Clinical Experience
Sunrise Clinical System Version 6.1

The Emergency Room: Hybrid System

Meetings and Collaborative Care Councils

orkflow of the EMR

The KBC ( Knowledge Bas Charting) 3.4 Upgrade 6

The Role of the Nurse Informaticist

Comprehensive Analysis of my Clinical Experience

After completing 100 hours of practicum in informatics, the following will show the time at the site with my preceptor. The practicum took place at Franklin Hospital - North Shore Long Island. North Shore-LIJ which is an award-winning health system that consist of world-class tertiary hospitals, a nationally well-known children's hospital, a notorious mental facility and an assortment of community hospitals, in addition to a range of wellness and health programs. North Shore-LIJ Health System consist of 16 award-winning hospitals and approximately 400 physician practice locations all through New York, as well as Long Island, Manhattan, Queens and Staten Island. North Shore-LIJ Proudly serving an area of seven million people, North Shore-LIJ delivers world-class services…...

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Works Cited

North Shore-LIJ Health System. (2014, April 29). Retrieved from North Shore LLJ:  http://www.northshorelij.com/hospitals/services-and-programs/bariatric-surgery 

Russell, C.L. (2010). A clinical nurse specialist -- led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement. Clinical Nurse Specialist, 24(2), 69-75. doi:10.1097/NUR.0b013e3181cf554d

Seidl, K. L. And Newhouse, R.P. (2012). The Intersection of evidence-based practice with 5 quality improvement methodologies. JONA, 42(6), 299-304. doi: 10.1097/NNA.0b013e31824ccdc9

Smith, K., Tremblay, M.L., Richer, M.C., and Lanctot, S. (2010). Exploring nurses perceptions of organizational factors of collaborative relationships. The Health Care Manager, 29(3), 271-278. Doi:10.1097/HCM.0b013e3181e9351a

traumatic experience with a patient a few years ago that still left me with a bad feeling. It was a hit-and-miss instance, and the fact that it was so, more closely being miss than hit, has stayed with me ever since. It was the first time that I ever came so breathtakingly close to being implicated in causing another to die. I hope it will be the last. As to the lessons that it can teach me -- there are several.
The story was the following: It was one fine, not especially busy aturday morning when this patient was wheeled in for a percutaneous transfemoral aortic valve implantation. While the cardiology team was inserting the femoral guide wires and sheath for valve placement the ventricle was perforated. Usually we have more time and can proceed more placidly, but in this particular case, we had to rapidly respond and open the…...

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Source

Brennan, TA et a l (1991). Incidence of Adverse Events and Negligence in Hospitalized Patients -- Results of the Harvard Medical Practice Study I. N Engl J. Med 1991; 324:370-376

Greenlaw, J. (1981). Understaffing: Living with the Reality, 9 L. Med. & Health Care 23- 41

Clinical ReviewRelationship with Preceptor and Fulfillment of Clinical GoalsMy experience in the Comprehensive Psychiatric Emergency Program (CPEP) has been significantly enriched by my relationship with my preceptor, who has been great in guiding and gradually increasing my responsibilities. In terms of fulfilling my clinical goals, I have made progress, particularly in understanding psychiatric conditions and patient care, but I recognize the need for further improvement in writing concise psychiatric notes and managing my time effectively.Evaluation of the Agency/Clinical SiteThe CPEP is a first point of contact for patients with acute psychiatric conditions, providing a high-energy and challenging environment. The interdisciplinary team works cohesively and quickly. As a psychiatric NP student, I observe that NPs help with managing patient care by balancing clinical assessments with therapeutic interventions. The site is conducive to learning although fast-paced.Factors Influencing the NP RoleThe main barrier to my role as an NP student has been the…...

Clinical supervision provides a mechanism of data collection and the information reclamation in support to the recent projects and the programmatic developments.
Management of the high number of complex mental health caseloads

These implementations occur under the influence of the Workplace Implementation Committees (WIC) that were established to the oversee agreement by the CMS at the local levels. The CMS is supposed to accompany the implementation of the policies that clearly outline the expectations and responsibilities based on periods and review methods (Cogan 1972). The implementations are expected to be transparent in the process of the WIC members and the staff groups. This includes the clear articulate mechanism for regular workload assessment, management and review.

I. egularly collect the workload from all the executives to make the caseload management process easier.

II. Use the caseload information to make the staff allocation of the resources while measuring their performances.

The workforce plan and individual plans…...

