COMMUNITY HEALTH
Community Health
Arvind K Deol
Prof: Dr. Kimberly Helms
Public Health Nursing (NUR-443-NU003)
Date: 11/02/2018
COMMUNITY HEALTH
Introduction
A community is a group of people linked by social ties, which share a common perspective or
interests and may or may not share a geographical location. Such community members have
characteristics such a common culture or ethnic heritage, where the people live, similar ages,
speak the same language or share the same religion.
Topic: How to prevent sexually transmitted diseases among the youth.
The target population: The target population for this teaching plan is the youth who engage in
a very risk sexual behavior that may lead to adverse health outcomes. The target teenagers will
be primarily grade 9-10.
Planning before teaching:
Below is a summary of the teaching plan that will take place.
The supplies, equipment and materials required.
For a successful teaching, the following materials must be supplied.
•
•
•
•
•
A laptop that will be used by the instructor.
Overhead screen for displaying the contents.
Condoms for demonstration.
DVDs that will also be used for demonstration.
Chalk, pens and paper for general use by both the instructor and the learners.
Time – the teaching activity is estimated to take 45-60 minutes approximately.
Cost – The estimated cost for the learning activity will include the following.
•
•
The laptop will already be owned by the instructor.
The other additional materials will cost an approximate of 80-100 ddollars.
COMMUNITY HEALTH
Completing the educational template.
Your Name
Arvind K Deol
Agency / Target Population
People with STDs
Overall Educational Goal
Address health needs
Needs
Assessment
People with
STDs serve
as a bridge
for
transmission
of
the
diseases.
Special
Considerations
The causes of
the certain
disease.
The highest
population with
the named
disorder.
Objectives
The main
objectives
for
the
teaching
How conversant
plan
are they with
include
this disorder?
Is it possible to the
following.
address this
disorder in the
community?
Content
The
teaching
plan is
about the
prevention
of the
infection
and
spread of
STDs.
Teaching
Strategies
(estimated
time if
applicable )
The
teaching
strategies
that will
be used as
stipulated
in
this
teaching
plan
Written
material
Evaluation
Some of
the
written
materials
will
include
the
following.
This
section
will
explain
how the
learners
will
be
gauged
Needs assessment.
People with STDs serve as a bridge for transmission of the diseases and hence a need
assessment has to be included in this document plan.
The needs assessment method will involve the following.
•
Administering an anonymous self-questionnaire to the learners to answer some
questions which will help the instructor gauge the past knowledge of the learners about
STDs.
COMMUNITY HEALTH
•
•
Conducting a survey – a survey will be conducted before the actual teaching by
collecting relevant information from the population such as the number of people who
might have been infected with STDS.
Conducting community meetings – community meetings will be administered so that
the instructor will obtain adequate feedback from the learners.
Objective.
The main objectives for the teaching plan include the following.
1. The population should be able to identify the paths that STDs transmit in relation to
multi- sex partners.
2. The learners should be able to understand different prevention strategies for the STDs.
3. The learners should be able to able to list the most common STDs along with their sign
and symptoms.
Content.
The teaching plan is about the prevention of the infection and spread of STDs. The learners will
be introduced to different types of STDS and their signs and symptoms . They will also be
taught different measures that can be taken to prevent the spread of these diseases. Finally in
case there is some among the target population that is infected they will be guided on how to
seek medication. The presentation will be divided in to sessions of around 10 minutes per
session.
Teaching strategies.
The teaching strategies that will be used as stipulated in this teaching plan will include the
following.
•
•
•
Use of questions and answers – using questions and answers will ensure that the
target population is actively engaged in the teaching process.
Use of charts – charts with diagrams will be used to provide clarity to the learners.
Such diagrams will illustrate different aspects such as showing different sign and
symptoms of different STDs.
Lecturing – The instructor will use lecturing methods to ensure that the content that
is being communicated is effectively passed to the learners.
COMMUNITY HEALTH
•
•
Use of the internet – the learners will be given time to do further research on the
internet for further understanding.
Use of videos – use of videos will allow the learners to understand the contents
being taught without much memorization.
Written material.
Some of the written materials will include the following.
•
A handbook that will contain details information about STDS.
Evaluation.
This section will explain how the learners will be gauged and how the extent to which
the objectives were achieved will be measured. The evaluation techniques that will be
used include the following.
1. Use of questionnaires – questionnaires will be developed which the learners can answer
at the end of the session. Example of questions in the questionnaire will include the
following.
• Was the demonstration provided by the instructor useful ?.
• Was the spread of the STDs identified by the visual effects ?.
2. Pre-test and post-test – This is achieved through the analysis of the contents the
learners had before the teaching activity and comparing with contents of the students
after the learning activity.
3. Open dialogue – some aspects tend to be ineffective when presented INA open dialogue
hence the effectiveness of open dialogue must be gauged.
4. Pre-assessment and post-assessment – the learners will be actively involved in the
demonstration and hence the effectiveness of the demonstration should too be
evaluated. For example, before the video demonstration the learners will be asked to
explain how a condom is placed and then after the video they will be asked whether
there would be something new they would have learned.
