TECH – MOD 4 – Assignment

NURS 6051: Transforming Nursing and Healthcare through TechnologyFrank BashumikaWalden UniversityApril 20, 2019 Literature Review: The Use of Clinical Systems to Improve Outcomes and EfficienciesThe development of clinical systems strategies is informed by research (Walden University, n.d.). This paper will examine some recent studies and how they have impacted the development and application of clinical systems within the context of nursing practice and healthcare delivery. A comprehensive search of four databases (CINAHL, Medline, Ovid, and PsycINFO) yielded more than 50 articles for analysis. The search terms were: clinical, systems, outcomes, efficiencies, and impact. Some of the articles, however, had little relevance to the nursing practice. Others either lacked full-text availability or they were older than five years. In the end, five peer-reviewed articles were identified and analyzed as below:Article 1Alanazi, A. & Al-Anazi, Y. (2019). Challenges in personal health records adoption. Journal of Health Management, 64(2): 104 – 109. This study examined the challenges that prevented widespread adoption of patients’ Personal Health Records (PHR) despite the wide acknowledgment of its potential impact on patient outcomes. A corollary goal was to develop a method for its adoption. Study participants included healthcare executives (chief executive officers, chief information officers, and health information project managers) and executives and managers in the healthcare information technology. The qualitative study found that executives understood the impact of PHR in improving communication and patient care, and reducing cost. An example of areas where PHR can significantly make a difference is in the management of elderly patients and those with chronic conditions; PHR provides ready availability of the patient’s medical information, enabling physicians and other caregivers to manage the condition effectively and efficiently. According to the findings, however, executives were finding it difficult to prioritize the implementation of PHR due to the absence of healthcare electronic records (HER) systems, ineffectual integration of PHR with HER systems, and inadequate experience and computer literacy among staff. The study concluded with a recommendation for the prioritization of PHR adoption in every hospital and that the goal could be achieved through “effective staff training, better patient orientation, and dedicated health informaticians” (Alanazi, 2019). With their findings and recommendations, the researchers have made a significant contribution to the improvement of healthcare delivery. Article 2Hanna, Lauren, Huggins, Catherine, E., Furness, Kate, Silvers, Anne, M., Savva, June, Frawley, Helena, Croagh, Daniel, Cashin, Paul, Low, Liang, Bauer, Judith, Truby, Helen, Haines, and Terrence. (2018). Effect of early and intensive nutrition care, delivered via telephone or mobile application, on quality of life in people with upper gastrointestinal cancer: Study protocol of a randomized controlled trial. BMC Cancer, 18(1): 1-13. DOI: 10.3109/17483107.2015.1070439. This study, conducted in Australia and New Zealand for 18 weeks using a randomized controlled trial sought to establish the feasibility and effectiveness of the telephone and mHealth for managing nutritional challenges of patients living with cancers of the upper gastrointestinal tract. The study was necessitated by the fact that the disease adversely affects patients’ nutritional status and quality of life. Commencing early nutritional interventions for patients soon after diagnosis can result in adequate oral food intake and better patient outcomes. The study provided evidence of a strategy to improve the quality of life for patients in their homes. The results of the study have provided a patient-centered approach that caters to patients at home and has a positive impact for people newly diagnosed with the cancers of the upper gastrointestinal tract.Article 3Danial-Saad, A., Kuflik, T., Weiss, P. L.T., and Schreuer, N. (2016, April). Usability of clinical decision support system as a facilitator for learning the assistive technology adaptation process. Disability & Rehabilitation: Assistive Technology, 11(3): 188-194. The study examined the usability and impact of Ontology Supported Computerized Assistive Technology Recommender (OSCAR), a Clinical Decision Support System (CDSS), on learning the matching process. It also investigated the relationship between its usability and learnability. Participants were 26 expert and novice clinicians divided into two groups. In terms of OSCAR’s usability, the study found no significant difference between the expert and novice clinicians. A significant correlation was found to exist between the usability of OSCAR and the ability to learn the adaptation process. The researchers concluded that a CDSS cannot be successfully developed without paying careful attention to its usability. That means that user-centered design principles should be applied. In effect, therefore, the development of a CDSS requires close collaboration with the end users.Article 4Alexander, G.L., Steege, L.M., Pasupathy, K.S., & Wise, K. (2015). Case studies of IT sophistication in nursing homes: A mixed method approach to examine communication strategies about pressure ulcer prevention practices. HYPERLINK “javascript:__doLinkPostBack(”,’ss~~JN%20%22International%20Journal%20of%20Industrial%20Ergonomics%22%7C%7Csl~~rl’,”);” o “Search for International Journal of Industrial Ergonomics” International Journal of Industrial Ergonomics, (49): 156-166. The study investigated the effect of IT use in nursing homes on communication and the quality of care for patients with pressure ulcers and those needing skin care. The study was informed by the fact that although IT use had the potential to improve