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References

Cogan, M.L. (1972). Clinical supervision. Boston: Houghton Mifflin.

ERIC Clearinghouse on Educational Management., & National Institute of Education (U.S.). (1984). Clinical supervision. Eugene, or: ERIC Clearinghouse on Educational Management, College of Education, University of Oregon.

Powell, D.J. (1980). Clinical supervision: [1]. New York: Human Science Pr.

Bernard, J.M., & Goodyear, R.K. (1998). Fundamentals of clinical supervision. Boston: Allyn and Bacon.

In certain countries, an effective supervisor possesses basic teaching skills, facilitation skills, negotiation and assertiveness skills, counseling and appraisal skills, mentoring skills, and knowledge of learning resources and certification requirements (Kilminster).
The most important aspect of the role of an effective supervisor is giving supervisee responsibility and the opportunity to practice it (Kilminster, 2000). Supervisees come to view the supervisor as a colleague and this leads them to become self-directed. Some supervisees consider teaching skills and techniques, interpersonal style and professional competence the most important characteristics of an effective supervisor. An effective supervisor shows empathy, is supportive, and exhibits flexibility, instruction, knowledge, interest in supervision and good tracking of supervisees. He is interpretative, respectful, focused ad practical. In contrast, an ineffective supervisor is rigid, shows little empathy and provides low support. He fails to consistently track supervisee concerns, teach or instruct. He is indirect and intolerant. He is close-minded. He…...

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BIBLIOGRAPHY

Borders, L.D. (1994). The good supervisor. ERIC Digests: ERIC Clearinghouse on Counseling and Student Services. Retrieved on October 28, 2011 from  http://www.ericdigest.org/1995-1/good.htm 

Joslin, v. (2008). Ten traits of a good supervisor. Associated Content: Yahoo. Inc. Shine.

Retrieved on October 28, 2011 from  http://www.associatedcontent.com/article/969660/ten_traits_of_a_good_supervisor.html 

Kilminster, S.M. (2000). Effective supervision in clinical practice settings. Vol 34

Concisely, Comfort results when an individual keeps of negative or unhealthy living and sticks to positive and healthy living. Comfort has been associated with positive institutional outcomes that include patient satisfaction. The outcome of Comfort is therefore one of the most important indicator of measuring success in nursing practice particularly for patients and families going through some tough or stressful healthcare conditions.

Benefits of the Comfort theory to the Clinical Nurses of the 21st Century

Comfort theory is an important theory that is applicable to the 21st Century clinical practice because of its many inherent benefits or advantages. This theory defines the working environment for healthcare practitioners while at the same time it charts the direction for improving the services offered by the clinical nurses. The universality of the language and concepts used in presenting the theory also promotes its wide acceptance. The simplicity of the tenets of the Comfort theory ensures…...

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References

Kolcaba, K. (2003) Comfort Theory and Practice: A Vision for Holistic Health Care and Kolcaba, K.Y. (1994). A theory of holistic Comfort for nursing. Journal of Advanced Nursing, 19(6), 1178-1184.

Kolcaba, K., & DiMarco, M.A. (2005). Comfort Theory and its application to pediatric nursing. Pediatric Nursing. New York, NY: Springer Publishing Company, Inc.

Magyrary, D. (2002) Positive mental health: a turn of the century perspective. Issues of Mental Health Nursing, 23, 331-349

Malinowski, a., & Stamler, L.L. (2002). Comfort: exploration of the concept in nursing. Journal of Advanced Nursing, 39(6), 599-606.

Clinical Supervision and its Strengths and eaknesses

Annie Pettifer and colleague Lynn Clouder explain in the peer-reviewed journal Learning in Health and Social Care that clinical supervision is commonly used in professional contexts as a way to "guide reflection with the purpose of advancing practice" (Pettifer, 2008, 169). Clinical supervision "…enables critical practice and development of personal knowledge, professional expertise and competence" (Pettifer, 169).

Pettifer mentions that there is no hard and fast rule as to how the clinical supervision model should be presented. There are many interpretations, the author explains, and there is "conceptual ambiguity" as well; but the ambiguity can be explained because there can be no single model that meets all the professional needs of principals. But that said, there is a basic definition of clinical supervision that is presented by the authors:

"…[clinical supervision] is a formal process of support and learning which enables individual practitioners to develop knowledge…...

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Works Cited

Gibble, J.L., and Lawrence, J.D. (1987). Peer Coaching for Principals. Educational Leadership.

