Reply 1

Normil Dilande

St. Thomas University

NUR 415: Health Care System Issues

Professor Rousseau

July 19, 2022.

Emergency Preparedness & Health Policy

How My Work Environment Prepares and Responds To Emergency Preparedness

                 The threat of man-made emergencies is the core focus in my work environment. In preparing for these issues, my workplace encourages a multi-stakeholder and multi-disciplinary approach encompassing the roles of the police, medical providers, environment and structural engineers, housing and transportation experts. They anticipate the types of disasters that are most likely to occur in the hospital environment. There is an in-house disaster preparedness framework and policy to complement the regionalized approach that has been adopted by the government. Hospitals anticipate both natural and man-made disasters and so that is still the case with my workplace. However, in this case, I will mainly focus on the man-made emergencies such as terrorist attacks, transportation incidents, data theft, and chemical and biological attacks. In the current emergency preparedness program, there is the acceptance that each of these incidents or threats poses a different challenge to the organization. In that case, there should be some level of capacity in the organization to respond to each sort of emergency.

             Like any other hospital, my workplace has finite resources and so there is always the need to focus most of the resources on the most likely or the potentially serious incidences. For instance, when targeting to respond to terrorist attacks, there is the acknowledgement that bombings are the most commonly occurring forms. When bombings occur, they result in serious forms of penetrating and blunt trauma other than the physical burns and related injuries. The subway and train attacks that occurred in Madrid more than a decade ago are most notable. On the other hand, there is also the likelihood of bioterrorism or nuclear attacks. The impact of such occurrences on overall public health would definitely be catastrophic (Sheikhbardsiri et al., 2022). In essence, my workplace seeks to prioritize emergency preparedness and response based on the level of likelihood of specific attacks or emergencies occurring. In essence, emergency preparedness is not a blanketed approach but rather a carefully crafted plan that is based on real-world events and occurrences in the past.

How I See Health Policy Impacting Nursing Practice in Preparing For Emergencies

             Nursing plays a major role in the context of preparing for a disaster. For instance, it helps in preparing individuals and communities so that they are better placed to counter and mitigate potential hazards whenever disasters come about. Health policies of this nature mainly target the most vulnerable populations such as pregnant women and infants in cases of unique needs that are presented in the aftermath of an emergency. Health policy impacts nursing practice in preparing for emergencies in a myriad of ways. Such policy seeks to ensure standardized training for nurses and first responders. It emphasizes the essence of inter-professional collaboration and open communication throughout the organization, and more so the impact that funding has on these kinds of incidents. Health policy also demonstrates that preparing for emergencies is not a one-man show but rather a multi-stakeholder approach involving the hospital, public health facilities, community health partners, and the government.

              In essence, emergency preparedness is quite dynamic (Goniewicz et al., 2021). In that same regard, existing health policy will impact nursing differently in the coming years. That being the case, additional research is still needed in order to facilitate communication, encourage collaboration, and standardize training materials and regimes. Being effectively prepared can help to reduce anxiety, fear, and the losses that often accompany the occurrence of disasters. Nurses have to play active roles in such processes since they have been trained on the sorts of emergencies to expert and how they should respond when such incidences occur.

References

Goniewicz, K., Goniewicz, M., Burkle, F. M., & Khorram-Manesh, A. (2021). Cohort research analysis of disaster experience, preparedness, and competency-based training                     among nurses. PLoS One, 16(1), e0244488. https://doi.org/10.1371/journal.pone.0244488 (Links to an external site.)

Sheikhbardsiri, H., Doustmohammadi, M. M., Mousavi, S. H., & Khankeh, H. (2022). Qualitative study of health system preparedness for successful implementation of                           disaster    exercises in the Iranian context. Disaster Medicine and Public Health Preparedness, 16(2), 500-509. https://doi.org/10.1017/dmp.2020.257

Reply 2

Therese Boulay

St. Thomas University

NUR-415-AP1: Healthcare Issues

Professor Rousseau

July 21, 2022

Emergency Preparedness & Health Policies

      Living in Florida has taught healthcare and the community how important emergency preparedness and responding to a pandemic is very important. After experiencing several catastrophic natural disasters like hurricanes Katrina and Irma, and after the deadly pandemic of Covid 19, the country has instilled health policies and passed Acts that help prepare and protect us from the aftermath of these disasters. The paper will discuss what preparations and responses to emergency preparedness that my facility had in place during Hurricane Irma, and how health policies can impact nursing practices.

