What did you like or dislike about taking an asynchronous online course?
I really don't like taking online courses because I learn best in the classroom with lecture. However, I did learn a lot through this course. This course has been effective because normal things that I would not do like creating a Blog I have done. I have found that it really isn't that bad and I shouldn't be so nervous about trying new things with computers.
What topic did you learn the most about and what was your favorite topic?
I learned a lot about website evaluations and if they are credible or not. I think applying this to practice is essential as a practitioner because patients are constantly self diagnosing or turning to the internet for medical information. If we can direct our patients to websites that can enhance their care then they will have correct information and better outcomes.
What did you like least?
I had a difficult time with Module 5. I wish this could be taught in a different format. I struggled posting to the discussion board and understanding the websites that we were to gather information from. Maybe an online lecture with a power point and a podcast would make this better. For me I struggle with just looking things up and learning, but for some reason the concepts failed to sink in.
Do you have any other comments for us?
In general, I learned a lot from this course and a lot of my fears of informatics were decreased. However, I still think that when a whole course is taught online it would be nice to have different formats for understanding some concepts. The book was boring and I felt it was vague when discussing websites like those for Module 5.
Wednesday, August 4, 2010
Sunday, July 18, 2010
Module 5
Why would a patient want to create a blog?
I can think of aspects where patients may want to create a blog and that is chronic conditions where others may gain support and insight into someones personal posts regarding their illness. My personal physician created a blog because he was in liver failure. He had to take a leave of absence for a year and many of his patients wanted to know how he was doing. His office staff was so inundated with phone calls regarding his health that they could not focus on their regular jobs. He created the blog to up date his staff, patients, family, and friends of his health and the process of receiving a live donor liver transplant. It was very cool to follow and the ease of logging on at anytime to check on him was awesome. Him or his wife updated frequently and it really great to see him become healthy again. While he was on leave his office hired an awesome NP to cover for him and he was able to introduce her. The comments for her care were phenomenal on his blog and he posted several times how happy he was that his patients were receiving great care. Now she sees her own patients and all of his sick patients because he is immnocompromised and it works out.
Why would a health care provider create a blog?
I think a health care provider blog would be awesome to create. For me, I would have updates in care or simple things like getting immunizations done prior to the big rush for the school year. Or another thing would be what sort of illness has been diagnosed in the clinic. I can think of an instance where this would have been useful. Two summers ago when Crypto broke out in the swimming pools and all of the kids were getting sick and admitted for dehydration, I think it would have been helpful for parents to look at their healthcare providers blog and go, "wow, we went swimming, the kids have been sick they may have Crypto". Also, a link to the health department would be nice to see what actions to protect your children and what should be done from a parents aspect when treating kids. I think it would enable practitioners to access some pretty awesome literature and get it to parents in a free format that is easily accessible. Public libraries have free internet access, so if parents don't have a computer or internet at home it is a way to communicate or read information from the provider.
What are ethical considerations when blogging on a public website?
Obviously, you would never post patients personal information or anything that could link a patient for specific treatment. I think posting general information about healthcare and only specific information like there has been a lot of strep infections seen in the clinic recently. You would never name anyone or give details to violate HIPPA. I think updates would be helpful to remind parents to get their children immunized or remind them about bike helmet safety, water safety, etc. The other thing I think you have to be careful about is giving medical advice when you haven't actually seen the patient. As a provider I would make sure parents understood that this is a general website for their information and medical advice would not be given out by any provider. If they seek medical advice they need to be seen in the clinic.
I ultimately see blogging as an asset and am eager to see if other providers use this in their practice and the information they provide to their public.
I can think of aspects where patients may want to create a blog and that is chronic conditions where others may gain support and insight into someones personal posts regarding their illness. My personal physician created a blog because he was in liver failure. He had to take a leave of absence for a year and many of his patients wanted to know how he was doing. His office staff was so inundated with phone calls regarding his health that they could not focus on their regular jobs. He created the blog to up date his staff, patients, family, and friends of his health and the process of receiving a live donor liver transplant. It was very cool to follow and the ease of logging on at anytime to check on him was awesome. Him or his wife updated frequently and it really great to see him become healthy again. While he was on leave his office hired an awesome NP to cover for him and he was able to introduce her. The comments for her care were phenomenal on his blog and he posted several times how happy he was that his patients were receiving great care. Now she sees her own patients and all of his sick patients because he is immnocompromised and it works out.
Why would a health care provider create a blog?
I think a health care provider blog would be awesome to create. For me, I would have updates in care or simple things like getting immunizations done prior to the big rush for the school year. Or another thing would be what sort of illness has been diagnosed in the clinic. I can think of an instance where this would have been useful. Two summers ago when Crypto broke out in the swimming pools and all of the kids were getting sick and admitted for dehydration, I think it would have been helpful for parents to look at their healthcare providers blog and go, "wow, we went swimming, the kids have been sick they may have Crypto". Also, a link to the health department would be nice to see what actions to protect your children and what should be done from a parents aspect when treating kids. I think it would enable practitioners to access some pretty awesome literature and get it to parents in a free format that is easily accessible. Public libraries have free internet access, so if parents don't have a computer or internet at home it is a way to communicate or read information from the provider.
