NURS 8210 Medication reconciliation at admission, transfer, and discharge Assessment
NURS 8210 Medication reconciliation at admission, transfer, and discharge Assessment
The location of this medical service framework is in Georgia. The framework involves a total of six healing centers spread across Georgia, including more than one hundred areas for care provision. However, the anchor health care facility is located in Atlanta. The anchor health facility, which has a bed capacity of 488 was established over 100 years ago, and is serving as a private and non-revenue focused organization. Currently, the facility is among the top acute-care community health care settings and is rated among the best five facilities with outstanding patient outcomes. Besides, the facility has over 1,000 physicians that offer different care in areas such as cancer, transplant, women services, cardiac, nervous system science, and orthopedic.
Medication reconciliation at admission, transfer, and discharge has been designated a required hospital practice to reduce adverse drug events. However, implementation challenges have resulted in poor hospital adherence. This study aimed to assess the processes required to carry out medication reconciliation: the health professionals involved, the tasks and time devoted to medication reconciliation in general hospital settings. Adverse drug events (ADEs) are the sixth leading cause of death in the United States and represent a significant financial burden to health care institutions at an estimated cost of $5.6 million per hospital per year. Approximately one-quarter of patients experience an ADE after hospital discharge. At least 58% of these ADEs are preventable due to incomplete drug information received by hospitals, prescribing or dispensing errors, and overuse or underuse of medications. In fact, at admission, 60-70% of medication histories contain at least one error, such as omitting a particular medication. The most commonly omitted medications are cardiovascular, pain, anti-infectious, and central nervous system medications, such as anti-depressants and sleeping pills. After discharge, failure to obtain a complete and accurate pre-admission medication history is also responsible for most ADEs.
The first setting is the physicians group. The physicians group is renowned as the pioneer of the multi-site practice in America acknowledged as patient-centered medical home. As such, the Health Care Incentives Improvement Institute recognized this facility as the first accountable care organization (ACO) in Georgia. The other health care facility is a 189 bed capacity community hospital which is credited by Health grades as one of the finest 50 hospitals in America. Cumulatively, the other hospitals constitute a 215 bed capacity community hospital, a 136 bed capacity community hospital, a 97 bed capacity hospital, and a 52-bed capacity community hospital. Taken together, there are more than 2620 physicians across these hospitals. Moreover, the physicians’ group has more than 170 physicians across Georgia (Piedmont Healthcare website, 2016). The organization is keen on innovation and has developed a telehealth technology which has been extensively used to reach remote areas. This project considerably relied on the perspective of Y. Brook who is the Director of Inpatient Coding for the above organization. Given the crucial position Brook is holding in the organization, the project expect to gain significant insights about the progress the organization has made regarding the clinical documentation and coding of the patient record. The 3M 360 CAC utilizing natural language processing for CDIS and coding software was implemented for a period of six months with the official launching in May 2015. The implementation involved training on aspect of enhancing clinical documentation to realize the requirements of ICD-10-CM/PCS.
In previous Discussions and Applications, you have explored various aspects of health information technology systems: the historic development of HIT, how data flows across HIT systems, and standards and interoperability requirements including specific terminologies used in your practice setting. In this Application Assignment, you will have the opportunity to further develop your analysis skills by closely examining the implementation of a health information technology system. As a doctorally prepared nurse, you may find yourself in the position of leading a HIT project team; to be an effective leader and move health information technology projects forward in your organization, you must be able to logically and critically analyze the many aspects and challenges of implementing such a system and then present your insights in a succinct and professional manner. This exercise provides an opportunity to hone those skills.
Carefully review the project requirements below and plan your time accordingly. Be sure to refer to the standards of nursing informatics practice as you develop this Application, which serves as your Major Assessment for this course.
To prepare:
- Investigate a health information technology system or health information technology application in your area of interest. The health information technology system/application may be in any setting where health care information is developed or managed. You may choose your system or application from any organization or virtual environment.
