[Solved] Situational Approach
Sara deals with two very different situations in this episode, one with Dr. Acharya, and one with Paula. Based on your readings about the situational approach and path-goal theory, how do Sara’s leadership style and behaviors differ with each interaction? Specifically, describe why it is important that Sara approaches her interaction with Paula differently than she does with Dr. Acharya.
[Solved] Possible Endings Provided
scenario
1. A HIPAA violation occurs, and client data is exposed to the media.
· In the body of the pper, discuss the scenario in relation to HIPAA, legal, and other regulatory requirements that apply to the scenario and the ending you chose.
Choose and identify one of the possible endings provided for the scenario, and implications to the scenario.
Make recommendations about what should have been done and what could be done to correct or mitigate the problems caused by the scenario and the ending you chose.
· Present the advantages and disadvantages of informatics relating to your scenario and describe professional and ethical principles appropriate to your chosen ending.
· The conclusion should summarize what you learned and make reflections about them to your practice.
[Solved] Project Team Spent Months
McGonigle and Mastrian, (2022) discuss the Systems Development life cycle or SDLC. They cite various approaches to the SDLC, including The waterfall model, where the output from one stage flows into the next, RAD or rapid application development that uses a quickly developed prototype that can be tested by users, Object Oriented Systems Development or OOSD, which assigns commodities that exist in reality to objects within computer software. Per Gogou et al, (2002), the benefit of this is that the system can focus on the relationship of these objects to each other rather than be designed from a procedural standpoint. There is also DSDM or the Dynamic System Development Model, which per McGonigle and Mastrian, (2022) is useful when a new system must be developed quickly and may have to be adjusted to meet unforeseen needs as it is developed. There is also a method discussed called Agile, which emphasizes the way the work (that the system will be supporting) is done and the way the people doing the work perform together.
These different approaches have different names for their phases. However, per Dr. Kevin Johnson in Walden (2018) the four general phases of SDLC are Planning, Design, Implementation, and Evaluation/ Maintenance. This video also stresses the importance of nurse involvement in each phase for the success of the new system.
Planning
In the planning stage, Dr. Johnson (Walden, 2018) describes two critical steps. First, he states that the individuals involved in systems development must remember that the whole thing is a cycle, and steps may need to be revisited. Second, he states that we must define what we need the system to do. It is essential that there is nurse representation, especially in this stage, because nurses will be the ones using the system, and they need to have input on how the system should operate. McGonigle and Mastrian, (2022) discuss for example, working with stakeholders (in this case, the nurses) to ask what a system “should have, must have, could have and would have,” identifying the “must have” facets of a system as the ones necessary for its success.
Design
Per McGonigle and Mastrian, (2022) use of healthcare technology can save lives, but when it is implemented without regard to actual workflow, it can create more danger than safety. This is why a nurse needs to be involved in the design stage of the systems development life cycle. These writers state that workflow analysis is a key part of the design (or re-design) process and that workflow analysis is a key skill that a nurse informaticist should possess to be part of the team that looks at workflow during the design stage of the SDLC. . I can think of a time in my last agency when the project team spent months “redesigning” the system with little or no influence from the direct care staff, and the result was basically to move all our widgets around and give the calendar a new look. There were no processes added that could have enhanced our workflow, such as the ability to create a working client list for each nurse or to do batch processes like adding vitals for all clients on a list. If the nurse staff had any input into this planning stage, it could have given the project management team better direction and resulted in changes that were more meaningful to patient care. The new design, without input from staff, actually got in the way of care by offering no meaningful changes to actually help the workflow. It also required a few days of learning where the design team relocated the same old tools to just affect a different “look”.
