The Application of Data to Problem-Solving Discussion

Medicine, research, techniques, etc. are constantly changing and adapting to new ways of life. As mentioned in the video in this week’s resources, there are many things that can now happen in your own home that can also happen in a hospital or other healthcare facility. Technology is quickly changing, and data can be collected and accessed in many various ways. It is important for us as nurses to have complete access to all sorts of data in order to make decisions and increase our knowledge since everything around us is constantly changing. The Application of Data to Problem-Solving Discussion

It is no secret that nurses are key to quality and safety to ensuring the best patient outcomes, and in order to ensure those great outcomes, we must have access to data. Medical databases serve a critical function in healthcare, including the areas of patient care, administration, research and education (Martin, 2008). One important database to not only me but other employees in my facility is our own patient database. We see so many patients it truly is hard to keep up with all of their information. I will tell you about a situation that me and a few others were in regarding a patient’s blood type. Our records/database showed that a new patient had a different blood type than what she told us. We conducted ABO typing to mix her blood sample in with various antibodies only to realize the data was completely wrong. How this happened, I have no idea to this day! After reading this discussion board task, I knew immediately what I wanted to talk about, and not a day goes by that I do not think about it. I will tell you though that it was very concerning. Have any of you had this happen to you? Or maybe something similar?

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As a nurse I would use clinical reasoning to always double check, triple check, etc. if the records match what the patient says. Errors are all around us. Errors in the database happen, but if it was not for us asking her questions about all of her information, I do not know what would have happened. Asking questions is a strict policy at my facility, so I have no doubt that we would not have caught that error, but just the fact that there was an error has me constantly checking each patients record. The Application of Data to Problem-Solving Discussion

According to El Camino Health (2019), generally, knowing your blood type isn’t necessary unless there is a medical emergency involving blood loss. However, you could actually be missing out on important health clues by not knowing your blood type. Research has shown that blood type can influence your risk for a myriad of health conditions, from heart and vascular diseases to thinking and memory problems. Knowing your blood type can be an important piece of information, not only for emergencies, but also to help steer you in a direction to make certain lifestyle changes to avoid blood type-related health conditions.

References:

Knowing Your Blood Type is More Important Than You Think. (2019, April 01). Retrieved from

https://www.elcaminohealth.org/stay-healthy/blog/knowing-your-blood-type-more-

important-you-think

Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in

Population Health [Video file]. Baltimore, MD: Author.

Martin G. S. (2008). The essential nature of healthcare databases in critical care medicine.

Critical care (London, England), 12(5), 176. https://doi.org/10.1186/cc6993 The Application of Data to Problem-Solving Discussion

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.

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. The Application of Data to Problem-Solving Discussion

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.

A 2007 study in the Journal of Nursing Scholarship estimated 27,000 patients are restrained every day in United States hospitals (The Atlantic, 2014).  The use of physical restraints for any patient is considered a treatment failure.  Emergency psychiatric units in most hospitals sometimes put aggressive, agitated patients in 4-point locked restraints.  In 2018, Capital Health Regional Hospital in Trenton New Jersey where I am employed had 41 patients in restraints (Department of Psychiatry Screening Center Performance Improvement Report Card, 2018).  One patient in restraints is too many and poses many risks such as suffocation, broken limbs, or even death.  The use of restraints runs counter to a patient/family-centered approach to care and goals of care.  It damages therapeutic relationships, negatively affects a patient’s dignity, further stigmatizes the individual, and may result in physical, psychological, or emotional harm (Healthcare Management Forum, 2015). The Application of Data to Problem-Solving Discussion

Keeping a record of restraint cases is helpful; however, management needs to find ways to lower restraint rates.  The Joint Commission has mandated reducing the use of restraints as recommended in its newsletter, Quick Safety Issue 47:  De-escalation plan (The Joint Commission, 2019).  Avenues to explore could be direct involvement of nursing staff at the bedside which can safely reduce the use of restraints in critical care settings (Critical Care Nurse, 2013-2014).  Collecting data on patient to staff ratios may also be a factor due to hospitals being short-staffed and overworked (MedPage Today, 2016).  Management would also need to check chart reviews, rounding frequencies, staff education, and staff training in agitated and psychotic patient de-escalation techniques.  The implementation of a quantitative, quasi-experimental study would be an inexpensive way to determine a cause and effect relationship between multiple variables.  One may also consider the trial use of new, novel approaches to reducing aggression and agitation with the Loxapine (Adasuve) inhaler treatment which holds the promise of reducing the use of restraints (Open Access Springer Links, 2019).

The nurse leader analyzing the data would formulate possible causes leading up to why an agitated, aggressive patient was placed in restraints.  By finding the root cause, we could educate the staff to reduce triggers leading to placing a patient in 4-point locked restraints.  Analysis of the data and the use of new approaches in reducing restraint use can and should be investigated to lower the numbers of aggressive and agitated patients not only in Trenton but across the United States. The Application of Data to Problem-Solving Discussion

References

Lupkin, S. (2016, March 2). Patient Restraints: Bad Medicine? Retrieved from MedPageToday,https://www.medpagetoday.com/hospitalbasedmedicine/generalhospitalpractice/56501

Mah, Ph.D., T. M., Hirdes, Ph.D., FCAHS, J. P., Heckman, MD, MSc, FRCPC, G., & Stolee, Ph.D., P. (2015, May 26). Use of Control Interventions in Adult In-Patient Mental Health Services. Healthcare Management Forum. http://dx.doi.org/http://doi.org/10.1177/0840470415581230

Megan Anderson BS RN. Department of Psychiatry Screening Center Performance Improvement Report Card, personal communication, January 2018

Mitchell, MSN, APRN, ACNS-BC, CCRN, D. A., Panhsin, MSN, APRN, ACNS-BC, CCNS, CCRN, T., & Seckel, MSN, APRN, ACNS-BC, CCNS, CCRN, M. A. (2013-2014). Reducing Use of Restraints in Intensive Care Units: A Quality Improvement Project. Critical Care Nurse. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30068727

Pacciardi, B., Calcedo, A., & Messer, T. (2019, March 19). Inhaled Loxapine for the Management of Acute Agitation in Bipolar Disorder and Schizophrenia: Expert Review and Commentary in an Era of Change. Open Access Springer Links, 19(1), 15-25. http://dx.doi.org/10.1007/s40268-019-0262-3   The Application of Data to Problem-Solving Discussion

Parikh, R. (2014, August 18). Rethinking Hospital Restraints. The Atlantic. Retrieved from https://psnet.ahrq.gov/resources/resource/28275/rethinking-hospital-restraints

Quick Safety Issue 47: De-escalation in healthcare. (January 28, 2019). Retrieved from https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-47-deescalation-in-health-care/ The Application of Data to Problem-Solving Discussion