The application of data to problem-solving

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The application of data to problem-solvingThe application of data to problem-solvingIn the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge. The application of data to problem-solvingIn this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.To Prepare:Reflect on the concepts of informatics and knowledge work as presented in the Resources.Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.BY DAY 3 OF WEEK 1Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?Scenario is early ambulation in post surgical to prevent post operative problems ( example: DVT, Pneumonia, Pain, etc.)APA format and minimum of 3 citations. intext and references.I will provide 2 sources, one website and one PDF file and then you can use whichever ones you would like. The application of data to problem-solving… informatics.pdf212 Forecasting Informatics Competencies for Nurses in the Future of Connected Health J. Murphy et al. (Eds.) © 2017 IMIA and IOS Press. This article is published online with Open Access by IOS Press and distributed under the terms of the Creative Commons Attribution Non-Commercial License 4.0 (CC BY-NC 4.0). doi:10.3233/978-1-61499-738-2-212 Evolving Role of the Nursing Informatics Specialist a Lynn M. NAGLEa, Walter SERMEUS b, Alain JUNGERc Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada b Leuven Institute for Healthcare Policy, University of Leuven, Belgium c University Hospital of Lausanne, Lausanne, Switzerland Abstract. The scope of nursing informatics practice has been evolving over the course of the last 5 decades, expanding to address the needs of health care organizations and in response to the evolution of technology. In parallel, the educational preparation of nursing informatics specialists has become more formalized and shaped by the requisite competencies of the role. In this chapter, the authors describe the evolution of nursing informatics roles, scope and focus of practice, and anticipated role responsibilities and opportunities for the future. Further, implications and considerations for the future are presented. Keywords. Nursing informatics specialist, role function, connected health, data science, big data, personalized medicine, clinical intelligence, virtual care 1. Introduction By 2018, 22 million households will use virtual care solutions, up from less than a million in 2013. Average (healthcare) visits among these adopter households will increase from 2 per year in 2013 to 6 per year in 2018, which include both acute care and preventive follow-up services in a variety of care settings—at home, at retail kiosk or at work. [1] Nursing informatics roles have taken many forms in focus and function over the last decades; suffice it to say that they have not been consistently described or defined in terms of scope of practice. At the time of this writing it is clear that role of nursing informatics specialists will continue to evolve at an increasingly rapid rate in the coming years. The unfolding of new health care paradigms will bring greater connectivity between care providers and patients, include a wide array of emerging technologies and an increasing emphasis on data analytics will make the integration of informatics competencies into every area of nursing an imperative. 2. Brief history of roles of the past and present The earliest and most common types of informatics work assumed by nurses has included: oversight of organizational workload measurement systems, project leadership, systems educator, and nursing unit or departmental information technology resource. In many instances, these roles were enacted on the basis of a specific identified organizational need and were often secondments to the Information Technology Department. It was not unusual for these roles to have the designation of L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist 213 “IT nurse” [2]. The application of data to problem-solvingAs role responsibilities and job titles have been widely varied, so have the qualifications for each. The need for more specificity and consistency in nursing informatics roles has been recognized for several years [3, 4, 5]. The advent of formal education programs for nurses interested in specializing in informatics has occurred in conjunction with increasing sophistication in the use of information and communication technologies (ICT) in clinical practice settings. Today, nurses have the option to pursue specialization and credentials at a variety of levels including graduate specialization and specialty certification. Advanced credentials and certification (e.g., Certified Professional in Healthcare Information and Management Systems – CPHIMS) have afforded nurses the opportunity to achieve credibility and legitimacy regarding the specialty informatics knowledge and skills they bring to bear in nursing practice and academia and healthcare in general [6]. This credibility has been recognized with the development of executive level positions such as the “Chief Nursing Informatics Officer” (CNIO) in some countries. The position of the “Chief Medical Informatics Officer” (CMIO) is much more prevalent and deemed essential in medium and large health care organizations while the C-level nursing