To reflect on an information governance issue, inspired by an observation made in practice or on reading around the topic. Maximum 2,000 words

Please also refer to the lecture of reflection and the accompanying PowerPoint slides. 

You can only reflect on your own practice and this must be something related to health information governance (or a parallel issue with relevance to health information governance). It could be an incident from the past, made critical by something we discuss during the taught week or by something you read about governance.

As this is a form of ‘guided reflection’, it is recommended that you use the following headings and prompts for your paper based on Gibbs Reflective Cycle:

Model for academic reflective writing

1. Describe the situation/event

· Why was it important?

· How does it relate to IG?

1. Feelings

What were your thoughts and feelings/what were the good and bad points of the situation/event?

· Did it impact on others, and how?

· How did you feel at the time?

· What was your role?

1. The key issue

On the basis of 1 and 2, what is the main IG related issue emerging?

· Having identified the IG issue, it becomes possible to find suitable literature

1. Analysis

Making sense of the situation – a) What does the literature say about the issue and the situation? b) What are the legal and ethical perspectives. c) What alternatives were there?

1. Conclusion 

What have you learned a) about the issue, b) about yourself and c) about the best alternative way to manage the situation/event?

1. Action Plan

What would you do if the situation arose again ? What do you need to do to further develop yourself/your skills/your knowledge/ your practice?

Polypharmacy is a common concern, especially in the elderly.

• List the definitions of polypharmacy you encounter in your readings. There is more than one.
• Discuss three risk factors that can lead to polypharmacy. Explain the rationale for why each listed item is a risk factor. This is different than adverse drug reactions. ADRs can be a result of polypharmacy, and is important, but ADRs are not a risk factor.
• Discuss three action steps that a provider can take to prevent polypharmacy.
• Provide an example of how your clinical preceptors have addressed polypharmacy.

Reference must be within 5 years

Comment1

Clinical nurse leader role (CNL) is  a new specialty developed in nursing to prepare highly skilled nurses    to focus on the improvement of quality and safety outcomes for patients. According to IOM report on 1999 large number of death occurred as result of avoidable medical errors. In response to this   American Association of Colleges of Nursing(AACN) launched the role of clinical nurse leader ,to educate and strengthen nurses to improve safety, quality and better outcomes of care delivered. The CNLs provide education to all and corporate with evidence based practice (“Clarifying the clinical nurse leader role: guardian of care – American Nurse Today”, 2018).

 The clinical nurse leader (CNL) is an advanced clinician with master’s level education. Education is necessary to bring clinical competence and knowledge to serve as a resource to entire nursing team. CNLs  who works with multi-disciplinary team of physicians, pharmacists, social workers clinical nurse specialists’.CNL collect and evaluate treatment results .CNLoften manages other nursing staff and even serve as a resource to the entire team.CNL s require strong problem  solving and critical thinking skills to evaluate the quality of patient  care (2018) .

Comment2

Clinical nurse leaders (CNL) are nurses that can be described as advanced generalists. They serve general populations within medical care. CNLs will deal with oncology patients, bariatric patients, cardiology patients, etc. These patients will have a variety of diagnoses and treatment plans that the CNL will have to be familiar with. As such this places CNLs as prime educators within the medical system that educate the groups with whom they work on the most current evidence based practice. As a result this improves the delivery of patient care. For example, CNLs will work with clinical nurse educators (CNE) to address areas of educational gaps for the staff. They will then assess the feedback given by the staff to note areas of improvement and/or success (Monaghan, 2011).

In order to become a qualified CNL, one must have a nursing degree and  complete a master’s degree in order to ensure clinical competency and mastery. After which, a program designed to teach the role of CNL to the students (Stanley, 2018).

The success of CNLs has been quantified many times over particularly in the Veterans Health Administration (VHA). With the implementation of CNL roles, the VHA has documented an increase in nursing hours per patient day, reduction of sitter hours for patients with dementia, decrease in preoperative and gastrointestinal patient cancellations, and increase in the compliance of providing discharge teaching by the nursing staff, reduction in ventilator-associated pneumonia, reduction in falls, nosocomial infections, and pressure ulcers” (Monaghan, 2011).

Topic: Medical record documentation is required to record pertinent facts, findings, and observations about an individual’s health history, including past and present illnesses, tests, treatments, and outcomes. The medical record chronologically documents the care of the patient and is an important element contributing to high-quality safe care.Discuss your State Board of Nursing nurse practitioner documentation guidelines and how this can impact your level of reimbursement in the clinical setting.