COMMUNITY HEALTH
References
Thrall, G. (2017). Methods for conducting a training assessment.
Kaplan, R. (2018). Toolkit for making written materials.
Allard, E. (2015). School health to prevent AIDS and STDS.
Policy Analysis
Arvind K Deol
Thomas Edison State University
Date-- 03/17/2018
COMPREHENSIVE ADDICTION AND RECOVERY ACT
The Senate passed the comprehensive addiction and recovery act (CARA) on July 13, 2016. The
house also passed the same bill on July 8 and now is awaiting presidential consent. The bill
comprises of inputs from a collection of parties that makes it alarming. It provides full extensive
care and support including pulling efforts to access addiction treatment and reversal of overdose
medications. The bill also provides issues based on law enforcement and criminal justice.
Nurses and practitioners are important stakeholders during an epidemic of the opioid and heroin
abuse. These parties excise a direct administration to the abuse agonist buprenorphine since high
mitigations are usually carried out by nurses and related agencies. This is the change American
nurses association among other millions of people is pushing for regarding amendment of CARA
bill. Moreover, an increase in channeled grants regarding the two drug epidemics has called for
collaboration between all practitioners and the government to fight for abuse prescriptions. This
paper will help understand the role of CARA bill in improving the wellbeing of American public
safety and health of the society as well as addressing the role of nurses in this epidemic (Tracey,
2011).
Background
Section 303 of the CARA ACT was signed into law in 2016 that made several changes regarding
treatment of heroin abuse using buprenorphine. One of the changes has been expanded to nurse
and practitioners and health assistants up to 2021.
Some issues have been highlighted below;
Section 107 includes a change of policies regarding access to overdose treatment. This part
authorizes the department of health to fund health practitioners which are federally chosen, all
opioid program facilitated and any nurse and practitioner who prescribes buprenorphine. The
section also requires training of healthcare providers about the prescription, co-prescribing and
connecting patients to the appropriate treatment. Section 110 covers overdose reversal,
medication access and access to grants from a department of health to be able to access to pursue
their plans especially regarding training the public on matters concerning heroin and opioid.
Section 301 is an evidence-based treatment of heroin- opioid, treatments and interventions
allowing practitioners to receive grants. Those who receive grants are stated care organizations,
local governments, and non-profit making organizations which exist in areas facing an opioid
epidemic in high rates in order to expand their medical and treatment standards.
Section 303 is the most important provision; the part provides medication based treatment to
addiction. The section relates changing the law regarding addiction treatment using
buprenorphine. First, the policy outlines that nurses and medical practitioners must complete the
required training period to be able to work with a physician provided by the state of law. This
includes setting specific laws and regulations regarding this practice in every state. Second, the
department is given the power to administer patients based on severity to which medication and
care are to be administered directly. Moreover, the secretary of the department of use is equipped
with a task to search about opioid treatment and submit the report to the Congress. Lastly, ‘the
state warns practitioners concerning reducing patient limits to critical levels lower than 30.
Lastly, Section 601 focuses on making changes towards allocation of grants and allows the
health department to plan for any opioid and heroin epidemic. These plans include; education,
maintaining prescription, expanding availability, implementing direct efforts and advancing
awareness.
CARA implementation will minimize social, economic, political, cultural and environmental
issues associated with an opium-heroin epidemic. According to the attorney heroin and opium
are fetal threats to public health and law enforcement agencies. Addiction to heroin compromises
the goal of the health department and law enforcement agencies. Addiction gives rise to crimes
as well chronic such as cancer. Surprisingly, in 2015, $180 was allocated to fight this particulate
epidemic fight which could have been used for other development projects. According to reports
from Centre of disease control of 2015, increasingly high death rate resulting from heroin and
opium abuse a number higher than that resulting from road accidents. Statistic indicates the
youth as direct victims of the epidemic; the society loses the potential and energy to move
towards the next goal.
Plan for implementation
Nurses and practitioners in this expanded waiver of five years have to compete for 24 hours of
eligible training to be eligible to prescribe and supervise other physicians as required by law. The
American Association of nurse practitioners has created an interactive forum with other
organizations to create comprehensive laws and regulations specific to each state to deal with the
epidemic. The policy also requires practitioners to obey practice regulations by maintaining
patient levels at thirty. General other requirements include clinical tools and provider clinical
support. Once the two policies have been met, any practitioner or nurse can start prescribing
buprenorphine and applying for grants. CARA modification plan .has been established under
evaluation plans before 2021. Nurse practitioner organization has created an additional 16 hours
to officers operating a department of psychiatry and osteopathic departments. Moreover, CARA
modification would allow nurses to independently ad mister buprenorphine alongside other
medicines.
This bill is essential while solving critical problems arising from drug abuse. Thanks to the
government for passing CARA bill of 2016. The incarceration of affected persons has not been
addressed to the later. Nurses’ provisions in CARA exploits the bill top its full potential.
Practitioners are the direct parties that deal with strategies based on opium and heroin epidemic.
