NUR 514 Week 7 DQs

Week 7 DQ 1 What quality standards or performance measures guide your role or specialty as an advanced registered nurse? Using these standards, discuss how informatics can be used to improve quality of care. Make sure to discuss meaningful use and incorporate the topic materials, such as the American Health Information Management Association (AHIMA) and Information Governance websites in your response.

With the continuous introduction of challenging problems within healthcare, nurse leaders must assume the role of implementing innovative care models. Utilizing technology within healthcare has the ability to provide improved care while decreasing cost, so driving policy change to incorporate further technology is essential. Nurse leaders can do this by acting as a change agent. First, nurse leaders must create an environment that is ready and willing to change (Handzel, 2021). This can be done by sharing ideas, listening to opinions from others, involving a team approach, and acting authentically. Additionally, nurse leaders must investigate levels of risk, barriers, short-term goals, and long-term goals. Once these models have been implemented, the nurse leader has the responsibility to reflect on the outcome of the change and make further changes as appropriate.

The Electronic Health Record (EHR) is the primary means of interprofessional communication. The ethical and legal issues are patient safety and quality, and documentation. The United States has reached 95 percent penetration with electronic health records as a tool to document healthcare delivery in acute care hospitals and aid clinical decision-making since adopting the Health Information Technology for Economic and Clinical Health Act in 2009. There is growing evidence that electronic health records (EHRs) have unexpected consequences that compromise patient safety. Safe and effective clinical care is only possible if doctors are equipped with the tools, they need to make ethical decisions based on usability challenges (McBride et al., 2018).

The American Nurses Association (ANA) (2015) Scope and Standards of Nursing Practice set the standard of practice for registered nurses in the United States, including the requirement that “Nurses shall document important data accurately and, in a way accessible to the interprofessional team” (ANA, 2015, p. 54). All nursing documentation must adhere to “factuality, correctness, completeness, timeliness, organization, and compliance” (ANA, 2015, p. 270). Documentation must be transparent and correct for nurses’ contributions to patient outcomes and healthcare organizations’ continued success (McBride et al., 2018).

The necessity of using encryption software on all computers and mobile devices. Email encryption is one form of in-transit encryption. An intrusion detection system’s job is to monitor any suspicious behavior on a network. Solutions for auditing that keep an eye out for unauthorized access to protected health information. Protect confidentiality by locking screens, informing the team of locking screens, locking screens and informing the team of any changes through frequent audits. This will help ensure conformity with applicable norms and limits of practice.

References

McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and addressing ethical issues with use of electronic health records. OJIN: The Online Journal of Issues in Nursing, 23(1). https://doi.org/10.3912/ojin.vol23no01man05

Sample Answer 2 for NUR 514 Week 7 DQs

Week 7 Q 2 Review HIPAA, protected health information (PHI), and requirements for privacy and confidentiality in EHRs. Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice. Discuss possible consequences for compromising patient data and measures you can implement in your own practice to protect patient privacy and confidentiality.

HIPAA and PHI are laws that regulate the use and dissemination of consumer data. The regulations through the requirements for privacy and confidentiality ensure that healthcare providers do not misuse patient information in unauthorized ways (Balestra, 2018). For example, one of the legal issues that might arise is sharing patient information with a third party. Patient information should remain confidential and private. Registered nurses might share patient information through their social media posts, violating the privacy rule. Sharing patients’ identifiable information can lead to serious repercussions including loss of license or a lawsuit against the hospital. An ethical issue that a registered nurse might be involved in based on confidentiality and privacy of data is accessing information patient health information from an uncensored location (Pool, 2022). For example, accessing patient data from home computers or other personal devices is unethical because of the potential for a security breach. This is because personal devices do not have the cybersecurity features required to protect patient data. Moreover, the registered nurse might leave that information in open access to family members who will end up seeing sensitive patient information.

As the implementation of electronic health records and telehealth systems increases, they also present a challenge in the effective protection of patient data. These systems involve the electronic transmission of patient data, in the process exposing such information to a security breach (Zhou et al., 2019). To promote the security of sensitive patient information, one measure is to install cybersecurity features and make cybersecurity part of an organization’s culture (Pool, 2022). For example, electronically transmitted data should be in an encrypted format so that even if intercepted by a third party, they cannot access it. Another feature of cybersecurity is password protection using two-step verification and strong passwords to prevent other people from bypassing a provider’s passwords and accessing the system.

