Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Health information technologies have significantly transformed the provision of healthcare in the modern world. Health organizations continue to adopt health information technologies that enhance their ability to achieve care outcomes such as quality, efficiency, and safety in the patient care process. Nurses and other healthcare providers are responsible for determining the safety, efficiency, and effectiveness of the different technologies utilized in healthcare. Therefore, the purpose of this research paper is to perform a literature review on the use of telemedicine in patients suffering from cardiovascular health problems.

Literature Review

The first study included in the review is the research by Jiménez-Marrero et al., (2020). The authors evaluated the efficacy of telemedicine-based intervention for patients suffering from chronic heart failure and ventricular ejection fraction of at least 40%. The study was a sub-analysis of a randomized controlled trial (Insuficienca Cardiaca Optimitzacio Remota iCOR study). The participants in the study were 178 patients who were randomly assigned to either usual care or telemedicine. The results obtained after six months of follow-up showed that the incidence of acute non-fatal heart events was significantly lower in the intervention group (telemedicine) compared to the usual care group. There was also a significant reduction in heart-failure-related costs in telemedicine compared to the usual care group. Therefore, it can be learned from this article that telemedicine reduces adverse events and healthcare costs in heart failure patients compared to usual care.

The other study is the systematic review by Battineni et al., (2021). The research analyzed the usefulness of telemedicine systems for providing personalized care needed to prevent cardiovascular disease. Articles for the review were obtained from databases that included Scopus, PubMed, Scopus, and CINAHL. The search led to 19 articles that met the developed inclusion criteria. The analysis of data showed that telemedicine interventions modify morbidity and mortality if administered promptly to patients with cardiovascular diseases. The results also showed that telemedicine could reduce access to hospitals and other services when not necessary and pressure in hospitals by lowering the acute occurrence of cardiovascular diseases. Therefore, it can be learned from this article that telemedicine interventions improve the treatment outcomes of cardiovascular diseases. It also reduces intense pressure on healthcare systems due to the rise in cardiovascular cases and unnecessary hospital visits and hospitalizations.

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The third article is the research by Farabi et al., (2020), which systematically reviewed the economic evaluation of studies that

compared the effectiveness of telemedicine with usual care for patients suffering from cardiovascular diseases. The systematic review utilized articles that were obtained from databases that included Embase, PubMed, Google Scholar, SID, Magiran, Scopus, and Global Health. The search yielded more than 20 articles that were included in the review. The analysis of data from the articles showed that telemedicine improves clinical outcomes for patients suffering from cardiovascular disorders. It also reduces healthcare costs that patients incur. As a result, concurrent use of telemedicine with usual care interventions could be more cost-effective. It is learned from this article that besides improving health outcomes, telemedicine reduces the healthcare costs that patients with cardiovascular diseases incur.

The last article is a systematic review by Rush et al., (2018). The authors compared the efficacy of virtual education delivery with usual care on patient outcomes in patients suffering from chronic illnesses. The authors searched databases that included CINAHL, MEDLINE, and EMBASE for literature sources. The search yielded 16 articles that were included in the review. The analysis of data showed that telehealth modalities that were utilized in the studies included web, videoconferencing, telephone, and television interventions delivered to patients suffering from chronic obstructive pulmonary disease, diabetes, and heart failure. The results also showed that virtually-delivered interventions were associated with significantly improved outcomes compared to usual care or control conditions. Therefore, it is learned from this study that telehealth or telemedicine is associated with improved outcomes compared to the usual care in patients suffering from chronic illnesses such as heart failure.

Conclusion

The findings from the above articles show that telemedicine or telehealth is highly effective for patients suffering from cardiovascular diseases. The data from the articles agree that telemedicine improves patient outcomes in cardiovascular diseases. The outcomes include the modification of morbidity and mortality rates among the patients. The results also showed that telemedicine reduces the healthcare costs that patients with cardiovascular diseases incur. The reduction is attributed to the minimization of adverse events associated with the diseases. There is also a reduction in unnecessary hospital visits, which translates into cost-effectiveness in healthcare. The results of the analysis also demonstrated that telemedicine reduces pressure on hospitals due to increased cases of cardiovascular diseases. It also eliminates unnecessary seeking of healthcare services by the patients. Therefore, the authors recognize the need for the incorporation of telemedicine into the usual care offered to patients suffering from chronic illnesses such as heart failure and diabetes. The incorporation will enhance patient outcomes in the treatment process.

