Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations Essay

Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations Essay

Healthcare problems have a significant impact on various care aspects. In this era of technology, healthcare facilities can leverage technology to improve patient outcomes and lead to quality outcomes. Care coordination and community resources can also be used to improve the success of efforts in managing healthcare problems. Catheter-acquired urinary tract infections have been the primary focus of this capstone project. The previous assessments discussed the effects of the problem on care quality, safety, and cost to the system, evidence-based strategies to manage the problem, collaboration, communication, and leadership strategies. This essay discusses the impact of technology, care coordination, and community resources in managing the healthcare problem.

Healthcare technologies can be leveraged to help address this problem. The technologies of interest are electronic health records and healthcare dashboards. Electronic health records are vital technologies that allow healthcare providers to store and retrieve data for healthcare uses. All patient data is securely stored in HER, improving retrieval and utilization processes compared to files prone to destruction, misplacement, and other issues such as legibility (Colborn et al., 2019). EHR can be used to collect and store patient data, for routine care practices, and to inform healthcare projects. Colborn et al. (2019) note that EHRs are vital data sources for diagnosing CAUTIs, and facilitating their management. The technology can also facilitate other roles, such as monitoring, because checklists can be embedded as standardized terminologies to facilitate the change. This technology is also significant to professional communication and is thus vital to CAUTI prevention. In contemporary practice, electronic health records play vital roles in communication and are reliable channels of communication and coordination

Healthcare dashboards are other vital technologies to this problem. Healthcare dashboards show the real-time performance of institutions in various quality indicators. They help healthcare providers monitor projects. The Agency for Healthcare Research and Quality recommends these two technologies for managing CAUTIs (AHRQ, n.d.). Makic et al. (2022) show that healthcare dashboards can be leveraged to determine and alert care providers on unsafe catheter removal practices, such as a prolonged number of days in situ. In contemporary practice, healthcare dashboards are professionals’ companions and help show daily progress and changes in care quality indicators, which serve as a reminder and motivation o professionals in quality improvement.

There are various barriers to the application of healthcare technologies. One of the major problems is the lack of organizational leadership support. The barrier reduces the vigilance and significance of these technologies, which affects the utilization of these technologies (Bersani et al., 2020). Lack of staff knowledge is another contributing factor to their underutilization. Some nurses do not understand these technologies, such as healthcare dashboards, and how to use them to leverage change. Bersani et al. (2020) note that the lack of knowledge and perceived difficulty affects their utilization and subsequent patient outcomes. Barnes et al. (2022) note that change resistance due to the unfamiliarity of healthcare dashboards can also limit their utilization. Electronic health records and healthcare dashboards are expensive technologies, but their large-scale implementation and widespread uses make them cost-effective. Their maintenance costs are also low. In most facilities, these technologies exist and are just leveraged to improve outcomes. These technologies will help enhance communication, monitoring, data management, and organization of the change program. Thus, these technologies are significant to change’s management.

Care Coordination and Community Resources in Addressing the Problem

Care coordination refers to the synchrony of patient health services from interprofessional teams. Catheter-acquired urinary tract infections are associated with various factors, from diabetes, gender (women most affected), prolonged use, and unnecessary indications. The preventive interventions are multifaceted, and the prevention team requires many professionals to ensure proper catheter utilization, care, and removal practices. Busbee et al. (2020) studied the effects of the interprofessional Analyze-Control-Improve model on the detection and management of CAUTIs. The study results showed that interprofessional teams help ensure quality patient outcomes in care delivery. Professionals’ collaboration and care coordination have superimposed effects on CAUTI prevention and care delivery efficiency (Busbee et al., 2020). Gregory et al. (2023) also show that coordinated activities from the prescribing (doctors and advanced practice nurses) to intervening teams (nurses) help reduce CAUTIs and improve their monitoring. Contrary opinions oppose care coordination and interprofessional collaboration and care coordination, citing delayed decision-making with no guarantee of quality decisions and subsequent outcomes (Loving, 2021).