Implementation
In Walden University (2018) Kevin Johnson speaks about the most significant challenge to implementation being acceptance of change among the end users of the system. To ensure buy-in, he speaks about the necessity of collecting input from staff, with the recognition that not all views on what is the best direction can be satisfied. So during implementation, there needs to be the recognition that not all system users will be happy with the new system (because even if they had input, their input might not have been utilized). Cho et al, (2021) discuss resistance to change during implementation and state that resistance may not be apparent because nurses may understand the implications to their career by overtly resisting the change. But there may be hidden resistance, which can be even more damaging to the process. These writers state that an important nurse role in the implementation change is to have nurses that are super users (that they refer to as “nurse champions”) who are well trained in the use of the EHR, and can demonstrate and also promote from within the benefit of the EHR to other staff. McGonigle and Mastrian, (2022) also discuss training as an important step of implementation. In this area, nurses need to participate to be trained. But another critical role for the nurse and nurse informaticist is to be able to train their cohorts. And in the case of a major change like the adoption of a new system, it is not just about educating people on use but leading them to embrace change. Tyler (2019) describes an important role of a nurse informaticist as being able to lead their cohorts through change. The nurse informaticist needs to be involved to get people to “unfreeze” and accept change, move through the process of change, and then embrace the new way of working. I was not here for the new implementation of EPIC at my present place of employment. However, the physician I work under told me of several Physicians, who were at the end of their careers, and quit due to the complexities of the new system. These were providers who may have delayed their retirement by a few years but got so frustrated learning to use EPIC that they left early. It is clearly important that there are cohorts who can help new users learn the system , not just for the success of the system, but also for employee engagement.
Maintenance/Evaluation
In the Maintenance and evaluation stage of the SDLC the new system needs to be evaluated to see if it is working and have the necessary changes applied (This goes back to Dr. Kevin Johnson’s statement in Walden (2018) that the process is cyclic and constantly needs to be revisited and evaluated to ensure it is meeting the needs of the healthcare facility and its patients. Untalan et al, (2022), besides recommending the use of super users for direct staff training as part of implementation also support the importance of evaluation and maintenance of the system through some sort of metric like lean sigma six to see if the system is meeting its goals. In their case, they created an audit tool. They combined it with nursing huddles to discuss barriers and pathways to meet specified nursing issues until their system had 100% resolution of identified issues. This demonstrates the importance of nursing involvement in this phase. If the nurses are not able to meet their care goals with the use of the system, and if the system cannot be modified to let nurses meet their patient care goals then it is not going to be much help to the facility’s nurses or patients. In my old agency, we were at least asked for feedback after the changes. I did not see any immediate changes to the system after feedback was collected. But there was at least an avenue for quality improvement that was staff experience related.
Along the SDLC the involvement of nurses (the people who will be mostly utilizing the system for patient care ) will always be of the strongest importance. Input into what a system will be used for, how it can be designed to do the job, whether it is accepted, embraced, and learnable, and how it works for its users revolves around the nursing staff. It is especially up to the nurse informaticist to bridge the gap between the nursing staff and the IT professionals who will be coding and building the system.
References
Cho, Y., Kim, M., & Choi, M. (2021). Factors associated with nurses’ user resistance to
change of electronic health record systems. BMC Medical Informatics & Decision
Making, 21(1), 1–12. https://doi.org/10.1186/s12911-021-01581-zLinks to an external site.
Gogou, G., Mavromatis, A., Maglaveras, N., Engelbrecht, R., & Pappas, C. (2002).
DIABCARD CCMIS—A Portable and Scalable CPR for Diabetes Care. IEEE
Transactions on Biomedical Engineering, 49(12), 1412.
https://doi.org/10.1109/TBME.2002.805460Links to an external site.
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of
knowledge (5th ed.). Jones & Bartlett Learning.
Tyler, D. D. (2019). A Day in the Life of a Nurse Informaticist: Super Users. Journal of
Informatics Nursing, 4(1), 18–20.
Untalan, E., Cardenas, P., & Jenkins, Z. (2022). From Old to New: Process of
Integrating PACU Phase 1 Documentation and Workflow from Old Electronic Health
Record (EHR) System to New Electronic Health Record (EHR) System. Journal of
PeriAnesthesia Nursing, 37(4), e9. https://doi.org/10.1016/j.jopan.2022.05.024Links to an external site.
Walden University, LLC. (Producer). (2018). Managing Health Information
Technology [Video file]. Baltimore, MD: Author.
Walden University, LLC. (Producer). (2018). Systems Implementation [Video file
Baltimore, MD: Author.