- Examples of health information technology systems or health information technology applications that are acceptable include but are not limited to:
- Consumer health applications
- Clinical information systems
- Electronic medical record (EMR) systems in hospitals or provider offices
- Home health care applications
- School health applications
- Patient portal/personal health record
- Public health information systems
- Telehealth (i.e., from facility to home)
- Simulation laboratories
- Health care informatics research and development centers
- Examples of health information technology systems or health information technology applications that are acceptable include but are not limited to:
- Discuss your proposed health information technology system/application with your Instructor before proceeding with your finalselection. You may visit a health care organization in person or virtually in order to make your final choice about the health information technology system or health information technology application of interest.
- Choose the best strategy to gain information about your selected information technology system/application. Some ways to gather information include virtual visits; vendor demonstrations; on-site visits; interviews via face-to-face, phone, or teleconference. You must conduct at least one interview for this project.
- Complete a literature search to gather information about your selected information technology system. You may also need to review related scholarly articles to help answer the questions presented below.
NOTE: In your submitted report, do not share proprietary information, personal names, or organization names without permission.
To complete:
Your deliverable is a 12- to 15-page scholarly report, not counting the title page or references. A successful report should leave the reader with confidence in understanding the answers to all the questions listed below. Graphics may be used to illustrate key points.
Organization Information
- Briefly describe the health information technology system/application and the organization type (hospital, clinic, public health agency, health care software company, government health information website, private virtual health information site, etc.).
- Is the health information technology system/application clinical, administrative, educational, or research related?
- What were the key reasons for the development of this health information technology system/application, i.e., what made the organization believe this system/application was needed? How did this organization determine those needs? Did the organization use specific tools to conduct needs assessments, staff opinions, or workflows?
- How did the organization determine that this specific system/application could fulfill its predetermined needs?
- Who manages this health information technology system/application and where are they located within the organization’s administrative structure?
Information System Application Design and Development
- Many health care systems have multiple independent entities that work together toward the common goal of providing high-quality care. How did—and do—the various stakeholders make decisions related to this health information technology system/application? Were the end users involved in the development of this health information technology system/application?
- How are individuals trained to use the health information technology system/application?
- How are security issues addressed? How does this health information technology system/application support a legally sound health care record?
- Where did initial funds for this health information technology system/application come from?
- Who manages the budget for this health information technology system/application?
- Have organizational or political issues impacted the ongoing funding for this health information technology system/application?
- What are the arrangements for planned or unplanned downtime?
- How are health information technology system/application upgrades scheduled or planned?
- How has the health information technology system/application changed in response to health care reform and related legislation?
- What suggestions could you make regarding changes needed to support health care reform and related legislation?
Innovative Aspects of the System
- How does the health information technology system/application utilize technology innovations?
- What technology innovations would you recommend for this organization? What innovations presented in this course, or found through your own research, could this organization benefit from?
- What innovations could further promote evidence-based practice and efficiency within this organization?
End Product
Your report is a scholarly paper and needs to include a minimum of 10 citations from peer-reviewed journals. Every statement made in a scholarly report must be supported by a reference. Be very cautious when stating your opinion, or using terms suggesting absolute facts, or values, as these must be supported by references. Note that textbooks, including the course texts, are composed of information cited from other sources (see the reference section in the course textbooks). With this in mind, there should be an adequate number of appropriate references (a minimum of 10). Please note that primary sources are to be used. Peer-reviewed journal articles should make up the bulk of your references (90%). If referring to a book, be sure to include all information in APA
style, including specific page numbers when necessary. Note that an article referred to in a book is a secondary source. More on this topic is available in the APA Publication Manual and in the Walden Writing Center. See also “Policies on Academic Honesty” listed at the Walden website.
A superior paper demonstrates breadth and depth of knowledge, and critical thinking appropriate for doctoral level scholarship. The report must follow APA Publication Manual guidelines (7th edition) and be free of typographical, spelling, and grammatical errors. This Application is the Major Assessment for this course. You will submit this document by Day 7 of Week 9.
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 8210 Medication reconciliation at admission, transfer, and discharge Assessment
By Day 7 of Week 9
Final Report: 12- to 15-page scholarly report is to be submitted.