Preparedness for hurricane Irma

      Hurricane Irma was a catastrophic natural disaster in 2017, that affected the community, and healthcare system, especially the nursing homes. Post-Katrina Emergency Management Reform Act (2006), reorganized Fema, which established a Disability Coordinator, and coordinated and supports evacuations, and recoveries (Mason et al., 2020). When the facility I worked at, which was a nursing rehabilitation home, became aware of the possible hit of Hurricane Irma through Florida, the facility began preparation the same day. The nursing department made sure every nurse chose if they wanted to work before, during, or after the storm. The facility prepared our units making sure we had several large containers filled with water in case the water system stopped working, the pharmacy provided extra medication for all the patients, galloons of water were in place for hydration of the patients, and medication administration records were printed out to sign in case we lost power, flashlights were administered to every unit, and one emergency cell phones were distributed to every unit. Patients’ beds were also moved away from all windows. Nurses were instructed to bring overnight bags since we were not sure what would be in the aftermath of Hurricane Irma.

Response to emergency preparedness

      The responses to the preparedness were very organized and all the different disciplinary worked together to help prepare for the hurricane. Nurses came together as a team. Although the response after the storm was not what the facility expected, it had staff in concern. We were left without power for several days, nurses were exhausted and short-staffed, the heat was felt through the units, portable fans were not immediately available for the units, there were not enough emergency phones, and many patients ended up being transferred to hospitals for heat exhaustion. We learned the devasting effect of having no power. Florida has instituted an emergency power rule to ensure that nursing homes can provide an environment where temperatures do not go above 81 degrees for at least 96 hours in the event of a power outage (Dosa et al., 2020). Since then, extra generators, and hundreds of fans are kept in storage, and new air condition units have been put in place.

Health policies and their impact on nursing practices

      Health policies should involve stakeholders, organizations, and especially nurses. Nurses should be protected and kept up to date about the preparedness of disaster health policies. The Pandemic and All-Hazards Preparedness Reauthorization Act 2013 authorizes funding for public health and medical preparedness programs (Mason et al., 2020). A study has shown that long-stay residents experienced greater morbidity and mortality because of factors like, patients being at risk for transfer trauma associated with evacuation, post-storm heat, and availability and adequacy of direct-care nurse staffing ( Dosa et al., 2020). Nurses should be made aware of policies, preparedness, and changes through in-services periodically. Nurses become overworked and stressed because we have to worry about our patients and our own families. This can interfer with our practices. One of the biggest barriers we see is that natural disasters capture our attention during the warning, impact, rescue phases, and response phase, then the media and scientists move on, which leaves everyone to fall short of answers when the next event occurs ( Shultz & Galea, 2017).

Conclusion

      Preparedness and responding to natural disasters take a lot of planning. Planning should not only include preparation before but should also include preparation after an emergency.  Not only patients are impacted, but nurses and healthcare teams suffer the consequences when preparedness is not in place. I am glad that we came together as a team and everyone reacted quickly to make sure our patients were kept safe after hurricane Irma. Hopefully, we continue to research better preparedness before the next hurricane.

 References

Dosa et al., (2020). Association between exposure to Hurricane Irma and mortality and hospitalization in Florida nursing home residents.             JAMA Network Open, 3(10), e2019 460. https://doi.org/101001/jamanetworkopen.2020.19460 (Links to an external site.).

Mason. D. J., Gardner, D. B., Outlaw, F.H., & O’Grady, E.T. (2020). Policy and Politics in Nursing and Health Care (8th ed.). _St. Louis MO:                   Elsevier. ISBN: 9780323597968 

Shultz, J.M. & Galea. S. 2017 (2017). Preparing for the next Harvey, Irma, Or Maria – Addressing research gaps. The New England Journal of              Medicine, 377(19), 1804-1806. https://doi.org/10.1056/NEJMp1712854 (Links to an external site.)

