Conceptually, in time past the center and emphasis of concerns existed was portrayed on disease-oriented health care system but now the health care reform is shifting the focus from a disease-oriented health care system toward wellness and prevention. Probably owing to the immense number of people living with a chronic disease about 75% of the nation’s total health care consumption resulted from caring for individuals with chronic diseases (National Association of Insurance and Financial Advisors (NAIFA), 2013). Protracted and chronic disease not merely affects health and quality of life, but it is also the main domain of health care and consequently ensuing in accumulative health insurance costs (NAIFA, 2013).

The health care reform shifting regarding wellness and prevention is to keep health insurance affordable. While chronic diseases have been establishing to raise the cost of healthcare, the prevention of chronic disease will invariably help and support lower health care cost. The hallmark objective is to facelift and basically educate the public to optimistically and absolutely prevent chronic diseases. The reform has acknowledged and identified three risk dynamics that are related with the development of chronic diseases: poor diet, inactivity, and smoking (NAIFA, 2013). Education programs with sound lifestyle modification on disease prevention, such as proper dietary, exercise and healthier lifestyles will encourage and inspire sound health and longevity, therefore plummeting and reducing the financial encumbrance on the healthcare delivery system (NAIFA, 2013).

Nursing care presumptively fits into this transference regarding wellness and prevention because health and wellness education have generally and historically been a fundamental and integral propensity or element of nursing practice (Luck, 2013). Nurses possess and retain the indispensable tools to fashion and create health education programs that encircle the nations renewed attention and motivation on wellness and prevention. However, the nursing profession is centralized on offering and providing individualize holistic care. Providing care to the individualize care is essential and imperative as nurses teach prevention and wellness strategies to keep their healthy patients wholesome. Furthermore, nurses are obligate to dynamically partner with physicians to promote the value of an integrative standard and model of health and wellness (Luck, 2013).

 

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Please read the peers discussions and respond to them APA format with reference

Discussion 1

Nurse Managers and Leaders play a vital role in the reengineering of health care. Advocating for legislation to ensure the safety of the work environment and for procedures which enhance patient care and outcomes is important in reengineering health care. A manager and a nurse leader also needs to ensure that staff are practicing with in their scope of responsibilities , which requires updating unit polices/procedures and requiring continuing education to ensure nurses are performing their duties that in line with updated guidelines . Additionally, w hen change is needed, it’s the responsibility of managers/leaders to ensure changes are implemented within a reasonable amount of time. Change that takes place in too rapid a period may create too much anxiety and allow for numerous errors. Some of the ways Nurse Managers reenginer the health care system is by using ethical and professional decision making to protect the rights of patients and employees. They also ensure a legal environment. Nurse managers should keep up with the legal aspects in health care. This is very important because being legally knowledgable protects patients, employees and the organization as a whole. Nurse managers need to be cognizant of the environment in which they function in order to anticipate the need for change.

References

Huber, D. (2014). Leadership and Nursing Care Management, 5th Edition. [ Pageburstl ]. Retrieved fromhttps://pageburstls.elsevier.com/#/books/978145574…Discussion 2

In the reengineering of healthcare, the nurse manger is
responsible for creating safe, healthy environments that support the work of
the health care team and contribute to patient engagement. The role is
influential in creating a professional environment and fostering a culture
where interdisciplinary team members are able to contribute to optimal patient
outcomes and grow professionally,” the American Organization of Nurse
Executives said.

Nurse managers need strong communication and leadership

skills. They should be adept at coordinating resources and personnel and
meeting goals and objectives. They must be effective leaders who can strike a
balance between working with the nursing staff and the healthcare facility
administrators.

The Agency for Healthcare Research and Quality, a branch of

the U.S. Department of Health and Human Services, said nurse managers are
change agents. They work with staff to find and implement useful changes to
improve patient wellness and safety outcomes. Nurse managers also implement
regulatory guidelines for patient safety set by state and federal agencies,
such as the U.S. Centers for Disease Control and Prevention, the Joint
Commission, and Centers for Medicare & Medicaid Services. They have to make
sure the staff is educated on care standards and can implement them as needed.