Grading Criteria
Document: Week 9 Major Assessment 5 Rubric (Word document)
Health Information Technology Project Evaluation
Program LO: 3
3: Educator / Consultant
DNP Essential: 4
4: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care
Health information technologies have transformed significantly the provision of healthcare services in the modern world. Healthcare organizations embrace new technologies on a regular basis with the aim of enhancing the safety, quality, and efficiency of their patient care. The realization of such goals in care process contributes to improved organizational performance, competitiveness, and trust by the healthcare consumers. Healthcare providers play a pivotal role in facilitating the implementation of new health information systems in their organizations. They provide insights into the system needs of the technologies they need to enhance patient care and explore evidence-based data to support its use. Healthcare organizations can embrace different types of technologies to enhance their service provision. One of such technologies is telehealth. Therefore, this research paper explores telehealth, as a technology adopted in the practice site to enhance the quality, safety and efficiency of patient care. The paper explores aspects that include organization information, information system application, design and development, and innovative aspects of telehealth system use in the organization.
Organization Information
Description of the System
The selected health information system is telehealth. Telehealth is a technology used in delivering and facilitating health as well as health related services such as medical care and patient education through digital communication and telecommunication technologies. The technology is also applicable for use in the delivery of healthcare services such as self-care, provider education, and health information services through digital communication and telecommunications technologies (Tuckson et al., 2017). The examples of telehealth technologies utilized in healthcare include liver video conferencing, electronic transmission of patient data, remote patient monitoring, and mobile health applications.
Telehealth technology has different modalities that that enable the healthcare providers and patients to interact in the care delivery process. The modalities include synchronous, asynchronous, and remote patient monitoring. Synchronous entails the real-time live audio-video interactions that are possible with telehealth system. Asynchronous refers to the store and forward technology that enables the transmission and interpretation of images, messages, and data (Tuckson et al., 2017). Cumulatively, synchronous and asynchronous anchor the remote monitoring of the patient status through the transmission of clinical data from a distance.
The organization type where the selected technology is being utilized is a hospital setting. The hospital uses the technology to provide remote care to its patients suffering from chronic illnesses. It uses it to ensure that patients receive timely care that minimizes the risk of adverse events in disease management. The organization also uses the technology as part of its approaches to enhancing care coordination. Through telehealth, the hospital has been able to provide patient-centered care that enhances their level of satisfaction with care and their empowerment.
Type of the Health Information Technology System
Telehealth is both clinical, educational, and research related system. Accordingly, telehealth can be used for clinical purposes. It is used in providing remote monitoring of patients. Healthcare providers and patients interact through the system to explore the response to treatment and need for additional interventions. Healthcare providers also use telehealth to facilitate remote inter-professional collaboration. Different healthcare providers can work together in patient care through methods such as teleconferencing. The remote inter-professional collaboration ensures that patients receive the best care that addresses their actual and potential health related needs (Lurie & Carr, 2018). Examples of the ways in which telehealth is used in clinical practice includes remote management of chronic conditions such as heart disease, diabetes, asthma, and depression.
Telehealth system is also an educational application. Healthcare organizations adopt telehealth systems for patient and provider education. Healthcare providers offer education remotely to patients using the telehealth system. They educate patients about lifestyle and behavioral interventions that can be used to improve the health outcomes of their patients. They also use it to empower them on the self-care interventions used to minimize the need for hospital visits and hospitalizations (Young & Schneider, 2020). Examples of the ways in which telehealth is utilized in the education of patients includes patient education on the self-care management of obesity, diabetes, heart disease, and recurrent conditions such as asthma. The delivery of education to patients through telehealth minimizes the costs incurred in travelling for physical encounter with the healthcare providers (Rush et al., 2018). Telehealth is also utilized in clinical research. Telehealth technologies such as mHealth technologies have been explored for use in improving treatment adherence among patients. They have also been explored for use in promoting sustained lifestyle and behavioral modifications in patients with conditions such as obesity, diabetes and heart disease (Döğer et al., 2019). Therefore, the research outcomes inform the clinical practice of nursing.
