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Discussion 1.1: Introductions and ExperienceIntroduce yourself stating your name, years of experience as an RN, and current specialty. Then, in a graded discussion, answer the following questions:What is problem based learning? (2-3 sentences, cited and referenced)What does Technology Informatics Guiding Education Reform (TIGER) intend for nursing? (2-3 sentences, cited and referenced)Describe your interaction with technology as a nurse as an asset or liability. (3-4 sentences, citation/referenced optional).Respond in a friendly yet academic discussion format to at least 2 classmates. Offer your new classmate an informatics related website that you have found in Nelson & Staggers (2014), or in an internet search. Access Discussion 1.1 in the course to review the instructions for formulating and submitting this discussion post.

Discussion 1.2: Experience Interacting with InformaticsDescribe your interaction with a technology used at your work from the perspective of only one of the sciences that comprises Nursing Informatics (computer, information, nursing, cognitive, etc.). Access Discussion 1.2 in the course to review the instructions for formulating and submitting this discussion post.

Discussion 2.1Topic

Assignment 2.1Scenario

Assignment 2.1: Communication (Google+ group assignment)A patient has been admitted and had been found in his home by neighbors, lethargic and unable to communicate, but he has a license with identification. The Electronic Health Record identifies him as Mr. Kenneth Lister, who has had multiple comorbidities, diabetes, heart failure (ejection fraction of 30%), and history of cancer. He was last admitted to DRHA in 2011 for a successful coronary angiogram, but following the procedure, he had recurrent events of hypoglycemia, despite many years of well-maintained blood glucose levels, and experienced a fall when trying to get out of bed. It is unknown if Mr. Lister has had any recent admissions to other hospitals or procedures since 2011. He is currently in the ICU with blood glucose of 350 mg/dl and highly irregular heart rate. The plan is to send him to a medical unit once he has stabilized. The nurses in ICU have been recently trained and are using an Intensive Insulin Therapy (IIT) clinical decision support system (CDSS). The IIT CDSS is new to the ICU and can provide tighter control of blood glucose levels. However, the medical unit does not yet use IIT CDSS. Discuss the answers to the questions on the Assignment 2.1 page in a recorded Google+ Hangout with your assigned group. Access Assignment 2.1 in the course to review the instructions for formulating and submitting this assignment.

Discussion 2.1: Syllabus ReviewThoroughly read the syllabus.Identify the combined weight (percentage) of your assignments and discussions for each eight modules.Determine which modules only have a single assignment for the week.Complete the Group Representative Table and post. Access Discussion 2.1 in the course to review the instructions for formulating and submitting this discussion post.

Assignment 2.1: Communication (Google+ group assignment) A patient has been admitted that had been found in his home by neighbors lethargic and unable to communicate, but he has a license with identification. The Electronic Health Record identifies him as Mr. Kenneth Lister, who has had multiple comorbidities, diabetes, heart failure (ejection fraction of 30%), and history of cancer. He was last admitted to DRHA in 2011 for a successful coronary angiogram, but following the procedure, he had recurrent events of hypoglycemia, despite many years of well-maintained blood glucose levels, and experienced a fall when trying to get out of bed. It is unknown if Mr. Lister has had any recent admissions to other hospitals or procedures since 2011. He is currently in the ICU with blood glucose of 350 mg/dl and highly irregular heart rate. The plan is to send him to a medical unit once he has stabilized. The nurses in ICU have been recently trained and are using an Intensive Insulin Therapy (IIT) clinical decision support system (CDSS). The IIT CDSS is new to the ICU and can provide tighter control of blood glucose levels. However, the medical unit does not yet use IIT CDSS. Discuss the answers to the questions on the Assignment 2.1 page in a recorded Google+ Hangout with your assigned group. Access Assignment 2.1 in the course to review the instructions for formulating and submitting this assignment.

Assignment 2.1: Communication (Google+ group assignment)A patient has been admitted that had been found in his home by neighbors lethargic and unable to communicate, but he has a license with identification. The Electronic Health Record identifies him as Mr. Kenneth Lister, who has had multiple comorbidities, diabetes, heart failure (ejection fraction of 30%), and history of cancer. He was last admitted to DRHA in 2011 for a successful coronary angiogram, but following the procedure, he had recurrent events of hypoglycemia, despite many years of well-maintained blood glucose levels, and experienced a fall when trying to get out of bed. It is unknown if Mr. Lister has had any recent admissions to other hospitals or procedures since 2011. He is currently in the ICU with blood glucose of 350 mg/dl and highly irregular heart rate. The plan is to send him to a medical unit once he has stabilized. The nurses in ICU have been recently trained and are using an Intensive Insulin Therapy (IIT) clinical decision support system (CDSS). The IIT CDSS is new to the ICU and can provide tighter control of blood glucose levels. However, the medical unit does not yet use IIT CDSS. Discuss the answers to the questions on the Assignment 2.1 page in a recorded Google+ Hangout with your assigned group. Access Assignment 2.1 in the course to review the instructions for formulating and submitting this assignment.