Reference:

The Roles of a Nurse Manager: Leading the nursing profession

into the future. (2017, May 24). Retrieved from
https://onlinenursing.duq.edu/blog/roles-nurse-man…

Discussion 3

In this era of modern technology, the health care organizations and hospitals have started adopting the innovative and creative management strategies in order to improve the health care processes with the support of the leaders or managers (Birken et al.). The business activities in hospitals are affected by a large number of internal and external factors. The hospitals are currently evaluating the trends in the health care environment as the external factor come to bear in luxuries. The role of a nurse manager or leader in health care involves the care of both internal and external factors. It is a tough position as the nurse leader plays a significant role in keeping the health management processes in motion. The nurse manager unites the health care team in order to provide well centered and reengineered health care services to the patients.

There are many characteristics that allow the nurse leaders to play a significant role in the reengineering of health care. One of the characteristics is the ethical decision making which means that the nurse managers should use the ethical and legal professional codes in order to implement policies and take care of the rights of the patients and employees working the health care areas. Also, the nurse leaders or manager should keep the legal aspects up to date in the field of health care. It involves reinforcing laws and legislation as required in the health care system. It is very vital in health care as being legally aware assists in protecting patients, employees and organizations.

Apart from the ethical decision making and legislation, the advocacy also plays an important role in nursing management and staff. Many times the nursing roles find themselves in a position to advocate for others which can involve providing other people with the information and data which strengthens them to make their own decisions and acting in the place of another person who cannot advocate for their own. The advocacy is based on decision making rather than making decision for others. In addition to this, changing management is an important aspect related to the role of nurses in reengineering of health care. In this era, change happens very quickly as compared to the old days. Sometimes it happens so quickly that it becomes difficult to analyze the series of changes i.e. which change has finished and which change has begun. The nurse leaders analyze the need for a change, create opportunities and a shared vision, communicate and involve people, develop structures that support the change and reinforce the change (Kodama, and Fukahori). The leaders also solve the conflicts and crisis that may occur in the successful implementation of the required change.

Leaders play a significant role in shaping up the organization culture and satisfy the customers in association with the latest advancements in the required field. The nurse manager or leaders are required to learn and adapt the new technologies continuously in order to play a vital role in the reengineering of health care. It improves the quality management processes of the internal environment of the organizations which ultimately becomes a strong point. Thus, the outcomes should be analyzed and evaluated clearly in order to improve the workflows and the business procedures that take place inside a health care organization.

Work Cited

Birken, Sarah A et al. “Uncovering Middle Managers’ Role In Healthcare Innovation Implementation”. Implementation Science, vol 7, no. 1, 2012. Springer Nature, doi:10.1186/1748-5908-7-28. Accessed 28 June 2018.

Kodama, Yoshimi, and Hiroki Fukahori. “Nurse Managers’ Attributes To Promote Change In Their Wards: A Qualitative Study”. Nursing Open, vol 4, no. 4, 2017, pp. 209-217. Wiley, doi:10.1002/nop2.87. Accessed 28 June 2018.

Discussion 4

The role of a nurse manager is a tough position. As a leader you play a vital part in advancing and keeping the healthcare system in motion. The nurse manager initiates & unites the health care team to deliver a patient centered, well engineered health care system. According to Grand Canyon University (????) there are several characteristics/scenarios that allow the nurse manager to play a vital role in reengineering the health care system:

Ethical decision making-Nurse managers use both ethical and professional codes to protect the rights of patients and employees. Managers take in account ethical and professional codes when making decisions.

Legal environment-Nurse managers should keep up to date with the legal aspects in health are. This is important because being legally knowledgeable protects patients, staff members and organizations.

Advocating-Nurse managers play a vital role in advancing for patients and staff. There are situations in which the nurse manager needs to step in and advocate for patients and staff.

Change-Managers and leaders help initiate change in the fast paced world of healthcare. They find new approaches in healthcare based on evidence based practice to allow the hospital to administer the best quality of care.

Conflict resolution-In situations in which there is conflict between team members, patients or even managers, leaders step in to advocate and defuse the situation. This allows for a safe work place environment for staff and patients.

Communication during high stress-Leaders prepare team members for crisis situations. Through providing information, teamwork and preparation. For example, during a disaster, leaders guide team members to appropriate stations and keep staff calm and proactive.