CARA has a promising future for US citizens that guarantee public safety. An appropriate plan
has been established regarding criminal justice, safety, and public health. Moreover, the mutually
peaceful atmosphere has been created between young citizens, sheriffs, and medical personnel.
This is the reason why the bill is our choice.
State of the bill
Practitioners have described the bill as a link between medical disorders and health care needs.
This has promised treatment of disorders with efficiency without detox. The bill gained the
popularity that aroused 23 senators to send a proposal to a department of health to consider an
advanced role in buprenorphine treatment. Moreover, the policy has gained support from other
diverse groups both pro-life and pro-choice. Association of a nurse, health administrators,
judiciary and the attorney, as well as law enforcement agencies, have been on the first line. No
doubt, the bill will graduate to law.
Role of nurses
Nurses and medical practitioners are in the first line to mitigate heroin and opioid epidemic and
reducing discrepancies government channeled grants and resources. CARA is established under
six pillars as established by the attorney to address the issue of opioid and heroin abuse. What
seem to be basic roles of practitioners includes; overdose reversal, reforms to criminal justice,
treatment and prevention to the affected forms part of CASA six pillars. After implementation,
nurses will have advanced powers to administer buprenorphine for treatment of opioid and
detoxication as well medication where the pain is being experienced. This will give nurses
independent powers to counter patients and mitigate effects brought by the epidemic.
Detecting substance is another role to nurse and practitioners. If the medical officer detects the
substance, NIDA (national institute on drug abuse) has provided a fast method of screening that
enables the nurse give the appropriate medication and referral while remaining non-judgmental
(Okie, 2010). A nurse should carefully assess patients’ in order to match their pain with
medication. Assessing starts with asking about the history of the substance, psychiatric statuses
such as family background, past and current medications. Lastly, the most important role is to
education. Oral and written instructions should be given to nurses to give patients proper
dosages, prescriptions, names and durations of taking the drug (Tarantine, 2017). For instance,
an internal medicine publication JANA revealed most of the patients keep medicine to use in the
future. This calls for the necessity to install knowledge to dispose of unused drugs.
Conclusion
Patients need an opioid prescription and any policy change should never distract prescription of
these drugs in any situation. The new policy should not change health operations of the past but
add collaborative feature among parties in fighting opioid and heroin epidemic in the United
States for the better of the nation.
References
Baird, C. (2015). Role of Medication in the Treatment of Opioid Use Disorders. Journal
of Addictions Nursing. 26(4), 214-216. doi: 10.1097/JAN.0000000000000101
Griffiths, D. (2017). Preventing Opioid Abuse: The Role of the Nurse. Retrieved from
https://www.wsna.org/news/2017/preventing-opioid-abuse-the-role-of-the-nurse
Bingel, U., Wanigasekera, V., Wiech, K., Mhuircheartaigh, R. N., Lee, M. C., Ploner, M.,
& Tracey, I. (2011). The effect of treatment expectation on drug efficacy: imaging the analgesic
benefit of the opioid remifentanil. Science translational medicine, 3(70), 70ra14-70ra14.
Raisch, D. W., Fye, C. L., Boardman, K. D., & Sather, M. R. (2002). Opioid dependence
treatment, including buprenorphine/naloxone. Annals of Pharmacotherapy, 36(2), 312-321.
Baird, C. (2015). Role of Medication in the Treatment of Opioid Use Disorders. Journal of
Addictions Nursing. 26(4), 214-216. doi: 10.1097/JAN.0000000000000101
Griffiths, D. (2017). Preventing Opioid Abuse: The Role of the Nurse. Retrieved from
https://www.wsna.org/news/2017/preventing-opioid-abuse-the-role-of-the-nurse
Manworren, R & Gilson, A,. (2015). Nurses’ Role in Preventing Prescription Opioid Diversion.
2hours Continuing Education, 115(8), 37-39.
McDaid, C. (2016). Why Is The Comprehensive Addiction & Recovery Act So Important?
Retrieved from https://www.huffingtonpost.com/carol-mcdaid/why-is-thecomprehensive-_b_8210918.html
Okie, S. (2010). A flood of opioids, a rising tide of deaths. New England Journal of Medicine,
363(21), 1981-1985.
Tarantine, R. (2017). How Nursing Is Helping To Combat The Opioid Epidemic. Retrieved from
https://www.huffingtonpost.com/ruth-tarantine-dnp-rn/how-nursing-is-helpingto_b_10637130.html
Nursing Informatics: Telemedicine/ Telehealth
Nursing Informatics: Telemedicine/ Telehealth
Name: Arvind K Deol
Thomas Edison State University
Date: 06/24/2018
Nursing Informatics: Telemedicine/ Telehealth
NURSING INFORMATICS: TELEMEDICINE/ TELEHEALTH
Abstract
For better decision making and quality internal nursing practice, information becomes a key
factor. The work environment is intense when it comes to details since a lot of their activities
involve information, diagnosis, and assessment of the healthcare needs of their clients.
