Task: Research and Pharmacology
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Write a 4-6 page annotated bibliography where you identify peer-reviewed publications that promote the use of a selected technology to enhance quality and safety standards in nursing. Before you begin to develop the assessment you are encouraged to complete the Annotated Bibliography Formative Assessment. Completing this activity will help you succeed with the assessment and counts towards course engagement. Rapid changes in information technology go hand-in-hand with progress in quality health care delivery, nursing practice, and interdisciplinary team collaboration. The following are only a few examples of how the health care field uses technology to provide care to patients across multiple settings: • Patient monitoring devices. • Robotics. • Electronic medical records. • Data management resources. • Ready access to current science. Technology is essential to the advancement of the nursing profession, maintaining quality care outcomes, patient safety, and research. This assessment will give you the opportunity to deepen your knowledge of how technology can enhance quality and safety standards in nursing. You will prepare an annotated bibliography on technology in nursing.
Task: Research and Pharmacology A well-prepared annotated bibliography is a comprehensive commentary on the content of scholarly publications and other sources of evidence about a selected nursing-related technology. A bibliography of this type provides a vehicle for workplace discussion to address gaps in nursing practice and to improve patient care outcomes. As nurses become more accountable in their practice, they are being called upon to expand their role of caregiver and advocate to include fostering research and scholarship to advance nursing practice. An annotated bibliography stimulates innovative thinking to find solutions and approaches to effectively and efficiently address these issues. Demonstration of Proficiency By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria: • • Competency 3: Evaluate the impact of patient care technologies on desired outcomes. o Analyze current evidence on the impact of a selected patient care technology on patient safety, quality of care, and the interdisciplinary team. o Integrate current evidence about the impact of a selected patient care technology on patient safety, quality of care, and the interdisciplinary team into a recommendation. Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients. • o Describe organizational factors influencing the selection of a technology in the health care setting. o Justify the implementation and use of a selected technology in a health care setting. Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies. o Create a clear, well-organized, and professional annotated bibliography that is generally free from errors in grammar, punctuation, and spelling. o Follow APA style and formatting guidelines for all bibliographic entries. Preparation To successfully complete this assessment, perform the following preparatory activities: • • Select a single direct or indirect patient care technology that is relevant to your current practice or that is of interest to you. Direct patient care technologies require an interaction, or direct contact, between the nurse and patient. Nurses use direct patient care technologies every day when delivering care to patients. Electronic thermometers or pulse oximeters are examples of direct patient care technologies. Indirect patient care technologies, on the other hand, are those employed on behalf of the patient. They do not require interaction, or direct contact, between the nurse and patient. A handheld device for patient documentation is an example of an indirect patient care technology. Task: Research and Pharmacology
Examples of topics to consider for your annotated bibliography include: o Delivery robots. o Electronic medication administration with barcoding. o Electronic clinical documentation with clinical decision support. o Patient sensor devices/wireless communication solutions. o Real-time location systems. o Telehealth. o Workflow management systems. Conduct a library search using the various electronic databases available through the Capella University Library. o Consult the BSN Program Library Research Guide for help in identifying scholarly and/or authoritative sources. o Access the NHS Learner Success Lab, linked in the courseroom navigation menu, for additional resources. • Scan the search results related to your chosen technology. • Select four peer-reviewed publications focused on your selected topic that are the most interesting to you. Notes • Publications may be research studies or review articles from a professional source. Newspapers, magazines, and blogs are not considered professional sources. • Your selections need to be current—within the last five years. Annotated Bibliography Prepare a 4–6 page annotated bibliography in which you identify and describe peer-reviewed publications that promote the use of your selected technology to enhance quality and safety standards in nursing. Be sure