Reference

Grand Canyon University (NRS-451V Lecture 5. Retrieved July 1, 2018 from https://lc-ugrad3.gcu.edu/learningPlatform/user/users.html?operation=home&token=D9MGLcmh277D%2bRsjON6WUcn%2bTpW%2bj%2fwGDgWfsc4QZ%2bpV3H0m%2fZ9CAo%2f7JJkoBVre&classId=2146760#/learningPlatform/loudBooks/loudbooks.html?currentTopicname=Organizational%20Culture%20and%20Values&viewPage=past&operation=innerPage&topicMaterialId=ec0ec62b-fc64-4116-8c49-ef1b90d4d739&contentId=e0dbfc00-b214-4c77-85d5-9f299b901e72&

Birken, S., Lee, S., Weiner, B. (2012, April) 3 Uncovering middle managers’ role in healthcare innovation implementation. Retrieved July 1, 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC33724…

Discussion 5

Nurse managers and leaders are not receiving enough attention in health services research, yet they play a crucial role in healthcare re-engineering and implementation of health care policies. They are involved in revising and changing organizational structures and redesigning of the functioning systems in place. The primary focus in making a change is to analyze the outcome of patient care from the consumers perspective and maximize productivity through proper alteration of established systems (Huber, 2013). Nurse leaders and managers focus on methods that would enhance patient-centered care, teamwork, and collaboration, evidence-based practice. They would use their background and current evidence-based research to improve patient outcome.

System failures are the root-cause of higher mortality rates and efforts should be made to address these issues. In an interview, Jim Collins, a professional business analyst, explains how institutions fall from excellent performance to good to mediocre to dangerous and even disastrous. He uses an analogy of the early stages of diseases to describe how organizations look healthy on the outside but are falling apart on the inside. (Cone, 2002) The chief problem with these issues is that most institutions are in denial of their systemic weakness that contributes to medical errors. It is the responsibility of nurse managers and leaders to bring these systemic issues to the organization and find solutions that would optimize the delivery of adequate patient care. Furthermore, nurse leaders should fully understand their scope of practice and create autonomous roles that would impact and change the health care system.

Reference:

Cone, J. (2002). Built to be great: T+D talks with Jim Collins about what it takes to go from good to great. T+D, (8). 22.

Huber, D. (10/2013). Leadership and Nursing Care Management, 5th Edition [VitalSource Bookshelf version]. Retrieved from https://bookshelf.vitalsource.com/books/9781455740…

Discussion 6

The role that the nurse manager or leader plays in the reengineering of health care is that they help organizations reorder priorities, help provide more cost-effective care, and increase value to patients. Reengineering assists in redesigning administrative functions, clinical services, and caregiving programs to improve health status (Edens, 2005). Reengineering is a necessary skill of health care organizations if they want to succeed in the future.

As changes in nursing occur continuously, negotiation skills of leaders and managers are needed to handle downsizing, mergers and restructuring. Nurse leaders and manager need to anticipate and be ready for change.

Edens, P., (2005). Workplace Reengineering, Reorganization, and Redesign. Retrieved July 1, 2018, from http://www.medscape.com/perspective/medscapecritic…

 

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Question Description

This assignment is worth a total of 200 points.

Due Date

The Lifestyle and Health Practices Profile is to be submitted at the end of Week 2.

Disclaimer

When completing a Lifestyle and Health Profile on an actual client, it is essential that the information is accurate and all areas are addressed. **Please note that for this assignment, a few sections containing sensitive information have been marked optional.** This assignment will only be shared for academic-related purposes, and will not be seen by your classmates. However, if you wish to leave any of the areas marked “option to not respond” blank, points will not be deducted. All areas not marked as optional must be completed for full credit. Contact your instructor if you have any questions or concerns.

Directions

1. Download the required NR305 Week 2 Personal Lifestyle Form March19 (Links to an external site.)Links to an external site.. You will document your responses to the profile using this MS Word document.
2. Complete the Life and Health Practices Profile, using yourself as the client. Please document your responses professionally, as you would in a client’s actual health record. Provide enough information to have answered the questions completely. For clarity, write full sentences in your documentation. To receive full credit, all questions must be addressed, except for those indicated as optional. If a question does not apply to you, please indicate this in the findings as “N/A”.
3. Once you have completed the profile, type your answers to the three questions listed under the form. APA format is not a requirement, however, please write in paragraph form when appropriate. Sentence structure, spelling, and grammar are important.
4. You are required to complete the form using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site.. Click on the envelope at the top of the page.
5. Save the completed form by clicking on Save as and add your last name to the file name, for example, NR305_W2_Personal_ Lifestyle_Form_Smith.
6. Submit the completed form to the Lifestyle and Health Practices Profile form by Sunday, 11:59 p.m. MT at the end of Week 2. Please post questions about this assignment to the Q & A Forums so the entire class may view the answers.

**Academic Integrity Reminder**

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment. Please see the grading criteria and rubrics on the page.

NOTE: Please use your browser’s File setting to save or print this page.