Huston, T., and Weaver, C.L. (2008). Peer Coaching: Professional Development for Experienced Faculty. Innovations in Higher Education, Vol. 33, 5-20.

Pettifer, A., and Clouder, L. (2008). Clinical supervision: a means of promoting reciprocity between practitioners and academics. Learning in Health and Social Care, 7(3), 168-177.

Pfeifer, D. (2011). Transforming Staff through Clinical Supervision. Reclaiming Journal,

According to the AACN's report, "Nurse Practitioner Primary Care Competencies in Specialty Areas: Adult, Family, Gerontological, Pediatric, and Women's Health" (2002), "Competencies are the domain or body of knowledge and skills that essentially define a profession or discipline. This domain of competencies guides training programs, provides expectations for employers, and drives the nature of assessment instruments and performance standards for credentialing institutions, certifying agencies, and accrediting organizations" (p. 14).
The core competencies for nurse practitioner graduates are intended to help candidates used what they have already learned and require a graduate-level education in order to attain certification as an APN and the AACN has developed this graduate curriculum as the basis for advanced practice nursing. As described by AACN, advanced practice nursing preparation includes ". . . graduate nursing core content (e.g., research, health policy, ethics, and more) and advanced nursing practice content (e.g., advanced health assessment, advanced physiology and…...

Since modern medicine can sustain patients with proper medical follow-up for years, it becomes incumbent on the profession to follow the patients and provide them with the knowledge and tracking to insure that they are observing the procedures and medications which prolong their quality of life. Given hospitals' short-term orientation with the patients, there is a need to bridge patient care before, during and after acute-care visits.

While there are some nursing specialties which can be regarded as solely hospital- or community-based, many of the specialties call for a more holistic notion of patient care. y combining the CNS and NP specialties, this profession has a better chance of assuring better patient outcomes, and a better quality of life for the patient.

ibliography

ennett, .J. (1998). Psychiatric mental health nursing: thriving in a changing environment through outcomes-based measurements. Semin. Nurse Manage., 144-148.

erger, a.M.-F. (1996). Advanced practice roles for nurses in tomorrow's healthcare systems.…...

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Bibliography

Bennett, B.J. (1998). Psychiatric mental health nursing: thriving in a changing environment through outcomes-based measurements. Semin. Nurse Manage., 144-148.

Berger, a.M.-F. (1996). Advanced practice roles for nurses in tomorrow's healthcare systems. Clinical Nurse Specialist, 250-255.

Chaska, N.L. (2001). The Nursing Profession Tomorrow and Beyond. Thousand Oaks: Sage.

Cukr, P.L. (1997). The psychiatric clinical nurse specialist/nurse practitioner: an example of a combined role. Arch Psychiatr Nurs, 2-12.

Clinical Learning Outcomes
Interaction of Variables.

Evaluating clinical learning outcomes

Describe the skill and the learner you intend to teach and evaluate

Because of cutbacks in the number of days new patients are allotted to spend in the hospital, patients and their families are increasingly responsible for more of the patient's care, even immediately following a diagnosis of a serious illness such as type I, or juvenile, insulin-dependent diabetes. Teaching patients to correctly monitor their blood sugar and self-administer insulin is essential, but it requires a high level of patient compliance and willingness to learn. It is essential that young patients and their parents have a thorough understanding of the process.

Briefly describe how you would design the learning experience

Learning is a step-by-step process. It is important not to bombard patients with knowledge right away, when they are still frightened and confused. Also, although there are real risks with insulin injection, these risks should not…...

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References

Hahn, K.K. (1990). Teaching patients to administer insulin. Nursing, 20(4), 70-70.

Retrieved:  http://search.proquest.com/docview/79701645?accountid=10901 

Silvestrone, J.M. (2004). Performance-based assessment: Improving the value of laboratory and skills examinations. New Directions for Teaching & Learning, 100, 65 -- 71.

Clinical isk Management
Hospitals are one of the top listed high-risk places of work. Just like any high-risk workplaces, Clinical isk Management (CM) procedures are formulated to enable hospitals in identifying, containing, as well as manage work related risks such as injuries, which are bound within the facilities. Implementation of element contained in risk management procedures in any hospital setting should be effected in order to ensure for the safety of both patients and workers accommodated in the facility.

isk Management

isk management is highly prioritized in most high-risk organizations. Technological advances have been realized in modern medicine progressively resulting to more complex care and treatment processes. Despite the positive result of leveraging care opportunities, such advancements may result in adversities that might in turn affect patients and staff working in hospital environments. Since it is far from possible to eradicate such risks completely, clinical risk management procedures are there to enhance the…...