that your annotated bibliography includes all of the following elements: • • • Introduction to the Selected Technology Topic o What is your rationale for selecting this particular technology topic? Why are you interested in this? o What research process did you employ? o What databases did you use? o What search terms did you use? o Note: In this section of your bibliography, you may use first person since you are asked to describe your rationale for selecting the topic and the research strategies you employed. Use third person in the rest of the bibliography, however. Annotation Elements o For each resource, include the full reference followed by the annotation. o Explain the focus of the research or review article you chose. o Provide a summary overview of the publication. o According to this source, what is the impact of this technology on patient safety and quality of care? o According to this source, what is the relevance of this technology to nursing practice and the work of the interdisciplinary health care team? o Why did you select this publication to write about out of the many possible options? In other words, make the case as to why this resource is important for health care practitioners to read. Conclusion/Recommendation o How would you tie together the key learnings from each of the four publications you examined? o What organizational factors influence the selection of a technology in a health care setting? Consider such factors as organizational policies, resources, culture/social norms, commitment, training programs, and/or employee empowerment. o How would you justify the implementation and use of the technology in a health care setting? Consider the impact of the technology on the health care organization, patient care/satisfaction, and interdisciplinary team productivity, satisfaction, and retention. Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like: Running head: ANNOTATED BIBLIOGRAPHY ON TECHNOLOGY IN NURSING Annotated Bibliography on Technology in Nursing Learner’s Name Capella University Managing Health Information and Technology Annotated Bibliography on Technology in Nursing August, 2019 Copyright ©2019 Capella University. Copy and distribution of this document are prohibited. 1 ANNOTATED BIBLIOGRAPHY ON TECHNOLOGY IN NURSING 2 Technology in Nursing Pulse oximetry is one of the most common methods of measuring the percentage of oxygen saturation in blood (Narayen et al., 2016). Pulse oximeters play a crucial role in critical care settings by detecting low levels of oxygen saturation. Pulse oximeters are also adopted by anesthesiologists in recovery, emergency, and pediatric wards; operation theatres; and neonatal units (Hendaus, Jomha, & Alhammadi, 2015). This annotated bibliography provides insight into how pulse oximeters are used, their limitations and accuracy, and patient outcomes. Annotated Bibliography Hendaus, M. A., Jomha, F. A., & Alhammadi, A. H. (2015). Pulse oximetry in bronchiolitis: Is it needed? Therapeutics and Clinical Risk Management, 11, 1573–1578. Task: Research and Pharmacologyhttps://dx.doi.org/10.2147%2FTCRM.S93176 This article discusses the use of pulse oximetry in pediatric wards. The authors state that hospitals in the United States admit a significant number of children every year with bronchiolitis and other respiratory problems. These problems are usually monitored with the help of a pulse oximeter, an instrument used to measure the saturation of oxygen in the blood. Oxygen saturation levels are used by health care providers to evaluate a patient’s respiratory status and are one of the deciding factors for a patient’s discharge. Pulse oximetry is frequently used in pediatrics (in pediatric intensive care units and pediatric wards) and in emergency departments. Pulse oximeters are used to monitor oxygen saturation during resuscitations, while estimating perfusion, while detecting pulsus paradoxus, and while screening infants for congenital heart disease. Though the source does not fully explain why the limitations occur, it identifies several cases in which pulse oximeters are likely to be inaccurate. Pulse oximeters have certain Copyright ©2019 Capella University. Copy and distribution of this document are prohibited. Commented [A1]: Comprehensive information regarding the types of pulse oximetry devices, selection criteria, decision makers, and associated costs is not available in the selected papers. The two types of pulse oximeters and their advantages over the others is provided; however, information on the various types of pulse oximeters is not available and the associated costs are not provided. This paper does mention that this technique is cost-effective which can fulfill the required criteria. ANNOTATED BIBLIOGRAPHY ON TECHNOLOGY IN NURSING 3 limitations due to inadequate signals. Inadequate signals occur in cases of anemia, bright external light, dark skin, nail polish, low perfusion, and intravenous dye. Pulse oximeters show low readings in cases of venous pulsations such as severe right heart failure, tricuspid regurgitation, and blood pressure cuffs or tourniquets above the site of the pulse oximeter.
