Policy Politics in Nursing and Healthcare

Implementation of Electronic Medical Records

Implementation of Electronic Medical Records Introduction Information technology has recently become one of the most reliable technologies in efficient service delivery. Implementation of the system within health sector is viewed as a move in reducing medical errors, hence promoting patient safety as well as reducing costs. However, implementation of the new models requires variety of measurable elements capable of creating an impact on patient safety initiatives (Borkowski, 2009). Proposal on Implementation of EMR Electronic Medical Records are associated with many functions within the health care system. Patient health records contain important information, such as patient health care, financial breakdown, legal information as well as detailed research and quality improvement cases. Such information is always necessary within the medical field, hence it needs to be shared amongst many professional medics within the health care field. Such demand makes it a little cumbersome to use paper health records calling for the development of an automated health recording system. Electronic Medical Record will provide chances for improving quality of care and patient safety within health organizations. The system will help in providing solution to the challenge of dealing with integrated healthcare delivery by providing detailed, reliable and accessible timely information on patient health status across the medical field whether in primary or secondary health care. The EMR will reduce the costs on keeping paper records as well as decreasing inefficiencies within health care sector. The EMR has got increased storage capabilities enabling data to be stored from any region and for longer periods of time, enabling instant retrieval of information to many people even in remote sites (Young, 200, p 99). The idea on fragmentation of clinical records posed by paper records will be minimized hence reducing costs, which could have been otherwise incurred on current and future patient care (Schloeffel, 2001, p 1). The built-in intelligence capabilities of the EMR system will assist in recognizing abnormal laboratory results. The system provides efficient access to protocols, care plans, critical paths and other databases on healthcare knowledge such as pharmaceutical information (Borkowski, 2009). Start-up costs might be of disadvantage to many since it can be excessive at times. Allocation of capital to information system provides added costs on health care expenditure. Another disadvantage is that it requires substantial technical knowledge for the system to be used efficiently. This calls for all the physicians and clinicians to have prior knowledge on the system operation for purposes of realizing benefits of interactive on-line decision support (Borkowski, 2009). Proposal on Implementation of CPOE Computerized Physician Order Entry (CPOE) presents one of the point-of-care products which will help in playing the key role in dealing with the cases concerning patient safety objectives. The system involves electronic communication of orders as well as detailed protocol for checking against drug references and other medical information. CPOE is physician-focused and will help in the issues of developing fewer medication transcription as well as order errors. The tool will help most physicians in selecting correct medication and therapies for each patient. The equipment’s ability to customize ordering processes will assist in easy identification of physician needs and most importantly allow for prevention of problem occurrence by counter checking errors before completion of any order. The tracking system involved in this technology will help clinicians and physicians to evaluate their actions and compare to those of their peers in addition to comparing treatment recommendations within the given standards and guidelines (Borkowski, 2009). However, the CPOE may not be effective on its own until it is integrated together with other crucial clinical information systems. Another disadvantage is that there is still possibility of incurring errors within the system owing to the natural assumption that computers are always right. There are also multiple steps involved in operating multiple screens required for completion of order signing. This proves to be time-consuming when used by many people is at the same time. Frequent computer access might not be possible, especially in cases where only few computer stations are available in spite of many users (Borkowski, 2009). Changes within organizations normally occur either as planned or unplanned. Planned changes are known to arise from either single or series of changes linked to organization goals and objectives. While unplanned changes normally arise as a result of the unexpected uncertainties within the organization. Various changes are required for the purposes of incorporating the modern computerized equipment with the work