POST 1

Jacqueline

   The selected topic for this week’s discussion board is Diabetic Knowledge and foot care.

     In the selected research article, the study is designed to explore how the Diabetics long-term foot self-care is impacted by his/her knowledge obtained about proper foot self-care. The study’s overall purpose was to assess the relationship between foot care knowledge and foot self-care in African Americans with Type 2 Diabetes Mellitus. 

This study sample includes African Americans diagnosed with Type 2 Diabetes residing in the US’s southern region; for participant recruiting, a convenience and snowball sampling plan was used via online survey engine, also telephone, email, and flyers that detailed the study.

Descriptive analysis and analysis of variance (ANOVA) were employed to analyze basic foot care knowledge, specialized foot care knowledge, and foot self-care within the participants. The data was also analyzed by:

1. Whether the participant had insurance.
2. Education level.
3. Gender to test for any potential moderating effects.

In the study by Bonner et al. ( 2019), A one-way analysis of variance is conducted to evaluate the relationships between participant gender, insurance status, and education level with primary and extended foot care knowledge and basic and extended foot self-care.

     The findings in this pilot study demonstrated that in an African American population with T2DM, regardless of varied education and gender, there are considerable differences between how foot care knowledge is translated into actual foot self-care behaviors. This result confirms that without that additional knowledge, there is the potential to adopt poor foot self-care behaviors.

The use of Inferential statistics strengthens this research study. ANOVA helps determine whether the differences between groups of data are statistically significant to strengthen a study. According to Polit (2010),” ANOVA tends to yield accurate results even if the population distributions depart from normality “(p.139). The study discussed here is significantly strengthened by using the analysis of variance; the findings reveal that positive insurance status is protective in preventing lower extremity disease complications associated with T2DM. 

Studies show that efficient foot care interventions can prevent or reduce morbidity and disability in those with T2DM (Neder &Nadesh, 2003).   Studies have also shown that foot care interventions reduce T2DM associated amputation rates between 44% and 85%. (Barth et al., 1991). This study’s results play a critical part in applying evidence-based practice as it proves the efficacy of education regarding outcome improvements and emphasizes the importance of health care equality. This study showed that insurance status had considerable influence on the participants’ comprehensive foot care knowledge, and conversely, the lack of insurance was a barrier.  

Reference:

Barth, R., Campbell, L., Allen, S., Jupp, J., & Chisholm, D. (1991). Intensive education 

improves knowledge, compliance, and foot problems in type 2 diabetes. Diabet Med, 

            8(2), pp.111-117.

Bonner, T., Guidry, J., & Jackson, Z. (2019). Association between foot care knowledge and 

practices among African Americans with type 2 diabetes: An exploratory pilot 

study. Journal of the National Medical Association, 111(3), 256-261. 

doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.jnma.2018.10.004

Neder, S., & Nadash, P. (2003). Individualized education can improve foot care for patients with 

diabetes. Home Healthc Nurse, 21(12), 837e840.

Polit, D.(2010). Statistics and Data Analysis for Nursing Research. (2nd ed.). Upper Saddle 

River, NJ:  Pearson. 

POST 2

Lodian

Summarize the study discussed in your selected research article and provide a complete APA citation. Include in your summary the sample, data sources, inferential statistic utilized, and findings.

The topic is I chose End-of-Life Care for People with Cancer from Ethnic Minority Groups: A Systematic Review. The article contends that African Americans as an ethnic minority group recognized with significant barriers to optimal end-of-life care (LoPresti et al., 2016). The researcher points out end-of-life decision-making in different ethnic groups also found variations in ethnic minority groups in relation to preferences for life-sustaining treatment. The author states that knowledge and understanding regarding the end-of-life care treatments conflict with cultural values and the true meaning of comfort care, which is often misunderstood (LoPresti et al., 2016). The same cannot be said about Caucasians as the understanding of comfort care and end-of-life care treatment is often seen as a time in making their loved one comfortable when further treatment options are futile.

Evaluate the purpose and value of this particular research study to the topic.