References

Balestra, M. (2018). Electronic Health Records: Patient Care and Ethical and Legal Implications for Nurse Practitioners. The Journal for Nurse Practitioners, 13(2), 105-111. https://doi.org/10.1016/j.nurpra.2016.09.010.

Pool, J. (2022). Data privacy concerns and use of telehealth in the aged care context: An integrative review and research agenda. International Journal of Medical Informatics, 160. https://doi.org/10.1016/j.ijmedinf.2022.104707.

Zhou, L., Thieret, R., Watzlaf, V., Dealmeida, D., & Parmanto, B. (2019). A Telehealth Privacy and Security Self-Assessment Questionnaire for Telehealth Providers: Development and Validation. International Journal of Telerehabil, 11(1):3-14. https://doi.10.5195/ijt.2019.6276.

Sample Answer 3 for NUR 514 Week 7 DQs

Nur 514 Topic 7 DQ 1

The advent of technology and its subsequent adoption in healthcare has literally ensured that the industry has become driven by technology. The ubiquitous nature of technology in health care is evidenced in the more than 40 000 health-related application as per a study in 2012 (Boulos et al., 2014). These apps have improved the quality of health care services. The concept of apps as a medical device has thus ensured that health care services have remarkably improved based on the number of apps and the widespread adoption of the same in health care. Accordingly, MEDITECH, Ambulatory HER is one of the apps that can improve health care in the country. This app offers complete web charts to providers, allowing them to instantly access patient records from across health care settings at the touch of a button (Wager, Lee, & Glaser, 2013). Due to the app, providers have the capacity to tap on a patient’s record so as to view test results, schedule procedures and appointments, order prescription, and follow the progress of patients’ health conditions. The Ambulatory HER also possesses another population management platform that helps health care professionals to identify at-risk patients. Thus, the features of the application are important as they aid providers to offer important health care services using updated information, which leads to improvement of services.

Interoperability Challenges

However, inasmuch as the applications have innumerable benefits to the health care industry, the integration of the data has revealed some challenges that require urgent interventions. One of the issues related to mobile data interoperability in health care is the configuration of the pass-through server that acquires data from a practitioners’ devices to the storage servers and backend mainframe (Reisman, 2017). This can pose security risks that may lead to violation of HIPPA laws, leading some providers to get their own interface engine. Also, interoperability systems have essentially been made for usage in big screens. Thus, making them accommodate data from a small screen has proven difficult for the players in the industry. Moreover, mobile devices such as iPhones have custom applications, which complicates the interoperability operations (Bolous et al., 2014). The addition of say an iOS HER implementation into a long list of approved regulatory implementations may confuse practitioners. Therefore, whereas the adoption of mobile applications has resulted in improved services, these challenges will need to be addressed in order for them to become even more effective.

Patients’ Reticence in Sharing Data

Sharing of personal data is one area that has received significant attention from health care researchers. Studies have revealed that almost half of respondents would share information about themselves if the information was going to be used to improve health care such as in the development of new treatments and medications (Kim, Joseph, & Ohno-Machado, 2015). Even then, the discomfort concerning sharing personal data remains high among patients. However, the reticence in sharing personal data can be overcome when incentives are adopted during the process. According to Kim, Joseph, and Ohno-Machado (2015), the intransigence of patients to share such data reduces when a physician explains to them the utilization of the data. Offering better explanations concerning the intended usage of the data will go a long way in making patients become comfortable with the process. Also, assuring them of the privacy of the information and ensuring that they trust a physician will result in less resistance when it comes to sharing data.

References

Boulos, M. N., Brewer, A. C., Karimkhani, C., Buller, D. B., & Dellavalle, R. P. (2014). Mobile medical and health apps: state of the art, concerns, regulatory control and certification. Online journal of public health informatics, 5(3), 229. doi:10.5210/ojphi.v5i3.4814

Kim, K. K., Joseph, J. G., & Ohno-Machado, L. (2015). Comparison of consumers’ views on electronic data sharing for healthcare and research. Journal of the American Medical Informatics Association: JAMIA, 22(4), 821-30.

Wager, K. A., Lee, F. W., & Glaser, J. P. (2013). Health care information systems: A practical approach for health care management. San Francisco, CA: Jossey-Bass.