Assignment 3.1Scenario

Discussion 3.1Topic

Discussion 3.1: Electronic Health Records (Group Post)The Centers Medicare and Medicaid (CSM) EHR Incentive Programs provide financial incentives for the "meaningful use" (MU) of certified EHR technology. To receive an EHR incentive payment, providers have to show that they are "meaningfully using" their certified EHR technology by meeting certain measurement thresholds that range from recording patient information as structured data to exchanging summary care records. MU has 4 Stages and most organizations have seized the financial opportunities from MU 1. MU 2 offers an increased focus on nursing data collection with respect to Clinical Quality MeasuresVisit the following weblink: Meaningful Use Regulations (HealthIT.gov)Meet and work with your team privately in your group's discussion board within the Private Group Forum (in the Discussions section of this course).In order to redeem financial incentives from the CMS, organizations' EHR's must meet Stage 2 MU Criteria in the CMS Clinical Core Measures such as: Care coordination, patient safety, clinical guidelines, health outcomes, patient engagement, use of healthcare resources, and public health with more planned for 2015.Chose 2 criteria and explain how your group as a clinical leaders plan to demonstrate MU 2 in your real or hypothetical organization.Note: Please see the Guide to Navigating Your Course under RN MSN Information and Resources for instructions on posting and replying to the discussion board. Access Discussion 3.1 in the course to review the instructions for formulating and submitting this discussion post.

Assignment 3.1: A Day in the Life of a Nurse (Individual Paper Assignment)As a nurse, you are an information system (IS) that is constantly processing. We are constantly processing data and information in order to provide the best possible care for our patients. Information systems (IS) contain hardware and software that processes data into information that has meaning to humans with knowledge to interpret the information. The Foundation of Knowledge model (McGonigle and Mastrian, 2009) displays interrelationships among data, information, knowledge and wisdom. “Nursing is an information intensive profession. The steps of utilizing information, applying knowledge to a problem, and acting with wisdom, form the basis of nursing science.” (McGonigle and Mastrian). Technology in general and EHRs, more specifically, expedite the transformation from data to wisdom utilizing knowledge and information. Data are raw facts; information is processed data that has meaning; and knowledge is the awareness and understanding of a set of information and ways that information can be made useful to support a specific task or arrive at a decision. Wisdom is the synthesis of knowledge, experience, insight, and understanding (decision) followed by an application or decision to act in an appropriate situation. Wisdom is focused in the mind with consideration of the future. Bellenger (2004) explains the relationships among data, information, knowledge, understanding and wisdom that classifies the content of the human mind into 5 categories. Of the five categories, only wisdom incorporates visions and future design. Your brain can function like a computerized information system, taking raw numerical data about a patient and transforming it into a decision about what needs to happen next. However, your brain is much more complex than a computer because you can process much more abstract data, such as irregular speech or gait patterns. For example, when you observe a patient’s behavior, you are collecting raw data, then you add other data from the chart (or other sources) and compile into information that has meaning, process the information using your wealth of nursing and human knowledge, finally you make a decision and act. As a nurse, your wisdom guides you to include experience that anticipates the future, perhaps requiring additional information and subsequent decisions. Your brain is an efficient IS and can perform this entire process in split seconds or consciously decide to take a longer time to add more data, information or knowledge and delay decision making for days. Access Assignment 3.1 in the course to review the instructions for formulating and submitting this assignment.

Assignment 4.1Scenario

Discussion 4.1Topic

Assignment 4.1: Ethical Issues (Google + group assignment)You are on a nursing committee at the hospital. There have been many readmits of CHF patients and it is recommended that a program of monitoring blood pressure, weight and heart rate be implemented. It is suspected that the readmitted patients need more monitoring help at home. The committee is asked to collect data from hospital records about available patients who are readmitted. Administration is interested in the availability of caregivers in patients’ homes and their financial ability to hire caregivers. The hospital administration is considering encouraging nanochips that attach to the wrist of frequently readmitted patients that will send BP and HR data back to a monitor in cardiac unit nursing station. The administration wants to help with monitoring those who don’t have caregivers to help them and intervene before an exacerbation of heart failure. Discuss the answers to the questions on the Assignment 4.1 page in a recorded Google+ Hangout with your assigned group.

Discussion 4.1: Pros and Cons ListIf the patient and family would agree to have a nanochip placed in their arm to help with current and updated information access, using the provided document template, list 7 Pros and 7 Cons for storing patient-specific data on nanochips.Post your Pro/Con list. Decide which of the 7 has the great impact on patient centered care. Support your decisions for the one you chose class DB. Access Discussion 4.1 in the course to review the instructions for formulating and submitting this discussion post.

