The practice problem I have chosen is nursing burnout. Burnout was prevalent in nursing prior to COVID-19 but has gotten increasingly worse with this global pandemic. It is important that we take care of the ones who take care of our patients. Healthcare workers take care of sick and dying often with no one left to take care of them. It is important that special measures are taken to help take care of the nurses to help prevent burnout. If nurse’s burnout who will be left to take care of everyone else. The article I found discusses nursing burnout as it relates to the Nursing Work Life Model. It discusses how the nursing practice environment has a direct impact on nursing care and patient outcomes. The model looks at factors regarding nurse work life factors, burn out and nurse patient outcomes (Spence & Leiter, 2006). This model looks at, five factors as characteristics of effective professional nursing practice environments and how they interact with each other and affect nurse and patient outcomes through the burnout/engagement process. The 5 work life factors are: (1) effective nursing leadership, (2) staff participation in organizational affairs, (3) adequate staffing for quality care, (4) support for a nursing (vs medical) model of patient care, and (5) effective nurse/physician relationships. Leiter and Laschinger6 described how these factors interact to predict the extent of nurses’ burnout or engagement with their work (Spence & Leiter, 2006).
Evidence Based Practice (EBP) has been defined as the conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of quality, cost-effective health care (Gray, Grove, & Sutherland, 2017). One model that is new is Maslach Burnout Inventory (MBI). This model talks about and assesses burnout in several different professions including nursing. There is a survey called the MBI-Human Services Survey (MBI-HSS) which focuses on emotional exhaustion and over extension by work, depersonalization, finally personal accomplishment which looks at someone feeling of self-competence and successful achievement. This model helps to assess for the level of burnout in nurses. This topic is difficult to find research on because most models apply to patients and not very many apply to actual nurses.
EBP requires looking at more than just science and research. One must have expert judgement of the seasoned clinician as well as the knowledge generated from science. Research is defined as the diligent, systematic inquiry or investigation to validate and refine existing knowledge and generate new knowledge (Gray, Grove, and Sutherland, 2017). Nursing researchers need to implement the most effective research methodologies to develop a unique body of knowledge that is core to the discipline of nursing (Gray, Grove, and Sutherland, 2017). EBP takes that very specific nursing research and makes it a project and uses clinical expertise to implement that plan.
Edition, M., MBI-HSS, I., MBI-HSS, R., MBI-HSS, G., (Data), T., License, M., Reproduce, M. and shipping, M., 2021. Maslach Burnout Inventory – Human Services Survey (MBI-HSS) – Assessments, Tests | Mind Garden – Mind Garden. [online] Mindgarden.com. Available at: <https://www.mindgarden.com/314-mbi-human-services-survey> [Accessed 10 February 2021].
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence (8th ed.). St. Louis, MO:
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing. (5th ed.). Wolters Kluwer Health.
Spence Laschinger, Heather K. PhD, RN; Leiter, Michael P. PhD The Impact of Nursing Work Environments on Patient Safety Outcomes: The Mediating Role of Burnout Engagement, JONA: The Journal of Nursing Administration: May 2006 – Volume 36 – Issue 5 – p 259- 267
The research practice problem I chose is Hospice care in the African American and Caucasian community: The misconception about end of life care. According to Peterson et al. (2019), as the population ages in the United States, more and more individuals are faced with serious illnesses with complex health care decisions. Often, making a decision about end-of-life care is difficult and challenging for patients and their families when serious illnesses occur. A common concern that is typically faced is the misconception about hospice care and what services are provided. The gap in knowledge about end of life care between African American and Caucasian’s are at different spectrums. As every nurse knows, engaging in effective communication allows patients and their caregivers to make sound decisions regarding end-of-life needs. However, racial and ethnic groups, especially ethnic minorities, find it difficult in excepting or receiving end-of-life care (Boucher & Johnson, 2021). The research is an excellent undertaking to understand further the disparities between African Americans and their perception about end-of-life care compared to Caucasians and their elected understanding about end-of-life care.
It is a known phenomenon that minorities African Americans are less likely than Caucasians to receive care consistent with their end-of-life wishes. With this known disparity, standardized education and training need to be benchmark providing insights on how hospice care in the African Americans would work and its comfort care implications (Johnson et al., 2016). Integrating social change in the community is of utmost importance. Currently, minorities and the African American community often perceive health care as one-sided. With the correct implementation of a hospice care education and its initiative, educating individuals in a structured way would garner relationships and promote positive social change.
Boucher, N. A., & Johnson, K. S. (2021). Cultivating cultural competence: How are hospice staff being educated to engage racially and ethnically diverse patients? American Journal of Hospice & Palliative Medicine, 38, 169-174. https://doi.org/10.1177/1049909120946729
Johnson, K. S., Payne, R., Kuchibhatla, M. N., & Tulsky, J. A. (2016). Are hospice admission practices associated with hospice enrollment for older African Americans and Whites? Journal of Pain & Symptom Management, 51, 697-705. https://doi.org/10.101 6/j.jpainsymman.2015.11.010
Peterson, L. J., Hyer, K., Meng, H., Dobbs, D., Gamaldo, A., & O’Neil, K. (2019). Discussing end-of-life care preferences with family: Role of race and Ethnicity. Research on Aging, 41, 823-844. https://doi.org/10.1177/0164027519858716
Differentiate the information needs within your organization
Information is currently considered an important need for competitive necessity and competitive advantage. Health organizations rely significantly on data to make informed decisions on the ways of achieving the needs of their target populations through service quality and excellence. Information needs in an organization differ significantly. For example, the information needs of the finance department aim at determining the cost-effectiveness and efficiency of the organization. On the other hand, the information needs of a psychiatry unit focus on the safety and quality indicators of health such as incident rate and adverse events in the provision of care. The management team of health organizations is interested in data that relates to the running of operations (Schreier et al., 2020). An example is their focus on the cash position on a daily basis to ensure optimum operations in the organization.