 

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Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

References:

• Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

• Response posts: Minimum 100 words excluding references.

Discussion 1

This week the discussion is focused on information and data that is utilized in everyday clinical practice. Those of us that practice today and are relatively new nurses may not be completely aware of how much informatics has created and affected daily life for many clinical providers especially when it comes to electronic health records. Years ago, electronic health records weren’t commonly used in some facilities and in this day and age it can be hard to believe. This post will look a little closer into informatics as well as the implementation of the electronic health record that is so heavily used today.

Informatics is a large part of health care and for that reason there will be a closer look placed into informatics and more specifically clinical informatics. Informatics is generally related to the information system that is set up to receive information online to make things easier to locate. Essentially informatics is the science of information and can also be known to a degree as information technology or IT (Aston, 2014). There are those in the clinical setting that are directly responsible for managing informatics and help to manage the process of easing providers in better understanding the system and the electronic health records (Aston, 2014). Clinical informatics are related more specifically to information around health technologies versus general informatics which is related to various innovations in technology that has created large databases that becomes more easily accessible every day (Huber, 2014).

Clinical informatics can generate a lot of positivity for patient care within an organization. One recent example of clinical informatic within the unit that I work in is the initiating of allowing patients to receive some access to their health record. The access that the patient can gain is through an iPad used during their stay that can allow them to specifically see who is caring for them from doctors to nurses and patient support assistants. This has allowed patients to better recognize the providers that are interacting with them, at times the interaction can be so quick that they may not remember who they spoke with that day. Another example of clinical informatics that helps with patient care is bed management/monitoring systems within organizations such as the one that I work in that helps to keep track of the patient census. Along with that census it keeps track of the location of patient which can help when a nurse just comes on shift and may not know which area the patient is located at the time from dialysis to an MRI or a CT. These are just two examples of clinical informatics that have led to positive experiences for patients and staff members to help improve and better manage patient care.

Along with clinical informatics within a unit and organization there are also methods of data management that nurse managers can utilize to improve patient care within a unit. One example of data management and collection is the effort nurse managers make to ensure that proper hang hygiene is used. This example seems silly but there has been a significant decrease in the number of caretakers that aren’t practicing good hand hygiene when entering and leaving a room. Another example of this is data collection and management related to reducing infections f central lines which revolve around improved patient hygiene. When the data was brought back after the implementation of the hygiene audits and discussion of the topic there was a directly correlation to the decrease of these infections. Data management done through the various systems that exist help managers to better track these thing as well as improve patient care.

Lastly the electronic health record needs to be discussed a little more thoroughly when it comes to clinical informatics. Specifically, the implementation of the electronic health record being mandated by then President Bush. In 2004, President Bush had created an initiative to mandate the creation of electronic health records for all by 2014. With the growth in technology many felt the need for improvement in health care as well, which would further be seen with health care reform during the presidency of Barack Obama. The health care record for patients began to become electronic which is now so common place now that one would find it hard to imagine that it had not always been this way. For President Bush the mandated implementation of the electronic health record was setting in progress the movement to better health technology for all.

References

Aston, G. (2014, January). Powering the Information Machine. Retrieved July 2, 2018, from https://blackboard.ohio.edu/bbcswebdav/pid-8213791-dt-content-rid- 54487195_1/courses/NRSE_4580_SU2_1031_LEC_SUM2_2017- 18/CONTENT/MODULE_3/INSTRUCTIONAL_MATERIALS/REQUIRED_RESOUR CES/NRSE_4580_M3_IM_Powering_the_Information_Engine.pdf

Huber, D. (2014). Leadership and nursing care management. 5^th edition. St. Louis, Missouri: Saunders.

Discussion 2

Patient care has evolved significantly over the past few decades. It has transformed from a trail of paper charting to a collection of electronic healthcare data. Various information is now collected electronically as part of routine care, allowing for easier analysis and more prompt improvements. As a result, real-time data can be used to expedite patient care, create safer hospital environments, and better utilize nurses’ time. The purpose of this paper is to discuss informatics within healthcare, how it improves patient care within my healthcare organization, as well as discuss the reasoning behind the 2014 mandate of electronic health records.

Over the past few decades, information technology has rapidly changed the face of healthcare practice and delivery. The use of informatics, which is the general application of data, information and knowledge within multiple professions and organizations, uses data collection and computations as a tool to solve problems, as well as determine consequences to individuals, organizations, and society (Indiana University – Purdue University Indianapolis, 2018). Clinical informatics is the integration of informatics and information technology within healthcare itself. This process uses data to analyze, design, implement and evaluate information and communication systems to enhance health outcomes, improve patient care, as well as strengthen the clinician-patient relationship (American Board of Preventive Medicine, 2018).