counterpart remains less common. Several authors [7-11] have described the role and competencies for these senior informatics positions, yet the valuing of these positions remains limited among health care provider organizations. In addition to the evolution of formalized training programs for nurses interested in informatics, the specialty of nursing informatics has continued to evolve and has become recognized in local jurisdictions, nationally and internationally. Groups of likeminded nurses have organized into special interest groups affiliated with larger interdisciplinary organizations (e.g., International Medical Informatics Association Special Interest Group on Nursing Informatics (IMIA-NI-SIG)). Organizations such as the Canadian Nursing Informatics Association (CNIA), the American Nursing Informatics Association (ANIA), the Nursing Informatics Working Group of the European Federation for Medical Informatics (EFMI-NURSIE) are examples of forums for nurses to network, collaborate and profile their work in informatics. The existence of these specialty organizations has served to further legitimize the work of nurse informaticians and provided a venue for advancing regional, national and international efforts in nursing informatics. Through conferences, meetings and the offering of educational sessions, virtually and face to face, these networks of nurse informaticists have collectively advanced the practice and science of nursing informatics. A case in point is the International Nursing Informatics Congress and post-conference, now held bi-annually and hosted by countries across the globe. Outputs of these meetings include publications such as this one; benefitting nursing informatics specialists and the nursing profession worldwide. The application of data to problem-solvingAt the time of this writing, we find nursing informatics specialists in virtually every clinical practice setting. The roles and focus of their work endeavors are wide and varied. The titles of “informatics nurse”, “nurse informatician”, and “nursing informatics specialist” are but a few of the titles applied to nurses working in the field. Many of the roles of the past and present have been more extensively described elsewhere [2,12]. For the purpose of this chapter, the authors use the title of nursing informatics specialist to provide illustrations of the potential focus of these roles current and future. Roles to date have largely focused on supporting acquisition, implementation and evaluation of clinical information systems in health care organizations. As noted by McLane and Turley [4], “informaticians are prepared to influence, contribute to, and mold the realization of an organization’s vision for knowledge management” (p.30). 214 L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist Nurses have been in pivotal roles at every step of the systems life cycle and instrumental in the success of deployments at every level of an organization. From the provision of executive oversight, project management, systems education and training, and analytics, nurses in clinical settings have become core to organizations’ information management infrastructure and support. In addition to health care provider organizations, nursing informatics specialists can be found in the employ of technology vendors, retail outlets, and consulting firms while many others have created their own entrepreneurial enterprise. Over the last few decades, technology vendors, hardware and software, have come to appreciate the invaluable contribution of nurses to the development, sales and deployment of their solutions. Throughout the world, nurses are also engaged in academic pursuits to advance the knowledge base of nursing informatics through the conduct of research. Efforts are underway in many countries to advance the adoption and integration of entry-to-practice informatics competencies into undergraduate nursing programs. Notwithstanding some of the ongoing gaps in the provision of informatics content in undergraduate nursing education, many courses and programs have been taught in a variety of post-secondary education institutions over several years by nursing informatics specialists. In fact it is not unusual for many nurses to develop an interest in informatics through a single course and subsequently pursue further studies and employment opportunities. Since the early 90’s many graduate level courses and degrees, certificate and certification programs have been developed and offered world-wide. Nurses have pursued these opportunities recognizing the necessity of informatics knowledge and skills now and particularly into the future, as they face an increasingly connected world of digital healthcare. To a large extent, the core competencies of the nursing informatics specialist have become essential for all nurses and expectations of the specialist role will continue to evolve even further. 