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Learning Theories & Principles and Quality Health Care

Choose one learning theory and/or principle you think is most useful to the advanced practice nurse (APN) in providing high-quality health care to clients. Explain your rationale for choosing this theory and principle. 

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources published within the last 5 years.

    Ethical Issues Related to Social Media 422

     

    After studying Module 3: Lecture Materials & Resources, discuss at least two potential ethical issues that could be of concern with nursing use of social media.

     

    Submission Instructions:

    • Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 3 academic sources. Your initial post is worth 8 points.
    • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.

    Chapter 14

    Personal Health Records (PHRs)

    Copyright © 2018, Elsevier Inc. All rights reserved.

    What Is a Personal Health Record?

    Paper

    Persistent data storage that is portable and shareable

    Electronic

    Persistent data storage that is portable and shareable plus additional functions that include access to electronic health records (EHRs), secure messaging, and scheduling

    Copyright © 2018, Elsevier Inc. All rights reserved.

    2

    Paper still most common form of record.

    2

    Trends Related to Personal Health Records

    Rise of personal computing devices and the internet

    Development of EHRs

    Governmental policies (Health Insurance Portability and Accountability Act [HIPAA], Health Information Technology for Economic and Clinical Health [HITECH])

    Person’s desire for functions

    Copyright © 2018, Elsevier Inc. All rights reserved.

    3

    Mobile devices changing how PHRs will be delivered and what they can offer.

    3

    Blue ButtonSM for Patient Access to Electronic Health Records

    Developed in 2010 to allow patients to access their records with the click of a button

    Records available in either human-readable or machine-readable format

    Features clinical, demographic, financial/health benefits and invoices, and other information related to the health and medical care of patients

    Copyright © 2018, Elsevier Inc. All rights reserved.

    4

    Mobile devices changing how PHRs will be delivered and what they can offer.

    4

    Attributes of an Ideal Personal Health Record

    Comprehensive, longitudinal data

    Data ownership, control, and privacy

    Portability

    Data sharing

    Access

    Unique and desired services

    Customization

    Copyright © 2018, Elsevier Inc. All rights reserved.

    5

    5

    Benefits of an Ideal Personal Health Record

    Improved care coordination and patient safety

    Improved care by informal caregivers and self-management

    Improved self-care

    Copyright © 2018, Elsevier Inc. All rights reserved.

    6

    Provide examples of reduced duplication between providers, improved adherence and satisfaction when informal caregiver is able to follow up electronically, and improved self-care through goal setting, planning, and reminders.

    6

    Types of Personal Health Records

    Stand-alone

    Untethered

    Tethered

    Networked

    Copyright © 2018, Elsevier Inc. All rights reserved.

    7

    Systems are determined by what they are linked to; a stand-alone system is linked to nothing else,

    a networked system is a linked to all sources of data for the given patient.

    7

    Benefits of Current Personal Health Records

    Experience of care

    Quality of care

    Utilization and costs

    Copyright © 2018, Elsevier Inc. All rights reserved.

    8

    Limitations of data are that experience is measured as satisfaction with care, quality is based on short-term outcomes, and cost is based on utilization.

    8

    Barriers to Adoption

    Awareness

    Usability

    Privacy concerns

    The digital divide

    Provider engagement

    Interoperability

    Law and policy

    Copyright © 2018, Elsevier Inc. All rights reserved.

    9

    Most people are not aware of PHRs; poor people and minorities less likely to adopt PHRs; about 2/3 of people say they are concerned about privacy of PHRs; both PHRs and EHRs suffer from usability problems.

    9

    Awareness

    2010 survey:

    More than 50% of people are unaware of PHRs.

    Up to 76% of people are unaware of telephone applications for tracking health information.

    2008 survey of rural physicians:

    More than 25% are unaware of PHRs.

    Up to 59% are unaware whether patients had or used PHRs.

    Copyright © 2018, Elsevier Inc. All rights reserved.

    10

    Usability

    Users are disappointed in the:

    Amount of data available

    Type of data available

    Need to enter all the data themselves

    Limited options for sharing data with clinicians

    Copyright © 2018, Elsevier Inc. All rights reserved.

    11

    Privacy Concerns

    Although studies show that PHRs can securely exchange health information, users are still concerned with security.

    Copyright © 2018, Elsevier Inc. All rights reserved.

    12

    The Digital Divide

    Individuals of lower socioeconomic status, ethnic minorities, and older individuals are less likely to adopt a PHR.

    Copyright © 2018, Elsevier Inc. All rights reserved.

    13

    Interoperability

    PHR data and functions are constrained by the systems to which the PHR is linked.

    Several data representation exchange standards have been developed and proposed to mitigate this concern.

    Continuity of care record (CCR)

    Clinical document architecture (CDA)

    Continuity of care document (CCD)

    Copyright © 2018, Elsevier Inc. All rights reserved.

    14

    Law and Policy

    State laws sometimes interfere with PHRs:

    In California, certain results may not be electronically released for any reason.

    Current laws prohibit healthcare providers from delivering care across state lines.

    Copyright © 2018, Elsevier Inc. All rights reserved.

    15

    Barriers to Ideal Personal Health Records

    Technical

    Policy

    Copyright © 2018, Elsevier Inc. All rights reserved.

    16

    Current records are not interoperable.

    In some states current laws prevent full sharing of EHR data and prevent practice of medicine across state lines, limiting the use of PHRs for e-Visits.

    16

    Future of Personal Health Records

    Generalizability of current evidence

    Improvements:

    Expand the scope of data in the PHR.

