NURS-6051C Module 1: Week 1: Discussion

The Application of Data to Problem-Solving

In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.

Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.

In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

Resources

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

WEEKLY RESOURCES

To Prepare:

  • Reflect on the concepts of informatics and knowledge work as presented in the Resources.
  • Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

By Day 3 of Week 1

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

By Day 6 of Week 1

Respond to at least two of your colleagues* on two different days, asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.

*Note: Throughout this program, your fellow students are referred to as colleagues.

Solution

As traveling nurse who works at different long-term care facilities, I’ve noticed that falls are becoming more of a concern. There was recently a week where there were 8 falls at a facility with one resulting in multiple fractures. A CNA was using a Hoyer lift without a second person. The wrong sling size was also used and not hooked up properly causing the resident to fall mid air. The resident was sent to the ER for immediate evaluation. Unfortunately, due to the resident’s condition (MS), recovery was difficult and she died three days later.

There is obviously so much wrong with the scenario above. An investigation was conducted and state was notified. Data was assessed to determine root cause analysis for falls.  It was noted that fall prevention measures were not properly implemented nor were post fall protocols being followed. Nurses were not notifying the appropriate parties, initiating/completing neuro checks, documenting falls properly, implementing new interventions and adding them to the care plan, and/or residents are not being transferred safely according the Kardex resulting in a fall. This facility received a tag from the state due to poor adherence to fall measures. There were cases where residents had delayed x-rays with noted injuries due to falls follow ups not being monitored accurately or even passed on to the next nurse at shift changed.

Common factors such as medication, incontinence, confusion, etc. could be derived from the data. The data is useful to help us determine an appropriate intervention. EMARS, progress notes, and incident reports were  the sources for review.

Implementing a standardized checklist for falls was the plan to help ensure nurses are following the policy and not missing critical steps. Having a checklist for those high fall risk residents that are identified on admission for nurses to complete on rounds during shift change could be a helpful too to ensure fall prevention measures are in place (nonskid footwear, bed in low position, call light within reach, etc.). A post fall checklist will ensure that protocols and documentation aren’t being missed. Residents would be impacted by the change positively. By having this checklist in place, this will ensure that proper interventions are implemented to prevent future falls and any future deterioration post fall. Adherence to this policy would be following state guidelines which would help keep the facility up and running.  “Although prevention of a fall is paramount, clear understanding of what to do following a fall is essential. This assessment provides an opportunity to rapidly assess a patient for injuries and intervene to reduce potential harm from these injuries, as well as re-assessing their risk and implementing strategies to reduce further falls” (Nelson and Reynolds, 2015).

Nurse leaders would be responsible for monitoring effectiveness of interventions, ensuring interventions remain in place, and completing frequent chart audits.

References:

Nelson, E., & Reynolds, P. (2015). Inpatient Falls: Improving assessment, documentation, andmanagement. BMJ quality improvement reports, 4(1), u208575.w3781.https://doi.org/10.1136/bmjquality.u208575.w3781

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