References

Battineni, G., Sagaro, G. G., Chintalapudi, N., & Amenta, F. (2021). The Benefits of Telemedicine in Personalized Prevention of Cardiovascular Diseases (CVD): A Systematic Review. Journal of Personalized Medicine, 11(7), 658. https://doi.org/10.3390/jpm11070658

Farabi, H., Rezapour, A., Jahangiri, R., Jafari, A., Rashki Kemmak, A., & Nikjoo, S. (2020). Economic evaluation of the utilization of telemedicine for patients with cardiovascular disease: A systematic review. Heart Failure Reviews, 25(6), 1063–1075. https://doi.org/10.1007/s10741-019-09864-4

Jiménez-Marrero, S., Yun, S., Cainzos-Achirica, M., Enjuanes, C., Garay, A., Farre, N., Verdú, J. M., Linas, A., Ruiz, P., Hidalgo, E., Calero, E., & Comín-Colet, J. (2020). Impact of telemedicine on the clinical outcomes and healthcare costs of patients with chronic heart failure and mid-range or preserved ejection fraction managed in a multidisciplinary chronic heart failure programme: A sub-analysis of the iCOR randomized trial. Journal of Telemedicine and Telecare, 26(1–2), 64–72. https://doi.org/10.1177/1357633X18796439

Rush, K. L., Hatt, L., Janke, R., Burton, L., Ferrier, M., & Tetrault, M. (2018). The efficacy of telehealth delivered educational approaches for patients with chronic diseases: A systematic review. Patient Education and Counseling, 101(8), 1310–1321. https://doi.org/10.1016/j.pec.2018.02.006

RE: Discussion – Week 6

COLLAPSE

The use of information and communication technologies is an ever changing and growing trend for healthcare. As technology transforms the field of nursing, nurses become responsible for applying that data and technology to their practice in order to better serve their patients and increase positivity of patient outcomes. We all use technology of all types everyday during our routine shifts. Monitors, IV pumps, electronic medical records, smart patient beds, and messaging through systems such as Epic or Vocera are just a few of the “basic”, everyday use technologies used at my healthcare facility. One technology that has seen a recent increase in use at my facility is telehealth visits.

So, what is telehealth? “Telehealth involves the use of electronic communications and information technology to deliver health-related services at a distance” (New Mexico Nurse, 2021, p. 4). Whether it is our nephrologist making rounds at the hospital and taking a break to have a telehealth office appointment with his outpatients, or the eICU telehealth team checking in on a critical patient who is needing around the clock care, I see telehealth being used everyday. The additional support that a telehealth program offers to clinicians empowers us to oversee a larger population and gain insight into those patients who are at the greatest risk of needing immediate intervention (ENP Newswire, 2016). The benefits of using telehealth are exponential. Aside from improving outcomes and providing expanded access to affordable care, telehealth programs can also help “address multiple cohorts within a population ranging from highest cost patients with intensive ambulatory care and acute needs, to discharge transition and chronic patient management, to prevention and wellness for the general population. These programs use a proactive care model to clinically transform the delivery of care to address growing clinician shortages while improving patient outcomes” (ENP Newswire, 2016). While there are many clinical benefits in the use of implementing telehealth, there are also some associated risks.

One inherent risk associated with the use of telehealth is questionable data integrity. Who is ultimately responsible for ensuring the accuracy of data collected, and who is responsible for ensuring that there is not a breach of security associated with patient healthcare data? According to an article by New Mexico Nurse, “practitioners must adhere to traditional clinical standards of care, and practice within the scope of practice authorized by law. The American Telemedicine Association has promulgated a variety of practice guidelines” (New Mexico Nurse, 2021, p. 6). As nurses, and the largest group of practicing clinicians, we must hold ourselves accountable for applying and adhering to all that health care technology entails. Healthcare in times of Covid has brought renewed attention to telehealth medicine. Legislation is ongoing to promote waivers, permanently extending the ones placed for emergency care when the nation was shutdown. These waivers would remove geographic restrictions to obtaining excellent care and update the healthcare delivery system to provide the best clinical outcomes with less restrictions for both the patient and the healthcare provider.

