Central Luzon Doctors Hospital Educational Institution Brgy.San Pablo Tarlac City A.

Y 2010-2011

Submitted by: GROUP 4 Basilio, Ann Charmaine D. Coles, Amy G. Pangilinan, Myra Joy D. Quiaoit, Roselle B.

Submitted to: Mrs. Jhoane Tipay

 SITUATION A.) Juana Dela Cruz was admitted through the hospitals emergency department in congestive heart failure. During her admission she was asked to verbally acknowledge whether her demographic data were correct. Ms. Dela Cruz did so. Extensive diagnostic tests were done, including radiology studies. It was later discovered that all of Ms. Dela Cruzs information had been entered into another clients file. How would you correct this situation? What departments, or other agencies, would need to be informed of this situation?

ANSWER: In this situation, all we can do is to correct what is wrong, first is to call the areas involve in this patient that the indicated test where submitted in a wrong person especially inform the physician to have his correct orders to the correct person, some areas affected are laboratory, emergency, ECG, stress testing area 2D echo and x-ray room, also remind the nurse in every shift to double check so that it wont happen again

Situation B.) A non-English-speaking Vietnamese man was admitted through the emergency department with suspected tuberculosis (TB). The system carried information under his name. Mr.Nguyen nodded his head when the admitting clerk pointed to the demographic screen. Mr.Nguyens address for follow-up, the man there was not the Mr.Nguyen who had been treated for TB. How would you address this problem? Explain your rationale

ANSWER: This is a problem or an error in entering a data into the system, sometimes its a human error, and most probably a system error. If we encounter this kind of problem we should double check the demographic data of the patient regarding on his nationality and the people who we can contact so we will able to know where he is. In this issue we should look for more details about the patient, and as a community nurse we should also check the patient chart.

 Situation C.) You notice that the new nurse practitioner for one of your major orthopedic practices has a PDA on which he keeps patient information. Today he left it in the cafeteria. What should you do?

ANSWER: One of the responsibilities of a nurse is to secure and maintain the privacy of our patients. That includes keeping any information accessible only to the persons who are concerned to the patient. If I was the one who noticed the new nurse that left his PDA in the cafeteria I will immediately bring it back to him and I will talk to him about the rights of the patient and his responsibility as a competent nurse. Especially the area where he left the PDA is accessible by anyone. Luckily the PDAs today with patient information are equipped with password and cannot be accessed by just anyone.

Situation D.) The administration at St. Johns Hospital takes pride in their strong policies and procedures for the protection of confidential client information. In fact, St. Johns serves as a model for other institutions in this area. However, printouts discarded in the restricted-access IS department are not shredded. On numerous occasions, personnel working late observed the cleaning staff reading discarded printouts. What action, if any, should be taken by IS administration? Provide your rationale. If current practices are maintained, are there any additional potential risk for unauthorized disclosure of client information? If you answer yes, identify what these risks might be.

ANSWER: For a staff in such institution there must be a part in their contract that simply specifies what will happen if printouts are not properly disposed or its been spread out the hospital or other people. For the IS department they can talked to the staffs involved in the said situation and let them be reminded in the said contract or else consequences is on its way. Yes there are any potential risks for unauthorized disclosure of client information. The risk for the said situation, in some other countries identity of files and information of the people are important. There are possibilities that anyone can make that document different and spread it that can cause the damage of the said institution and the owner of the documents that have been shared to others.

 Situation: E.) You notice several of the new physicians playing computer games on the nursing unit. You had not been aware of these games previously. What, if any, action should you take? Explain your rationale. ANSWER: According to studies in improving utilization begins before a system is installed and extends throughout its lifetime. Areas to consider include: Choice of System Selection Process Implementations Training/Documentation On-Going Activities

Choice of Systems Frequently systems are selected based on a list of features. The one with the most features is considered best. That, of course, makes the selection process relatively easy. A wiser choice would take into account practical considerations as to whether or not major components would be used. Selection Process It is possible that the entire selection process may need to be overhauled. If the organization has not reviewed the evaluation methodology in detail to make sure it is appropriate to the systems being evaluated, the process may be the root of the problem. While everyone understands that equipment and systems need to be replaced from time to time, it is just as important to determine whether or not procedures and processes have become obsolete before they are used again. The new physicians are now facing in the so called-UNDERULIZATION which means that the computer system of the hospital are not being used according to its proper function or usage. For noticing the new physicians playing computer games on the nursing units, the first thing that I will do is to report this to my chief nurse so that she will do the first action and she will be aware on whats goingon on the nursing unit. I will be guided also on my report to the new physicians when the report reach to the heads of the hospital. A selection process is often used because : This is the way we've always done it

