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MHI-815-INFORMATICS FOR ADVANCED PRACTICE

Module 7: Discussion

Assignment Description:

Health Information System

1. Provide a brief summary of your project and the integration of technology. Please include at least one in-text citation in your summary.

2. Share the vision of your project and the integration of your chosen technology.

3. Identify how you might minimize barriers and maximize the outcomes of your project

4. Include outside references (textbook or peer reviewed literature) in your response.

Guided meditation apps are a form of technology that can be used to support mindfulness-based stress reduction interventions. These apps typically provide users with audio recordings that guide them through a meditation practice, often with a focus on deep breathing, body awareness, and relaxation techniques.Research suggests that guided meditation can be an effective tool for reducing stress and promoting overall well-being. For example, a randomized controlled trial conducted by Jain and colleagues (2015) found that a guided meditation intervention led to significant reductions in perceived stress, anxiety, and depression among a sample of healthcare professionals. Similarly, a systematic review and meta-analysis by Khoury and colleagues (2015) found that mindfulness-based interventions, including guided meditation, were associated with reduced symptoms of anxiety and depression.In the context of certified nurse midwives, who are at high risk for burnout and stress-related health problems, my vision is that the use of a guided meditation app could be a valuable tool for promoting self-care and reducing stress. However, it is important to note that the effectiveness of any intervention will depend on a range of individual and contextual factors, and that further research is needed to assess the specific impact of guided meditation apps on this population.

To minimize barriers and maximize the outcomes of a project aimed at implementing a guided meditation practice to reduce stress among certified nurse midwives, the following strategies could be considered:1. Involve key stakeholders: Engage certified nurse midwives, clinical leaders, and other relevant stakeholders in the planning and implementation of the project. This will help to ensure that the project is tailored to the needs and preferences of the end users, and that it aligns with the broader goals and priorities of the organization.2. Provide training and support: Offer training and support to ensure that certified nurse midwives have the necessary skills and knowledge to use the guided meditation app effectively. This may include providing access to training materials, offering group or individual training sessions, and providing ongoing support and feedback.3. Address technical issues: Address any technical issues that may arise during the implementation of the project, such as connectivity or compatibility issues with the app. This may involve working with IT support staff or the app vendor to troubleshoot issues and ensure that the app is functioning properly.4. Monitor and evaluate outcomes: Regularly monitor and evaluate the outcomes of the project to assess its effectiveness and identify areas for improvement. This may involve collecting data on stress levels, burnout, and other relevant outcomes before and after the implementation of the project, and soliciting feedback from certified nurse midwives and other stakeholders.

References:Jain, F. A., Walsh, R. N., Eisendrath, S. J., Christensen, S., Cahn, B. R., & Wallace, B. A. (2015). Critical analysis of the efficacy of meditation therapies for acute and subacute phase treatment of depressive disorders: A systematic review. Psychosomatics, 56(2), 140-152.Khoury, B., Sharma, M., Rush, S. E., & Fournier, C. (2015). Mindfulness-based stress reduction for healthy individuals: A meta-analysis. Journal of psychosomatic research, 78(6), 519-528.

 

My project is directed towards helping children with anxiety and depression by using a cognitive behavioral therapy program called Creating Opportunities for Personal Empowerment (COPE). Anxiety and depression in children are an increasing problem and have become a public health concern due to issues following children into adulthood and increasing the risk of suicide Ghandour et al., 2019). Children that are identified with anxiety or depression may be referred but often the family has problems with obtaining the help needed. There are not enough therapists to meet the need and parents/caregivers will often encounter long waiting lists. The COPE program can be implemented in school and community settings. The COPE program gives children tools to empower them to handle stressors in life and build resilience. Children without symptoms of anxiety and depression or who are prodromal also benefit from the sessions Although this program has written materials it can be supported through the use of technology applications and programs. My desire is to use technology in a way that will help and enhance the program (Gashi Shatri, 2020; Militello, & Hutson, 2022)).

My vision for the program is that every child that completes the program will have developed the resilience needed to face the struggles that they will have in life. In the 7 weekly sessions with small groups of 3-4 children, I hope to provide a program that will keep them engaged in the material during the session and in the weeks between the sessions. Integrating Plickers which is a formative evaluation quiz application will be helpful to assure students are understanding the material and break up material with questions that prompt recall. Having important, encouraging videos on the Canvas program page can be used to help them build their knowledge and encourage them to use tools they have developed in their everyday life. Using PowerPoint slides will help to keep the big ideas in focus for the topics being learned. The PowerePoints can also be used for translations of difficult words and concepts into their own “heart” language. Also, it will help to pause to interpret what the word actually means for English speakers. 