Information is also needed to develop care plans; other healthcare professionals also have to
know the healthcare information about the patient; budget reports and staffing also need to be
analyzed by the nurses. Over the years especially in the 21st century, there have been
tremendous technological advancements especially when it comes to information. This presents
an opportunity as well as a challenge for the nurses to stay updated with the current information
and should use or consider it whenever they are making decisions. Data processing has been
eased through faster computers, data analysis and decoding has become even simpler through the
invention of sophisticated software that can do the same., then there is the rise of the internet
which has elevated information transmission to an all different level, health professionals as
well as organizations can easily connect and communicate on issues concerning them. The
healthcare system has not been left behind in terms of invention of more effective software and
applications that could ease their operations. There has been an increased pace to implement the
Electronic Health Record System which provides an effective way of storing all medical
information related to a patient’s interaction with any medical institution. This information is
secure and can easily be retrieved by the patient or any authorized medical personnel whenever
needed. Nursing informatics is greatly popular among the nurses as an area of specialization that
gives rise to nursing informaticians. However, nursing informatics capabilities should be
Nursing Informatics: Telemedicine/ Telehealth
incorporated by all nurses in their practice. According to the 1999 National Nursing Informatics
Project, “Nursing informatics (NI) is the application of computer science and information
science to nursing. NI promotes the generation, management, and processing of relevant data to
use information and develop knowledge that supports nursing in all practice domains.”
Introduction
Technological advancement in the medical sectors offers an array of opportunities and
challenges to nurses. It is important for any nursing staff to be well acquainted with the
knowledge of nursing informatics. This is the basis of all current nursing practices including,
research, administration, clinical practice, and education. One of the topics of great consideration
in nursing informatics is telehealth or telemedicine. These two terms are often used interchangeably although there is the difference. The first one to be used was telemedicine, but due to
technological advancement and improved medical care, telehealth came up. Telemedicine is
whereby technology is applied in the provision of clinical services. Telehealth, on the other hand,
is much broader and covers broader consumer challenges. The definition of telehealth according
to The Federal Network of Telehealth Resource Center is as follows, “a collection of means or
methods, not a specific clinical service, to enhance care delivery and education.” This article
explores the theoretical models of telehealth/telemedicine and outlines how it could be used in a
specific nursing informatics issue.
Nursing Informatics: Telemedicine/ Telehealth
Any scientific discipline requires some theoretical basis on which to operate. Nursing
informatics is no exception. Some theoretical models have been advanced to provide a basis on
which nursing informatics could operate. Nursing informatics is a merger of three sciences;
Information Science, Computer Science and Nursing Science.
Data/Information/Knowledge/Wisdom (DIKW) Model
Coming up with a working theory for nursing informatics proved challenging because Nursing
informatics is a multidisciplinary subject hence finding a theoretical model that would address all
its concerns was not easy. The Data-Information-Knowledge-Wisdom model is one of the
theories that were recently recommended to have a high capability of addressing these setbacks.
The American Nurses Association adopted it in 2008 (American Nurses Association, 2008). This
model includes the following concepts;
•
Data constitutes the smallest components of the DIKW theoretical model. Data is normally
presented by small or discrete facts. It involves observation with little elucidation. These discrete
facts usually describe the patient and his environment. This could include medical diagnosis of a
patient such as one diagnosed with malaria. The environment of the patient could be maybe from
tropical regions in Africa. Datum is the word used to describe single information. According to
this theory, a datum has very little meaning on its own. It must be supplemented with other
additional information.
Nursing Informatics: Telemedicine/ Telehealth
•
Information is data when some meaning is attached to it (Madney et al., 2011). Information
usually creates a meaningful and reasonable picture through the combination of a variety of data
points. Some of the questions answered by information include “who,” “what,” “where” and
“when.” For example, a patient diagnosed with malaria and comes from the tropical regions
could have probably been bitten by a mosquito since the female Anopheles mosquito infests
these areas majorly.
•
Knowledge is synthesized information. It is said that knowledge is power and power is got
through a tactical organization of facts and ideas. Here meaningful information is constructed fro
the data points or facts. Quite often, assumptions do affect knowledge. It is therefore important to
develop a central theory which considers all the patterns of relations and variation between
different clusters of information. In the diagnosis of a medical condition, when different
information clusters are merged, it is possible to establish whether the patient is at risk of
developing some adverse effects
•
Wisdom, on the other hand, involves the appropriate mastery and use of knowledge when it
comes to solving human problems (American Nurses Association, 2008). Majorly, issues related
to wisdom are not taught but integral and involve a person using his or her intuition to establish
whether a certain intervention is necessary or not. Intuition enables a nurse to give the most
appropriate medication to a given patient according to the prevailing circumstances. In handling
emergency cases, a lot of wisdom may be required; a nurse would be required to organize all the
information and knowledge they might have and use it to determine the proper and most
effective sequence of treatment.
Nursing Informatics: Telemedicine/ Telehealth
This model offers Avery effective way in which patient information could be used by a nurse to
ensure that quality services are delivered to the patients. In a nutshell, the DIKW theoretical
model involves the collection and naming of data, an organization of information, interpretation,
and understanding of the knowledge and finally the application of the knowledge with ethics and
compassion in practical wisdom.