 

Reply 3

Judith Abelard

St Thomas University

NUR-422-AP2

Professor Henriquez, Lisbet

July 21, 2022

 

 

Training, New Information System & Evaluation

Implementing new information systems in healthcare institutions requires specialized skills to improve efficiency and reliability. Training involves equipping healthcare practitioners and staff with the basic knowledge needed to operate, enhance and maintain new information systems. New information systems are essential in collecting, storing, and processing data necessary for providing information and knowledge in making critical decisions in healthcare. This paper describes training provided when a new information system is implemented in our healthcare organization.

End-user training is used in our organization when a new information system has been implemented. Nurses and other healthcare practitioners are involved in end-user training, learning to manage and store the collected data in healthcare facilities. Nurses are trained in a task such as collecting and storing patient electronic medical records. New information systems are characterized by new interaction interfaces, thus making it necessary to educate nurses on how to interact with further information. End-user training is essential in helping nurses and other healthcare practitioners acquire skills to perform healthcare services effectively and improve patients’ satisfaction.

Information system problem troubleshooting. Nurses and other stakeholders in our healthcare organization are trained to handle fundamental problems that may arise when using new information systems. Some basic troubleshooting techniques include restarting the information systems, checking internet connectivity, and using the command lines to fix problems when using new information systems. Training healthcare practitioners to troubleshoot information systems problems is vital as it helps reduce slow times that may be experienced when the information systems are not used (Vaishnavi et al., 2019). Nurses are also trained to determine specific information system problems such as software and hardware issues. Through this training, nurses can understand the physical components of information systems and the programs facilitating efficient data collection and management.

Nurses, the end users of systems, are involved in system evaluation in our healthcare organization. The system’s end users play a vital role in monitoring and analyzing system performance. Nurses play a critical role in our organization as they collect and manage information in the systems and thus interact regularly with the system making it necessary to involve them in system evaluation (Simamora, 2019). Nurses are essential in system evaluation as they help to determine whether the intended goals and objectives of a new information system are achieved. The efficiency and effectiveness of the information system are defined in our healthcare organization through monitoring and assessing how nurses carry out a task when serving patients. Involving nurses in system evaluation has critically helped the healthcare organization management to determine problems and system advancements that need to be addressed to improve efficiency and customer satisfaction.

In conclusion, information systems significantly improve healthcare service delivery and customer satisfaction. Information systems help create an efficient and effective environment for nurses to collect, manage and store patients’ medical records. Implementing new information systems in healthcare organizations requires specialized skills for operating new information systems. Training nurses and other healthcare practitioners involve developing the skills and knowledge needed to use new information systems efficiently. Some standard training techniques for implementing new information systems in our organization include end-user training and troubleshooting problems associated with new information systems. Our organization involves nurses, the main stakeholders of information systems in evaluation. Nurses play a significant role in evaluating a system as they directly interact with the information systems, thus providing reliable information about the implemented system.

References

Simamora, R. H. (2019). Socialization of information technology utilization and knowledge of information system effectiveness at Hospital Nurses in Medan, North Sumatra. International Journal of Advanced Computer Science and Applications, 10(9).

Vaishnavi, V., Suresh, M., & Dutta, P. (2019). A study on factors associated with organizational readiness for change in healthcare organizations using TISM. Benchmarking: An International Journal.

 

Reply 4

  Training, New Information System, and Evaluation

                                                                                           Daniela Abreu Abreu

                                                                                           St Thomas University

                                                                                                      NUR 422

                                                                                         Instructor: Lisbet Henriquez

                                                                                                      July 20, 2022

 

 

Training, New Information System, and Evaluation

The health care system has greatly changed with noticeable reforms and restructuring taking place as a result of technological advancements and innovations. The introduction and implementation of information systems in the health care system have positively impacted service delivery (Shin et al., 2017). As a result, new roles and responsibilities have emerged in the nursing practice as the integration of information systems continues to be adopted. Information systems have proved to be an effective management tool in the health care system (Mitchell & Hull, 2020). The new roles and responsibilities have challenged nurses to seek more education on the operation of the systems and to remain relevant in the practice. The complexity and cost of different information systems as well as the rate of change in computer technology are various factors that should be considered when evaluating the appropriate information system to implement (Lin, 2017). Nurses and nurse leaders need a sound knowledge of health care information systems and an understanding of the nursing practice to be able to obtain the computer tools relevant to the practice (Sahay, Sundararaman, & Braa, 2017).