environment. The change undergoes three environmental stages including; societal environment, task environment then finally internal environment. Within the societal environment, EMR technology will have to be approved by the legal authorities within the government by looking at its technological and economical impacts within the health sector (Borkowski, 2009). Technologically the equipment has the capability of speeding up the recording on individual health matters as well as ability to store large amount of data and sharing it over wide area within the shortest time possible. It saves on costs since it makes health records available within reach of medical practitioners and patients. The socio-cultural forces which tend to oppose the nature of the records in exposing patients medical records to the public would be dealt with by promising confidentiality to the patients’ medical information through the use of specified passwords. Only the patients and trusted medics would be allowed to use the specified password whenever they want to access the patient’s medical information for the purposes of further treatment. Legal acts like the HIPAA would be enforced to ensure that tough measures, including fines are imposed on those trying to misuse individual’s medical records discriminatorily. In some places, employers use medical records to discriminate individuals on employment opportunities (Borkowski, 2009). The task environment includes several players such as employees, special interest groups, competitors, customers amongst others. Dealing with competitors will call for marketing the superior abilities and qualities of the technology. Employees would be placed on thorough training on how to use the equipment confidentially without loosing on the confidence of the patients concerning their medical records. Suppliers would be endowed with the task of working with computer specialists for the purposes of EMR installations. Internal forces related to the structures, processes as well as resources within the organizations which at times lead to low profit margins could be addressed by ensuring the efficiency of the equipment through delivery. This could save on costs required for the storage of large amount of documents; the technology would as well confine all medical data to one source making it easier for services to be delivered without fragmented processes (Borkowski, 2009). Some of the challenges involved include such cases as lack of autonomy, especially in the process when patient’s data is shared amongst health care providers without informing the patient. The exposure of patient’s data does not guarantee fidelity in any way since it can be stolen by unknown parties. This could easily lead to compromised treatment within the society since patients may be overwhelmed by fear of exposure. Conflicts arise within the medical ethical principles concerning safety of patient health records. There is a breach on confidentiality and right to privacy on the side of the patients. Hence patients can easily be discriminated within the market place as mentioned earlier in the article (U.S. Department of Health and Human Services, 1998). Computer-based Electronic Health Records presents one of the technological advances within health care system. Such technology is of great benefit in health sector since it has helped in improving the level of access and quality at affordable costs. On the same note, computerized system will help in providing accurate information on billing hence allowing medics to forward any payment claims electronically. This would ensure timely and efficient payment to health care providers. It would save the patient hectic time, which might arise in providing information over and over whenever they seek medical attention (Lohr, 2007). The use of computerized medical systems enables improvement on the quality of care provided and also guarantees reduction in medical errors. There is improvement in the level of efficiency and reduction in medical costs since the methods enable easy coordination between health care providers on patient’s care. The system would enable smooth transfer of information, eliminating the possibilities which had earlier been experienced in duplication of health information by the third parties (Hartzband and Groopman, 2008). References Borkowski, Nancy. (2009). Organizational Behavior, Theory, and Design in Health Care. NY: Jones Bartlett Ppublishers. Hartzband, P. Groopman, J. (2008). Avoiding the Pitfalls of Going Electronic? New England Journal of Medicine, (358), 1656-1658. Lohr, S. (2007, June 11). Risks and Rewards; Who Pays for Efficiency. New York Times. Web. Schloeffel, P. (2001). Background and Overview of the Good Electronic Health Record. Retrieved from gehr.org/ U.S. Department of Health and Human Services. (1998). Security and Electronic Signature Standards; Proposed Rule. The Federal Register, 45 (142). Young, K. M. (2000). Informatics for Healthcare Professionals. Philadelphia: F.A. Davis.