Sociotechnical theory
This theory focuses on the various social issues that may have an impact on the implementation
of a technological system in a given healthcare organization. This theory was advanced after a
common failure in the implementation of several information systems in the 1990s (Nohr & A
arts, 2010). Socio-technical issues were the main cause of the implementation failures. These
issues included poor coordination among health practitioners and the information systems
together with the medical institutions in which the systems were implemented. Such poor fit led
to an array of failures resulting in unintended results.
The structures of the health organizations changed greatly. These included the management and
the power hierarchy within the organizations. This was due to the adoption of the health
information systems. The organizational environments together with the relationship between
healthcare staff and the patients were greatly altered. The relationship between the health
professional teams themselves also changed greatly.
On analysis of the contribution of healthcare systems towards quality and safe healthcare
considers fit in socio-economic structure as a catalyst towards the realization of improved
Nursing Informatics: Telemedicine/ Telehealth
outcomes when it comes to delivery of healthcare services when the health is implemented into
the technological system.
Another possible cause of the implementation failure is the blind adoption of the technological
system whereby some organizations adopted the processes that were modeled by the system
without considering the structure and issues within the organization. The could have led to a poor
technology - organizational fit which normally results into issues such as the programmed
functions of the system being bypassed, some staff maybe were not using the system functions,
and some could have rejected the system in total. The functions could have also been used in
ways in which they were not intended for. Such disorganization may lead to an in an orderly
manner of healthcare service delivery to the patients limiting the improvement of quality service
delivery to the patients which was the initial intention of the implementation of the systems. This
theory advocates for a greater understanding and corporation in the use of a given technological
system in whichever health organization it is employed. It is only through this that patients
would be able to get quality healthcare.
Schwirian's model
This model uses the Nursing Informatics (NI) pyramid which was advanced to act as a guide in
the conduction of nursing research. It intended to create order during research by creating
standard steps to be followed by anyone who was out to do any nursing research. The pyramid
also makes it easier for a nurse researcher to point out areas that could be of great significance
when researched (Turkey, 1996).
Some of the elements of the Nursing Informatics pyramid include;
Nursing Informatics: Telemedicine/ Telehealth
•
Raw materials. Any nursing information constitutes this. It could be a problem affecting the
nursing department or an issue that needed some intervention for improvement purposes.
•
Technology. This comprises the roles technology could do in addressing the issue.
•
Users. The purpose of the research should be beneficial to the intended users. Users could be
students or even the nurses in their profession
•
Goal. This is the most important element, and it represents the objective for which all the
three preceding elements are channeled.
“Information, users, and computer interact to form a Nursing Informatics activity. Placement of
the goal at the apex of the pyramid intends to show the importance of the ultimate goal of the
Nursing informatics activity.” (Schwirian: 1986).
Having a good research model in nursing informatics helps in ensuring that nursing professionals
come up with a standard problem and follows a guided direction in conducting their research.
Chaos Theory
This theory was developed from some subjects including meteorology, mathematics and
computer science. This theory in itself is science and involves the systems within the global
nature. Complex systems can be modeled using mathematical equations which are very simple.
A greater output could be realized through a minimal input. The systems involved in nursing
practice are at time s complex and dynamic and their analysis could be done using the chaos
theory.
It is important for buses to understand this theory because in case one is doing research or study
on a given issue of interest, understanding the method that was applied in analyzing the
Nursing Informatics: Telemedicine/ Telehealth
phenomenon should be understood quite properly. Chaos theory thus offers some ways in which
the world could be analyzed.
The theory explains the behavior of complex systems and explains how such systems are
controlled by straightforward rules. A small input can create a great difference. Although these
changes are not random, it is possible to predict them by applying simple mathematics and
computers.
Knowing the characteristics of natural systems and the nonlinearity exhibited by statistical
models is of great help to nurse researchers. The chaos theory could help greatly when it comes
to analysis in nursing. This is achieved in three ways; mathematical constructs; the notion of
chaos; and properties exhibited by chaotic systems.
Nurses deal with complex systems in their daily practices. These include physiological systems,
biochemical systems, human systems and even healthcare systems. Chaos theory is applicable in
a number of these systems which are natural.
One application of the chaos theory is in the explanation of how events that might seem too
random have a certain mathematical or simple pattern in which is its components associate.
Nonlinear dynamics could be applied in predicting such chaotic system. The demographic study
is one case where chaos theory could be applied especially the concern is on the prediction of
population growth. Prediction of a disease pattern could also be difficult when it comes to
epidemiology. Thus the chaos theory could become handy. Some factors could set in that lead to
the interruption of a steady system making predictions difficult. For example, the disease could
arise in a given population leading the interruption of a population that was steadily increasing
Nursing Informatics: Telemedicine/ Telehealth
Chaos theory is applied in nursing informatics. Computers can model systems. Simple
mathematical formulas could thus be used to create complex systems which could be used by
nurses to manage, collect and analyze data. This eases the work of the nurses as the work of data
analysis is left to the computers as they focus on service delivery to the patients.