3. Emerging roles for nursing informatics specialists The healthcare sector continues to evolve in the application and use of technologies to support the delivery of care.The application of data to problem-solvingORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERSFactors including: a) rising health care expenditures, b) the increasing incidence of chronic disease, c) the ubiquity of technology, d) an aging demographic, e) personalized medicine, f) mobile and virtual healthcare delivery, g) the emergence of consumer informatics, h) genomics, i) big data science, and connected health are and will continue informing the evolution of nursing informatics roles. One of the main challenges we have to cope with is the difference in growth rate that is exponential for the new technology and knowledge yet is still linear for changing human behavior, learning, organizations, legislation, ethics, etc, A linear growth rate is mostly represented by a function in a form like y(x) = ax+b. An exponential growth rate is mostly represented by a function in a form like f(x) = kax. For example: In an exponential world where the information is doubling every year, 5 exponential years would equal to 25 or 32 linear years which has a massive impact on the management of professional knowledge. In reality, we estimate that knowledge development in healthcare, which has doubled every century until 1900, is now estimated to double every 18 months. And the pace is getting faster. This means that when nurses finish their education, the knowledge they gained might be already outdated. The traditional way of developing procedures, protocols and care pathways, sometimes requiring a year to develop, are outdated when they are finalized and are L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist 215 insufficient to guide future practice. The only way forward is to integrate and embed the new knowledge in electronic patient records using algorithms and decision support systems so that practice remains aligned with new knowledge and insights. The impact might be that best practices can change very quickly and what is viewed as best practice before your holiday leave might be different upon your return to work. Making the connection between these different dimensions of time will be a key-role of the evolving role of the NI specialist. A second challenge is that clinical practice in the future will be largely team based. The nature of teams will include interprofessional teams, patients and their relatives and a wide range of virtual devices (internet of things – IoT) that are all connected. Teams will work across boundaries of organizations and will be organized around a particular patient. We still have to come up with new labels for naming these temporary virtual interprofessional patient teams. Practically it will mean that nurses will be (temporary) members of different teams at the same time. This notion of teamwork is in contrast with what we normally see as teams organized in organizations, departments and units. It will challenge how teams will be managed, led, and evaluated. But it will also challenge the communication within teams and the exchange of information. 3.1 Virtual and connected care The delivery of health services virtually is becoming commonplace in many places around the globe.The application of data to problem-solvingVirtual care has been defined as: “any interaction between patients and/or members of their circle of care, occurring remotely, using any forms of communication or information technologies, with the aim of facilitating or maximizing the quality and effectiveness of patient care” [13, p 4]. The most common modalities of virtual care are currently in use in telemedicine. Telemedicine has been largely used to conduct remote medical consultations, assessments and diagnosis (e.g., teledermatology, telestroke, telepsychiatry) through the use of computer technology and associated peripheral devices including digital cameras, stethoscopes and opthalmoscopes, and diagnostic imaging. More recently, the tools of telemedicine have been extended to the provision of remote nursing monitoring and assessment particularly for individuals with chronic diseases such as congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). The nurses providing these tele-homecare services are not necessarily informatics specialists but the design and management of the monitoring tools, infrastructure and support services may be provided by them in the future. Another emerging area of nursing informatics practice will likely focus on the use of remote monitoring technologies such as sensors and alerts embedded in structures (e.g., flooring, lighting, furniture, fixtures) and appliances (e.g., stove, refrigerator) in the homes of citizens. These tools offer the promise of supporting seniors to maintain a level of independence in their own homes longer, particularly those with cognitive or sensory impairments. Such devices might trigger direct messaging to providers, lay and professional, flagging potentially harmful situations and affording early intervention as necessary. Different types of sensors (e.g., sleep, activity, falls, ambulation, continence, fluid and electrolyte) will also contribute new supplementary data to health information repositories, offering the possibility of linking to other data sets and provide new insights to the well-being of individuals in the community especially the aged and those living with chronic illness. With the increasing use of consumer health solutions such as patient portals and smartphone apps for self-monitoring and management of health and disease, nurse 216 L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist