MODULE 5 - THE END

Okay, I saved this module for the last, but I enjoyed the readings - I think we all have biases and the more we practice, the more biases' we have, but not only the amount of time in practice, but also the settings that we practice in. The articles highlighted this fact for me, I do tend to have biases' but I also believe that they are of value as long as the patient is being treated with quality clinical care. Nursing quality data needs to support decisions made in the clinical setting. Decision support systems is the ability to support these good quality decisions and the input of quality nursing data is essential. We must as nurse practitioners continue to ensure this. Sorry, this is weak but...it's done.

MODULE 7 - Question 4

The content of infomatics has been interesting to me, I was very excited at the beginning of the course, but then again, it seemed that it was difficult to remain intent on learning as time went on with the big lag in time of the modules. I do think that at some time I would like to do more with infomatics. I have learned more about EMS and EHR and how the systems work and what works with ours and what does not. Overall, it has been a good course and will influence my professional life. Thanks.

MODULE 7 - Question 3

So this question just got deleted, but the short answer is learning theories, I will not use them daily in practice and hope someday I will be able to review their value.

MODULE 7 - Question 2

On question one, I also wanted to say that I found infomatics in general a very interesting topic, though it seems that the modules would have been better if they would have been evenly spaced and now it's just a matter of trying to finish them up.
Again, I plan on looking more closely on what areas I can use in clinical support systems to enhance what I do in the clinical setting. I was looking forward to have more information on the use of PDA's but will have to research this for myself. The ethical issues that I might be confronted with are how updated the information is and not relying on this information solely for my clinical practice. Updating the information regularly will help with this as well as searching other sites for the information.

MODULE 7

The content/area that I found most interesting was the clinical support decision systems, though I have a new Vista computer and they were not compatible with my PDA. And I did not learn this until I went through the entire process of downloading the PDA installation. Nevertheless, I found the many different uses of these clinical support systems to be valuable, thank goodness my old laptop is still up and running. I have a few systems on my PDA such Epocrates, ABX Guide and Peds Omni, but look forward to using the other systems as wel.

Module 4 - Technologies

The three technologies I chose to analyze were PDA's because I have been using one for approximately one year and I need to know how to use it more effectively. Online learning because this is the way I enjoy learning and I have learned how to enjoy teaching. And blogging, my children use this method of communication to their friends spread far and abroad and I did not know how to make comments and sometimes could not find their blog, but I know how to now. I think right now I would personally learn best from online learning, BUT I want to learn best from PDA's since I have that technology in the clinical setting and am using it more. For adult learners, online learning would be the most applicable for learning in a short amount of time. Their is easier access to computers and PDA's cost money, but again I may change my mind as I learn more about the other two.

MODULE 4 - Value of learning theories

I am not convinced that learning theories are valuable, I would have to say that this module has been the most difficult for me. Though I understand that all theories are written for a purpose, I believe that we teach intuitively for the most part. Having said that, I also know that the theories must be presented and this would be used in powerpoints or online learning such as we have done in this module. It would be beneficial to apply the theories in a manner that directly applies to what the student is trying to learn. Specifically when doing online learning, Knowles states that "people learn best when treated as adults", so making students responsible for their learning is one way to apply a theory.

MODULE 4 - Strengths

My strengths were interpersonal, being able to relate to others and also spatial, the creation of visual images. Online learning would be a useful technology with these strengths. Online learning takes the ability to be creative in presenting material that will keep the student interested in the class. Though face to face interactions are a benefit of being interpersonal, I believe, this must also be a useful tool with online learning. Perhaps even more so because messages are sent back and forth and a tactful approach must be incorporated. I have enjoyed teaching online learning and being an online learner.

MODULE 6

I would like to be part of the planning stage of the lifecycle of a new system. As the provider in the office, it would important to have the correct programs to support the EHR, but also what other programs would be easily accessible to help with the visit. The planning of the system would help to ensure the proper amount of systems, the interaction between the different parts of the client visit, the ability to use other programs to help in the visit, the follow-up, the ability to write electronic prescriptions. Often these things are not thought of when non-medical personnel do not understand. Proper and early planning will make all happy and the system work well.