Information theory
This was derived from the manner in which the telephone was made. The information delivery
modes and the components of the information are very important aspects of this models. A
possible model that was suggested on how this theory works is whereby a nurse receives the
information concerning a patient and enters it into her desktop. The same information could get
to the patient's computer, fellow nurses and the physicians are tending to the patient. Along the
channel, the information is being stored for future reference in case the patient comes for
treatment again. This model, however, does not consider the case of a blind patient.
Further advancement of this theory was from the study of objects which include data,
knowledge, and information. These three objects are artificially related to each other, and the
absence of one creates chaos in the manner in which the rest operate. For healthcare processes to
be improved and practitioners to be benefited, the design of any healthcare system should put
consideration on these three objects (Blum, 1986).
Optimum transmission of information via a certain route is a major concern for this theory. It
could improve the following in nursing informatics if properly applied;
Nursing Informatics: Telemedicine/ Telehealth
•
Structure. The personnel, facilities and the organization as a whole would realize an increase
in capacity and quality of service delivery to patients and each other.
•
Process. The burden of dealing with a lot of work would be reduced and any activity carried
out would be appropriate because they would be object specific.
•
Outcome. The healthcare delivery status of the system being evaluated would improve, and
the patients would experience more satisfaction with the services.
Turley’s model
This model was aimed at creating and understanding in the various fields of research and
comparing them with each other to identify avenues where something is missing or in which
further studies should be done.
This model involves the involvement of cognitive science principles in Nursing Informatics.
Turley proposed that cognitive science should be included in the definition of nursing
informatics. Research has been carried by nurse scientists to determine what human brain does to
any data, information or knowledge that it processes and how this affects decision making in the
nursing field. To support decision making in nurses, it is important to include cognitive science
in their operation through the use of appropriate computer programmes.
The model was greatly inspired by the rise of artificial intelligence technology, an area of science
that focused on mimicking the cognitive abilities and functions of the human brain and installing
them in robots or computers enabling them to operate as humans
Nursing Informatics: Telemedicine/ Telehealth
Cognitive science is a link between natural and artificial intelligence. It enables people to
understand how information could be extracted, synthesized, stored and retrieved. Understanding
of these aspects plays a major role in the d modeling of computer software.
Decision making and problem-solving are very key aspects of nursing practice that technological
advancement could become handy in. One of the major roles of nurses is to enable people to
respond in the best ways possible to diseases and also to make them understand means of
preventing certain diseases from getting them. Nurses also help people to restore their health
back to normal like those who would want to achieve a healthy weight.
The systematic steps followed by nurses in problem-solving involve identification of the
problem. Establishing the characteristics of the problem and search for existing knowledge from
relevant sources that is related to the problem; the next step is the decision of on an appropriate
plan to be enacted; the final step is the rolling out of the plan and evaluation of its effectiveness.
This scenario is majorly possible for some of the common diseases and circumstances in which a
lot of research has been done and the nurses have some reference sources at their disposal. There
has been a reported increase in the complexity of patient situations. The medical information
available is also so wide that an individual cannot easily master it all at a go. This calls for the
development of artificial programs that could help nurses in making their decisions. One would
be able to weigh on the possible consequences of any given course of action before
implementation. At times, the programs may have knowledge or information that might not be
popular with the user. This could be the best information hence the healthcare practitioner can
choose the best action to take. Under unfamiliar circumstances, the nurse would be able to make
the best decision preventing postponement of problems.
Nursing Informatics: Telemedicine/ Telehealth
The Lewin's change theory
This model offers one of the best and simplest methods of executing change at any level be it
personal, organizational or group level. It is easy to apply, and many can witness to its
effectiveness. It is made up of three guided steps that a person could apply.
•
Undressing stage. This stage involves identification of a proper method that could be used to
free people from their old beliefs and systems of operation that were unproductive. This could
also be done by inspiring the people to understand that indeed change is necessary. In
transforming an institution that has been using a lot of paperwork into an electronic company
would involve telling the workers the disadvantages of the extensive paperwork.
•
Change stage. This is the core stage in which the thoughts, behaviors, and feeling of
everybody involved are channeled towards the better. This could be through the use of more
productive means of production or data storage.
•
Refreezing stage. This is the establishment and adoption of the change as a new behavior
making it the ultimate operating procedure that everyone should follow. This stage is always
subject backside; therefore, rigorous measures should be taken in ensuring that everyone is on
track through championing through leadership, rewards, and support.
This is a very simple procedure that could be applied in the nursing informatics to ensure a
successful implementation of new technological systems.
Roberts’s diffusion of innovation theory
This theory considers all the processes that normally take place in the process of people adopting
a new idea, product or practice. Rogers analyzed this model and pointed out that initially, the
Nursing Informatics: Telemedicine/ Telehealth
idea is adopted by very few people who might be open to it. As these initial few spreads, the
popularity of the idea increases as more and more people embrace it and a critical mass is
developed. Over time the idea undergoes diffusion in the entire population and becomes
saturated. There are five categories of embraces of innovation (Rogers, 2003); Innovators, early
adopters, early majority, late majority, and laggards.