informatics specialists will likely play a key role in their support and development. From the perspective of application design and usability, and training, nursing input and informatics expertise will be important to ensure appropriate and safe use of these tools. As individuals and their families become more active participants in their care through the use of applications and devices to connect with providers, they will likely also need expertise and support from the nursing informatics specialist. The application of data to problem-solving3.2 Knowledge generation and innovation The traditional ways of new knowledge generation is through research and the dissemination of findings in research journals. Knowledge is consumed by researchers and clinicians who transform it into relevant guidelines and care pathways. The time between the generation of research findings and application in the real clinical work can take several years. It is generally estimated that it takes an average of 17 years for research evidence to reach clinical practice [14]. Therefore clinicians are not always aware of existing evidence. In a landmark study, McGlynn et al. [15] evaluated the use of evidence-based guidelines in 30 conditions and 439 indicators for the use of the same. They showed that clinicians (doctors, nurses) only apply 50% of them in their daily practice. The use varied from 80% for structured conditions such as cataract to 10% for unstructured conditions such as alcohol addiction. There is also a lot of research demonstrating that nurses lack knowledge related to common procedures. Dilles study illustrated [16] that nurses lack sufficient pharmacological knowledge and calculation skills. Baccalaureate prepared nurses’ pharmacological knowledge averaged between 60% and 65% of the level expected. Segal et al. [17] analyzed the use of hip arthroplasty care pathways in 19 Belgian hospitals finding a high variability in providing evidence-based interventions. While post-op pain monitoring is in 100% of the care pathways, pre-op physiotherapy was only present in 25% of the care pathways. In the future of connected health, there will be direct links to knowledge generated by specialists from around the world. New knowledge will be automatically integrated and embedded into electronic patient records, and include new algorithms for decision support systems. It is interesting to note that Hearst Health Network, one of the largest media and communication groups in the world, is taking a leading role in healthcare. They started an intensive collaboration among strong health knowledge companies such as First Databank (FDB), Map of Medicine, Zynx Health and Milliman Care Guidelines (MCG). FDB is a United Kingdom company specialized in integrated drug knowledge to prescribe medication, follow-up drug interactions, improve clinical decision making and patient outcomes. Map of Medicine was created in the UK for clinicians by clinicians. It offers a web-based visual representation of evidence-based patient journeys covering 28 medical specialties and 390 pathways. Zynx Health offers a similar story from the US to provide evidence-based clinical decision support system solutions at the point of care through electronic patient records. MCG produces evidence-based clinical guidelines and software and is widely used in the US, UK and Middle East. Other examples of health information networks are CPIC (Clinical Pharmacogenetics Implementation Consortium) to help clinicians understand how available genetic test results could be used to optimize drug therapy, the International Cancer Genome Consortium (ICGC) which facilitates data sharing to describe genomic sequences in tumor types among research groups all over the world. In the information models, such as archetypes and Detailed Clinical Models (see section C chapter 1) offer summaries of evidence for specific clinical concepts. L.M. Nagle et al. / Evolving Role of the Nursing Informatics Specialist 217 Likely one of the most significant areas of focus for nursing informatics specialists in the near term is data science and the use of “big data”. Big data has been defined as: “large amounts of data emerging from sensors, novel research techniques, and ubiquitous information technologies” [18, p. 478]. Access to big data unveils a whole new sphere of informatics opportunities related to health and nursing analytics. According to Masys [19], big data is “that which exceeds the capacity of unaided human cognition and strains the computer processing units, bandwidth, and storage capabilities of modern computers”. The future development of nursing capabilities in data science will essentially lead to an entirely new cadre of nursing informatics specialists whose work will focus on deriving new nursing knowledge from not only electronic health record data, but also the data from sensor and remote monitoring technologies, patient portals and mobile apps describe …The application of data to problem-solving Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10 Order NowjQuery(document).ready(function($) { $.post(‘’, {action: ‘wpt_view_count’, id: ‘10430’});});jQuery(document).ready(function($) { $.post(‘’, {action: ‘mts_view_count’, id: ‘10430’});});

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