Case study - assignment question answer Example | Topics and Well Written Essays - 500 words

Case study - question answer - Assignment Example As such, they decided to offer higher than the original prices to benefit the workers and to enable them maintain their jobs. The following statement from the text, â€Å"...harangued the Japanese team about their hypocrisy...† referring to the British boss, clearly reveals the anger and disappointment that the boss had towards the Japanese negotiators. Additionally, the aspect of emotion also appears from this statement, â€Å"...offer you an additional fifty cents a tonne above the price that you originally asked for...†. This statement by the chief Japanese negotiator is a reflection of the Japanese feelings towards the proposal forwarded by the British negotiators. Indeed, they had mixed feelings. The decision made by the Japanese negotiators triggered excitement though it was accompanied by a lot of surprise. According to Hofstede’s cultural dimension theory, effective intercultural communication plays a very significant role in creating understanding among different cultures and therefore preventing any cultural difference. Miscommunication is caused by lack of cultural understanding and poor communication skills, which can only trigger cultural conflicts. Hofstede suggested some cultural dimensions like uncertainty avoidance, collectiveness and individualism among others. Accordingly, Hofstede claims that these cultural dimensions, when put into use, assist in overcoming cultural differences. Arguably, the Japanese negotiators, listening to their counterparts and weighing the consequences of what they were about to do, enabled them solve their cultural differences and stabilized the situation. Accordingly, the British negotiators were very much interested on the interest of the South African workers. As such, they focused on their main reason of setting the prices and maintaining their position concerning the price. The British boss, having been disappointed by the Japanese negotiators, decided to be

Report Essay Example | Topics and Well Written Essays - 2500 words - 9

Report - Essay Example This report is about the development and analysis of a database system for a recruitment agency that is operating worldwide and specializing in short contracts for programming and website development work. This report will offer a deep analysis of the main database design and development aspects for the business of recruitment agency. According to Oz Effy (2008), the processes of decision making and problem solving both are based on information. In addition, the decision making is vital process of everyone’ life, people work, play, communicate or do anything they need and use information. In the same way, in a corporation gathering the correct information efficiently, keeping it properly consequently thus it could be utilized and manipulated when needed, as well as making use of it to facilitate the corporation or individuals to attain personal or business objectives. Consequently, the main intention of database and information systems development and implementation is to have facility and support in the above discussed areas. We can use and apply these understanding and database information for getting success in every department of a business. However, in a corporation information system consists of databases, hardware, data, telecommunications, software, procedures and people. In addition, the use of in formation systems and databases can be seen in every walk of life. Their capacity to facilitate and resolve problems as well as making decisions makes them fundamental in our lives, society, business and management (Oz, 2008; Whitten, Bentley, & Dittman, 2000; Turban, Leidner, McLean, & Wetherbe, 2005). The recruitment agency has carried out a survey among 30,000 people and taken response against different personnel, job and web development related aspects. This data is available in form of flat file database. In other words, the

Designing The User Interface Essay Example | Topics and Well Written Essays - 1500 words

Designing The User Interface - Essay Example hich were exclusively available to computer users initially, are now easily accessible through mobile devices and cell phones to billions of users, thus assisting individuals with low incomes, low literacy or disabilities to make use of the available technology advancements, for example the Apple’s iTunes interface found on [http://www.apple.com/itunes/ (Shneiderman and Plaisant,7). All this is possible since the User-interface designers and researchers have harnessed advanced technology to serve human needs. Through User-interface design, many business success stories have been produced, notably in international partnerships and mega-mergers through increased decision-support and information sharing arising from the interface designs. Such partnerships and mergers include, for example, the partnership between YouTube found at [http://www.youtube.com/] and PlayStation3 (Shneiderman and Plaisant, 9). Nevertheless, User-interface design produces intense competition among business and individuals, as well as resulting to the infringement of copyrights and intellectual property legal battles, such as the ones between advanced cell phone and computer companies (Shneiderman and Plaisant, 12). Further controversies surrounding User-interface design includes the inadequacies of the user-interfaces, which have in turn resulted in violations of the issues of national defense, personal identification, crime fighting and personal electronic health records (Shneiderman and Plaisant, 5). At a personal level, user-interfaces have changed people lives, through assisting individuals and professionals to effectively accomplish their tasks, such as assisting doctors to undertake successful diagnosis or assisting pilots to fly planes safely (Shneiderman and Plaisant, 6). Nevertheless, there are various shortcomings associated with user-interfaces, such as the frustrations that users often have do encounter, in regards to the complexity of the interface menus, terminologies that