Nursing is a critical profession in the health care system and their input cannot be ignored. Nurses interact with patients more compared to any other health care profession (Lin, 2017). Their primary goal of providing health care to patients gives them an upper hand in understanding the patients’ needs and preferences. This makes it necessary to involve nurses in the evaluation and implementation of information systems in health care. Implementation of informatics in health care has aided in effective communication significantly impacting interprofessional collaboration (Lin, 2017). As a result, better patient’s outcomes have been achieved, and reduced medical and human errors. In my organization, nurses have been actively involved in the evaluation and implementation of health care systems. In the process of evaluating and implementing these information systems, nurses need to be trained and educated on a number of issues.

When introducing a new information system nurses need to be trained on the navigation of the various tools. Some of the information systems are complex and require a wide scope of ICT knowledge (Shin et al., 2017). It is, therefore, necessary to equip nurses with the relevant knowledge and skills to effectively and efficiently use the information systems to offer quality services. As earlier stated, nurses interact more with patients compared to other health care professionals. In organizations that offer telehealth services, patients need to be conversant with the system being used by the organization. To educate patients on how to navigate the system, nurses are best placed to take them through. It is therefore necessary to equip nurses with teaching skills that will give them the capacity to educate patients (Shin et al., 2017). Nurses too need to be trained on how to operate health care machines that are linked to the information systems. Innovations in technology have led to the development of health care machines and equipment that do not necessarily require a manual operation but are rather operated from computers (Shin et al., 2017). In order to effectively use equipment to offer health care services, nurses have to be trained. The application of informatics can not be avoided in the modern world as it has become a way of life.

Health care reforms due to patient demands have inspired the embracement of health information technologies such as electronic health records. The discovery of a new healthcare system has provided healthcare providers such as nurses with a plan on how to carry out health information technology implementation. Implementation of a well-designed information system provides a quick information flow used in the documenting process. However, nurses play a vital role in utilizing health information technology by ensuring the safety of patients where electronic documentation and the nursing environment have a positive impact (Shin et al., 2017). Evaluation of the health information systems helps better plan health services, thereby leading to better patient outcomes. Through the evolution of informatics in the health care system, nurse trainees are provided with the necessary skills to carry out the documentation on the computer instead of on paper. Through this advancement, health workers can collect, analyze, and document data more efficiently and accurately in the communication of patient care and data, which are easily accessible. This documentation method has provided a better way to deliver error-free inpatient care due to faster action and accessibility to patient information (Shin et al., 2017). Evaluation of health informatics is done by healthcare personnel through the involvement of the nurse’s leaders in the system range and designing courses, which helps system upgrades through the innovation enhanced in information technology, which can be used by healthcare personnel easily. This new implementation system in healthcare has dramatically reduced nurse’s burnout, which leads to better healthcare provision.

In conclusion, it is essential to provide training and courses on the systems and new technologies to nurses. Educating the nurses on the importance and effectiveness of telehealth projects emphasizes the benefits of telehealth directly or indirectly, patients, and people’s health positively. Healthcare agencies should ensure that high-quality, patient-centered, evidence-based care is provided to each patient. Nurses who have no access to technological advancements should be integrated into potential E-learning programs. Through this method, equal access to healthcare advancements and knowledge will be available to providers and the healthcare staff

 

References

Lin, H. (2017). Nursesʼ satisfaction with using nursing information systems from technology acceptance model and information systems success model perspectives. CIN: Computers, Informatics, Nursing, 35(2), 91-99. doi:10.1097/cin.0000000000000293

Mitchell, M. B., & Hull, S. C. (2020). The alliance for nursing informatics. CIN: Computers, Informatics, Nursing, 38(1), 5-7. doi:10.1097/cin.0000000000000614

Sahay, S., Sundararaman, T., & Braa, J. (2017). Institutions as barriers and facilitators of health information systems reform. Oxford Medicine Online. doi:10.1093/med/9780198758778.003.0006

Shin, E. H., Cummings, E., & Ford, K. (2017). A qualitative study of new graduates’ readiness to use nursing informatics in acute care settings: clinical nurse educators’ perspectives. Contemporary Nurse, 54(1), 64–76. https://doi.org/10.1080/10376178.2017.1393317

Reply 1

Normil Dilande

St. Thomas University

NUR 415: Health Care System Issues

Professor Rousseau

July 19, 2022.