Task: Research and Pharmacology Pulse oximeters might not detect hypoxemia in patients with elevated arterial oxygen tension levels because of the sigmoidal shape of the oxyhemoglobin dissociation curve. Also, pulse oximeters provide unreliable readings in cases of methemoglobinemia. The source highlights several limitations, which will help readers exercise caution when using pulse oximeters. However, despite these limitations, the use of pulse oximeters in pediatrics is recommended because they are handy and allow for noninvasive measuring of arterial oxygen saturation. Commented [A2]: Meets criterion 3 as it deals with organizational factors that influence the selection of a technology in health care setting. Jubran, A. (2015). Pulse oximetry. Critical Care, 19(1), 272. https://dx.doi.org/10.1186%2Fs13054-015-0984-8 This article provides insight into the principles, accuracy, functioning, and outcome of pulse oximeters. It discusses the potential advantages of multiwavelength pulse oximeters over conventional pulse oximeters. Multiwavelength pulse oximeters are capable of estimating the blood levels of carboxyhemoglobin and methemoglobin, whereas conventional pulse oximeters assume that dyshemoglobins such as carboxyhemoglobin and methemoglobin are absent because they can only distinguish between hemoglobin and oxyhemoglobin. Hence, physicians prefer to use multiwavelength pulse oximeters for more accurate results. In hospital settings, the transfer rate from a postsurgical care floor to the intensive care unit (ICU) is an important factor that influences the use of pulse oximeters. The resource reviews a study by Ochroch et al. in which patients were Copyright ©2019 Capella University. Copy and distribution of this document are prohibited. Commented [A3]: Deals with criterion 3: Organizational factors that influence the selection of a technology in health care setting. ANNOTATED BIBLIOGRAPHY ON TECHNOLOGY IN NURSING 4 monitored by pulse oximeters either continuously (oximeter group) or intermittently based on clinical needs as judged by a physician or a nurse (control group). The rate of ICU transfers for pulmonary complications was lower in the oximeter group than in the control group. Additionally, for patients who did require ICU transfers, the estimated cost of treatment from enrollment to the completion of the study was lower for the oximeter group ($15,481) than for the control group ($18,713) despite the patients in the oximeter group being older and having higher comorbidity. The reduction in pulmonary transfers to the ICU in the oximeter group was speculated to be the result of early recognition and treatment of postoperative pulmonary complications. As cited in Jubran, another study by Moller et al. indicates that anesthesiologists considered pulse oximetry to be of immense value as it guides clinical management.
Task: Research and Pharmacology Anesthesiologists recommend the use of pulse Commented [A4]: Deals with criterion 3: Organizational factors that influence the selection of a technology in health care setting. oximeters because they believe that maintaining oxygenation within limits might help prevent irreversible injury. Pulse oximetry is, therefore, a key part of the standard protocol for monitoring critically ill patients. Narayen, I. C. et al. (2016). Aspects of pulse oximetry screening for critical congenital heart defects: When, how and why? Archives of Disease in Childhood – Fetal and Neonatal Edition, 101(2), F162–F167. http://dx.doi.org/10.1136/archdischild-2015-309205 This article describes how pulse oximetry is being implemented worldwide for the screening of critical congenital heart defects (CCHD). The use of pulse oximetry to screen for CCHD is highly recommended because it is effective, quick, simple, and costeffective. The authors state that training parents and caregivers and using tools that are computer based can improve pulse oximetry screening. Pulse oximetry helps detect significant pathology and is reliable for keeping track of CCHD, which requires constant Copyright ©2019 Capella University. Copy and distribution of this document are prohibited. Commented [A5]: Fulfills the rubric criteria: Justify the implementation and use of a selected technology in a health care setting. And also fulfills: Describes organizational factors influencing the selection of a technology in the health care setting.