Reasons for Technology Adoption
The hospital developed telehealth technology for use in the management of patients with chronic conditions due to a number of reasons. One of the reasons was to prevent and minimize unnecessary hospital visits by patients with chronic conditions. Patients with chronic conditions such as diabetes and heart disease comprise the majority of individuals with the highest utilization of care services in the US. The statistics from the US shows that about 30% of the emergency visits by patients with chronic illnesses are unnecessary. The unnecessary visits cost the patients, hospitals and health organizations about $8.3 billion on an annual basis (Castellucci, 2019). The leading conditions that cause unnecessary visits to hospitals include hypertension, heart failure, diabetes, chronic obstructive pulmonary disease, and behavioral health conditions such as substance abuse and mental health issues (Sarkies et al., 2020). Therefore, the hospital adopted the technology to prevent and minimize unnecessary hospital visits and hospitalizations for patients with chronic illnesses.
The other reason that led to the adoption of telehealth system in the organization was to reduce healthcare costs that patients with chronic illnesses incur. Telehealth eliminates the need for unnecessary hospital visits as well as travelling by patients. Through it, patients incur minimal costs in managing their conditions, leading to cost-efficiency in the care process. Telehealth also eliminates the risk of adverse events in chronic conditions (McGrowder et al., 2021). For example, the timely engagement of the patients with their healthcare providers ensures that symptoms of adverse events in chronic conditions are identified and managed in a timely manner. As a result, it ensures safety, quality and efficiency in chronic disease management.
The organization also adopted telehealth system to enhance the level of patient engagement. Accordingly, telehealth technology enables patients to take enhanced control over their health and wellbeing. Telehealth systems such as educational videos and health management applications provide patients with informed knowledge and skills for the effective management of their chronic health problems. They also empower the patients to take action for their health problems through initiatives such as physical activity to lose weight and gain the emotional support that they need (Gajarawala & Pelkowski, 2021). Patients are also able to undertake other activities such as scheduling their appointment, secure online portals for communication, and interact with their patients, hence, enhanced patient engagement to achieve outcomes such as satisfaction and empowerment.
A number of things made the organization believe that telehealth system would work in enhancing chronic disease management in the organization. One of them was evidence-based data. The organization involved its healthcare providers such as nurse practitioners and physicians in undertaking systematic analysis of the existing evidence on the effectiveness of telehealth in chronic disease management. The analysis showed that telehealth could enhance the safety, quality and efficiency of patient care, thereby informing its adoption (Lillicrap et al., 2021). The other thing that made the hospital believe that telehealth would work was evidence from other organizations in the region. Most of the hospitals in the region were successfully adopting telehealth systems for chronic disease management. Therefore, it considered its use to maintain and improve its competitiveness in the industry.
The organization determined the need for telehealth using a number of indicators. One of them was the efficiency of operations in the hospital. The analysis of operational efficiency showed that the emergency department was overcrowded in most of the times. Overcrowding led to delays in service provision to patients with acute health needs and diversion of incoming referrals. A further analysis showed that almost 30% of the patients in the emergency department were those with chronic illnesses that did not need any emergency visits or services. Therefore, the hospital considered adopting telehealth to eliminate unnecessary emergency visits and overcrowding in the emergency department due to patients with chronic illnesses (Castellucci, 2019). The other indicator was the cost of care incurred by patients due to unnecessary hospital visits. Therefore, the indicators informed the need for the telehealth system in the hospital.
(Scroll down for table)
| ASSIGNMENT PROMPT | Target
5 points |
Acceptable
3 points |
Unacceptable
1 point |
Score/Level |
|
Abbreviated Research Proposal Paper
Part 1: Information on Organization
(5 points)
Program LO: 3
DNP Essential: 4 |
Exemplary quality.
Content is of a professional portfolio quality; addresses every major subsection in the assignment description of health information technology system/application and the organization type; key reasons for development of this health information technology system/application; management and administrative structure of health information technology system/application using advanced critical thinking skills; does not summarize or paraphrase the content of the literature review, rather demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Excels in meeting expectations for graduate level work. Fully meets expectations for LO 3 Fully meets expectations for Essential 4 |
Well-developed, good quality work. Content is of a professional portfolio quality; addresses at least 80% of the major subsections in the assignment using adequate critical thinking skills; includes some summarizing or paraphrasing of literature review; demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Fully meets expectations for graduate level work.