The purpose of the study evaluates the need of patients needing hospice care and the level of understanding obtained before electing services. The distrust of the health care delivery system is an important factor regarding decision-making at the end of life among African Americans. The historical root of distrust stems from generations of perceptions of unequally rendered services, abuses in medical experimentation, and economic injustice (Johnson et al., 2016). It is important for African Americans patients to have a clear understanding of end-of-life care, which can help to reduce anxiety and curb distrust.

Did using inferential statistics strengthen or weaken the study’s application to evidence-based practice?

Inferential statistics is performed prior to data collection rather than afterward. Descriptive statistics summarize the data to describe what occurred in a sample. In contrast, inferential statistics are calculated to generalize the findings from a sample to the entire population of interest (Trafimow & MacDonald, 2017). In the study, inferential statistics strengthen and determine whether differences between one or more groups. Inferential statistics rely on appropriate sampling methods to ensure maximal representation of the population. Inferential statistics are based on probability theory and the process of hypothesis testing (Gary et al., 2017). Inferential statistics can be classified as either parametric or nonparametric. Nonparametric statistics are most commonly used for variables at the nominal or ordinal level of measurement, which means that they are used for variables not having a normal distribution (Gary et al., 2017). Statistical significance is calculated using information contained only in the sample rather than the population and may use measures of central tendency appropriate for ordinal level data, that is, the median rather than the mean (Trafimow & MacDonald, 2017).

References

Gray, J. R., Grove, S. K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Johnson, K. S., Payne, R., Kuchibhatla, M. N., & Tulsky, J. A. (2016). Are hospice admission practices associated with hospice enrollment for older African Americans and Whites? Journal of Pain & Symptom Management, 51, 697-705. https://doi.org/10.101 6/j.jpainsymman.2015.11.010

LoPresti, M. A., Dement, F., & Gold, H. T. (2016). End-of-life care for people with cancer from ethnic minority groups. American Journal of Hospice & Palliative Medicine, 33, 291-305. https://doi.org/10.1177/1049909114565658

Trafimow, D., & MacDonald, J. A. (2017). Performing inferential statistics prior to data collection. Educational & Psychological Measurement, 77, 204-219. https://doi.org /10.1177/0013164416659745

POST 3

Lolade

Describe your selected ethical issue

            Health organizations collect patient data for use in monitoring and evaluating the effectiveness of patient care. The collection and management of patient data is associated with a number of ethical issues for the health organization and providers of care. One of the ethical issues associated with data collection and information management in my institution of healthcare is protecting the privacy and confidentiality of data. Healthcare organizations must strive to promote the integrity of the patient information that they obtain. The patient’s data should be protected from access from unauthorized parties. Health organizations must put in place mechanisms that minimize the risk of data loss through mechanisms such as hacking and data breaches. Health organizations must also ensure that the healthcare providers promote anonymity in the use of patient data. The identity of the patients should not be linked to their health needs of problems when sharing data with other providers (Milton, 2017). The organization should promote privacy by ensuring that the data is used for its intended purpose only. 

Analyze the potential liabilities that this issue poses to the organization by referencing the AMIA Code of Ethics

            According to AMIA Code of Ethics, the ethical issue of promoting data integrity is associated with a number of legal liabilities. Accordingly, patients have the right to seek for compensation for damages if the healthcare institution does not safeguard the integrity of their private and confidential data. Loss of data integrity may predispose the patient to physical, social, and emotional suffering. Therefore, health institutions must be held accountable for the violation of the rights of the patients. Healthcare providers also face similar liabilities if they engage in activities that threaten the integrity of the patients’ data. 

 Formulate strategies that the organization could implement to address the ethical issue

The organization can adopt a number of interventions to address the ethical issues associated with data integrity. One of the interventions is training the healthcare providers about promotion of data integrity. Training ensures that the providers understand the behaviors that should be adopted to ensure data integrity. The organization should also adhere to the regulations that govern the use of patient data such as HIPAA (Barnable et al., 2018). Lastly, the organization should develop policies that guide the use of patient data by the staff, hence, protection of data integrity. 

