?

6 replies 

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare

• Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
• Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
• Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
• Think about a personalized plan of care based on these influencing factors and patient history in your case study.

By Day 3 of Week 1

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

Respond to the prompts after each scenario. 

Scenario 1: 

Justin is a front-office assistant at a local physician’s office. On a busy day at the office, Justin is consumed by patients and their needs. While helping a patient, Sarah, the other front-office assistant, calls Justin over to answer questions regarding the patient intake process. Justin explains the process to Sarah and then continues to work with the patient at his window. Later that day, Justin reflects on the situation and is frustrated that he had to stop working with his patient to explain a process to Sarah that he has already explained a dozen times. Justin takes to social media to express his frustrations with Sarah and her inability to take care of patients properly even though she has been trained. 

Write a 175- to 260-word response to the following prompts: 

• Explain how Sarah might perceive Justin’s actions.
• Explain the ramifications of using social media as an outlet for voicing frustrations about a co-worker.  
• Provide an example of a more effective communication method to use in this situation. 

Scenario 2: 

Jana works in a long-term care facility that cares for all types of patients. She receives emails from multiple co-workers throughout the day, and today she receives the following email from Sean: 

“Hi Jana, 

I noticed that I DIDN’T receive your monthly report yesterday. I NEED to get it as soon as possible TODAY so that I can finish the final report.  

Thanks, Sean”

Write a 175- to 260-word response to the following prompts: 

• Explain how Jana might perceive the tone of this email.
• Describe whether you perceive Sean’s tone to be appropriate or inappropriate.
• Provide an example of a more effective communication method to use in this situation.

Scenario 3:  

Robert is an older patient checking in at the window of his local retail health clinic. The office assistant is taking Robert’s insurance card and asking a couple of follow-up questions. Robert asks the assistant to speak up because of some background noise. The assistant starts speaking slower and enunciates her words instead of speaking louder.  

Write a 175- to 260-word response to the following prompts:  

• Explain how Robert might perceive the office assistant’s reaction.
• Explain the ramifications of communicating with patients in this manner.
• Provide an example of a more effective communication method to use in this situation.

Cite a minimum of one reference to support your assignment.

Format your assignment according to APA guidelines. 

Submit your assignment (the three responses) in one document.

 Reflection Assignment 2: Meeting Essential VIII

This week, reflect on ethical principles and your understanding of ethical decision-making frameworks as they have evolved over the course of your RN-BSN program at WCU. Identify specific ethical standards and moral conduct codes. How does your academic work support evidence of meeting the following?

Essential VIII: Professionalism and Professional Values

• Outcome #1:Demonstrate the professional standards of moral, ethical, and legal conduct.

Review your past academic work, evaluate your effectiveness at meeting this program essential, and ponder the impact that this proficiency will have on your future.

Identify how you met the essential by referring to the assignment(s) specifically in your response. Additionally, reflect on and make connections between your academic experience and real-world applications. 

Recommended: Refer to work you completed for NURS 521 Ethics in Heath Care and NURS 510 Policy, Organization, and Financing of Health Care, as well as other courses, to gather academic examples and evidence of having met this essential.

Your reflection should be 1 page and APA Style. Reference and cite any sources you use.

Discussion: The Inclusion of Nurses in the Systems Development Life Cycle

In the media introduction to this module, it was suggested that you as a nurse have an important role in the Systems Development Life Cycle (SDLC). With a focus on patient care and outcomes, nurses may not always see themselves as contributors to the development of new systems. However, as you may have observed in your own experience, exclusion of nurse contributions when implementing systems can have dire consequences.

In this Discussion, you will consider the role you might play in systems development and the ramifications of not being an active participant in systems development.

To Prepare:

• Review the steps of the Systems Development Life Cycle (SDLC) as presented in the Resources.
• Reflect on your own healthcare organization and consider any steps your healthcare organization goes through when purchasing and implementing a new health information technology system.
• Consider what a nurse might contribute to decisions made at each stage of the SDLC when planning for new health information technology.

By Day 3 of Week 9

Post a description of what you believe to be the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system. Provide specific examples of potential issues at each stage of the SDLC and explain how the inclusion of nurses may help address these issues. Then, explain whether you had any input in the selection and planning of new health information technology systems in your nursing practice or healthcare organization and explain potential impacts of being included or not in the decision-making process. 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

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 9, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making” (pp. 175–187)
Chapter 12, “Electronic Security” (pp. 229–242)
Chapter 13, “Workflow and Beyond Meaningful Use” (pp. 245–261)

Agency for Healthcare Research and Quality. (n.d.a). Health IT evaluation toolkit and evaluation measures quick reference guide. Retrieved September 27, 2018, from
https://healthit.ahrq.gov/health-it-tools-and-resources/evaluation-resources/health-it-evaluation-toolkit-and-evaluation-measures-quick-reference

Agency for Healthcare Research and Quality. (n.d.b). Workflow assessment for health IT toolkit. Retrieved September 27, 2018, from https://healthit.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit

Required Media

Louis, I. (2011, August 17). Systems development life cycle (SDLC) [Video file]. Retrieved from https://www.youtube.com/watch?v=xtpyjPrpyX8

Laureate Education (Producer). (2018). Interoperability, Standards, and Security [Video file]. Baltimore, MD: Author.
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Laureate Education (Producer). (2018). Managing Health Information Technology [Video file]. Baltimore, MD: Author.