Effects of “To Err Is Human” in Nursing Practice

Transforming Nursing
DISCUSSION- 1

The Effects of “To Err Is Human” in Nursing Practice

The 1999 landmark study titled “To Err Is Human: Building a Safer Health System” highlighted the unacceptably high incidence of U.S. medical errors and put forth recommendations to improve patient safety. Since its publication, the recommendations in “To Err Is Human’ have guided significant changes in nursing practice in the United States.

In this Discussion, you will review these recommendations and consider the role of health information technology in helping address concerns presented in the report.

To prepare:

Review the summary of “To Err Is Human” presented in the Plawecki and Amrhein article found in this week’s Learning Resources.

Consider the following statement:

“The most significant barrier to improving patient safety identified in “To Err Is Human” is a “lack of awareness of the extent to which errors occur daily in all health care settings and organizations (Wakefield, 2008).”

Review “The Quality Chasm Series: Implications for Nursing” focusing on Table 3: “Simple Rules for the 21st Century Health Care System.” Consider your current organization or one with which you are familiar. Reflect on one of the rules where the “current rule” is still in operation in the organization and consider another instance in which the organization has effectively transitioned to the new rule.

Please Provide References

Learning Resources

Required Readings

American Nurses Association. (2015). Nursing informatics: Scope & standards of practice (2nd ed.). Silver Springs, MD: Author.

“Introduction”

This portion of the text introduces nursing informatics and outlines the functions of the scope and standards.

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

Chapter 1, “Nursing Science and the Foundation of Knowledge”

This chapter defines nursing science and details its relation to nursing roles and nursing informatics. The chapter also serves as an introduction to the foundation of knowledge model used throughout the text.

Chapter 2, “Introduction to Information, Information Science, and Information Systems”

In this chapter, the authors highlight the importance of information systems. The authors specify the qualities that enable information systems to meet the needs of the health care industry.

Wakefield, M. K. (2008). The Quality Chasm series: Implications for nursing. In R. G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses (Vol. 1, pp. 47–66). Rockville, MD: U. S. Department of Health and Human Services.

Pages 1–12

These 12 pages highlight the issues raised by the Quality Chasm Series and examine their long-term implications for nursing. The text reviews external drivers of safety and quality, design principles for safe systems, and guidelines for health care redesign.

Cipriano, P. F., & Murphy, J. (2011). Nursing informatics. The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 282, 286–289.

In this article, the authors focus on how nurses can use health information technology to help transform health care using the recommendations included in the 2010 Institute of Medicine report “The Future of Nursing, Leading Change, Advancing Health.” The author also discusses the 2011 National Strategy for Quality Improvement in Health Care.

Plawecki, L. H., & Amrhein, D. W. (2009). Clearing the err. Journal of Gerontological Nursing, 35(11), 26–29.

This article presents a summary of the Institute of Medicine report “To Err Is Human: Building a Safer Health System.” The authors provide an overview of what has been accomplished in the decade following the IOM report, focusing in particular on health information technology.

Required Media

Laureate Education (Producer). (2012e). Introduction to nursing informatics. Baltimore, MD: Author.

In this video, Doris Fischer, Richard Rodriguez, Carina Perez, and Carmen Ferrell introduce the concept of nursing informatics. These individuals provide insight into how informatics is transforming the health care system by improving efficiency and quality of care.

Optional Resources

Hilts, M. E. (2010). Up from the basement. Health Management Technology, 31(9), 14–15.

Retrieved from the Walden Library databases.