Module 3 - Post 3

The search in google was by far the easiest when searching for obesity and infants and breastfeeding, the results were clear and factual, I was excited to see so many that were relevant to what I wanted to know. The same information is probably also found in PubMed but I would have to search longer for the quick information I would need. The guideline index was the least helpful, it was harder to decipher. Again I use bookmarked journals such as the American Academy of Family Physicians and the University of Michigan Health Website. Context relevant information might be helpful, but it would take time to learn and right now I need to use the searches that are the quickest.

Module 3 - Post 2

I used EndNote and would say that I understand the benefits of using this reference manager but it will take a lot more practice to figure the ins and outs. I can actually use EndNote and search PubMed and then save the search in a new library. I had a harder time trying to import any references that I first looked at in the PubMed website. In the future I hope to explore all of the parts of this system because it can be used as a reference tool in the clinical setting but will take more time than I have right now! I am glad I learned the basics of using it.

Module 3 - Post 1

My clinical problem was obesity AND infants AND breastfeeding. The index did help me to search for these results. The readings helped in learning how to narrow the search. The search it
self was not too hard, but I would not use this in a clinical setting. I use "google" mostly along with different electronic journals that I have bookmarked. To use this in clinical practice would be too time consuming, often while I am in the room I will google and then print results for the patient or allow them to read the information with me in the room. An index search would not work in the amount of time I have for teaching. The tool is good for doing general research.

MODULE 2 - STRUCTURED TERMINOLOGIES

Our clinic uses CPT and ICD-9 codes for coding, we have the ICD codes on the computer and then also have a billing sheet where the level and ICD codes are documented. Many are not in the computer or on the sheet so we have a great billing person who will document for us when using correct medical terminology. We use structured medical and nuring terminologies for the most part, though we also use a lot of shorthand and abbreviations. The physicians actually use the most shorthand and abbreviations and the rest of the clinic adjusts and understands what is being said. Many of the codes and terminology are unknown to our lay front end and medical help. This sometimes will create a problem in the flow of the clinic.

The clinical data base is useful in promoting quality patient care by establishing benchmarks for immunizations and monitoring if are patients up-to-date. Monitoring if diabetics are getting their hemaglobin A1C done, along with eye checks, foot checks, etc. Since multiple providers see the same patient at different times, the codes provide evidence of promoting quality patient care and if not done, then using the information to establish this type of care.

N6004 Module One

1. Presently at my office in West Valley we use Spring Charts as our electronic record. It is very verstatile, we are able to track the client from appointment time, check-in with front desk, check-in with MA and then when the client is ready for the provider. We are also able to access drugs, order lab tests and do the full client record. On the family practice side all three providers use the system exclusively and have computers in all rooms to chart as we go. On the OB/GYN sides, one provider rarely uses the system and one will use for visits outside of OB visits. The biggest problem is that is will frequently shut down, and your note is lost, bummer!

2. I believe that knowing about information technology and management for the DNP graduate is essential in providing excellent service to all of our clients. In reading the book, I have been intrigued at all of the information that is available and what has been done to make IT easier for me, though I feel I know so little. The system and the knowledge of the system will definately increase good client outcome and the ability to use evidence-based practice, which is so important in the changing climate of my diverse population. Also, others are using IT and many are very advanced such as the VA, and we as DNP graduates must keep up this technology in order to communicate with one another for again the best outcomes for our clients.

3. I network with many different advance practice nurses, however, none are in the same system that I am in, (except when I am in the Intermountain Healthcare System) I am very anxious to learn how to do this networking using IT. It will make my job more efficient and give the client the best possible care. Right now, this networking, at times, can be very time consuming. Using this blog for sharing of ideas, some of which we talked about during the chat, will be great. I am looking forward to the process. Thanks.

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