What are ethical considerations when blogging on a public website?
Obviously, you would never post patients personal information or anything that could link a patient for specific treatment. I think posting general information about healthcare and only specific information like there has been a lot of strep infections seen in the clinic recently. You would never name anyone or give details to violate HIPPA. I think updates would be helpful to remind parents to get their children immunized or remind them about bike helmet safety, water safety, etc. The other thing I think you have to be careful about is giving medical advice when you haven't actually seen the patient. As a provider I would make sure parents understood that this is a general website for their information and medical advice would not be given out by any provider. If they seek medical advice they need to be seen in the clinic.
I ultimately see blogging as an asset and am eager to see if other providers use this in their practice and the information they provide to their public.
Monday, July 5, 2010
Module 4
How did the readings influence your perception of your own clinical decision-making?
For me the readings brought me one step closer to basing my own clinical practice on EBP. I have been supportive of this action, especially when I have seen older nurses who do not follow protocols or bother to promote a change in practice, even for patient safety. As I have become more educated, I see the that this method of practice does promote the best quality for our patients. It's sort of like "our leg to stand on". The standard of "well that's what we always do" is outdated and archaic, we need to be fluid and change our practice to where evidence points us. The readings helped me to realize that I must keep my education up-to-date to move with change and practice currently based upon the best evidence.
For me the readings brought me one step closer to basing my own clinical practice on EBP. I have been supportive of this action, especially when I have seen older nurses who do not follow protocols or bother to promote a change in practice, even for patient safety. As I have become more educated, I see the that this method of practice does promote the best quality for our patients. It's sort of like "our leg to stand on". The standard of "well that's what we always do" is outdated and archaic, we need to be fluid and change our practice to where evidence points us. The readings helped me to realize that I must keep my education up-to-date to move with change and practice currently based upon the best evidence.
Saturday, June 26, 2010
Module 3 Teaching and Technology
What sort of teaching is done in your nursing role?
I currently work in Same Day Surgery and Post-Anesthesia Care Unit. The teaching that I do most of consists of controlling post-op pain. There are varying degrees of patients who either want to manage their pain with narcotics and understand that it is ok to take them or patients who do not want anything to control their pain because they fear addiction. It seems to me I spend a lot of time discussing pain medicine and when it is appropriate to take pain medicine and when the patient should begin to wean themselves off. Doctors don't do a very good job of educating patients regarding this, they simply write out the prescription for what the patient wants and walk away. As I have worked in this role for 2 years now I have seen a lot of physicians prescribe a considerable amount of pain medication and in my opinion I think they do it so they won't get phone calls for more in the middle of the night, on a weekend, or when they are busy in clinic. Now that I have been on that soap box I will get off and discuss some other aspects of teaching, I teach about caring for extremities after orthopedic surgery, post-op care after general surgeries like gallbladders and hernia repairs, gynecology procedures, and all aspects of ENT surgeries.
Is there any nursing role that does not involve teaching in some manner? I would definately say no, no matter what role a nurse is in you are always teaching. This may be in mentoring, administrative, floor nursing, surgery, ICU, etc. Nurses are always caring for someone and teaching, its ingrained in us, we even teach when we are not at work.
I currently work in Same Day Surgery and Post-Anesthesia Care Unit. The teaching that I do most of consists of controlling post-op pain. There are varying degrees of patients who either want to manage their pain with narcotics and understand that it is ok to take them or patients who do not want anything to control their pain because they fear addiction. It seems to me I spend a lot of time discussing pain medicine and when it is appropriate to take pain medicine and when the patient should begin to wean themselves off. Doctors don't do a very good job of educating patients regarding this, they simply write out the prescription for what the patient wants and walk away. As I have worked in this role for 2 years now I have seen a lot of physicians prescribe a considerable amount of pain medication and in my opinion I think they do it so they won't get phone calls for more in the middle of the night, on a weekend, or when they are busy in clinic. Now that I have been on that soap box I will get off and discuss some other aspects of teaching, I teach about caring for extremities after orthopedic surgery, post-op care after general surgeries like gallbladders and hernia repairs, gynecology procedures, and all aspects of ENT surgeries.
Is there any nursing role that does not involve teaching in some manner? I would definately say no, no matter what role a nurse is in you are always teaching. This may be in mentoring, administrative, floor nursing, surgery, ICU, etc. Nurses are always caring for someone and teaching, its ingrained in us, we even teach when we are not at work.
