NURS 4220 – Week 2 Practice Experience Discussion – Applying Measurement Tools to a Practice Problem
As a Staff Nurse in a small practice of approximately 1000 patients, where there has been no Electronic Health Record(EHR) system until last year, all manual charts are being transferred to the EHR system. The focus is on identifying Diabetic Mellitus patients. Diabetes is an inability of the body to produce or properly use insulin, the hormone needed to convert sugar, starches, and other foods into energy. Data is often easily gathered and easily available (Spath, 2013). Claim encounter data and pharmacy data can be used to identify patients with specific diagnoses and procedure codes or search for medication related to Diabetes within the last year (Spath,2013.). The Electronic Health Record (EHR) will allow us to customize the data and include all patients in practice or patients belonging to a specific provider. A data collection system is a reliable way to get information. Using Administrative files (which consists of patient’s demographics, patient’s diagnosis, and diagnosis codes), Patient records (history and physical, procedures and treatments done), and Miscellaneous business and clinical information ( ICD codes for several diseases being treated and billing for treatments performed) can be used to determine how many diabetics are in practice.
To determine how many Diabetes meet the 8 components of the Healthcare Effectiveness Data and Information Set (HEDIS) in Comprehensive diabetic care. The 8 components are listed below. First, the input of EHR will filter and determine the diagnosis of Diabetes between the ages 18 – 75, the hemoglobin A1C (HbA1c) testing, eye exam (retinal), medical attention for nephropathy, blood pressure control (<130/80 mmHg), blood pressure control (<140/90 mm Hg), urine screening and statin therapy. When we Input the data on a spreadsheet, this will help to identify if all the 8 Components of HEDIS have been met amongst the 1000 patients in practice, hence to determine the patients that are diabetic.
NURS 4220 – Week 2 Practice Experience Discussion – Applying Measurement Tools to a Practice Problem
Upon input of EHR, the system should be able to filter and quickly display who the diabetic patients are. I would recommend the management to train staff on electronic documenting, updating and keeping medical records, using a spreadsheet to gather information as we keep track of the 1000 patients. I would recommend having a contact person to follow up with the patients on the annual physical examination and recommend the 8 components of Hedis to be tested to determine if they are diabetic. I would implement the use of line charts, bar charts, flow charts, pie charts and histograms in data collection. Nurses are committed to delivering high-quality improvement that influences patient outcomes. Spath(2013).
Reference
Spath, P. (2013). Introduction to healthcare quality management (2nd ed.). Chicago, IL: Health Administration Press. http://www.cdc.gov/media/presskits/ aahd/diabetes.pdf 3 Peter Bach et al. HEDIS 2014 Technical Specifications for Health. www.premera.com/documents/0316888.pdf
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Question 
NURS 4220 – Week 2 Practice Experience Discussion – Applying Measurement Tools to a Practice Problem
Take on the role of the staff nurse in the scenario, and post an explanation of how you would go about finding out how many diabetics are in your practice and how many meet all 8 components of HEDIS comprehensive diabetes care.