 Another organization did it this way We read about this approach in a respected publication It is the quickest and easiest method we can find A consultant recommended it None of these are valid reasons to use a particular approach. While they may be a good source of ideas about what to do there is only one final conclusion that is legitimate. "We are using this approach because we have reviewed it in detail and it meets the objectives of our organization regarding the evaluation and implementation of new technology". This statement implies that a set of objectives have been developed. If this is not the case, a list of objectives should be drawn up which are broader than merely specifying an ideal system. These objectives might include: Select the "Best" System Develop Creative Users "Survive" the Implementation Minimize Selection Costs Regarding the experience of users, it is easy to assume that the replacement of an existing computer system will be noticeably easier than the installation of the first system. Very often this is not the case. The major issue is change. There is a reluctance to give up a "comfortable" old system in spite of its short comings - whether or not that old system is manual or computerized. In any case the evaluation criteria should be considered much earlier in the process - before everyone gets bogged down in the details. If a broader view is taken initially, priorities can be established and the details fall into place more easily. The traditional "specification" approach to soliciting proposals is not a good solution for this problem. In this approach, vendors would be told exactly what to provide - ideally to meet the needs of all users and they would bid systems according to this specification. This approach was developed many years ago - at a time when vendors did a large amount of custom programming and were not reluctant to modify their system for each site. The complexity of modern systems and the costs of maintaining multiple versions of software have changed all that. For the most part it is not possible to tell a vendor what a system should do in hopes of meeting all of the criteria established by an interdisciplinary committee.

The second objective - Develop Creative Users - is intended to help users get the most out of whichever system is chosen. Early and thorough user involvement including numerous contacts with current users are critical to meeting this objective. The potential benefits of a very good system can be offset by a bad installation. Selecting the right system does not guarantee a smooth installation. Therefore, one goal of the selection process should be to prepare users for the implementation. Finally, costs must be kept under control. It is particularly difficult to get numerous users in a large facility involved in a selection process without wasting hundreds of hours of staff time in meetings. Waste must be avoided but involvement is mandatory. A well-structured team approach can be used to focus effort through key individuals while accommodating input from all concerned parties. An important part of the process is to divide up responsibilities between staff members, the project team, a management committee that must oversee the work and the various departments involved. Poor scheduling is the cause of many problems. Too often inexperienced teams have no idea how long a project will take. The tendency is to be optimistic. No one wants to think an evaluation might take six months, a year or more. Even though receiving approval to proceed on a project may take years, once it is received the pressure is on to do things quickly. "You have approval to pick out a system and we want it done in six months" - another schedule plucked from the air! A realistic schedule can be prepared following a few simple rules: Develop a Task List Determine Resources Required and Available Expect the Unexpected Be Pessimistic Remember the "Regular Jobs" Then Develop a Schedule

1. Visit the sage software EHR demonstration at http://www.sagehealth.com/wps/wcm/myconnect/sagehealth/www.sagehealth.com/products/ehr/int ergy ehr/intergy product demonstration. What features did you like or dislike? Please justify your responses.

ANSWER:
The whole sage EHR is very helpful to our society especially on the patients needs and the medical teams care for the patients. The features are very user friendly and it has a complete access through the other areas whereas the result of all the test are compiled at the specific patient and can access even though on your home to have a care free to the patient. All the features are great what have we discussing is how about power breakdown and you cant access the patients data. How would you render care?

3.Search the Internet for information on the Leap Frog Group. How is this information related to nursing informatics?

ANSWER:
The Leapfrog Group is an initiative driven by organizations that buy health care who are working to initiate breakthrough improvements in the safety, quality and affordability of healthcare for Americans. Leapfrog is a member supported program aimed at mobilizing employer purchasing power to alert Americas health industry that big leaps in health care safety, quality and customer value will be recognized and rewarded. The Leapfrog Group was founded by a small group of large employers, initially supported by the Business Roundtable (BRT) and launched in November 2000. Leapfrog is supported by the BRT, The Robert Wood Johnson Foundation, Leapfrog members and others. A 1999 report by the Institute of Medicine gave the Leapfrog founders an initial focus reducing preventable medical mistakes. The report found that up to 98,000 Americans die every year from preventable medical errors made in hospitals alone. In fact, there are more deaths in hospitals each year from preventable medical mistakes than there are from vehicle accidents, breast cancer and AIDS. The report recommended that large employers provide more market reinforcement for the quality and safety of health care. Leapfrogs founders realized that they could take leaps forward with their employees, retirees and families by rewarding hospitals that implement significant improvements in quality and safety.

The Leapfrog Groups growing consortium of major companies and other large private and public healthcare purchasers provide health benefits to more than 37 million Americans in all 50 states. Leapfrog members and their employees spend tens of billions of dollars on health care annually. Leapfrog members have agreed to base their purchase of health care on principles that encourage quality improvement among providers and consumer involvement. If all hospitals implemented just the first three of Leapfrogs four leaps or recommended quality and safety practices: over 57,000 lives could be saved, more than 3 million medication errors could be avoided, and up to $12.0 billion could be saved (Lwin 2008) each year.

RELATIONSHIP BETWEEN LEAP FROG GROUP AND NURSING INFORMATICS Implementation of information technology in a hospital setting requires attention to many people-related and organizational issues. (Dixon 1999) People-related issues associated with information technology often fall into four categories: staff preparation and training, process changes, continuity of patient care, and IT and administrative support.(Anderson and Stafford 1999) As technology moves closer to the patients bedside, the number of clinical personnel who interact with a system increases. This expansion broadens the user base and adds to the need for wider acceptance by the nursing staff. (Souther 2001) Nurses are the most frequent users of clinical information systems and as such are often the resource person other users turn to for assistance. This provides significant impetus in ensuring their being integrally involved in the design/selection, development/build and implementation. (Ball, Snebecker and Schechter 1985; Davis 1993; Ash, Gorman, Lavelle, et al 2003; Le, Teich, Spurr and Bates 1996) As nursing settings become ubiquitous computing environments, all nurses must be both information- and computer-literate. (ANA 2001) If clinical staff is not motivated to use an information system, having the best system serves no useful purpose. (Barr 2002)

Potential Benefits of Using Program Delivery To patients Leapfrog Group has emphasized computerized physician order entry as a cornerstone to promoting patient safety. (Leapfrog Group 2008)

To staff Nurses (and other staff) with higher levels of computer expertise are going to have more self-efficacy (comfort and knowledge in being able to perform their work) (Dillon, Lending, Crews and Blankenship 2003) Staff feels system enhances their job performance. (Davis 1989 and 1993; Patterson and Nguyen 2004) Computer proficiency encourages lifelong learning that builds critical thinking skills (Smedley 2005) Retention people want to be good at what they do, help them be successful (Pratt 2002)

To management Improvement of human behavior and placement of nurses where they can have the most effect (Courtney 2005) Training demonstrates encourage and support for nurses (and other staff) use of information technology. Incorporating staff computer learning needs into training supports a better organized strategic approach to implementation and ultimately enhances the adoption of new technology. (Dillon, Blankenship and Crews 2005)

What is the difference between online learning and distance education? Distance education has been a method of learning for individuals wanting to study at home for at least one hundred years, starting with correspondence learning (home study) via postal mail. With the greater use of computers and the Internet, it is now possible to offer distance education programs using only the online modality. In fact, distance education programs in the US and Canada use online learning so much, that for many people distance education is thought to be only about online learning. But in reality, not all distance education programs are offered offered totally online. In fact, many distance education programs use a mix of modalities in that they also refer the learner to physical books. However, even these books are increasingly available online.

In many developing countries where the availability of computers and access to the Internet cannot be assumed, distance education very often still uses a mix of hard-copy study guides, books and attendance at weekend classes. There are many initiatives to try to change the problems of access to ICT, e.g., "One Laptop Per Child (OLPC)", so that those countries can also reap the benefits of using ICT in learning. Why is everybody asking about online learning? In these difficult financial times, there has been a massive increase in the number of learners wanting to know more about online learning & distance learning (or elearning - also written as e learning or e-learning). Not only is learning online usually more affordable, it is also more convenient for these distance education learners. What is important to recognize is that anyone can register for online courses and earn their degrees. In this manner, they can study full time or part time, if they have other responsibilities. Many people have found that this is the best way to start a new career or complete certain credits they were lacsking for that degree while they maintain their current job. But one of the good things about online learning is that it is not only used in distance education programs - it is also used for campus-based programs. For us nurses it is a big help for us to know something about distance learning, as a nurse in duty we should know the latest thing about our field. On our modern times there are so many new gadgets that are been discovered and we should be updated to it.