Community resources are also significant to the management of CAUTIs and other infections. Patient care does not end at the facility, and the continuity of patient care interventions in the homes and the community is significant. Most available community resources are local health centers for catheter care, insertion, removal practices, and educational resources that help patients understand and participate in preventing CAUTIs. Mangal et a. (2022) conducted a study to determine the effectiveness of community members’ (parents) education on CAUTI prevention. The study results showed that the remote participation of community members brings vital perspectives to the care team on care interventions at home, promoting quality outcomes. Ford et al. (2020) support these findings and state that education in community settings can supplement efforts directed towards CAUTI prevention and management to produce better outcomes. Websites such as the CDC, WHO, and the AHRQ are vital sources of information for the population, and directing patients to such sites can help improve outcomes through knowledge enhancements. McEwan et al. (2022) note that online patient education is a viable CAUTI prevention community resource that can be used to promote awareness and better health outcomes. Patients and populations enhanced knowledge leads to quality outcomes and contributes significantly to CAUTI prevention in homes (Ford et al., 2020).

In contemporary practice, care coordination is significant, and professionals focus on making team decisions to ensure the decisions are high quality and meet the patients’ needs (patient-centered). They also utilize community resources such as focus/support groups and online resources to produce quality patient outcomes. Barriers to care coordination include interprofessional conflict, which impedes collaboration and cripples care coordination efforts (Loving, 2021). Seeding interprofessional harmony can help improve care coordination and ensure individuals reap the benefits of interprofessional collaboration. Lack of professionals’ knowledge of the existence and utilization of community resources affects their utilization.

State Board Nursing Practice Standards/Organizational/Governmental Policies Associated with Health Technology, Care Coordination, and Community Resources

Government policies regulate practices in many ways. They dictate the use, structure, access, and quality of healthcare technologies and resources. One of the significant policies is the HIPAA, which regulates data sharing hence care coordination. Qin et al. (2019) state that HIPAA affects care coordination significantly due to its stringent rules on data sharing, especially with non-medical professionals, despite the importance of sharing the data. HIPAA regulates the quality of healthcare technologies and community resources, such as homeless shelters and support groups. All virtual groups must comply with the HIPAA privacy rule, which regulates access and sharing of patient information to safeguard protected health information. HIPAA ensures privacy, confidentiality, and security, and it requires healthcare institutional technologies to ensure data is safe from unauthorized personnel access. Interventions to ensure safe access include password access, monitored login, specific activity, and patient information deidentification (Moore & Fyre, 2019). Dewangan et al. (2019) note that. The policy will inform the selection of technology and community resources to use. It will also increase vigilance because any HIPAA rule breaches attract fines to the healthcare facility, imposing disciplinary measures on the care providers involved. The technologies and resources must meet the basic requirements to ensure patient information’s security, confidentiality, and safety. The policy will also guide on which information can be accessed for the selected project and which information, when collected, will amount to a HIPAA data privacy breach (Moore & Frye., 2019).

The nursing profession is subject to various regulations and policies that affect the scope of practice. Nurses’ roles are not confined to hospital settings. They work with other professionals and institutions, such as community centers, homeless shelters, and support groups, to ensure care continuity and promote quality patient health outcomes. Care coordination is thus essential to their roles. HIPAA regulates nurses’ health information-sharing practices and whom they coordinate within the care process (Qin, 2019). The HIPAA act is significant to care coordination and community resources because nurses restricted information sharing. At the same time, the act helps ensure authenticity in care delivery and that resources, personnel, and institutions involved in care coordination are HIPAA compliant, and that patient information is safe (Qin, 2019). The affordable care act is a government policy that significantly affects nurses’ scope of practice in care coordination. The act strengthens the nurses’ scope of practice by pressuring them to work with professionals within and outside facilities to ensure improved patient care access (Cleveland et al., 2019). Thus, these policies will be significant in informing the scope of nurses’ practice in care coordination and utilization of community resources. HIPAA will regulate the management of CAUTI in this project in various ways. It will regulate data sharing and dictate which data can be collected and which can and cannot be collected for use in this study. In addition, HIPAA will help regulate the professionals involved in the study based on its regulations on professionals who can access patient data.