This model could be of great importance to health administrators, information technologists, and
nursing informatics agents. They can learn the importance of starting with a smaller but effective
beginning.
The way forward is the adoption of telehealth by health organizations. This is where the world is
headed to. Patients’ needs are raising daily ad it is important to find better and effective means of
enhancing decision making among the nursing staff and other clinicians.
In conclusion, nursing informatics is a field that any healthcare provider, not only nurses, should
have a hint on as it entails some of the current means of service delivery. It is important to u
understand how it operates.
Nursing Informatics: Telemedicine/ Telehealth
References
American Nurses Association. (2008). Nursing informatics: Scope and standards of practice.
Silver Spring, MD: nursesbooks.org.
Benner, P. (2000). The wisdom of our practice. The American Journal of Nursing, 100(10), 99101, 103, 105.
Blum, B. I. (1986). Clinical information systems. The Western Journal of Medicine, 145(6), 791797.
Retrieved
from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1307152/pdf/
westjmed00160-0055.pdf
Graves, J. & Corcoran, S. (1989) The study of nursing informatics. Image: Journal of Nursing
Scholarship, 21 (4) Winter, 227-230.
Graves, J. R., & Corcoran, S. (1989). The study of nursing informatics. Image–the Journal of
Nursing Scholarship, 21(4), 227-231.
Keller, C. (2005). “Virtual learning environments: three implementation perspectives.” Learning,
Media and Technology 30(3): 299-311.
Murray, P. 1997. Chaos and complexity on the Internet: A selective review of
Nelson, R. (2002). Major theories supporting health care informatics. In S. P. Englebardt & R.
Nelson (Eds.), Health care informatics: An interdisciplinary approach (pp. 3-27). St.
Louis, MO: Mosby.
Nursing Informatics: Telemedicine/ Telehealth
Nøhr, C., & Aarts, J. E. C. M. (Eds.). (2010). Information Technology in Health Care: Sociotechnical Approaches 2010: from Safe Systems to Patient Safety (Vol. 157). IOS Press.
resources. Complexity and Chaos in Nursing. Summer 33.
Rogers, E. (2003). Diffusion of Innovations. Fifth edition. Free Press: New York.
Topaz, M. (2013). Invited Editorial: The Hitchhiker’s Guide to nursing informatics theory: using
the Data-Knowledge-Information-Wisdom framework to guide informatics research.
Online
Journal
of
Nursing
Informatics
(OJNI),
17
(3).
Available
at
http://ojni.org/issues/?p=2852
Turley (1996). Toward a model for nursing informatics. Image: Journal of Nursing Scholarship
28 (4), Winter, 309-13.
Turley, J. P. (1996). Toward a model for nursing informatics. Journal of Nursing Scholarship,
28(4), 309-313.
Running head: PUTTING RESEARCH FINDINGS INTO PRACTICE
Putting Research Findings into Practice
Thomas Edison State College
Arvind K Deol
Date 08/29/2018
1
PUTTING RESEARCH FINDINGS INTO PRACTICE
2
Abstract
This paper discusses how cancer treatment research findings can be implemented with the
main question revolving around identifying and getting to know what are the Palliative Care
Research Opportunities and Issues that are more concerned with cancer patients with untreatable
or advanced illness part of those approaching end-of-life in quality care clinics. It is suggested
that an apparent opportunity is in place in advancing the science as well as making better the
quality of care for those people affected with the disease of cancer and this is aroused by the
collapse of palliative care high-quality clinical research highly linked to other clinical conditions
of non-palliative. The paper has also identified ethical concerns that are highly linked with
research in palliative care and they include complexity in assessing research participation
benefits as well as risks, randomization including also patients’ not stable mental status with
assessing capacity difficulty. It is worth noting through the paper that when a firm basis in
evidence-based clinical practice is lacking, the patients’ care having untreatable cancer will at all
times revolve around or based on provider understanding and anecdotal evidence.
PUTTING RESEARCH FINDINGS INTO PRACTICE
3
Introduction
In the health sector, palliative and supportive care continue to be a key feature as far as
quality care in cancer patients is concerned, and this is particularly those patients with the
incurable or advanced diseases. Researchers have put more emphasis on the diagnosed person’s
life, with or living with challenges of cancer, the long-term or late cancer effects including its
treatment (Schnipper, 2017). Palliative care has been identified as an approach that highly
consists of interdisciplinary care with the chief goal revolving around giving quality as well as
comfort, instead of cure continuation to the suffering people and the loved ones.