Emergency Preparedness & Health Policy

How My Work Environment Prepares and Responds To Emergency Preparedness

                 The threat of man-made emergencies is the core focus in my work environment. In preparing for these issues, my workplace encourages a multi-stakeholder and multi-disciplinary approach encompassing the roles of the police, medical providers, environment and structural engineers, housing and transportation experts. They anticipate the types of disasters that are most likely to occur in the hospital environment. There is an in-house disaster preparedness framework and policy to complement the regionalized approach that has been adopted by the government. Hospitals anticipate both natural and man-made disasters and so that is still the case with my workplace. However, in this case, I will mainly focus on the man-made emergencies such as terrorist attacks, transportation incidents, data theft, and chemical and biological attacks. In the current emergency preparedness program, there is the acceptance that each of these incidents or threats poses a different challenge to the organization. In that case, there should be some level of capacity in the organization to respond to each sort of emergency.

             Like any other hospital, my workplace has finite resources and so there is always the need to focus most of the resources on the most likely or the potentially serious incidences. For instance, when targeting to respond to terrorist attacks, there is the acknowledgement that bombings are the most commonly occurring forms. When bombings occur, they result in serious forms of penetrating and blunt trauma other than the physical burns and related injuries. The subway and train attacks that occurred in Madrid more than a decade ago are most notable. On the other hand, there is also the likelihood of bioterrorism or nuclear attacks. The impact of such occurrences on overall public health would definitely be catastrophic (Sheikhbardsiri et al., 2022). In essence, my workplace seeks to prioritize emergency preparedness and response based on the level of likelihood of specific attacks or emergencies occurring. In essence, emergency preparedness is not a blanketed approach but rather a carefully crafted plan that is based on real-world events and occurrences in the past.

How I See Health Policy Impacting Nursing Practice in Preparing For Emergencies

             Nursing plays a major role in the context of preparing for a disaster. For instance, it helps in preparing individuals and communities so that they are better placed to counter and mitigate potential hazards whenever disasters come about. Health policies of this nature mainly target the most vulnerable populations such as pregnant women and infants in cases of unique needs that are presented in the aftermath of an emergency. Health policy impacts nursing practice in preparing for emergencies in a myriad of ways. Such policy seeks to ensure standardized training for nurses and first responders. It emphasizes the essence of inter-professional collaboration and open communication throughout the organization, and more so the impact that funding has on these kinds of incidents. Health policy also demonstrates that preparing for emergencies is not a one-man show but rather a multi-stakeholder approach involving the hospital, public health facilities, community health partners, and the government.

              In essence, emergency preparedness is quite dynamic (Goniewicz et al., 2021). In that same regard, existing health policy will impact nursing differently in the coming years. That being the case, additional research is still needed in order to facilitate communication, encourage collaboration, and standardize training materials and regimes. Being effectively prepared can help to reduce anxiety, fear, and the losses that often accompany the occurrence of disasters. Nurses have to play active roles in such processes since they have been trained on the sorts of emergencies to expert and how they should respond when such incidences occur.

References

Goniewicz, K., Goniewicz, M., Burkle, F. M., & Khorram-Manesh, A. (2021). Cohort research analysis of disaster experience, preparedness, and competency-based training                     among nurses. PLoS One, 16(1), e0244488. https://doi.org/10.1371/journal.pone.0244488 (Links to an external site.)

Sheikhbardsiri, H., Doustmohammadi, M. M., Mousavi, S. H., & Khankeh, H. (2022). Qualitative study of health system preparedness for successful implementation of                           disaster    exercises in the Iranian context. Disaster Medicine and Public Health Preparedness, 16(2), 500-509. https://doi.org/10.1017/dmp.2020.257

Reply 2

Therese Boulay

St. Thomas University

NUR-415-AP1: Healthcare Issues

Professor Rousseau

July 21, 2022

Emergency Preparedness & Health Policies

      Living in Florida has taught healthcare and the community how important emergency preparedness and responding to a pandemic is very important. After experiencing several catastrophic natural disasters like hurricanes Katrina and Irma, and after the deadly pandemic of Covid 19, the country has instilled health policies and passed Acts that help prepare and protect us from the aftermath of these disasters. The paper will discuss what preparations and responses to emergency preparedness that my facility had in place during Hurricane Irma, and how health policies can impact nursing practices.