quality, safety, and efficiency in nursing homes in the US, many nursing homes did not have sophisticated IT infrastructure. Researchers observed that IT use could reduce or eliminate medical errors, promote patient safety, support decision making at point of care, enhance electronic data records, and develop systems that communicate with each other. The study found that certified nursing assistants (CNAs), registered nurses (RNs), and licensed practical nurses (LPNs) interacted in person more frequently in homes with low IT sophistication as compared to those in homes with high IT sophistication. There was less need for frequent operational face between caregivers in the homes with advanced IT as processes were IT supported. The researchers concluded that the advanced use of IT in homes had the potential of eliminating issues that affect nurses in nursing homes such as poor quality and difficulties in implementing proven care interventions. They recommended that (a) advanced IT be implemented in nursing homes to improve communication, clinical decision-making, and quality of care; and (b) EHRs be developed for effective data management but without disruption of communication between clinicians and patients.Article 5Khowaja, K. (2006). Utilization of King’s interacting systems framework and theory of goal attainment with new multidisciplinary model: Clinical pathway. Australian Journal of Advanced Nursing, 24(2): 44-50. This study used the King’s interacting systems framework and theory of goal attainment to understand determine whether implementing clinical pathways for patients undergoing transurethral resection of prostate (TURP) had any impact on quality, cost and patient and staff satisfaction. The study was carried out at the Aga Khan University Hospital (AKUH) in 2006 with participants comprising patients and healthcare professionals. The design was quasi-experimental, non-equivalent control group design using clinical pathway design.The study found that if successfully implemented, integrated clinical pathways resulted in the delivery of cost-effective, high quality and timely care. Its Impact was felt in all 12 variables related to nurses and physicians including documentation, consultation, and education, among others. The intervention further reduced non-clinical variables as well as post-operative complications. Overall, the study concluded that the implementation of clinical pathways significantly boosted patient and staff satisfaction even though it did not impact financial related variables in a significant way.ConclusionStudies have shown that the application of tech-supported clinical systems is essential for the improvement of healthcare both from the patients’ and the caregivers’ perspectives. Effective clinical systems improve efficiency, communication, reduce medical errors, support clinical decisions and overall produce better patient outcomes. This paper cannot over-emphasize the recommendations summarized from the reviewed literature in support of the utilization of research-based clinical systems in healthcare delivery.ReferencesAlanazi, A. & Al-Anazi, Y. (2019). Challenges in personal health records adoption. Journal of Health Management, 64(2): 104 – 109. Accessed on April 20, 2019, at https://ovidsp-tx-ovid-com.ezp.waldenulibrary.org/sp-3.33.0b/ovidweb.cgi.Alexander, G.L., Steege, L.M., Pasupathy, K.S., & Wise, K. (2015). Case studies of IT sophistication in nursing homes: A mixed method approach to examine communication strategies about pressure ulcer prevention practices. International Journal of Industrial Ergonomics, (49): 156-166. Accessed at https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/detail/detail?vid=3&sid=a5c9b76a-4eed-4c22-b66c-8dbadb38b718%40pdc-v-sessmgr01&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=2015-37146-018&db=psyhDanial-Saad, A., Kuflik, T., Weiss, P. L.T., and Schreuer, N. (2016, April). Usability of clinical decision support system as a facilitator for learning the assistive technology adaptation process. Disability & Rehabilitation: Assistive Technology, 11(3): 188-194. Accessed on April 16, 2019, at https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/command/detail?vid=13&sid=ca2cd7d7-00dd-4e7f-b007-ec84eff0e2de%40pdc-v-sessmgr06&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#jid=0NV&db=rzhHanna, Lauren, Huggins, Catherine, E., Furness, Kate, Silvers, Anne, M., Savva, June, Frawley, Helena, Croagh, Daniel, Cashin, Paul, Low, Liang, Bauer, Judith, Truby, Helen, Haines, and Terrence. (2018). Effect of early and intensive nutrition care, delivered via telephone or mobile application, on quality of life in people with upper gastrointestinal cancer: study protocol of a randomized controlled trial. BMC Cancer, 18(1): 1-13. DOI: 10.3109/17483107.2015.1070439. Accessed on April 16, 2019, at https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/command/detail?vid=13&sid=ca2cd7d7-00dd-4e7f-b007-ec84eff0e2de%40pdc-v-sessmgr06&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#jid=0NV&db=rzhKhowaja, K. (2006). Utilization of King’s interacting systems framework and theory of goal attainment with new multidisciplinary model: Clinical pathway. Australian Journal of Advanced Nursing, 24(2): 44-50. Accessed on April 16, 2019, at https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/command/detail?vid=13&sid=ca2cd7d7-00dd-4e7f-b007-ec84eff0e2de%40pdc-v-sessmgr06&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#jid=0NV&db=rzhWalden University. (n.d.). https://class.waldenu.edu/bbcswebdav/institution/USW1/201950_27/MS_NURS/NURS_5051_WC/USW1_NURS_5051_module04.html?course_uid=USW1.47020.201950&service_url=https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/wslinks&b2Uri=https%3A%2F%2Fclass.waldenu.edu%2Fwebapps%2Fbbgs-deep-links-BBLEARN

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