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References

Elizabeth, A. H and Betty, J.H. (1976). The American Journal of Nursing, Vol. 76, No. 6, pp. 924 -- 927: Lippincott Williams and Wilkins Publishers.

Stanbury, M. S and Anderson, H.A. (2000). Guidelines; Minimum and Comprehensive State-Based Activities in Occupational Safety and Health: DHHS (NIOSH) publication No. 95 -- 107.

Stanbury, M.J. And Goldoft, M. Use of OSHA Inspection Data for Fatal Occupational Injury Surveillance in New Jersey. Am J. Public Health 1990; 80: 200-202.

Tepper, A. (2000). Surveillance of Occupational Illnesses, Injuries, and Hazards in New Jersey. NJDOH.

In clinical situations, for example, problem-solving techniques are often required to ensure best practice. According to Lyth, some authors argue that a balance between roles should be maintained in order to optimize both clinical practice and theoretical knowledge.
Generally, it appears to be agreed among theorists that the focus of clinical supervision should be professional development and self-actualization. In addition, an inter-disciplinary approach to supervisory practice will also provide a platform for emerging best practice among the various professions, and ultimately benefit the practice in nursing. Although it appears that the theory on clinical supervision is often arbitrary and little researched, it is also true that the phenomenon has been in effect of many years, decades, and even centuries. For midwives, for example, supervision has been part of their profession since 1902, being a statutory requirement.

One problem with clinical supervision, according to Lyth (2000, p. 276), is the fact that…...

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References

Lyth, Gordon M. (2000). Clinical supervision: a concept analysis. Jounral of Advanced Nursing, Vol 31, No. 3.

Macdonald, Joanna. (2002, Feb). Clinical Supervision: a review of underlying concepts and developments. Australian and New Aealand Journal of Psychiatry, Vol. 35, Iss 1. Retrieved from  http://www.informaworld.com/smpp/content~db=all~content=a772090191 

McLean, Duncan (1996). Clinical Supervision. Psychiatric Bulletin, Vol. 20. Retrieved from  http://pb.rcpsych.org/cgi/reprint/20/1/1.pdf 

Todd, C. & O'Connor, J. (2005). Clinical Supervision. In N. Skinner, a.M. Roche, J. O'Connor, Y. Pollard, & C. Todd (Eds.), Workforce Development TIPS (Theory Into Practice Strategies): A Resource Kit for the Alcohol and Other Drugs Field. National Centre for Education and Training on Addiction (NCETA), Flinders University, Adelaide, Australia. Retrieved from  http://www.unodc.org/ddt-training/treatment/VOLUME%20D/Topic%202/8.Workforce%20Development%20TIPS.pdf

Salary

Employment Opportunities

Clinical coding specialists may work in hospitals, clinics, ambulatory, long-term and mental health care facilities, physicians' offices and government agencies that need coding expertise. (Western Kentucky University Website "Clinical Coding Specialist," 2003, NP)

Professional Association

American Health Information Management Association

233 N. Michigan Ave. Suite 2150

Western Kentucky University Website "Clinical Coding Specialist," 2003, NP)

According to an interview I conducted with a CCS, the traditional route to becoming a CCS has been to learn the systems on the job, especially with regard to institution specific computer coding systems, with minimal additional facility sponsored continuing education credit hours per year, yet as the job becomes increasingly important, with regard to accountancy and cost containment in medical care more and more institutions are requiring certification and therefore prior education with regard to clinical coding. The professional noted that when she began her job 15 years prior it was not unusual to hire people with minimal…...

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References

Johns, M.L. (2007) Information Management for Health Professionals Second Edition. AHIMA.

Tinsley, R. (1993). Engagements for Medical Professionals. Journal of Accountancy, 175(4), 34.

Western Kentucky University Website (2003) "Clinical Coding Specialist" Accessed September 8, 2008  http://www.wku.edu/Dept/Academic/chhs/scahec/clinicalcoding.htm

Clinical Goals
During this health assessment class I aim to close the gaps I currently have when considering experience in realistic clinical situations. An activity such as having to perform CPR on a patient can represent an important factor in making it possible for a student to gain a complex understanding of the domain. The class is going to provide me with the opportunity to assess the way that concepts such as cultural values, health notions, and caring practices performed in a particular institution work together in assisting people in need of health care.