References

Barnable, A., Cunning, G., & Parcon, M. (2018). Nursing Students’ Perceptions of Confidentiality, Accountability, and E-Professionalism in Relation to Facebook. Nurse Educator, 43(1), 28–31. https://doi.org/10.1097/NNE.0000000000000441

Milton, C. L. (2017). The Ethics of Big Data and Nursing Science. Nursing Science Quarterly, 30(4), 300–302. https://doi.org/10.1177/0894318417724474

POST 4

Victoria

 Nursing and Health Informatics Ethics and the Law

Selected ethical issue:

                                         Health Information Safety and Security

The privacy and safety of health data has been an ongoing issue in healthcare and has gotten worse with the adoption and implementation of HIT. Data security is the biggest concern of health care. Data privacy and security are increasingly a concern in nearly all industries but more so in the healthcare industry. The HITECH Act, enacted in 2009, is designed to promote the adoption and meaningful use of healthcare information technology. The legislation also addresses privacy and security concerns, as well as strengthens enforcement of HIPAA rules. HIT has made it easier to store and access patient’s previous data, and it is important for the healthcare industry to protect patient’s information from hackers. Electronic health records (EHRs) may enhance the safety of patient care, but emerging evidence suggests that they also produce risks of information security. These risks can emerge due to poor system design and usability, ineffective implementation of the system by the health care organization (HCO) or improper use of the system. While some of the risks may not be apparent to users in a complex health care environment, they have significant implications for patient safety. Even when a problem is detected, it may be difficult to determine its origin in a complex, distributed clinical computing environment. Despite efforts for greater attention to EHR-related safety risks, most HCOs and providers have limited awareness of these problems. To achieve the transformational benefits promised by pioneering EHR designers and developers, HCOs must ensure that HIT related patient safety is an organizational priority. They can facilitate this by securing commitment from organizational leadership and refocusing the organization’s clinical governance structure to facilitate measurement and monitoring of EHR-related safety risks. Developing an organizational culture that is amenable to proactively detecting, fixing, and learning from EHR-related safety concerns is critical (Sittig et al., 2020).

Potential liabilities of Health Information Safety and Security to the organization As Referenced by the AMIA Code of Ethics.

Disease management organizations uses telehealth services and home monitoring systems. Telehealth services could be undermined if privacy and security risks are not addressed. An example is for patients that uses a home monitoring system and devices like Prothrombin Time (INR) home testing devise and insulin pump, data from the devices can be mistakenly shared with third parties if there is inadequate security and privacy protection. In the AMIA code of ethics privacy laws, patient privacy is under the privacy rule of the Health Insurance Portability and Accountability Act (HIPPA) (Petersen et al., 2018).

Strategies to Address This Ethical Issue.

• Wireless networks and sensitive data should be guarded with unique usernames and passwords keyed to specific individuals.
• Limiting access to the technology infrastructure by eliminating unnecessary access to hardware and software and restricting individual users’ and systems’ privileges only to needed programs.
• Conducting screening and background checks as the majority of unauthorized intrusions occur from inside network firewalls.

Developing real-time methods to enable automated surveillance and monitoring of system performance and safety, establishing the cultural and legal framework to allow sharing information about hazards and adverse events, and developing models and methods for consumers/patients ((Shailaja et al., 2017).

                                      References

Petersen, C., Berner, E. S., Embi, P. J., Fultz Hollis, K., Goodman, K. W., Koppel, R., …

Winkelstein, P. (2018). AMIA’s code of professional and ethical conduct

2018. Journal of the American Medical Informatics Association: JAMIA, 25(11),

1579-1582. Retrieved from

https://academic.oup.com/jamia/article/25/11/1579/5134082

Shailaja, M., Hardeep, S., Traber D, G., William L, R., Brenda P, D., Elise M, R., & Dean F, S. (2017). Safety huddles to proactively identify and address electronic health record safety. Journal of the American Medical Informatics Association, 24(2), 261–267. https://doi-org.ezp.waldenulibrary.org/10.1093/jamia/ocw153

Sittig, D. F., Wright, A., Coiera, E., Magrabi, F., Ratwani, R., Bates, D. W., & Singh, H. (2020). Current challenges in health information technology–related patient safety. Health Informatics Journal, 26(1), 181–189. https://doi-org.ezp.waldenulibrary.org/10.1177/1460458218814893