Preparedness for hurricane Irma

      Hurricane Irma was a catastrophic natural disaster in 2017, that affected the community, and healthcare system, especially the nursing homes. Post-Katrina Emergency Management Reform Act (2006), reorganized Fema, which established a Disability Coordinator, and coordinated and supports evacuations, and recoveries (Mason et al., 2020). When the facility I worked at, which was a nursing rehabilitation home, became aware of the possible hit of Hurricane Irma through Florida, the facility began preparation the same day. The nursing department made sure every nurse chose if they wanted to work before, during, or after the storm. The facility prepared our units making sure we had several large containers filled with water in case the water system stopped working, the pharmacy provided extra medication for all the patients, galloons of water were in place for hydration of the patients, and medication administration records were printed out to sign in case we lost power, flashlights were administered to every unit, and one emergency cell phones were distributed to every unit. Patients’ beds were also moved away from all windows. Nurses were instructed to bring overnight bags since we were not sure what would be in the aftermath of Hurricane Irma.

Response to emergency preparedness

      The responses to the preparedness were very organized and all the different disciplinary worked together to help prepare for the hurricane. Nurses came together as a team. Although the response after the storm was not what the facility expected, it had staff in concern. We were left without power for several days, nurses were exhausted and short-staffed, the heat was felt through the units, portable fans were not immediately available for the units, there were not enough emergency phones, and many patients ended up being transferred to hospitals for heat exhaustion. We learned the devasting effect of having no power. Florida has instituted an emergency power rule to ensure that nursing homes can provide an environment where temperatures do not go above 81 degrees for at least 96 hours in the event of a power outage (Dosa et al., 2020). Since then, extra generators, and hundreds of fans are kept in storage, and new air condition units have been put in place.

Health policies and their impact on nursing practices

      Health policies should involve stakeholders, organizations, and especially nurses. Nurses should be protected and kept up to date about the preparedness of disaster health policies. The Pandemic and All-Hazards Preparedness Reauthorization Act 2013 authorizes funding for public health and medical preparedness programs (Mason et al., 2020). A study has shown that long-stay residents experienced greater morbidity and mortality because of factors like, patients being at risk for transfer trauma associated with evacuation, post-storm heat, and availability and adequacy of direct-care nurse staffing ( Dosa et al., 2020). Nurses should be made aware of policies, preparedness, and changes through in-services periodically. Nurses become overworked and stressed because we have to worry about our patients and our own families. This can interfer with our practices. One of the biggest barriers we see is that natural disasters capture our attention during the warning, impact, rescue phases, and response phase, then the media and scientists move on, which leaves everyone to fall short of answers when the next event occurs ( Shultz & Galea, 2017).

Conclusion

      Preparedness and responding to natural disasters take a lot of planning. Planning should not only include preparation before but should also include preparation after an emergency.  Not only patients are impacted, but nurses and healthcare teams suffer the consequences when preparedness is not in place. I am glad that we came together as a team and everyone reacted quickly to make sure our patients were kept safe after hurricane Irma. Hopefully, we continue to research better preparedness before the next hurricane.

 References

Dosa et al., (2020). Association between exposure to Hurricane Irma and mortality and hospitalization in Florida nursing home residents.             JAMA Network Open, 3(10), e2019 460. https://doi.org/101001/jamanetworkopen.2020.19460 (Links to an external site.).

Mason. D. J., Gardner, D. B., Outlaw, F.H., & O’Grady, E.T. (2020). Policy and Politics in Nursing and Health Care (8th ed.). _St. Louis MO:                   Elsevier. ISBN: 9780323597968 

Shultz, J.M. & Galea. S. 2017 (2017). Preparing for the next Harvey, Irma, Or Maria – Addressing research gaps. The New England Journal of              Medicine, 377(19), 1804-1806. https://doi.org/10.1056/NEJMp1712854 (Links to an external site.)