Meets expectations for LO3 Meets expectations for Essential 4 |
Superficially developed, unacceptable quality.
Content needs substantial revision for it to be of a professional portfolio quality; addresses less than 50% of the major subsections in the assignment using weak critical thinking skills; consists primarily of a summary of main ideas from the literature review; does not demonstrate an applied level of understanding. Lags behind expectations for graduate level work. Insufficient to meet expectations for LO 3 Insufficient to meet expectations for Essential 4 |
|
| Part 2: Information System Application: Design
(5 points)
Program LO: 3
DNP Essential: 4 |
Exemplary quality.
Content is of a professional portfolio quality; addresses every major subsection in the assignment clearly and succinctly addresses how stakeholders worked together to design and fund the system application including a detailed description of who manages the budget, and any organizational or political challenges that impacted the initial or ongoing funding of the system/application and how these challenges were addressed using advanced critical thinking skills; does not summarize or paraphrase the content of the literature that supports this section, rather demonstrates content mastery using examples and/or personalized reflections about the content of the literature; demonstrates an applied level of understanding through personalized reflections about the content area. Excels in meeting expectations for graduate level work. Fully meets expectations for LO3 Fully meets expectations for Essential 4 |
Well-developed, good quality work.
Content is of a professional portfolio quality; addresses at least 80% of the major subsections in the assignment using adequate critical thinking skills; addresses how stakeholders worked together to design and fund the system application including a description of who manages the budget, and any organizational or political challenges that impacted the initial or ongoing funding of the system application and how these challenges were addressed; includes some summarizing or paraphrasing of literature that supports this section; demonstrates content mastery using examples and/or personalized reflections about the content of the literature; demonstrates an applied level of understanding through personalized reflections about the content area. Fully meets expectations for graduate level work. Meets expectations for LO 3 Meets expectations for Essential 4 |
Superficially developed, unacceptable quality.
Content needs substantial revision for it to be of a professional portfolio quality; addresses less than 50% of the major subsections in the assignment using weak critical thinking skills; consists primarily of a summary of main ideas from the literature that supports this section; does not demonstrate an applied level of understanding. Lags behind expectations for graduate level work. Insufficient to meet expectations for LO 3 Insufficient to meet expectations for Essential 4 |
|
| Part 3: Information System Application: Implementation
(5 points)
Program LOs: 3
DNP Essential: 4 |
Exemplary quality.
Content is of a professional portfolio quality; addresses every major subsection in the assignment; identifies key security issues and provides a detailed description on how the issues have been addressed; provides an in-depth portrayal of management of health information technology system, including quality of health care records, training of users, and planning for downtime and scheduled updates; includes a thoughtful analysis of system changes in response to health care reform/legislation and well-reasoned recommendation of additional changes needed using advanced critical thinking skills; does not summarize or paraphrase the content of the literature review, rather demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Excels in meeting expectations for graduate level work. Fully meets expectations for LO 3 Fully meets expectations for Essential 4 |
Well-developed, good quality work.
Content is of a professional portfolio quality; addresses at least 80% of the major subsections in the assignment using adequate critical thinking skills; identified security issues and described how they have been addressed; provides an overview of management of health information technology system, including quality of health care records, training of users, and planning for downtime and scheduled updates; describes system changes in response to health care reform/legislation and recommendation of additional changes needed; includes some summarizing or paraphrasing of literature review; demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Fully meets expectations for graduate level work. Meets expectations for LO 3 Meets expectations for Essential 4 |
Superficially developed, unacceptable quality.
Content needs substantial revision for it to be of a professional portfolio quality; addresses less than 50% of the major subsections in the assignment using weak critical thinking skills; consists primarily of a summary of main ideas from the literature review; does not demonstrate an applied level of understanding. Lags behind expectations for graduate level work. Insufficient to meet expectations for LO 3 Insufficient to meet expectations for Essential 4 |
|
| Part 4: Innovative Aspects of the System
(5 points)
Program LO: 3 DNP Essential: 4 |
Exemplary quality.