Institute of Medicine. (1999). To err is human: Building a safer health system. Retrieved from http://web.archive.org/web/20141016134546/http://www.iom.edu/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf

Kohn, L. T., Corrigan, J. M., & Donaldson, M.S. (Eds.). (2000). To err is human: Building a safer health system. Washington, D. C.: Institute of Medicine. Retrieved from the National Academies Press website: https://download.nap.edu/catalog.php?record_id=9728

DISCUSSION-2

Nursing Informatics Competencies

Today’s fast-paced health care environment demands nurses to be skilled not only in their clinical practice or specialty area but in the use of technology tools that improve practice and lead to better patient care. Basic and advanced technology competencies are required and expected as technology increasingly touches and changes the job of every nurse. Numerous organizations, including the American Nurses Association (ANA), the American Medical Informatics Association (AMIA), and Healthcare Information and Management Systems Society (HIMSS), have developed nurse-specific technology competencies. The challenge for nurses is to identify both needs and training opportunities.

In this Discussion, you identify the role informatics plays in your professional responsibilities. You pinpoint personal gaps in skills and knowledge and then develop a plan for self-improvement.

To prepare:

Review Nursing Informatics: Scope and Standards of Practice in this week’s Learning Resources, focusing on the different functional areas it describes. Consider which areas relate to your current nursing responsibilities or to a position you held in the past. For this Discussion, identify one or two of the most relevant functional areas.

Review the list of competencies recommended by the TIGER Initiative. Identify at least one skill in each of the main areas (basic computer competencies, information literacy competencies, and information management competencies) that is pertinent to your functional area(s) and in which you need to strengthen your abilities. Consider how you could improve your skills in these areas and the resources within your organization that might provide training and support.

Please Provide References

Learning Resources

Required Readings

American Nurses Association. (2015). Nursing informatics: Scope & standards of practice (2nd ed.). Silver Springs, MD: Author.

“Functional Areas for Nursing Informatics”

This chapter describes the key functional areas of nursing informatics. It also clarifies the roles of informatics nurse specialists and informatics nurses.

“Informatics Competencies: Spanning Careers and Roles”

This chapter details an informatics competencies matrix that has been developed by reviewing research. It outlines best practices for successful use of health information technology.

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

Chapter 7, “Informatics Roles and the Knowledge Work of Nursing”

This chapter details the roles, competencies, and skills that ensure effective nursing informatics practice. The text also details the future of nursing informatics.

Chapter 8, “Information and Knowledge Needs of Nurses in the 21st Century”

In this chapter, the author emphasizes the need for embedding the core concepts and competencies of informatics into the practice of nurses. The chapter describes how this integration of concepts and competencies is necessitated by the integration of clinical information technologies into nursing practice.

Wakefield, M. K. (2008). The Quality Chasm series: Implications for nursing. In R. G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses (Vol. 1, pp. 47–66). Rockville, MD: U. S. Department of Health and Human Services. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK2677/

Pages 12–19

This chapter discusses four of the Institute of Medicine’s reports on the quality and safety of health care. Specifically, the chapter focuses on the issues, concepts, findings, and recommendations of To Err Is Human, Crossing the Quality Chasm, Health Professions Education: A Bridge to Quality, and Quality Through Collaboration: The Future of Rural Health Care.

Cheeseman, S. E. (2011). Are you prepared for the digital era? Neonatal Network, 30(4), 263–266.

This article explores the application of health information technology (HIT) in neonatal intensive care units. In addition, the article highlights national initiatives advocating for the implementation of HIT throughout the health care delivery system.

AMIA. (2012). AMIA. Retrieved from http://www.amia.org/

This homepage of AMIA (formerly known as the American Medical Informatics Association) details the activities of the AMIA, including its publications, programs, events, and policies.

Healthcare Information and Management Systems Society. (2012a). Healthcare Information and Management Systems Society. Retrieved from http://www.himss.org/

This homepage of the Healthcare Information and Management Systems Society displays research conducted by HIMSS and introduces various tools, events, and resources for professional development.

Healthcare Information and Management Systems Society.(2012b). Resources/reports. Retrieved from https://web.archive.org/web/20151108084347/http://www.thetigerinitiative.org/resources.aspx

This page of the TIGER website contains a list of resources and reports related to the development and implementation of technology informatics.