To be a scholarly project, measurement of outcomes will be necessary. Therefore, the RCADS-25 will be used as a pre-and post-test. Qualtrics will enable me to conveniently use a QR code to give quick and easy access to parents to survey their children. (Due to reading/language issues of many children, the RCADS-25 will be on paper and completed together.) Qualtrics will help compile the data to be analyzed.

Minimizing barriers in the scholarly project will be important to its success. Using ESL teachers, when possible, who will assist with the sessions when there are non-English speaking children present and assist with the translation of words for the PowerPoints and digital flashcards will help with language barriers. All information given must be tailored to the students’ reading levels for reading barriers. Behaviors may increase with the use of iPads. Sessions are short so the time must be maximized. Boundaries should be set before the beginning of each session, so the students know and understand expectations (Lauricella &Jacobson, 2022). Other issues include access to student iPads. Permission will have to be obtained from the school district to gain access. The use of technology will be important to enhance the sessions, but it will not replace the teacher and the teacher's ability to draw out good discussion and connection with the material.

References

Gashi Shatri, Z. (2020). Advantages and disadvantages of using information technology in learning process of students. J ournal of Turkish Science Education, 17(3), 420–428. 

Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., & Blumberg, S. J. (2019). Prevalence and treatment of depression, anxiety, and conduct problems in US children.  The Journal of Pediatrics206, 256–267. 

Lauricella, A. R., & Jacobson, M. (2022). iPads in first grade classrooms: Teachers’ intentions and the realities of use.  Computers and Education Open, 3. 

Militello, L., & Hutson, E. (2022). The good, the bad, and the potential: Best practices for navigating technology use among pediatric populations.  Advances in Family Practice Nursing4(1), 173–185. 

This DNP scholarly project is a quality improvement (QI) project. The aim is to implement a transformation in clinical practice, focusing on delivering daily care appropriately to patients undergoing peritoneal dialysis (PD) therapy. The proposed change involves introducing initial and eventually annual competency training for nurses involved in peritoneal dialysis care through a PowerPoint presentation.  Although utilizing the interactive approach of PowerPoint technology is commonplace in education, face-to-face with using this technology has been deemed the most effective evidence-based practice teaching method (Patelarou et al., 2020). This QI project proposes to increase the nurses’ knowledge of daily PD patient care, as demonstrated through pre-and post-questionnaires. Two patient outcome measures of the project's success would be reducing hospital-acquired complications and possible re-admissions from peritonitis infections. 

The project's vision is to employ a PowerPoint presentation in a face-to-face format for the training sessions. Ideally, the education department would have the capacity to offer the training through various channels, including face-to-face sessions, live streaming, or pre-recorded sessions. These flexible options contribute to the sustainability of the training program and facilitate efficient management by the education department. It is important for the education department to maintain ongoing communication and collaboration with the dialysis administrator and medical director to ensure that the training materials and content remain current and up-to-date.

Persistent barriers that need ongoing mitigation include the lack of understanding among other department managers regarding the significance of PD training and the potential time away from patient care for training purposes. It is crucial to educate nurses from all departments about the proper daily care required for patients undergoing PD therapy, as they may be called upon to provide care for these patients at some point. Managers should be willing to accommodate staff schedules to allow attendance at training sessions when they are available. Additionally, managers need to consider the diverse training options and make necessary adjustments to ensure adequate staffing levels on the floor for patient care.

References:

Patelarou, A. E., Mechili, E. A., Ruzafa-Martinez, M., Dolezel, J., Gotlib, J., Skela-Savič, B., Ramos-Morcillo, A., Finotto, S., Jarosova, D., Smodiš, M., Mecugni, D., Panczyk, M., & Patelarou, E. (2020). Educational interventions for teaching evidence-based practice to undergraduate nursing students: A scoping review.  International Journal of Environmental Research and Public Health17(17), 6351. 

1. Provide a brief summary of your project and the integration of technology Please include at least one in-text citation in your summary.