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Nursing Ethics

Nursing ethics are vital to all research and practice interventions and ensure that nurses’ actions represent the nursing profession’s ethical codes and research ethics. Butts and Rich (2019) note that nursing ethics includes autonomy to facilitate self-determination and independent decision-making. Nursing research will play a significant role in using applied technologies and community resources. The ethical principles of significance will include confidentiality, veracity, beneficence, and non-maleficence. The technologies selected must maintain patient confidentiality by sharing only the consented information. Autonomy will also be significant because individuals are subject to full disclosure of technologies that facilitate collecting, storing, and disseminating healthcare data (Butts & Rich 2019). The technologies and community resources must also relay maximum benefits and minimize patient risks. In addition, technologies such as patient portals may be significant so that patients have access to their health information and also understand the progress of the project in which they will be involved. Thus, nursing ethics will be significant in selecting and utilizing technologies and community resources.

Part 2

After meeting with the infection control nursing expert the second time, the infection control nurse helped discuss the effects of the problem on care quality, patient safety, and costs to the system and individuals. She also helped highlight the quality issues, which included pyelonephritis, septic arthritis, endophthalmitis, endocarditis, gram-negative bacteremia, and subsequent high mortality (Odoemene et al., 2019). These factors affect patient safety and quality care delivery. CAUTIs also cause discomfort and other infectious symptoms such as fever and headache, which affects patients’ self-reported healthcare experiences and satisfaction with healthcare services. We reviewed information from reputable databases and websites such as the CDC, the Institute for Healthcare Improvement, and the healthcare research and quality agency. These websites provide information on the prevalence, burden, prevention, and monitoring of CAUTIs. Reviewing these websites increased my knowledge of these CAUTI aspects and my desire to participate in CAUTI prevention in the healthcare facility for quality patient outcomes.

We revisited the objectives of the meeting’s simple definitions in CAUTIs management during the meeting. We then discussed the issues from quality, safety, and cost considerations and also evaluated the various organizational and governmental websites for information on CAUTI management. Based on my experiences, I plan to address the problem change based on my experiences. There are various interventions I have learned that are used to address the problem, such as clinician education, patient education, and checklists (AHRQ, n.d.). These interventions can also be used in bundles, as seen in the agency’s recommendations for healthcare research and the institute for healthcare improvement. What surprised me about the problem is the government policies surrounding it. The Centers for Medicare and Medicaid do not reimburse healthcare costs incurred when caring for catheter-acquired urinary tract infections (AHRQ, n.d.). Patients and healthcare facilities must pay these costs hence high healthcare costs to individuals and the system.

Conclusion

Healthcare technologies and community resources play significant roles in managing healthcare problems. Nurses use healthcare technologies to coordinate care and collaborate with other healthcare professionals. It is imperative to note that care coordination is affected by policies such as HIPAA and ACA. The nurses’ scope of practice in care coordination and healthcare technology and community resources use is also regulated by these policies. Understanding these policies and legislations will enhance success in care coordination, technology, and community resources utilization for CAUTI management. The problem would benefit from technologies such as healthcare dashboards and community resources for its management at the facility and in homes.