Assignment 5.1Scenario

Discussion 5.1Topic

Assignment 5.1: NEDSS (Google+ group assignment)Frank Barnes is a 47-year-old truck driver who was admitted to the Medical unit at DRHA. He shared a room with Kenneth Lister (from Mod. 2). He was in the room with Mr. Lister for only 1 day and then released to go back to work. After he was discharged, the laboratory reported that they had Isolated M. tuberculosis complex from a clinical specimen. Infection control personnel reviewed the EHR and observed that there were skin assessment notes about red lesions. Due to a recent increase in bedbug prevalence in homeless and other transient patients, the hospital is required to identify and report the possibility of an environmental infestation. Discuss the answers to the questions on the Assignment 5.1 page in a recorded Google+ Hangout with your assigned group.

Discussion 5.1: Privacy ConcernsDiscuss the benefits and risks of maintaining the Privacy Rule with regard to Protected Health Information during an outbreak of an infectious disease. Group A, B, C discuss benefits. Group D, E, F discuss risks. Consider bioethical implications such as autonomy, beneficence, non-maleficence and justice to guide your discussions. Access Discussion 5.1 in the course to review the instructions for formulating and submitting this discussion post.

Discussion 6.1Topic

Assignment 6.1Scenario

Assignment 6.1: Benefits of Telehealth (Individual Paper Assignment)Mr. Lister is going home with telehealth, more specifically a home telemonitoring device. Even though the use of telehealth does not often include hands-on interaction, the goal of keeping patients out of the hospital is consistent with nursing. Telehealth applications are designed to enhance the patient experience and improve clinical outcomes while providing care for patients in their home, rather than in institutional settings. Nurses can use telehealth in a manner that supports self-care by empowering patients which is a central tenet of nursing practice. You will need more information about his home and insurance: Medicare Parts A & B.Lives with wife.Has telephone line in home and experience with internet and computers.Mobile can ambulate 200 feet slowly due to weakness. Uses walker due to fear of falling again.Has been repeatedly admitted to hospital due to shortness of breath and edema related to lack of adherence to medication regimen ordered by HCP. Access Assignment 6.1 in the course to review the instructions for formulating and submitting this assignment.

Discussion 6.1: TelehealthTelehealth has been proposed as a new patient care technology to enhance patient safety. What are the benefits and barriers in keeping patients safe in their homes using patient centered technologies?Each group will contribute at least 3 benefits and 1 barrier to the discussion.Offer at least 1 innovative resolution to your described barrier. Access Discussion 6.1 in the course to review the instructions for formulating and submitting this discussion post.

Discussion 7.1Topic

Assignment 7.1Scenario

Assignment 7.1: Quality Improvement for Readmissions (Google+ group assignment)The group (a family member, Risk Manager, Unit Manager, and Nurse Informaticist) that is meeting (in G+HOA) has been called together because they represent the members involved in discussing a "never event" that has occurred on a DRHA unit. The purpose of the meeting is to ensure that the Quality Improvement team at DRHA has all the information that they need to support what is needed from the available electronic data collection tools. Discuss the answers to the questions on the Assignment 7.1 page in a recorded Google+ Hangout with your assigned group.

Discussion 7.1: A "Never Event" has occurred at DRHA (G+ group assignment)As a result of the "never event", you are asked to create a quality improvement report by your director. Create the report using the "How to Write a Quality Improvement Report" guidelines, SBAR or a tool you have used professionally to address the issues from the case study. Provide feedback to the case study creators in the form of a brief teaching note. Access Discussion 7.1 in the course to review the instructions for formulating and submitting this discussion post.

Assignment 8.1Topic

Assignment 8.1: Reflection Paper (Individual Paper Assignment)This course on healthcare technology to the patient has asked you to review and apply literature about different areas of nursing informatics. The MOST important contribution of technology is PATIENT SAFETY. Acknowledgement of this importance prompted the Robert Wood Johnson Foundation (2005) to fund an initiative, “Quality and Safety Education for Nurses” (QSEN) with the purpose of reformulating nursing education with respect to knowledge, skills and attitudes that are fundamental to nursing. The goal of QSEN is "to meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work (QSEN, 2009). Preheim, PJ, Armstrong, GE, Barton, AJ, (2009). The New Fundamentals in Nursing: Introducing Beginning Quality and Safety Education for Nurses’ Competencies. Journal of Nursing Education The KSAs identified as important include: K — Explain why information and technology skills are essential for safe patient care.S — Apply technology and information management tools to support safe processes of care.A — Value technologies supporting decision making, error prevention, and care coordination. Access Assignment 8.1 in the course to review the instructions for formulating and submitting this assignment.