The focus of my project is to improve screening of suspicion of elder abuse and elder maltreatment, for nurses in an acute care setting. Elder abuse is defined as an act intentional or unintentional, that causes harm to an individual 60 years of age or older. The perpetrator of older adult abuse is in a trusting relationship with the victim. There are six types of elder abuse: physical, psychological, emotional, sexual, financial, and neglect (Ross et al., 2020). As such the nurse must know what to look for to pass on assessment information for further screening (Mion & Momeyer, 2019)

 There are multiple parts to the elder abuse project. Part one is an assessment of current knowledge and attitudes of elder abuse via a pretest. Parts 2 and 3 occur two weeks after the pretest. First is an education session on elder abuse, followed by the introduction of a validated tool for abuse screening specific to the older adult population. Immediately following the education session, participants will complete a post test. The post test is to assess if there is a change in attitude and knowledge level as a result of the education session (Alessandri et. al., 2017). At the end of the session the nurses will be asked to use the tool in practice for two weeks. At the end of the two-week period, nurses will evaluate if the tool is useful, appropriate, and efficient for daily use.

Technology will be integrated in the program using Microsoft forms links for the pre and posttests. A QR code will be posted on the unit for the nurses to scan to gain access to the form for evaluation of the screening tool. The pre and posttests will be identical. No identifying information is collected with either test. However, to compare participant tests, nurses will develop a code for the purposes of matching and to identify if expected objectives were met.

All responses will be anonymous. This is done in hopes to obtain responses that are honest and help identify any needs for improvement of the process. Anonymous responses encourage dialogue and keeps the environment safe so no one feels they will be targeted for their feedback.

 

2. Share the vision of your project and the integration of your chosen technology.

Elder abuse is something that is not specifically taught in academia nor in acute or long-term orientations. With nurses being the person who is usually the first point of contact, not having the skills to properly care for the older adult population sets the patient and nurse up for poor outcomes. The vision of my project is to provide useful education as well as implementation of a screening tool that is useful and efficient to maximize outcomes for the older adult population (Cunningham et. al., 2020).

Strengthen relationships between the hospital and external resources for prompt delineation of services is also important for the success of the project in the long term. If the program is effective, through the screening process, resources such as meal services, financial assistance, or equipment for transferring the patient, are identified. Providing these services to families/caregivers/patients in need can help decrease the stress of daily caregiving, therefore decreasing unintentional abuse and neglect.

If the project is successful, the goal would be to integrate the screening tool in the electronic health record admission assessment. The goal would be for any patient 60 years of age or higher, who visits the hospital, the screening tool would automatically flag. If the patient is screened positive for suspicion of abuse, the provider would get an alert in their electronic chart to complete a more thorough assessment and proceed as necessary or legally required. The overall goal of my project is to increase the protection of a vulnerable population which is often overlooked because of ageism (Lachs et, al., 2021).

 

The technology I am integrating in my project is Microsoft forms for my pre and post test as a QR code to the evaluation that nurses will complete once they have trailed the older adult screening tool.

 

3. Identify how you might minimize barriers and maximize the outcomes of your project?

Completion of the tests and the evaluation is pivotal to the outcome of the project. If I do not get sufficient responses I cannot make a conclusion as to the benefit, or lack thereof, of the project. It is necessary to have buy-in, not only from the leadership of the unit, but also the nurses who will implement the tool into practice for the two-week period. A way to maximize participation is to empower the nurses to protect the individuals they serve by including them in the project development. Obtain ideas they may have in the front end, give a thorough explanation of expectations and the benefit of implementing an elder abuse program. Also, visiting the unit and developing a connection with the nurses and other staff will gain trust and hopefully improve participation which will improve program outcomes.

 

References

Alessandri, G., Zuffianò, A., & Perinelli, E. (2017). Evaluating intervention programs with  

a pretest-posttest design: A structural equation modeling approach.  Frontiers in Psychology8

Cunningham, S., Cunningham, C., & Foote, L. (2020). Recognizing Elder Abuse: An

Interprofessional Simulation Experience With Prelicensure Health Care Students.  Journal of geriatric physical therapy (2001)43(4), E58–E64. https://doi.org/10.1519/JPT.0000000000000257

Lachs, M., Mosqueda, L., Rosen, T., & Pillemer, K. (2021). Bringing advances in elder

abuse research methodology and theory to evaluation of interventions.  Journal of Applied Gerontology40(11), 1437–1446. 

Mion, L. C., & Momeyer, M. (2019). Elder abuse.  Geriatric Nursing40(6), 640–644.

Ross, M. E. T., Bryan, J. L., Thomas, K. L., Asghar-Ali, A., & Pickens, S. L. (2020). Elder abuse education using standardized patient simulation in an undergraduate nursing program.  Journal of Nursing Education59(6), 331–335. 

 

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