Endodontic Surgery (Apicoectomy)

Endodontic Surgery (Apicoectomy) In this modern times patient increasingly wish to preserve their natural dentition and often reluctant to get there teeth extracted . Endodontic surgery (apicoectomy) is the treatment performed on the root apices of an infected tooth, and its resection and removal of pathological tissues around the apices followed by placement of a filling (retrofilling) to seal the root end. Endodontic surgery offers patient a second chance or the final chance to save there tooth. Success of Root end surgery had a poor prognosis and success rate in the past but due to recent advances Endontics due to the surgical operating microscope and new tecniques the rate is much higher than before success Its indications are as follows 1 RCT treated tooth that has severe periapical inflammation despite of a satisfactory RCT 2 Tooth with persistant periapical inflammation and inadequate RCT and has the following problems a Severely curved root canals where access is an issue to reach the apex b Completely calcified root canals C Presence of post and cores in root d Breakage of small instrument or filling material where it is not retrievable and an infection is still present in the apical region. Teeth with periapical inflammation where completion of endodontic therapy due to 1 Foreign body present in the periapical tissues 2 Perforation of the inferior wall of the pulp chamber 3 Perforation of the root 4 Fracture of the apical third of the root 5 Dental anomalies (Dense in Dente ) 6 Access for periradicular curettage A non healing endodontic lesion is recognized by persistent pain and/or swelling, possibly with radiographic changes indicating increasing periapical bone loss. Non healing endodontically treated teeth that do not appear to be healing are not automatic indications for extraction and replacement with an implant. Persistent nonhealing cases can be saved by endodontic microsurgery with a predictably favorable prognosis Nonsurgical endodontic treatment has a high rate of clinical success despite the anatomic and pathologic challenges of the procedure. Success in case of tooth without periapical extension of pathosis is more than 90%. On the other hand, studies show that infected root canals with an extension of pathosis into the periapical space have a reduced healing capacity . previously the conventional endosurgery has very low success rate . it was recorded as low as 37.4 % but now with recent advancement in endodontic surgery the success rate has improved significantly. According to a study conducted by shimon Friedman and Chaim Mor ( success of endodontic therapy -healing and functionality) in patients were endodontic surgery is performed the chances of healing after retreatment is between 74 to 86 %and their chance of being functional overtime is 91 to 97 % .Another study ( modern endodontic surgery concept and practice by syngcuk Kim and Samuel Kratchman)said that the traditonal apical surge rybased on clinical symptoms and radiographic findings ranges from 44% to 90%.it has even higher success rate with the endodontic microsurgery. . According to another study (outcome of surgical endodontic treatment performed by a modern technique A meta anlysis conducted by Igor Tsesis , Surgical endodontic treatment have a success rate of 91 .4 % when followed up in a year time . According toa study named Outcome of endodontic micro re- surgery by Minju song and team à ¢Ã¢â€š ¬Ã‚ ¦. When an endodontic surgery fails we need to identify the problem and find the reason for failure. To solve the problem further treatment like retreatment with surgery and, extraction are the viable options. Some studies in the past have documented poor success rate if we have to redo a failed surgery again. But this study said that with the new microscope and microsurgical devices the success rate can be as high as 92.9 %. Most of the reason for failure is poor technique,poor seal at the apical region and not using biocompatible materials like MTA and super PBA in the past. In another recent study it was found that, at least in America, endodontic surgery was the least expensive intervention for failed RCT when compared to endodontic re-treatment and crown, extraction and fixed partial denture, or extraction and implant (Kim Solomon, 2011). When primary `endodontic treatment fails retreatment should be done and when retreated and if there is severe inflammation in the periapical tissues then endo surgery can be an option using advance techniqies and good operationg skill can add to the success of endo surgery. 