Monday, June 7, 2010
Module 2
I used PubMed as my electronic index and this was very helpful when accessing my clinical problem of treating diabetic foot ulcers with hyperbaric oxygen therapy. I found this to be a narrow topic that produced good information. This information was useful because it produced citations from medical journals and I set limits for randomized control trials which compared hyperbaric oxygen therapy with traditional therapy, this narrowed my citations down to 11.
The guideline index I used was the National Guideline Clearinghouse. This was not helpful in my search at all. I never had any results from my clinical problem and I tried to be more broad in my terms and entering diabet* for the disease/condition. I chose to do this so this index would not only look up information for diabetic, but also diabetes, diabetics, etc. This also did not help. I also omitted the term hyperbaric and just simply entered oxygen therapy, which also produced no results. The index recommended I truncate the terms, which I already had with diabetes. Just for fun I wanted to see what information National Guideline Clearinghouse did have on diabetes so I looked under Endocrine System Diseases then Diabetes Mellitus, which produced 83 guidelines. This produced a general list of guidelines for treating patients with diabetes, like how to give SubQ injections, diabetes in pregnancy, and primary prevention of kidney disease. Thus, my narrow search of hyperbaric oxygen therapy would never be found in this index. I feel like this is information we should know coming out of school and we shouldn't have to look this up.
I chose to use Google Scholar as my web search engine and surprisingly I did not get back thousands of citations for my clinical problem, only 22. But, I did put a limitation on the search: only search in Medicine, Pharmacology, and Veterinary Science. When I put the same search terms into regular Google and performed the search I was amazed that my citations were 22,500. I did not put limitations in this search criteria. Google Scholar produced some of the same results as PubMed, however many of these articles do not come in full text or as a free download. Some citations are around $20 per article. This route is not cohesive to a graduate student, I will be using PubMed through the library or EndNote to look for articles in full text.
The guideline index I used was the National Guideline Clearinghouse. This was not helpful in my search at all. I never had any results from my clinical problem and I tried to be more broad in my terms and entering diabet* for the disease/condition. I chose to do this so this index would not only look up information for diabetic, but also diabetes, diabetics, etc. This also did not help. I also omitted the term hyperbaric and just simply entered oxygen therapy, which also produced no results. The index recommended I truncate the terms, which I already had with diabetes. Just for fun I wanted to see what information National Guideline Clearinghouse did have on diabetes so I looked under Endocrine System Diseases then Diabetes Mellitus, which produced 83 guidelines. This produced a general list of guidelines for treating patients with diabetes, like how to give SubQ injections, diabetes in pregnancy, and primary prevention of kidney disease. Thus, my narrow search of hyperbaric oxygen therapy would never be found in this index. I feel like this is information we should know coming out of school and we shouldn't have to look this up.
I chose to use Google Scholar as my web search engine and surprisingly I did not get back thousands of citations for my clinical problem, only 22. But, I did put a limitation on the search: only search in Medicine, Pharmacology, and Veterinary Science. When I put the same search terms into regular Google and performed the search I was amazed that my citations were 22,500. I did not put limitations in this search criteria. Google Scholar produced some of the same results as PubMed, however many of these articles do not come in full text or as a free download. Some citations are around $20 per article. This route is not cohesive to a graduate student, I will be using PubMed through the library or EndNote to look for articles in full text.
Tuesday, May 25, 2010
Introduction-Module 1
I am Natalie Huggard and I am in the PNP-DNP program. I have been a Nurse for 13 years and I have worked in many areas in the hospital. My favorite areas were in the Newborn Intensive Care Unit, Same Day Surgery/Post Anesthesia Care Unit, and Pediatrics.
As a graduate level nurse I need to know about information management because it improves outcomes for patients, improves our clinical practice, and improve quality care.
I currently work in Same Day Surgery/Post Anesthesia Care Unit and access Xrays, pathology reports, lab results, history and physical, and ECG's. Our charting is all paper charting for the surgical services on the day of surgery. One thing that is monitored very closely in surgery is the time antibiotics are administered. SCIP guidelines dictate that antibiotics need to be administered 30 minutes prior to actual cut time for best outcomes of preventing infection. Our charts are audited and then the results are given to our manager. Our manager instructs the team on what changes we can do to improve our administration times.
As a graduate level nurse I need to know about information management because it improves outcomes for patients, improves our clinical practice, and improve quality care.
I currently work in Same Day Surgery/Post Anesthesia Care Unit and access Xrays, pathology reports, lab results, history and physical, and ECG's. Our charting is all paper charting for the surgical services on the day of surgery. One thing that is monitored very closely in surgery is the time antibiotics are administered. SCIP guidelines dictate that antibiotics need to be administered 30 minutes prior to actual cut time for best outcomes of preventing infection. Our charts are audited and then the results are given to our manager. Our manager instructs the team on what changes we can do to improve our administration times.
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