In order to see the best as far as a cancer treatment is concerned, there are elements of
practice that ought to be changed based on the research findings. First, it is worth noting that
there is a challenge due to lack of a solid foundation in the evidence-based clinical practice
which makes patients’ care having untreatable cancer at all times to be based or revolve around
provider experience as well as anecdotal evidence. This emerges as one of the major areas that
ought to be worked on. The health sector as a whole should consider the opportunities for
treatment that for a long time have been ignored or even delayed. It is proper to remember that
despite the existing bias on an optimal cure, overtreatment, or under-treatment of individuals
faced with advanced illness, it is necessary to commit base approaches of treatment and this is in
accordance to scientific facts rather than anecdotal knowledge. It is also important to note that
cancer treatment will call for full ethical as well as methodological barriers descriptions in the
palliative realms and care during end-of-life and approaches with a professional agreement in
instituting research strategies and design (Noriko, 2017). Recognizing that there exists an
opportunity in advancing the science and making better the excellence of care for individuals
affected with cancer is an excellent idea as putting in place such a change is the means through
PUTTING RESEARCH FINDINGS INTO PRACTICE
4
which necessary steps are made in the proper direction. In addition to this, it is recognized that
incorporating research advancements in procedures, policies, as well as methods in the palliative
care field is a great strategy to reducing the risk of future clinical practices that happen not to be
well informed and this will see that patients suffer less when compared to optimal care.
Putting into action evidence in practice is a process highly required in the health sector as
it where professionals are in the position to utilize research findings more routinely in practice. It
is so unfortunate that there are a lot of important researches that are often published but never
applied routinely for different reasons. It is worth noting that implementation is a complex as
well as active process which highly demand the involvement of individuals and teams, systems
and organizations in general. It is a system that to a great extent requires what is recognized as a
systematic planned approach. Some steps can be followed when it comes to implementing
research findings into practice. The first step is to demonstrate an evidence-practice gap, and this
involves acknowledging the fact that there is a gap between what is known and what is done in
practice (MacGuire, 1990). It is possible to find a new testing procedure being more accurate or
even sensitive than the ones that are currently being utilized. In the health sector, for example, it
will be proper to identify what evidence-based assessment or intervention is being overused or
underused. In most of these organizations, demonstrating a gap between what is known and what
is actually being locally done requires utilization of techniques such as interviews with clients or
staff, survey, medical record audit or a focus group with clients or staff.
The second step revolves around planning for change which is essential when it comes to
identifying possible barriers, resources or stakeholders to involve for maximum success. It is in
this step where one has to consider whether to liaise with patients, those responsible for
implementation and the roles of each individual in the whole process. The next step is identifying
PUTTING RESEARCH FINDINGS INTO PRACTICE
5
barriers as well as enablers to change as this helps in contributing to the evidence-practice gap.
This is done mainly because a series of barriers to change as well as their corresponding enablers
may to a big degree play a big role as far as the evidence-practice gap is concerned. The other
step is preparing for and commencing implementation because what follows after baseline data
has been collected is beginning the implementation process. However, it is worth remembering
that at all times, each aspect of the process ought to be carefully prepared as this makes it
possible for the implementation to take place smoothly. The last thing to focus on is evaluation
and planning, and this is the point at which we think of the whole process as a continuous quality
improvement.
It is worth remembering that there are potential barriers to the implementation of research
findings. Some of these potential barriers include lack of skills and knowledge by the concerned
professions, attitudes as well as beliefs of professionals and clients, organizational factors, for
instance, lack of transport or even equipment and role expectations (Funk, 1991). It is the sole
reason why it becomes of very important for all professionals to do more than just reading about
research. Doing so helps a lot in making these professionals ‘evidence-based practitioners.’ The
existing barriers to implementation of research findings make things challenging throughout the
process. However, it is also of great significance to understand that there are possible strategies
to overcome these barriers. For example, taking time to investigate the potential barriers will
never be a waste of time because doing so helps in eradicating the lack of awareness. It is also
essential for professionals to view treatment or testing procedure to be part of the work role they
have. This aids a lot fighting the possibility of an attitudinal barrier. Therefore, becoming aware
of these potential barriers to as well as identifying the strategies that can be utilized in making
PUTTING RESEARCH FINDINGS INTO PRACTICE
the whole process a success is an amazing undertaking that helps to see research being
implemented in the proper manner.
Conclusion
It is evident that the process of putting research into practice is not an issue to be taken
lightly. It highly involves identifying areas that are not doing quite well and working on putting
in place the necessary changes. Part of the process is being aware of the possible barriers to the
implementation and the possible strategies that can be utilized to avoid these barriers.
6
PUTTING RESEARCH FINDINGS INTO PRACTICE
7
References
Funk, S. G., Champagne, M. T., Wiese, R. A., & Tornquist, E. M. (1991). Barriers to using
research findings in practice: The clinician's perspective. Applied nursing research, 4(2),
90-95.
MacGuire, J. M. (1990). Putting nursing research findings into practice: research utilization as an
aspect of the management of change. Journal of Advanced Nursing, 15(5), 614-620.
Noriko, F., Ryota, O., Yuki, S., Fumitaka, N., Satoru, I., & Keiko, K. (2017). Qualitative
analysis of clinical research coordinators’ role in phase I cancer clinical trials.
Contemporary Clinical Trials Communications, vol 8, Iss C, pp 156-161 (2017), (C),
156.doi:10.1016/j.conctc.2017.09.009.
Schnipper, L.E. (2017). Central IRB review is an essential requirement for cancer clinical trials.
Journal of Law, Medicine & Ethics, 45(3), 341-347.
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