    Expand the functionality of the PHR.

    Copyright © 2018, Elsevier Inc. All rights reserved.

    17

    Current evidence limited to early adopters and integrated healthcare systems.

    Data could be comprehensive and integrated with national health information exchange.

    PHR functions could be personalized and motivational to facilitate health behaviors.

    17

    Choose a legislator on the state or federal level

    Choose a legislator on the state or federal level who is also a nurse and discuss the importance of the legislator/nurse's role as advocate for improving health care delivery. What specific bills has the legislator/nurse sponsored or supported that have influenced health care?

      Leadership Discussion 2 Response 2

      PLEASE RESPOND TO THE FOLLOWING POST OF A CLASSMATE IN 100 WORDS, Remember that your posts must be substantive and contribute to the dialogue that is taking place and Response posts must offer at least one new piece of information or insight.

      CLASSMATE'S POST:

      Time Management in Nursing 

      Your time management skills and techniques helps eliminate pressure from the to-do clutter. That, in turn, allows you to focus on more critical tasks and what matters most our patients (ANA, 2024). My strengths in time management are having open communication with my co workers; open communications helps me express concerns and seek help when I am feeling overwhelmed, coping strategies such as breathing exercises, and resilience allowing me to persevere through stressful situations. 

      Weaknesses I experience in time management are with boundary setting: as nurse regardless of my experience with some co workers I try to focus on the patient which sometimes lead me to take on more tasks, the emotional impact of taking care of patients for a long period of time and then becoming more ill regardless of the care they have received, and being a able to maintain an adequate work life balance. 

      Stress in The Work Place

      Job stress can be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker. Job stress can lead to poor health and even injury (CDC, 2024). In the workplace some of the ways I try to manage stress are by being organized by making list of the things I need to get done, taking breaks when I need to, and by managing my time. Some of my weaknesses in the a stressful workplace is that I don't leave work at work I get anxiety when I am home from work, becoming less productive at home, and feeling burnout. 

      Reference

      Centers for Disease Control and Prevention. (2014, June 6). Stress…at work (99-101). Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/docs/99-101/default.html#:~:text=Job%20stress%20can%20be%20defined,poor%20health%20and%20even%20injuryLinks to an external site..

      Time management tips for Nurses. ANA. (2024, February 8). https://www.nursingworld.org/content-hub/resources/workplace/time-management-tips-for-nurses/#:~:text=Honing%20your%20time%20management%20skills,what%20matters%20most%20%E2%80%94%20your%20patients.

        psychpath3

         Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research. 

         

        Kel is a 42-year-old certified public accountant (CPA) who dreams each year that she will board a cruise ship the day after Tax Day and go somewhere, anywhere, except Portsmouth, Virginia. Each year the dream, like the ocean, ebbs and flows, but this year she is not even going to think about such a “ridiculous idea.” In fact, she does not even have the energy to dream; getting out of bed and preparing to go to work is simply too labor intensive. 

        Each evening Kel retires to bed with a lack of energy to complete her normal tasks such as readying her clothes for work and making a lunch. She lacks the energy to shop in the evening; consequently, she eats mostly crackers and canned soup. She is not hungry, and her scale reflects this. She has lost 15 pounds over the last 2 months. She does not attend to her makeup or clothes; she finds both too taxing. The clothes she selects are drab and not ironed. At work she makes no effort to talk with her co-workers and does not initiate new contacts with clients. The normal work of filing taxes and writing reports, which she used to enjoy, are overwhelming, and she feels too disorganized to complete them. Telephone calls and e-mail messages from friends are ignored. Attendance at work is spotty.

        Sue, her sister, becomes alarmed with Kel’s unanswered telephone calls and e-mails. Worried, she decides to visit her sister at home. She finds the apartment unclean and in disarray. Kel is unkempt, disheveled, and looks sad. Her voice is monotone and flat. Kel tells Sue that she feels “sad and hopeless. Nothing is ever going to change. I am a bad person and I can’t even do my work right. Although I sleep for many hours, I am still tired all the time.” Sue is alarmed at the changes in her sister and arranges for Kel to visit a health care worker at the medical clinic.

        Questions:

         

        1. Describe the presenting problems.
        2. Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes.
        3. Formulate and prioritize a treatment plan. 
        4. Identify and discuss appropriate screening instruments for a patient who has suicidal ideation.

          Nutrition Log Reflection 2

           

          “You are what you eat.” Have you ever heard that? Although that saying is not exactly true, what we do eat does impact how we concentrate in class, work, perform in sports, and even affects our moods. The purpose of this activity is to deepen learning through reflective thinking. Follow these guidelines when completing this assignment: 

          • Keep a log of the foods and drinks you consumed (breakfast, lunch, dinner, snacks) from Monday through Friday (no weekends).
          • After reviewing your food log at the end of week 1, please answer the questions below:
          • How many days did you eat breakfast? __________
          • How many days did you eat at least 1 fruit? __________
          • How many days did you eat at least 1 vegetable? _________
          • How many days did you eat “junk food” (chips, candy, etc.)? ________
          • How many days did you drink soda? ______
          • How many total ounces of water did you drink per day? ______

          At the end of the week, reflect on what you ate for the week. Rate your nutrition for that week on a scale from 1 – 10 (with 10 being the best). Support your answer with examples of why you gave yourself that rating. Describe ONE change you would like to make to your diet. Reflect on what went well and what could be improved. Be sure to write in complete sentences. A strong paragraph is at least 5 sentences.

           

          • The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
          • The paper should be at least 5 sentences (approximately 100 words) in length.
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