References

Agency for Healthcare Research and Quality (AHRQ) (n.d.). Healthcare-Associated Infections Program: Toolkit for Reducing CAUTI in Hospitals. Retrieved March 15, 2023, from https://www.ahrq.gov/hai/tools/cauti-hospitals/index.html

Barnes, G. D., Sippola, E., Ranusch, A., Takamine, L., Lanham, M., Dorsch, M., Sales, A., & Sussman, J. (2022). Implementing an electronic health record dashboard for safe anticoagulant management: learning from qualitative interviews with existing and potential users to develop an implementation process. Implementation Science Communications, 3(1), 10. https://doi.org/10.1186/s43058-022-00262-w

Bersani, K., Fuller, T. E., Garabedian, P., Espares, J., Mlaver, E., Businger, A., Chang, F., Boxer, R. B., Schnock, K. O., Rozenblum, R., Dykes, P. C., Dalal, A. K., Benneyan, J. C., Lehmann, L. S., Gershanik, E. F., Bates, D. W., & Schnipper, J. L. (2020). Use, Perceived Usability, and Barriers to Implementation of a Patient Safety Dashboard Integrated within a Vendor EHR. Applied Clinical Informatics, 11(1), 34–45. https://doi.org/10.1055/s-0039-3402756

Busbee, V. W., Lindsay, S. L., Mayernik, C. A., & Ramey, J. (2020). CAUTI eradication through system culture change. American Journal of Infection Control, 48(8), S41. https://doi.org/10.1016/j.ajic.2020.06.040

Butts, J. B., & Rich, K. L. (2022). Nursing ethics: Across the curriculum and into practice. (6^th Ed.). Jones & Bartlett Learning.

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable Care: Harnessing the Power of Nurses. Online Journal of Issues in Nursing, 24(2). https://doi.org/10.3912/OJIN.Vol24No02Man02

Colborn, K. L., Bronsert, M., Hammermeister, K., Henderson, W. G., Singh, A. B., & Meguid, R. A. (2019). Identification of urinary tract infections using electronic health record data. American Journal of Infection Control, 47(4), 371-375. https://doi.org/10.1016/j.ajic.2018.10.009

Dewangan, K., Mishra, M., & Dewangan, N. K. (2021). A review: A new authentication protocol for a real-time healthcare monitoring system. Irish Journal of Medical Science (1971-), 190, 927-932. https://doi.org/10.1007/s11845-020-02425-x

Ford, D., Haupt, B., Rochon, R., Bartoshevich, D., Rodriguez, M., & Zuluaga, J. C. (2020). Beyond Bundles in Prevention of CAUTI and UTIs. Infection Control & Hospital Epidemiology, 41(S1), s139-s140. https://doi.org/10.1017/ice.2020.654

Gregory, M. E., MacEwan, S. R., Sova, L. N., Gaughan, A. A., & Scheck McAlearney, A. (2023). A Qualitative Examination of Interprofessional Teamwork for Infection Prevention: Development of a Model and Solutions. Medical Care Research and Review, 80(1), 30-42. https://doi.org/10.1177/10775587221103973

Loving, V. A. (2021). Collaborative, interdepartmental teams: benefits, challenges, alternatives, and the ingredients for team success. Clinical Imaging, 69, 301-304. https://doi.org/10.1016/j.clinimag.2020.10.003

MacEwan, S. R., Beal, E. W., Gaughan, A. A., Sieck, C., & McAlearney, A. S. (2022). Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections. Infection Control & Hospital Epidemiology, 43(9), 1129-1134. https://doi.org/10.1017/ice.2021.271

Mangal, S., Carter, E., & Arcia, A. (2022). Developing an educational resource for parents on pediatric catheter-associated urinary tract infection (CAUTI) prevention. American Journal of Infection Control, 50(4), 400-408. https://doi.org/10.1016/j.ajic.2021.09.006

Makic, M. B. F., Stevens, K. R., Gritz, R. M., Wald, H., Ouellet, J., Morrow, C. D., Rodrick, D., & Reeder, B. (2022). Dashboard design to identify and balance competing risks of multiple hospital-acquired conditions. Applied Clinical Informatics, 13(03), 621-631. https://doi.org/10.1055/s-0042-1749598