Two clinical informatic examples that have improved patient care within my organization include the integration of the SurgiCount Safety-Sponge System, a scanning device that provides an accurate, real-time count for surgery lap sponges in the operating room, and Bar Code Medication Administration (BCMA) technology, an inventory control system that utilizes barcodes to prevent human error during medication administration. SurgiCount Safety-Sponge System is a handheld, mobile computer and scanner that accounts for each safety-sponge used during patients’ surgery or procedures, such as cesarean sections and vaginal deliveries. This device has prevented over1,300 surgical sponges from being left inside patients, thereby averting unnecessary complications and pain, as well as eliminating more than $825 million in additional health care costs (Wynder, 2017). BCMA technology systems decrease medication and transcription errors, as well as improves patient safetybyelectronically verifying a patient’s identity before medication administration (Truitt, Thompson, Blazey-Martin, NiSai, & Salem, 2016).

Two data management tools that are used by the unit Nurse manager include Purposeful Hourly Rounding and Bedside Shift Report Statistics. This feedback reports patients’ perception of nurse engagement within their hospital experience. These two strategies improve patient care and safety by encouraging nurses to intentionally and routinely round on patients, as well as exchange current patient information at bedside and at the start of each shift. For example, Purposeful Hourly Rounding calls for staff nurses to check-up on patients routinely every hour. This strategy improves patients’ perception of nursing staff responsiveness, reduces patient fall incidences and use of call lights, as well as improves patient satisfaction scores (Mitchell, Lavenberg, Trotta, & Umscheid, 2014). Bedside Shift Report ensures that patients and their families are aware of the plan of care, ensures safe handoff from nurse-to-nurse, improves communication between the patient, family and staff, and provides an opportunity for questions and concerns to be voiced, leading to improved quality of care and safety (U.S. Department of Health and Human Services, 2017).

On April 27, 2004, President George W. Bush implemented the use of electronic health records (EHRs). As a result, this order created a new national health information system that linked health care networks, thereby improving the quality and efficiency of health care (Huber, 2014). EHRs provide quick access to current patient information, help clinicians to more effectively diagnose patients, improve productivity and efficiency, provide complete documentation and reduce overall costs (HealthIT.gov, 2018). Prior to this mandate, records were disjointed and if patients sought care from multiple clinicians, their health data was not immediately available and frequently incomplete.

In conclusion, there are many benefits to technological advancements within healthcare – improving patient safety, decreasing overall costs, and streamlining data processes, to name a few. Information and data integration through the mandate of EHR usage also provides clinicians with a more comprehensive picture of medical information. Together, this technology has reshaped the face of healthcare, which has resulted in improved patient care and outcomes.

References

American Board of Preventive Medicine. (2018). Clinical Informatics. Retrieved from American Board of Preventive Medicine: https://www.theabpm.org/become-certified/subspecia…

HealthIT.gov. (2018, March 21). What are the advantages of electronic health records. Retrieved from The Office of the National Coordinator for Health Information Technology: https://www.healthit.gov/faq/what-are-advantages-e…

Huber, D. (2014). Leadership and nursing care management. (5th ed.). St. Louis, MO: Elsevier-Saunders.

Indiana University – Purdue University Indianapolis. (2018). Informatics Defined. Retrieved from Indiana University – Purdue University Indianapolis: https://soic.iupui.edu/about/what-is-informatics/

Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. (2014). Hourly rounding to improve nursing responsiveness: A systematic review. Journal of Nursing Administration, 44(9), 462-472. doi:10.1097/NNA.0000000000000101.

Truitt, E., Thompson, R., Blazey-Martin, D., NiSai, D., & Salem, D. (2016). Effect of the implementation of barcode technology and an electronic medication administration record on adverse drug events. Hospital Pharmacy, 51(6), 474-483. doi:10.1310/hpj5106-474.

U.S. Department of Health and Human Services. (2017, December). Strategy 3: Nurse bedside shift report. Retrieved from Agency for Healthcare Research and Quality: https://www.ahrq.gov/professionals/systems/hospita…

Wynder, E. (2017, August 10). Hospitals absorb surgical safety system. Retrieved from Grand Rapids Business Journal: https://www.grbj.com/articles/88626-hospitals-abso…

 

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