Module 6 Game, Set, Match!

What did you like or dislike about taking an asynchronous online course?

Considering myself a novice in most activities involving a computer, I enjoyed the asynchronous online course, allowing me to go at my own pace. I found sitting at the computer for hours each day a bit monotonous, and found myself longing for classroom chatter. Having a Mac instead of the University of Utah supported PC made some of the coursework a bit difficult to access.

What topic did you learn the most about and what was your favorite topic? What did you like the least?

I found the modules on information retrieval the most helpful, and the module on teaching with technology the most eye opening. The module related to decision support has given me a good background for the up and coming “live” date at work. I have been able to share insight on why this move to an EMR is imperative, and after implementation how much safer, easier, and effective our jobs will become. (I still think I am the only one excited- we are meeting quite a bit of resistance to change)
I haven’t had a lot of time to Facebook, twitter, or blog- quite honestly before this class I found fellow co-workers that spent work time on these different websites to be time wasters. After the module on teaching with technology, I can see where a blog, an email, or Facebook might be a useful way to share generalized information to selected populations. (I have yet to try twitter)

Do you have any other comments for us?

Finding information regarding different websites during testing for this class was a bit nerve racking at first, yet the information was easy quite easy to find. Not only was I able to answer the test questions, but at the same time become familiar with different health related websites as well. After finishing this coursework, I feel a bit more confident in my skills on the computer, however, I look forward to putting this computer away for the next few weeks to rest and play.

Module 5 Policy and Ethical Issues

Why would a patient want to create a blog? What might they gain from this?
A friend and former patient created a blog when he was admitted for a bone marrow transplant. He gave daily updates of his life in the hospital, sharing laughs and tears. He shared his experiences, his hopes and his fears. He hoped to inspire others facing the same ordeal, and also provide updates to all his friends and family. He thought it helped take his mind off of not feeling good, something to look forward to, and a way of helping others get through the same kind of mind boggling experience at such a young age.

A friend’s husband went through a lap-band surgery, and now posts updates on his dramatic weight loss and new vitality. He does this to keep everyone updated, but also finds it therapeutic to see how far he has come. He hopes to inspire others.

Why would a health care provider blog? What might they gain from this?
A healthcare provider might blog about general things, like recommended diet and exercise for children, what immunizations are required before going to school, and the importance of well child checks even when one is not feeling ill. In providing information, it would first make others more aware of knowledge we often take for granted, and also provide a look into the personality of the provider-
One might also use a blog as a way to direct patients to reputable websites with pertinent information. It might prove a way to disseminate information to a large group rather than taking up the one-on-one time at an appointment.

What are ethical considerations when blogging on a public website, such as we’ve used for this class?
Privacy is a big concern. I found myself a little concerned with privacy while blogging for this class. I have avoided placing any pictures of my family for this reason- although my older children are involved with facebook- they can choose who their audiences will be.
Reproducing copyrighted materials to include in a blog raises ethical questions. Make sure to give credit where credit is due.
Blogging allows any citizen to put their First Amendment rights into action without a filter. Think about the audience that will read your blog, their educational background and values are important. Once it is in print, it is hard to take back.

Module 4

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

Kahneman (2008) describes the ‘Mode of Thinking’ involving two systems. The first system is described as intuition involving an automatic response. It is hard to control, a slow learner, associative, and easily jumps to conclusions. The second system, reasoning, results in a slower execution, requiring both control and effort. If the second system cannot monitor the intuitive or automatic system, performance changes.

‘Cognitive Dispositions to Respond’, also known as heuristics and biases, may impact clinical decision-making. One must examine what decisions are based upon, whether it is experience or evidence and in what combination. The logic or rationality behind a decision may be influenced by level of certainty or uncertainty, as well as values and beliefs. Use of computer systems may result in consistent performance not influenced by values or beliefs, and not affected by fatigue and distractions. Of course, the data has to have integrity.