I would apply theory in cases when laboratory results are either inconclusive or they are abnormal. This would mean that I would have to find a way to determine why these respective results are in this condition and get actively involved in trying to provide patients with solutions or with the ability to access treatment they need in…...

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Works cited:

Ward, H. & Barratt, J. "Passing Your Advanced Nursing Osce: A Guide to Success in Advanced Clinical Skills Assessment." "Radcliffe Publishing, 2009"

Zuzelo, P.R. "The Clinical Nurse Specialist Handbook," (Jones & Bartlett Publishers, 15 Oct 2010)

The American Association of Colleges of Nursing (AACN) and the Council on Graduate Education for Administration in Nursing (AACN, 1996; Dienemann & Aroian, 1995) operationally define the professional nurse as one who has been prepared with a minimum of a baccalaureate or higher degree in nursing. (Feldman & Greenberg, 2005, p. 219)
These were necessary requirement in the 90's. Now in an ever increasing age of need for more highly educated professional, the Clinical Nurse Leader armed with a Master's degree or better, is more adapted to handle a wide range of situations and create a fulcrum from which to balance all the staff in a given unit.

Literature eview

Clinical Nurse Leader

Kennedy, M.S.. (2004) Introducing the Clinical Nurse Leader. American Journal of Nursing, 104 (10), 22.

This article is a report regarding the decisions calling for a new role for nurses. The American Association of Colleges of Nursing (AACN), held an extraordinary…...

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References

Dalton, B., & Wright, L. (1999). Using Community Input for the Curriculum Review Process. Journal of Social Work Education, 35(2), 275.

Feldman, H.R. & Greenberg, M.J. (Eds.). (2005). Educating Nurses for Leadership. New York: Springer.

Kennedy, M.S.. (2004) Introducing the Clinical Nurse Leader. American Journal of Nursing, 104 (10), 22.

Knorr, R.S., Condon, S.K., Dwyer, F.M., & Hoffman, D.F. (2004). Tracking Pediatric Asthma: The Massachusetts Experience Using School Health Records. Environmental Health Perspectives, 112(14), 1424-1439.

I. Introduction
A. Definition of physical therapy
B. Role of the physical therapist
C. Types of physical therapy

II. History of Physical Therapy
A. Ancient origins
B. Development in the 19th and 20th centuries
C. Modern advances

III. Education and Training
A. Educational requirements
B. Clinical experiences
C. Continuing education

IV. Physical Examination
A. Subjective examination
B. Objective examination
C. Special tests

V. Treatment Planning
A. Goals of treatment
B. Development of a treatment plan
C. Collaboration with other healthcare professionals

VI. Treatment Techniques
A. Exercise therapy
B. Manual therapy
C. Electrophysical agents
D. Assistive devices

VII. Patient Education
A. Importance of patient involvement
B. Home....

Key Features of Evidence-Based Practice

Evidence-based practice (EBP) is a systematic approach to healthcare that integrates the best available scientific evidence with clinical expertise and patient values to make informed decisions about patient care. EBP has become increasingly important in modern healthcare due to the exponential growth of medical knowledge and the need to ensure that patients are receiving the most effective and appropriate care.

The key features of EBP include:

1. Integration of Research and Clinical Expertise:

EBP is based on the idea that the best decisions about patient care are made when clinicians consider both the latest scientific evidence and their own....

1. The Impact of Clinical Rotations on Medical Students Perception of Human Rights

    This title explores how medical students view human rights within the context of their clinical experiences.

2. Understanding the Role of Human Rights in Medical Education Perspectives from Clinical Rotations

    This title delves into the importance of integrating human rights principles into medical training during clinical rotations.

3. Human Rights Awareness Amongst Medical Students Insights from Clinical Training

    This title discusses how exposure to real patient cases during clinical rotations may shape medical students understanding of human rights.

4. Bridging the Gap Human Rights Education and Clinical Practice in Medical Training

    This title examines....

1. Icing an injury can help reduce inflammation, which in turn can aid in the healing process.

2. Studies have shown that applying ice to an injury can help decrease pain levels and improve overall comfort for the individual.

3. The use of ice therapy has been a common practice among athletes and healthcare professionals for decades, indicating its effectiveness in aiding in the healing of injuries.

4. Ice can help constrict blood vessels in the injured area, which can prevent excessive swelling and promote quicker recovery.

5. Cold therapy, such as icing, has been shown to be effective in....