I believe expanding telehealth and lessening restrictions to make it more accessible is one of the healthcare trends that will prove to positively impact our nursing practice. With the promise to contribute to improvements in patient care outcomes, efficiencies, and data management, it is up to nurses to promote and educate our patients on the use of this technology. Telehealth technology can improve patient outcomes and efficiency of care by making communication between provider and patient more accessible. Patients don’t have to worry about transportation or the cost to get to the doctor office. If they have questions about a new medication they have been prescribed, it is much easier to use telecommunication to reach out to their provider, ensuring increased adherence to treatment plans. “Increased engagement can also enable providers and patients to bring more stakeholders into the conversation, including family members or caretakers….Many aspects of virtual care can lead patients to feel more in control of their health care journeys. Empowering patients to decide where, when, and how they prefer to engage with their care team means they are more likely to have a satisfying care experience” (Hunt, 2021 p. 41).

References

Four leading U.S. health systems sign on to improve ICU care with Philips enterprise telehealth programs. (2016, February 24). ENP Newswire.

Hunt, D. (2021). Improve older patient communication with technology: Virtual visits can help drive better care plan adoption among patients. Urology Times, 49(4), 40–41.

Risk Management Considerations in Telehealth and Telemedicine. (2021). New Mexico Nurse, 66(4), 4–7.

Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
Identify and select 4 peer-reviewed research articles from your research.
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies

Links to an external site.

The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.
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By Day 7 of Week 8

Submit your completed Assignment.

submission information

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Rubric

NURS_5051_Module04_Week08_Assignment_Rubric

Criteria

Ratings

Pts

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:· Properly identify 4 peer-reviewed research articles you reviewed.

20 to >17.0 pts

Excellent

The response identifies 4 peer-reviewed research articles for the Assignment.

17 to >15.0 pts

Good

The response identifies 3 peer-reviewed research articles and one peer-reviewed article for the Assignment.

15 to >13.0 pts

Fair

The response identifies 4 or less peer-reviewed articles

13 to >0 pts

Poor

The response identifies less than 4 peer-reviewed articles or peer-reviewed articles are missing

20 pts

· Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

40 to >35.0 pts

Excellent

The response accurately and thoroughly summarizes in detail each study reviewed, explaining in detail the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described….Specific, accurate, and detailed examples are provided which fully support the response.

35 to >31.0 pts

Good

The response summarizes each study reviewed, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described….Accurate examples are provided which support the response provided.

31 to >27.0 pts

Fair

The response is missing one or two of the required elements or summaries are superficially addressed.

27 to >0 pts

Poor

The response is missing three or more required elements or the summaries are superficially addressed.

40 pts

· Synthesize the findings from the 4 peer-reviewed research articles in a cohesive conclusion.

25 to >22.0 pts

Excellent

Response includes a synthesis of the findings in an exceptionally well-written conclusion.

22 to >19.0 pts

Good

Response includes a synthesis of the findings in a well-written conclusion.

19 to >17.0 pts

Fair

The response is missing a synthesis of the findings or the conclusion is superficial.

17 to >0 pts

Poor

The response is missing a synthesis of the findings and the conclusion is not accurate or is missing.

25 pts

Written Expression and Formatting – Paragraph Development and Organization:Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.

5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

5 pts

Written Expression and Formatting – English writing standards:Correct grammar, mechanics, and proper punctuation

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (1-2) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (3-4) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts

Written Expression and Formatting – APA:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (1-2) APA format errors.

3 to >2.0 pts

Fair

Contains several (3-4) APA format errors.

2 to >0 pts

Poor

Contains many (≥ 5) APA format errors.

5 pts

Total Points: 100