Module 6

What is one new thing you learned in this module, or something that you knew but had forgotten?

Until I read chapter 10 in our textbook, I never really knew what all of the terms regarding computer security meant. I am familiar with terms virus, spyware and firewall. However, I was not familiar with some of the other terms such as worms, Trojan horses, logic bombs and bacteria.  It was not only interesting to me but a little frightening as well. 

There is a saying that says that ignorance is bliss and I guess it true to some extent because It is a little scary to me to see how many ways our computers and personal information can be threatened. 

Since beginning graduate school I feel like my computer is more of an appendage to my body than an accessory in my home.  I try to faithfully back up my computer, but it would still be devastating if something happened to it.  For this reason, I found the article entitled 10 tips to secure your laptop very useful.  This article contained very practical and simple steps that can be taken to make our laptops more secure.

This module was a good reminder to me of the things we all need to do to adequately secure our own information and the information of others. 

Module 5

How did the readings influence your perception of your own clinical decision-making?

 After watching  the lecture by Daniel Kahneman and reading the article by  Amos Tversky and Daniel Kahneman  from 1974 entitled” Judgement under uncertainty: heuristics and biases, discusses descriptive decision making. It made me realize how many times I make a decision based on my initial judgment.  I have never thought much about why or how I make these decisions.  Every time I work I make countless decisions about my patients.  After some introspection, I have concluded that a majority of the decisions I make are based on my own intuition in combination with my experiences.

I have always thought that nursing requires a great deal of intuition, and I was not surprised when this belief was validated in the lecture by Daniel Kahneman.  I find that the use of intuition is especially important in the neonatal population. They are not able to tell us as what is wrong and what doesn’t feel good.  We must rely upon our assessment skills and intuition. 

I remember when I was a new nurse in the NICU and the older more seasoned nurses would look at the baby, before any labs had been drawn, and know that the baby was septic.  I remember looking at that same baby and wondering how they knew, what were they seeing that I wasn’t seeing?  Over time I have been able to gain the skill/intuition to do this.  I now believe that the ability to make these assessments is based on the combination of experience and intuition. A good nurse must be able to recognize the very subtle changes that occur in the beginning stages of sepsis. This comes from repeated exposure to the situation.  They must also rely on their intuition and act when they think something is just not quite right.

It makes me very nervous to imagine myself as a neonatal nurse practitioner.  I know that I will again be relying on the more seasoned practitioners to help me develop the skills needed to develop expertise in this new role. 

Module 4

What sort of teaching is done in your professional role?

 Teaching is a focal part of my job as a neonatal intensive care nurse.   There is a lot of teaching done with the parents and the families of the neonate; things as simple as changing a diaper for the first time.  Teaching the parents how to take temperatures and move the oxygen saturation probe on their baby’s foot helps them to feel involved.  Another part of our job in the NICU is to assist the mother and teach her about breast feeding.

We also teach the parents about disease processes and procedures that affect their baby.

Aside from teaching the parents and families, as a unit charge nurse I am also responsible for continually educating and mentoring staff.  I am also responsible to educate expectant parents of what to expect when their premature infant is born. I am always amazed at how comforting information can be to new parents and family members of the neonate. Most people relax a little and feel empowered when they understand the why’s and what’s of what is being done to their baby.

  

 Is there any nursing/health care provider role that does not involve teaching in some manner?

I feel that every nurse/healthcare provider is a teacher. However, I feel that most people assume that any education provided by a nurse/healthcare provider is clinical in nature. While this may be true in the majority of cases, I would like to mention some examples of non-clinical education.

Nurses and healthcare providers in administrative/managerial roles are often faced with  challenges that don’t always include patient care. While a good portion of the education they provide includes keeping staff updated on clinical methods, they must also be skilled in educating their staff in regards to company rules/policies. A manager quickly realizes that a happy employee becomes a more productive and well- rounded employee. Happy employees require constant education in areas of interpersonal relationships with peers, patients and families. I cannot think of one person in healthcare/nursing that does not teach.

Module 3

You used an electronic index, a guideline index, and a web search engine to retrieve information relevant to your clinical problem. Compare and contrast your results. Which resources were useful/ not useful for your information retrieval task, and why?

The clinical problem that I decided to research was maternal use of SSRI’s and the effect on the neonate.  To begin, I did a google search which yielded no results.  I reworded my search to maternal use of antidepressants, this time I got only a handful of useful results but mostly it just brought up ads for different kinds of antidepressants. 

Next I searched the national guideline clearing house.  I found this method of retrieval difficult to use and never could find any results specifically aimed at my clinical problem. I was able to find information on the use of antidepressants but nothing in regards to their effect on the neonate when taken during pregnancy.

Lastly, I conducted a search on Endnote x4.  Using the World of Science and the Pubmed search data bases, I found over 200 publications that were relevant to my clinical problem. Needless to say, I found Endnote to be the most helpful way for me to search and obtain relevant information.  In Endnote, I am also able to organize my information by author or date.  It also allows me to make a file specifically for this particular search. 

I can see that each of these retrieval methods have their own strengths but for up to date professional research, I found Endnote to be the most helpful. 

Module 2

What is one way you could become involved in designing, selecting, evaluating or implementing an information system in your workplace?

Honestly, I have never been involved with the above processes in regards to an information system in my workplace. However, there are systems that could be improved upon and also new ideas that could be implemented. About one year ago, our unit implemented the use of a new program used to view radiological films. It was introduced rapidly into the unit without adequate introduction or staff training. After working with it some over the past year, I can only perform basic functions within the program. There are other nurses in the unit that have experimented with it on their own and have found that it contains a number of useful tools that are not utilized by everyone. I feel that this program still needs to be properly introduced to staff and they need to be oriented to it sufficiently. If everyone in the unit were able to utilize it completely, things like communication with physicians about x-rays in the middle of the night would be more effective. New staff members would also be able to view the films and orient themselves to common and unique findings.

Just like any other newly implemented program, staff needs to be trained adequately to be competent and efficient in use of such. In-services, super-trainers and follow up training would ensure that the bulk of the staff felt informed and empowered to use the program. If this training does not occur, the staff is unable to utilize it to its full potential.

Module One

Hi everyone-
This is Adrianna, most people call me Annie. I am in the NNP program. I live in Logan and have worked in the NICU for 8 years. Prior to that I worked on Peds for a couple years. I think that I have really found my niche' in the NICU, and I am excited to become a NNP.
Why is it important for a graduate level nurse to know about information management?
As a graduate level nurse I think it is important to be knowledgeable about vast variety of information available. The information could help manage a budget, organize a supply list, present new or pertinent information to staff, produce a staff schedule, and organize and present personal information. The list could go on and on. I believe that a graduate level nurse should have a general idea about the technologies out there not be afraid to venture out and learn new programs.
Information Technology in my unit:
The most recent advancement in technology in my unit is the installment of web cams in each of the individual rooms in the NICU. With these camera's the family members of the babies are allowed to call and we can turn on the web cam and they can view their baby. This includes siblings , grandparents and others who may live far away. The families really seem to love this, because while in the NICU the parents are only able to list 4 people that may visit the baby. Children under the age of 14 are not allowed in the unit. We do this in hopes to minimize the exposure to infections from the "outside".
Other technologies we use include: vocera's to communicate with each other and other departments. We still do paper charting, but we chart and scan our medications on the computer. We also view our x-rays on a computer. Many of our pediatricians are able to view the x rays at home or in thier offices. This is especially convenient in the middle of the night.

I am looking forward to learning more about information technology in this class!