The impact of these different needs on the implementation of HIT in your present organization
The differences in information needs have significant implications for health information technology in my organization. Firstly, the variation demands the use of a robust health information system that will enable the easy acquisition, organization, analysis, and presentation of the complex organizational data. The health information experts, managers, and leaders should possess advanced knowledge and skills in utilizing complex organizational data to make strategic decisions for the institution. The differences in the information needs also demand the need for interoperability in the systems (Saba & McCormick, 2021). The health information system that is adopted in the organization should facilitate easy transfer and exchange of information across departments for enhanced decision-making.
The impact of these different needs on the implementation of HIT in your present organization
The flow of information across HIT in my organization supports evidence-based practice. The information collection system enables the tracking of the organizational indicators of quality and safety. The data is collected and pooled in a central system where the organizational stakeholders can access and use the information to develop the desired strategies. Through this, the pooled information is utilized to develop quality improvement initiatives for evidence-based practice. Furthermore, the inter-professional teams use the data collected from the different departments to develop quality improvement initiatives, hence, underpinning evidence-based practice.
Saba, V. K., & McCormick, K. A. (2021). Essentials of Nursing Informatics, 7th Edition. McGraw-Hill Education.
Schreier, G., Hayn, D., & Eggerth, A. (2020). health 2020 – Biomedical Informatics for Health and Care: Proceedings of the 14th Health Informatics Meets Digital Health Conference. IOS Press.
Information architecture (IA) is the design and organization of websites to support finding, sharing, and understanding of information across many systems. It is the organization of information on a website that allows the user to reach the information easily. Health information architecture of health information systems is designed to serve the information needs of healthcare, policymakers, and program managers (Kumar et al., 2018). The purpose of information architecture is to create a structured shared information environment that is functional for users because finding information is important for users especially in healthcare where the web is the main gateway for information searching through the use of clinical decision support systems. Finding information quickly is important and searching for information in poorly organized websites can be frustrating therefore, it is vital to understand the information architecture of a website (Ball et al., 2011).
Information and information exchange are crucial to the delivery of care at all levels of the health care delivery system, the patient, the care team, and the health care organization. To diagnose and treat individual patients effectively, individual care providers and care teams must have access to at least three major types of clinical information, the patient’s health record, the medical-evidence base, and provider orders to guide the process of patient care. In addition, they need information on patient preferences and values and important administrative information (yen et al., 2017).
Difference in Information needs Within My Organization
The variation in information needs across my healthcare organization (disease management) makes the organization to implement healthcare information technologies (HIT) platforms and systems that will meet the information needs of each department. Considerations are given to each department to design and implement systems that will support and align the unique information needs of each department and role. The administrative roles platforms were designed to have a consolidated view of the organization and access to cost, quality management and patient care. At the care team level which comprises of nurses, dieticians, case managers, social workers. And enrollment specialists, each department have a platform that is specific for their roles and all these platforms are eventually merged together for continuity of care by the TRAX system, so that the patient’s health record, information on the patient’s preferences and values, clinical orders, administrative information, and all the data and information necessary to provide a personalized health management education will be accessible to those involved in the care of the patient (Yen et al., 2017).
Impact of Different Information Needs on the Implementation of HIT in My organization.
In an organization where there are different roles for different departments, the information architecture is to work out who does what and when, different roles in an organization means different information needs and different search practices.
How the Flow of Information Across HIT Systems Within My Organization Supports Evidence-Based Practice.
The flow of information across HIT systems within my organization supports evidence-based practice because being able to access information on a patient promotes the continuity of care as the information will help to analyze and optimize patient care as well as the delivery of care. Information systems support EBP because they capture, transform, and maintain data by processing raw data into information and knowledge, and the information becomes the evidence (Lavin,2015).
Ball, M. J., Douglas, J. V., Hinton Walker, P., DuLong, D., Gugerty, B., Hannah, K. J., . . . Troseth, M. R. (Eds.) (2011). Nursing informatics: Where technology and caring meet (4th ed.). London, England: Springer-Verlag.
Kumar, M., Mostafa, J., & Ramaswamy, R. (2018). Federated health information architecture: Enabling healthcare providers and policymakers to use data for decision-making. HEALTH INFORMATION MANAGEMENT JOURNAL, 47(2), 85–93. https://doi-org.ezp.waldenulibrary.org/10.1177/1833358317709704
Lavin,M. (2015). Health Information Technology, Patient Safety, and Professional Nursing Care Documentation in Acute Care Settings. http://ojin.nursingworld.org/
Yen, P.-Y., McAlearney, A. S., Sieck, C. J., Hefner, J. L., & Huerta, T. R. (2017). Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation. JMIR Medical Informatics, 5(3), e28. https://doi-org.ezp.waldenulibrary.org/10.2196/medinform.7476