Content is of a professional portfolio quality; addresses every major subsection in the assignment; provides a succinct description of the role of innovation in the health information technology system/application and thoughtful recommendations for additional use of innovations using advanced critical thinking skills; does not summarize or paraphrase the content of the literature review, rather demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Excels in meeting expectations for graduate level work. Fully meets expectations for LO 3 Fully meets expectations for Essential 4 |
Well-developed, good quality work.
Content is of a professional portfolio quality; addresses at least 80% of the major subsections in the assignment; provides a description of the role of innovation in the health information technology system/application and recommendations for additional use of innovations using adequate critical thinking skills; includes some summarizing or paraphrasing of the literature review; demonstrates content mastery using examples and/or personalized reflections about the content of the literature review; demonstrates an applied level of understanding through personalized reflections about the content area. Fully meets expectations for graduate level work. Meets expectations for LO 3 Meets expectations for Essential 4
|
Superficially developed, unacceptable quality.
Needs substantial revision to be worthy of a professional portfolio; addresses less than half the major subsections in the assignment using weak critical thinking skills; consists primarily of a summary of main ideas from the literature review; does not demonstrate an applied level of understanding. Lags behind expectations for graduate level work. Insufficient to meet expectations for LO 3 Insufficient to meet expectations for Essential 4 |
|
| Part 5: End Product
(5 points) |
The majority of references are from scholarly journals, support the topic well, and are current. All sources are peer reviewed. Minimum of 7 citations used. Paper stays within page requirements. APA format is used correctly throughout.
Report leaves the reader with confidence in understanding the informatics system; graphics are used to illustrate key points. Excels in meeting expectations for graduate level work. |
Most references are from scholarly journals and support the topic. Most references are fairly current. All sources are peer reviewed. Minimum of 7 citations used. The paper stays within page requirements. APA format is used with minimal errors.
Report leaves the reader with confidence in understanding the informatics system; graphics are used to illustrate key points. Meets expectations for graduate level work.
|
References are not sufficient or are mostly from the lay literature or out of date. Sources identified are a combination of peer reviewed and nonpeer reviewed. Fewer than 7 citations used. The paper is either too long or too short. Weak writing quality and/or little evidence of correctness of APA format.
Report does not leave the reader with confidence in understanding the informatics system; graphics are minimally used or not used to illustrate key points. Work lags behind expectations for graduate level work.
|
Health Information Technology Project Assignment:
Write a 12- to 15-page (plus references) paper that includes the following:
Organization Information (5 points)
- Briefly describe the health information technology system/application and the organization type (hospital, clinic, public health agency, software company, government health information website, private virtual health information site, etc.).
- Is the health information technology system/application clinical, administrative, educational, or research related?
- What were the key reasons for development of this health information technology system/application?
- Who manages this health information technology system/application and where are they located within the organization’s administrative structure?
Information System Application: Design (5 points)
- Many health systems have multiple independent entities that work together toward a common goal of providing health care. How did the various stakeholders work together to make decisions related to this health information technology system/application? Were the end users involved in the development of this health information technology system/application
- How was this health information system/application initially funded?
- Have organizational or political issues impacted the ongoing funding for this health information technology system/application?
- Who manages the budget for this health information technology system/application?
Information System Application: Implementation (5 points)
- How are security issues addressed; how does this health information technology system/application support a legally sound health care record?
- How are individuals trained to use the health information technology system/application?
- What are the plans for planned or unplanned downtime?
- How are health information technology system/application upgrades scheduled or planned?
- How has the health information technology system/application changed in response to health care reform and related legislation?
- What suggestions could you make regarding changes needed to support health care reform and related legislation?
Innovative Aspects of the System (5 points)
- How are technology innovations being used in the health information technology system/application?
- What technology innovations could you recommend for this organization?
End Product (5 points)
- The paper is 12- to 15-page report.
- The report leaves the reader with confidence in understanding the informatics system.
- Graphics are used to illustrate key points.
- The report is a scholarly paper and includes a minimum of 7 citations from peer-reviewed journals.
- Appropriate APA format is used.