Electronic medical resources (EMR) and health records provide clinical decision support interventions to guide and support the clinical user in establishing next steps, offering useful evidence-based knowledge, and providing relevant patient information in making an accurate diagnosis. The data collected from the EMR must be accurate if it is to be used in clinical decision-making. Multiple resources are required to design, maintain and monitor effectiveness of data within the electronic medical resources. Without electronic record sharing within the health care delivery system, this type of tool have not yet completely realized or utilized.


Kahneman, D. (2008, January 31). Explorations of the mind: Intuition [Video file]. Retrieved from http://www.youtube.com/watch?v=dddFfRaBPqg

Modue 3 Teaching with Technology

What sort of teaching is done in your nursing role?
Although the physician tells the patient which medication they will receive, it is the nurse that teaches the patient what that medication is, how long it will take, what are the pre-medications, what are the side effects, what we can do to manage those side effects, how long they will feel yucky for, what to do if they have problems, etc. It isn't just the patient who asks for education from the nurse, it is oftentimes family members who want to be able to help. As nurses, we use our experience to make the process better, even with something as easy as administering an injection. Patients are taught to stand on the opposite leg, relax, massage the site after injection (sometimes), how long it will hurt for, and when they should start to feel better.
I love to share my knowledge and experience, especially if it can then make a difference in how they feel and empower them to do things to help themselves. The ah-ha moments are priceless, and when brought to my attention, make my day.
I cannot think of any nursing role that does not involve teaching in some form or another.

Module 2

To date, I have used an electronic index (PubMed), a guideline index (National Guidelines Clearinghouse(NGC), and a web search engine (Google) to retrieve information on the reasons for noncompliance in diabetics.
First, I accessed PubMed and typed in a search for 'diabetes', which returned 353,844 results. I then limited the search to education and (lack of compliance). Yes, the parenthesis allow for phrases to be searched for, rather than the single words:) With these limits, the results were 74. Adding full text to the mix, the results were now 15. Although most of the articles were related to diabetes, only one really pertained to my search.
I next accessed NGC and typed in diabetes mellitus and education and (lack of compliance). The topic was too narrow, which resulted in zero results. I then tried diabetes and education, which resulted in 75. I then added noncompliance, which brought the result to 5. Although this was a rather specific search, again the results didn't help me to answer the original question.
Next, I tried a search with my old friend, Google, which found 1,650,000 results. The results(I only looked at the first page)seemed more relevant to my question.
Perhaps some practice composing great questions might come in handy?! Using some of the results titles from Google, I next tried 'improvement in compliance and education and diabetes' back at the PubMed site, which finally brought up articles applicable to my question.
Lesson learned: I can start a search on the Google site, it may help me formulate a question and get a feeling for what is out there. From there, I could go to PubMed to search for articles, or I could go to the NGC site to access guidelines and clinical trials. The differences seem to be quality of information.

Module 1 New experiences....

My name is Marilee Slade. I am beginning the third semester of the BSN-DNP program, emphasis in FNP. This blogging thing is very new to me, in fact, I still consider the computer a foreign object- yet, I continue to learn new things every day.
I am the mother of three, and mainly work in oncology.

There is a need to understand information management to be able to have a full range of tools at our disposal, as graduate level nurses. Without the aid of computers and software, trying to collect data and categorize it into useful information would be difficult, time consuming, and fraught with errors. An evidence based practice, with an informatics infrastructure, will readily allow data collected to be categorized thus decreasing unforeseen variations, while tracking quality control and outcomes.

IT, as related to my clinical practice setting is actually in the process of making huge leaps and bounds in progress. What a wonderful time to be learning this information- I believe I am the only nurse in my department that doesn't believe our new program will be a "waste of time". We are currently working on standardizing treatment templates- instead of writing each one individually. What a concept! The templates, with their structured forms and coded data, will then be used for tracking patients and their outcomes across time, and will help with reimbursement issues, billing and coding.
Although the thought of learning all this new information is frightening to me, I am also excited to be involved in the change.
Thus ends the first blog