Module ^- Last Posting for my Blog!

What did you like or dislike about taking an online course?
What topic did you learn the most about and what was your favoirte topic?
If you were the instructor, and this being the first course for all DNP and Master students, what would you do the same or different?


I enjoyed the online course because it allowed me to work at my own pace and be home with my family when I needed to be. This is a huge advantage when you have children and live in a rural area. Less travel time and less time away from family. What I disliked about the course is that I am a learner by example and discussion. It was hard for me at times to read, and fully understand the information without having an example or discussion. This was about my only set back.

I learned the most about going to the sites that support decision making. I really enjoyed searching and evaluating the sites that we will later use in our own practice for evidence based information. I actually purchased the site I was evaluating after using it with some of my physicians that I work with. This is an amazing tool that can help in decisions that we will have to make on a day to day basis when we are in practice.

I would probably try to make surer that the websites and links are all up and working, which I know that a lot of times it is out of anyone's control. I would also make sure that I respond in a timely manner to the students and make clear, concise instructions. Perhaps maybe less reading articles and more interactions modules that actually make you go out and search and get the experience needed.

Module 5

As I looked through the website, I was fascinated to see what grants are available for research. This site allows you to research the latest findings in diseases, patient improvements and also electronic monitoring systems. It also allows you to look back at past reviews and also to see what is happening now. If you are working on a dissertation or research project, it gives you the information about funding. This information and website is a lot of what we have been learning about, such as providing patient safety, quality, affordability, and allowing access to healthcare services. It also gives information on emergency preparedness for communities. Health care information system provides an increase in patient safety as well as a continuity of care. The design is to facilitate hospitals and outpatient services to increase there technology to improve patient safety.

Module 4

How did the readings influence your perception of your own clinical decision-making?

When reading these articles it increased my knowledge of what exactly it means to have clinical decisions in support systems. I was familiar with a few programs, but according to the article by Jane Anderson, she stated that you cannot base your decisions on knowledge and passed experience to treat and diagnose patients. You need to have knowledge-based evidence in the aid of diagnosis and treatment, these systems aid with a knowledge base information to apply evidence based recommendations at the point of care. CDSS software is essential as the clinical decision making process. (Anderson, 2008)This software can be used as a reference and perhaps a safety net that assists with diagnosis for consistency and guidance.

How do we reconcile the value of nursing experience with known heuristics and biases used in human decision-making?

According to the article, Judgment under uncertainty: Heuristics and Biases, it stated that people rely on a limited number of heuristic principles which reduce the complex tasks of assessing probabilities and predicting values to similar judgmental operations.(Tversky, Kahneman, 1974) These can be very useful but they can also lead to severe systematic errors. There are three heuristics that allow us to make judgments, which are representativeness, availability, and adjustment from an anchor. For representativeness, if people evaluate probability by representativeness, other prior probabilities will be neglected. This system uses probabilities like, what is the probability that object A belongs to group B? These groups base their decisions that A represents B. Availability is such that one might assess the risk of cancer among older people by recalling such occurances among one's acquaintances. This can be a useful clue in assessing probability because instance of large classes can usually be recalled better than small classes. By realizing only on availability can cause biases. As nurses, we tend to stereotype and predict an outcome according to our experiences and judgments.

How does nursing data quality relate to decision support?


Data quality is essential in assisting with decisions support. It allows one to have knowledge-based information and assist in correlating the symptoms and research into their practice. These systems allow for patient characteristics with knowledge base to generate recommendations for point of care. These are termed evidence based adaptive: moreover, these systems show promise as a means for bridging the gap between evidence and practice. (Anderson, 2008) These systems represent the decisions of human experts. The nurse is an active decision maker and by using CDSS, allows an increase in interdisciplinary communication. You can identify the management of certain diseases and conditions and improve care and consistency.

Module 3- My Multiple Intelligence Test Results….

Wow, what an interesting test. My results showed that my highest intelligence strength was Interpersonal. This is exactly me. I try to look at the perception of others and how they feel. I try to understand everyone personally and their behaviors. This is probably why I went into the medical field. I can interpret moods from facial expressions as well as body language. I enjoy being there for others. I was not too impressed with the results, because I know that this is me. My number 2 strength was Intrapersonal. This means self-awareness. This to defines me close. I am able to recognize change with in me and to do what needs to be done to get it finished. I am self aware of my problems and things around me.
What technologies might I incorporate to augment my personal learning based on these results?
I am a visual person. The technologies I want to incorporate are videos, face to face teaching, if possible. I usually can understand and comprehend easily, if I am able to actually perform it, and figure it out, or have a demonstration first.