Moore, W., & Frye, S. (2019). Review of HIPAA, Part 1: history, protected health information, and privacy and security rules. Journal of Nuclear Medicine Technology, 47(4), 269-272. https://doi.org/10.2967/jnmt.119.227819

Odoemene, C. A., & Adiri, C. O. (2019). Catheter-associated urinary tract infection offending pathogens, antimicrobial sensitivity, and complications. Nigerian Journal of Surgical Sciences, 29(1), 6. https://doi.org/10.4103/njss.njss_6_20

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Qin, F. (2019). The Debilitating Scope of Care Coordination Under HIPPA, 98 N.C. L. REV. 1395. UNC School of Law. https://scholarship.law.unc.edu/nclr/vol98/iss6/6

In a 5-7 page written assessment, determine how health care technology, coordination of care, and community resources can be applied to address the patient, family, or population problem you’ve defined. In addition, plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Report on your experiences during the second 2 hours of your practicum.

Introduction

As a baccalaureate-prepared nurse, you’ll be positioned to maximize the use of technology to achieve positive patient outcomes and improve organizational effectiveness. Providing holistic coordination of patient care across the entire health care continuum and leveraging community resource services can lead both to positive patient outcomes and to organizational improvements.

Preparation

In this assessment, you’ll determine how health care technology, coordination of care, and community resources can be applied to address the health problem you’ve defined. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.

To prepare for the assessment:

Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.

Conduct sufficient research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.

Review the Practicum Focus Sheet: Assessment 3 [PDF], which provides guidance for conducting this portion of your practicum.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

Instructions

Complete this assessment in two parts.

Part 1

Determine how health care technology, the coordination of care, and the use of community resources can be applied to address the patient, family, or population problem you’ve defined. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 3 [PDF] provided for this assessment to guide your work and interpersonal interactions.

Part 2

Report on your experiences during the second 2 hours of your practicum.

Whom did you meet with?

What did you learn from them?

Comment on the evidence-based practice (EBP) documents or websites you reviewed.

What did you learn from that review?

Share the process and experience of exploring the effect of the problem on the quality of care, patient safety, and costs to the system and individual.

Did your plan to address the problem change, based upon your experiences?

What surprised you, or was of particular interest to you, and why?

Capella Academic Portal

Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal.

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

Analyze the impact of health care technology on the patient, family, or population problem.

Cite evidence from the literature that addresses the advantages and disadvantages of specific technologies, including research studies that present opposing views.

Determine whether the evidence is consistent with technology use you see in your nursing practice.

Identify potential barriers and costs associated with the use of specific technologies and how those technologies are applied within the context of this problem.

Explain how care coordination and the utilization of community resources can be used to address the patient, family, or population problem.

Cite evidence from the literature that addresses the benefits of care coordination and the utilization of community resources, including research studies that present opposing views.

Determine whether the evidence is consistent with how you see care coordination and community resources used in your nursing practice.

Identify barriers to the use of care coordination and community resources in the context of this problem.

Analyze state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Explain how these standards or policies will guide your actions in applying technology, care coordination, and community resources to address care quality, patient safety, and costs to the system and individual.

Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of technology, care coordination, and community resources.

Explain how nursing ethics will inform your approach to addressing the problem through the use of applied technology, care coordination, and community resources.

Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.

Apply APA style and formatting to scholarly writing.

Additional Requirements

Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:

A title page and reference page. An abstract is not required.

Appropriate section headings.

Length: Your paper should be approximately 5–7 pages in length, not including the reference page.

Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.

Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.

Analyze the impact of health care technology on a patient, family, or population problem.

Competency 5: Analyze the impact of health policy on quality and cost of care.

Analyze state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Competency 6: Collaborate interprofessionally to improve patient and population outcomes.

Explain how care coordination and the utilization of community resources can be used to address a patient, family, or population problem.

Competency 8: Integrate professional standards and values into practice.

Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.

Apply APA style and formatting to scholarly writing.