Task: Research and PharmacologyANNOTATED BIBLIOGRAPHY ON TECHNOLOGY IN NURSING 5 diagnosis and immediate medical intervention. In almost every infant with CCHD, clinically undetectable hypoxemia is identified by pulse oximeters. Early studies of neonatal pulse oximetry screening for CCHD showed accurate details. As a result, the U.S. Secretary of Health and Human Services advised adding CCHD screening to the recommended uniform screening panel. According to a meta-analysis of 13 screening studies, pulse oximetry screening reported a specificity of 99.9 percent, a sensitivity of 76.5 percent, and a false positive rate of 0.14 percent. Therefore, the authors concluded that the universal screening criteria were met by pulse oximetry screening. Pulse oximetry screening shows no difference in accuracy when pre-ductal and post-ductal pulse oximetry measurements are performed. The authors also observed that pulse oximetry screening done 24 hours after birth increases the risk of late detection of CCHD in infants but decreases the false positive rate. Therefore, the use of pulse oximeters can be crucial for the early detection of CCHD and helps reduce mortality and improve postoperative outcomes. Nitzan, M., Romem, A., & Koppel, R. (2014). Pulse oximetry: Fundamentals and technology update. Medical Devices: Evidence and Research, 7, 231–239. https://doi.org/10.2147/MDER.S47319 This article offers comprehensive insight into how pulse oximetry works; particularly, it looks at the techniques involved in measurement, the limitations of using the techniques, and the accuracy that can be expected while determining oxygen saturation. Oxygen saturation (SaO2) is the measurement of the percentage of oxygen in hemoglobin. Pulse oximeters detect the significant decline of oxygen in the respiratory function of patients.
Task: Research and Pharmacology Measurements of oxygen saturation in pulse oximeters (SpO2) are often inaccurate when Copyright ©2019 Capella University. Copy and distribution of this document are prohibited. Commented [A6]: Fulfills the rubric criteria: Justify the implementation and use of a selected technology in a health care setting. ANNOTATED BIBLIOGRAPHY ON TECHNOLOGY IN NURSING 6 critically ill patients receive supplemental oxygen. The difference between SpO2 and SaO2 determines the accuracy of a pulse oximeter. Though the outcome of pulse oximetry in measuring SaO2 in sick patients is 3–4 percent inaccurate, pulse oximeters quickly detect the abrupt drop of SpO2 in anesthetized patients and in patients in intensive care units. Despite the limitations of pulse oximetry, SpO2 values obtained from the pulse oximeter are considered reliable for the detection of deterioration in respiratory function. Further, pulse oximetry has the advantage of being a noninvasive technique to measure oxygen saturation. Studies suggest that pulse oximetry should not be the only method to monitor SaO2 in the neonatal intensive care unit because of infants’ vulnerability to Commented [A7]: Fulfills the criteria: Justifies the implementation and use of a selected technology in a health care setting. Provides an in-depth and well-researched analysis of the impact of the technology on quality care and patient safety. retinopathy of prematurity, which is induced by the high partial pressure of oxygen in arterial blood. The authors conclude that technological advancements in pulse oximeters over the years have enabled them to diagnose and monitor patients better. Conclusion Despite their limitations, pulse oximeters are recommended for monitoring oxygen saturation levels in patients with respiratory problems.Task: Research and Pharmacology
The use of pulse oximeters helps reduce the rate of pulmonary transfers of patients from a postsurgical floor to the ICU. They play a crucial role in screening infants for CCHD, and therefore, the use of pulse oximeters in pediatric wards is highly recommended. Pulse oximetry helps in the early detection of certain diseases, thereby preventing irreversible damage to organs and reducing the rate of mortality. Pulse oximeters are a cost-effective resource in hospitals. They can easily detect a significant decline of oxygen in the respiratory function of patients. The rate of transfers to the intensive care unit due to pulmonary complications was significantly lower in patients who were continuously monitored using pulse oximeters than in patients who were intermittently monitored using pulse Copyright ©2019 Capella University. Copy and distribution of this document are prohibited. Commented [A8]: Fulfills criteria 3: Describes organizational factors influencing the selection of a technology in the health care setting. ANNOTATED BIBLIOGRAPHY ON TECHNOLOGY IN NURSING 7 oximeters. The readings obtained from pulse oximeters are reliable and help make immediate adjustments to a patient’s oxygen supply, which can help prevent irreversible damage or death. The limitations of conventional pulse oximeters are overcome by multiwavelength pulse oximeters, which can estimat …