Healthcare Information and Management Systems Society.(2012c). The TIGER initiative. Retrieved from http://www.thetigerinitiative.org/

This site includes information on the phases of the TIGER Initiative and includes related resources and reports, opportunities for strategic partnerships, and general information about TIGER.

Technology Informatics Guiding Educational Reform. (2009). TIGER informatics competencies collaborative final report. Retrieved from http://tigercompetencies.pbworks.com/f/TICC_Final.pdf

This text details foundational informatics competencies that nurses should possess in order to meet standards of providing safe, quality, and competent care. In particular, this article specifies requirements for nurses in the areas of basic computer competencies, information literacy, and information management.

The TIGER Initiative. (2009). Informatics competencies for every practicing nurse: Recommendations from the TIGER collaborative. Retrieved from https://web.archive.org/web/20150323183938/http://thetigerinitiative.org/docs/TigerReport_InformaticsCompetencies_001.pdf

This report supplies the findings and recommendations of the Informatics Competencies Collaborative Team. The text describes the background, methodology, findings, and recommendations for future work as stated by the team.

Quality and Safety Education for Nurses. (2012). Quality and Safety Education for Nurses. Retrieved from http://www.qsen.org/

This homepage supplies information on quality and safety competencies, teaching strategies, faculty resources, pilot schools, and QSEN Consultants.

Required Media

Laureate Education (Producer). (2012d). Health information technology competencies. Baltimore, MD: Author.

Optional Resources

Schleyer, R. H., Burch, C. K., & Schoessler, M. T. (2011). Defining and integrating informatics competencies into a hospital nursing department. CIN: Computers, Informatics, Nursing, 29(3), 167–173.

DISCUSSION-3

Standardized Coding Systems

As a result of the fragmented nature of the health care system, professionals in various specialty areas of medicine have developed their own unique sets of terminology to communicate within that specialty. In the past, limited attention has been given to codifying practices in order for them to be understood and utilized across disciplines or through different information technology systems. The implementation of a federally mandated electronic medical records system, therefore, poses a challenge to nursing professionals and others who must be prepared to utilize standardized codes for the new system. Why are coding standards important for promoting consistent, high-quality care?

According to Rutherford (2008, para. 15), “Improved communication with other nurses, health care professionals, and administrators of the institution in which nurses work is a key benefit of using a standardized nursing language.” In this Discussion you consider the reasoning behind and the value of standardized codification.

To prepare

Review the information in Nursing Informatics: Scope and Standards of Practice. Determine which set of terminologies are appropriate for your specialty or area of expertise.

Reflect on the importance of continuity in terminology and coding systems.

In the article, “Standardized Nursing Language: What Does It Mean for Nursing Practice?” the author recounts a visit to a local hospital to view its implementation of a new coding system. One of the nurses commented to her, “We document our care using standardized nursing languages but we don’t fully understand why we do” (Rutherford, 2008, para. 1). Consider how you would inform this nurse (and others like her) of the importance of standardized nursing terminologies.

Reflect on the value of using a standard language in nursing practice. Consider if standardization can be limited to a specialty area or if one standard language is needed across all nursing practice. Then, identify examples of standardization in your own specialty or area of expertise. Conduct additional research using the Walden Library that supports your thoughts on standardization of nursing terminology.

Please Provide References

Learning Resources

Required Readings

American Nurses Association. (2015). Nursing informatics: Scope & standards of practice (2nd ed.). Silver Springs, MD: Author.

“Metastructures, Concepts, and Tools of Nursing Informatics”

This chapter explores the connections between data, information, knowledge, and wisdom and how they work together in nursing informatics. It also covers the influence that concepts and tools have on the field of nursing.

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

Chapter 6, “Overview of Nursing Informatics”

This chapter defines the foundations of nursing informatics (NI). The authors specify the disciplines that are integrated to form nursing informatics, along with major NI concepts.

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