Module 2

Module 2

Question 1
My clinical problem that I wanted to research was medications errors in hospitals. My choice of electronic index was to search through the University of Utah remote access on CINAHL. This search engine or site is specifically used for nursing and allied health professionals. I have used this search engine in the past and it has come up with some excellent peer reviewed articles. This search index facilitated my ability to construct an efficient search because I was able to narrow the search down to exactly what I was looking for and it also was articles related to nursing. The time issue for me was not very long. I have used this site in the past so I was familiar on how to search and narrow down the citations to exactly what I was looking for. This particular index would be hard to access from my place of employment because it is a paid subscription website. If I wanted to find out certain information regarding a patient or illness, I would be unable to access this from my workplace. This would be one of the barriers I would have.

Question 2
The software that I am using is called Endnote. This software allows me to search bibliographic databases and retrieve references directly into my software. I can also attach full articles. It can also import and export references as well as store, manage and search for bibliographic references and place them in my library. As I continue to add references into my software, it will continue to build a list of references and place them in my library. I can also organize charts and figures. The functionality of this software is that I am able to create groups for my references to be placed in allowing me to retrieve them easily. This software, once familiar with it, allows me "to never leave home without it". I had to say that! I was introduced to this software while obtaining my BSN and it has been a lifesaver! You will never have to build a bibliography if you use this software.
Question 3
Electronic index can be very helpful if you know what you are doing and where you are searching. If you wanted to find information on tornadoes, you would not search the electronic index in a medical search engine. If you are aware of the different electronic indexes and search according to your information, then it should be simple. On the other hand, if you are not searching the right areas, it will be a lot more time consuming having to sort through the unneeded information. Guideline indexes are wonderful, if you are familiar with how to use them. Endnote takes some time to familiarize yourself with it and sometimes you have to edit the format but once you are, familiarize with it, it can be wonderful. The downside of that would be taking the time to learn your software. Not all software available is user friendly, so be aware. I am not a big fan of web search engines because I spend more time sorting through the unwanted information than actually reviewing the articles. Google is great for basic information like definitions, web addresses, but finding peer reviewed articles or information that is actually peer reviewed is hard to find. Some alternative strategies for finding information would be to review journals that are credible and also perhaps going to the library and searching through the information they have available. I think back how much things have changed today compared to 15 years ago. Remember the card system at the library? Do they still use that or is it electronic? I remember having to search through cars to find book and now you just have to type in a key word or phrase and all the information is displayed instantly.

Module 1

Hello, I am Michelle Torgersen. I am currently in the FNP program. As a graduate level nurse, I fell that it is important to know all areas of information management because of the role I will play as a FNP. Hospitals and even clinics are requiring nurses and staff to use databases and access their patient's information through computers. Myself as a Med/ Surg manager are required to do spreadsheets as well as keeping current on new computer flow sheets that need to be generated for my facility.I had the opportunity to help build and introduce our electronic charting into our facility. It was a total nightmare at first because I had to figure out the program, and then try to learn to build the flow sheets, assessments and vital records for the nursing staff to chart on. Our hospital has been electronic now for approximately 3 years and the bugs are still not all worked out. I have seen the nurses go from refusal, to acceptance to frustration. It is hard for a nurse who has done paper charting for 30 years to turn around one day and be expected to learn computer charting when she is unfamiliar with even turning the computer on. Within my practice, I see all the documentation as well as billing for Medicaid and Medicare. I am aware of the coding that goes on as well as the billing for a critical access hospital, in which we are. One problem I see with electronic record is that after a few years of electronic documentation and the computers decide to crash, everyone panics, and forgets what to do when technology decides to fail on us. We forget how we use to do it. Structured clinical data is very important in promoting quality of care because for one reason, it allows other practitioners to access what has been done with that patient to have continuity of care. Everyone is on the same page because they are all able to access the same record.

Hurray!

Well I made it through the first step of setting up a blog!