[Solved] Identify One Government Contract
Although fundraising and philanthropy are great ways to fund a nonprofit, sometimes there is a greater need than these efforts provide. Nonprofits also rely on grants and contracts, so it is important that you look at all possible funding opportunities to develop, manage, and grow nonprofits. For this discussion forum, you will identify funding opportunities for the nonprofit you created for your Week 3 assignment.
Prior to beginning work on this discussion,
In your initial discussion forum post, using the hypothetical nonprofit you created for your Week 3 assignment
Reminder:
Support your argument with at least two credible sources.
[Solved] Article Used Psychological Concepts
Briefly describe the issue you selected, and explain why you selected it. Next, explain which psychological concepts are most useful in understanding that issue. Using your selected scholarly article, explain how the psychological concepts were discussed in terms of your chosen issue. Also, describe how the author(s) of the article used psychological concepts to explain, or frame, your selected issue.
[Solved] External Site Smith
Many consider early and middle adulthood times of relatively little growth, but adults encounter a multitude of tasks and changes during these phases. For instance, the quality of relationships change, vocational choice might be solidified, formal education might be completed, parenting responsibilities might be present, and changes in physical capacities might set limits on behavior. An adult’s perceived success or failure can influence his/her sense of self and ability to accomplish tasks and navigate changes in early and middle adulthood.
In the United States, individuation is an important aspect of adulthood. Individuation refers to processes by which you become a unique individual with a distinct sense of identity. The process is sometimes identified as separation-individuation (Berger, 2016). Adulthood is the period in which roles change from that of a dependent child to a more autonomous individual with different responsibilities and commitments.
Boucher and Maslach (2009) discuss how the type of culture—individualistic or collectivistic—can influence the degree of individuation. Think about how cultural differences can influence the changes that adults face during early and middle adulthood. The influence of culture on these changes impacts individuation. Consider collectivist societies that value conformity over individuality. How does that impact an individual’s sense of uniqueness?
For this Discussion, you will examine individuation and cultural differences in individuation.
To prepare for this Discussion:
Post a description of the aspect of adulthood you selected. Then, explain individuation in terms of that aspect. Include an explanation of the challenges that might influence individuation. Be specific and provide examples from the Learning Resources. Use proper APA format and citations.
RESOURCES TO HELP WITH DQ
[Solved] Making Autonomy Impact Work
Employees are uniquely individual. This uniqueness makes them valuable because in that individual approach to work, each employee brings personality, history, culture, values, creativity, innovation, and other personal characteristics to the team. It also makes managing and leading employees challenging.
Also, employee morale and motivation are essential attributes of successful organizations. Employees who are not happy with the work environment become distracted, and, at worst, destructive to productivity and organizational efficiencies. Discuss the following:
[Solved] Avoid Unnecessary Exposure
Which approach would you recommend to Catarina during her pregnancy?
A. Catarina should maintain a healthy diet and appropriate exercise regimen, and she should avoid unnecessary exposure to environmental contaminants. She should also keep taking her current antidepressants.
Think about the factors that influenced your recommendation for Catarina. Why did you choose the option that you did? Include these issues in your response:
[Solved] Help Public Health Workers
Assume you have been asked by your nurse supervisor to review cancer statistics for your state and summarize for your department how they could be applied to your local community.
The CDC Wonder program can help public health workers manage trends by organizing data to make it consumable for program planning.
Explore the CDC Wonder program website to understand what data is available.
Select “Cancer Statistics” on the CDC Wonder page and then select “National Program of Cancer Registries 5-year Relative Survival.”
On the map, click on your state.
Review the “Top 10 Cancer Rates of New Cancer Cases” and “Top 10 Cancers by Rates of Cancer Deaths.”
Write a 500-word summary about how you might be able to use this data in your community. Include the following in your summary:
[Solved] Ensure Timely Completion
For this activity, you will select either an older adult or pregnant/post-partum mom and infant
individual/family to complete your 3 virtual or in-person home visits. To ensure timely completion of
conducting the home visits, it is important to identify an individual and schedule these visits early in the
semester. The three home visits are summarized below:
