Expert answer:Discussion Posts informatics Community Nursing
Expert answer:Reply to a discussion posts.Nursing and Health AssessmentsNursing informaticsCommunity Nursing
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Reply to discussion posts
Question 1: After walking in the room, founding Mr. Johnson on the floor unconscious, I will yell
for help or press call button for extra help. I will then assess Mr. Johnson using my ABC’s
(airway, breathing, circulation). Walking over to where Mr. Johnson is laying, I will tap him
asking if he is okay, while assessing for an airway, and checking for signs of life (looking for
chest to rise and fall), checking for a pulse. If Mr. Johnson shows no signs of life, I will start CPR
because he is a full code and continue until help has arrived. According to the mayo clinic, steps
before starting CPR:
Is the person conscious or unconscious?
If the person appears unconscious, tap or shake his or her shoulder and ask loudly, “Are you
OK?”
If the person doesn’t respond and two people are available, one should call 911 or the local
emergency number and get the AED, if one is available, and one should begin CPR.
If you are alone and have immediate access to a telephone, call 911 or your local
emergency number, before beginning CPR. Get the AED, if one is available.
As soon as an AED is available, deliver one shock if instructed by the device, then begin CPR.
If Mr. Johnson shows signs of life, I would still assess the airway, checking for obstruction,
check his breathing pattern to determine if oxygen is needed and assess for a pulse that can be
faint. Obtain vital signs. After falls, individuals sometimes sustained injuries, I will check Mr.
Johnson for any injuries or bleeding. If bleeding is present, found the bleeding and apply
pressure. After rapidly assessing my patient I will call the physician and relay the information in
SBAR format. According to Jarvis (2016), SBAR is a standardized framework to transmit
important in-the-moment information.
S- Mr. Johnson admitted for CVA, found unconscious on the floor, fall unwitnessed.
O- Found unconscious, not breathing, no pulse, no signs of life
A -Another CVA, Cardiac arrest
P- CPR, Defibrillation, Intubation
Answer:
Question 2: I chose the first scenario, upon entering the room I would assess the ABC, airway
breathing and circulation and then call the appropiate code. Mr Johnson is unconscious and
cannot answer questions and has a history of CVA and he fell I would ask for a backboard to get
the patient back to bed because he may have injuries to his neck, head or back from the fall. “In
a hospital setting the patient does not require a complete head-to-toe physical examination
during every 24-hour stay. He or she does require a consistent specialized examination at least
every 8 hours that focuses on certain parameters.” (Jarvis 2016) I would then start with a set of
vitals, assess his neck for any malalignments, assess for pain if he is awake I would assess his
pupils for PERRLA, call his name to see if he responds or can follow commands. Assess his grips
bilateraly if he is awake and assess his strength in upper and lower extremities also assess his
facial symmetry for any facial drooping because Mr Johnson already had a CVA he may already
have these sypmtoms as his baseline. Mr Johnson is going to need a stat brain CT and brain MRI
to asses for bleeding or if he suffered another CVA. I would then put him on tele if not already
put on O2 via Nasal cannula for support. “The rapid assessment requires a minute or less to
complete. This is your first encounter with your clients and collection of this data will enable
you to prioritize your tasks.” (Chamberlain 2017)
S Hi Dr Smith I am the nurse taking care of Mr Johnson in room 5250 who suffered an
unwitnessed fall and is unconscious on the floor
B Mr Johnson 89 y/o male admitted for CVA, vital signs BP 140/96 HR 85 R 20 T 98.6 and satting
100% on 2L of O2 NC I would then give a list of medications he is taking, especially if he is on a
blood thinner like plavix or coumadin and his PMH
A: Mr Johnson may have suffered another CVA
R: Stat CT of the brain, MRI of the brain and cervical spine, Xray of back and neck, labs PT-INR,
Ptt, CBC, and a BMP, EKG and troponin
Answer:
Question 3: The first week, I scored myself a 27 on the AACN Essentials Self-Assessment. This
week I have scored a 42. While most of my scores in the first week were scored at the “good”
level, this week I have been able to move those to the “very good” column. Some of the scores
that were in the “very good” column in the first week are now in “excellent”. I think this
difference in scores in due to a wider knowledge base of the field of informatics. While I
understood previously the impact of technology in healthcare, I was unaware of the many
impacts nurses can have on information systems. According to Hebda & Czar (2013), “there is a
growing body of knowledge on computers and informatics support as nurses and other
healthcare professionals continue to develop skills and competence in the integration of EBP
and he research process” (p. 542). Incorporating EBP into nursing practice through technology
has elevated patient care to new levels. It challenges nurses to remain on the forefront of
education and research. I have found this class has expanded my knowledge base of the
importance of nurses in the development, testing and implementation of new technologies.
Technology plays an important role in nursing practice, and it is important that nurses are there
to continually evaluate and improve those technologies. I will continue to expand my
knowledge with this specialty. According to Murphy (2010), “Nurses working in informatics
have been prolific in defining what they need in clinical information systems to support nursing
practice” (p. 206). In my hospital, we have served as a pilot facility for many new programs. I
would like to continue this testing of new programs; so that I may provide feedback on its
impact on the bedside nurse.
Answer:
Question 4: My original score in the beginning of the course was a 18, compared to week 1 I
scored myself a 25. I believe the main reason for the improvement is a deeper understanding
of the different aspects of patient care technologies. Nurse informatics has gained immense
attention in the recent times as a result of the increased need to enhance quality and accuracy
in service provision. Numerous patient care technologies and information systems have been
devised to enhance efficiency in healthcare centers. The information gained regarding these
technologies would be crucial not only in determining the features that one should be on the
lookout for in the purchase of such technologies but also determining the best fit for a
particular entity. Indeed, it is acknowledged that there are numerous vendors for every other
technology, with different packages incorporating different features (Hebda & Czar, 2013). This
necessitates that one have perfect information regarding the required and important features
prior to purchasing or implementing the same. Further, this would allow for proper knowledge
on the appropriate implementation of such technologies. The implementation of these systems
is supposed to enable providers to enhance the reimbursement rate and efficiency, as well as
improve the quality of care while averting the possibility of abuse and fraud (Pope, 2013).
Patient-care technologies have had significantly positive impacts in the recent times. As noted,
the technologies are aimed at enhancing efficiency in patient care. They bring together
information pertaining to the patient, his medical history, allergies and care provided. The
capacity to access such information regarding the patient saves immense time in patient care
and allows physicians to make accurate decisions regarding the most appropriate treatment
procedures (Hebda & Czar, 2013). Of particular note is the fact that the digitization of patient
information means that any healthcare professional of the patient’s choosing can access it. This
reduces the possibility of medical errors particularly with regard to the prescription of
medications or provision of particular treatment regimens.
Answer:
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