1 Microscope The microscope will provide good visualization, identification and treatment of infected canals, isthmuses and variant anatomy not reachable with traditional instrumentation techniques. Microscope can reach to more different locations and narrow spaces, by providing a clear field of vision. Good visualization also prevents damage to anatomical structures. Microscopic techniques significantly decrease complications and expand the case applicability for performing this procedure on teeth adjacent to these structures. With increased magnification and illumination, differentiating the root surface from the surrounding bone is also enhanced .A main cause of nonsurgical endodontic failure results from the inability to clean and sterilize the apical canal space, which is a complex anatomical entity. 2 ultrasonic tips That allow accurate preparation along the long axis of the root canal with clear visualization of the preparation . This technique will allow us to do root-end fillings in the proper position to seal the root canal to sufficient filling depth and thickness to effectively seal the canal, dentinal tubules and accessory canals. Ideal ultrasonic tip length is 3mm long. A minimum of 3mm preparation depth is needed to prevent leakage. 3 Surgical advances A smaller osteotomy will reduce bone removal (approximately 3-4mm) in diameter reduced bone and permits quicker uneventful postoperative healing postoperative healing. By removing less bone in the coronal direction, buccal bone can be preserved and subsequent periodontal sequelae that may lead to the loss of the tooth are prevented. Root-tip resection of 3mm is needed to eliminate lateral canals and apical ramification- A study shows that the resection of 3mm of apex eliminates 98 percent of apical ramifications and 93 percent of lateral canals. Root section bevel angle is reduced to 0 -10 degrees Clear examination of the resected root surfaces for fracture and anoatomical variations Root-end fillings with MTA (Mineral Trioxide Aggregate- It has excellent biocompatibility, osteo- and cemento-inductive capabilities, effective antibacterial and sealing properties, and faster radiographic healing in comparison to SuperEBA and IRM. MTA will not cause soft tissue discoloration that can otherwise result from root-end filling materials like amalgam Magnification Eyes or Loupes (1-4x) Microscope (4-24x) Illumination Dental light Bright focused light Armamentarium Macro-instruments Micro-instruments Osteotomy Size Large (7-10mm diameter) Small (3-3mm diameter) Bevel Angle Acute (45-60 degree) Shallow (0-10 degree) Root-end Preparation Non-axial Axial to long axis of tooth Depth of Root-end prep 1mm non-axial 3mm axial Inspection resected root surface None Always Root-end filling material Amalgam MTA Success rate over 1 year Less than 50% Over 90% Summary There are many factors to consider when choosing to perform microsurgery  on a tooth versus performing other treatment options such as  nonsurgical retreatment or tooth extraction. Fortunately for the patient,  the ability to perform endodontic microsurgery is an effective and highly  successful procedure that produces minimal discomfort, alleviates periradicular  pathosis, maintains restorations and provides for function and  aesthetics as shown in Figure 6.33,34

The Importance of the Negro Bank in Invisible Man Essay -- Ralph Elli

     Ã‚   The early Americana coin bank which the narrator of Invisible Man discovers one morning in his room at Mary's house is a reflection of the narrator's state throughout much of the novel. The offensively exaggerated Negro figure provokes an instant hatred in the narrator due to the tolerance it suggests. However, the narrator becomes personally offended by the object because of the similarities it holds to himself. While smashing the pipes with the bank, he yells out to his neighbors who are banging on the pipes, "'Get rid of your cottonpatch ways! Act civilized!'" (320). Thus he associates the hatred he feels for the bank figure with his neighbors who are acting no less civilized than he is. He is not aware of his own "cottonpatch ways" it appears.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In describing the bank, the narrator states that it is the kind of bank that flips coins from its hand into a large grinning mouth. In order to put money in the bank, one must feed the smiling, hungry Negro. At a point in the narrator's life where he has no money and has decided to join the Brotherhood out of a debt ...