Wally,I have reviewed your explanantion of your paper; however.docx

Wally,
I have reviewed your explanantion of your paper; however,
please review the instructions below and compare. This paper
should have been focused on telenursing, not the use of EHRs.
In each paragraph, your focus started with telenursing, but
quickly changed to EHRs. EHRs can be used in telenursing, and
this was the primary focus in your paper. Describing the
advantages and disadvantages of telenursing would include
allowing PCPs to assess their patients from a distance using
telecommunications, allow patients to be assessed at home using
monitors that are in healthcare facilities, allow physicians to
utilize specialist to obtain a second opinion about their patients,
etc. Telenursing can be used to monitor patients at home, via
video streaming, between healthcare settings, etc.This is the use
of telecommunication and IT to provide care or services to
patients.
Once you review the topic and instructions below, please
contact me at (229) 376-1539.
Directions From Doc Sharing
1. You are to research (find evidence), compose, and type a
scholarly paper based on the scenario described above. Reflect
on what you have learned in this class to date about technology,
privacy rights, ethical issues, interoperability, patient
satisfaction, consumer education, and other topics. Your text by
Hebda (2013, Chapter 25) discusses telehealth in detail.
However, your focus should be on the professional nurse’s role
in telehealth, such as telenursing. Therefore, do not limit your
review of the literature to your text. Nurses in various
specialties need to know about the advantages and
disadvantages of telenursing as it applies to their patients. For
example, when you discharge a patient from an acute care

setting, will a telenursing service assist that individual with
staying out of the hospital? You may need to apply critical
thinking skills to development of your paper.
2. Use Microsoft Word and APA formatting to develop your
paper. Consult the Publication manual of the APA, 6th edition if
you have questions, for example, margin size, font type and size
(point), use of third person, and so forth. Take advantage of the
writing service, Smarthinking, which is accessed by clicking on
the link called the Tutor Source, found under the Course Home
tab. Also, review and use the various documents in Doc Sharing
related to APA.
3. The length of the paper should be 4–5 pages, excluding the
title page and the reference page. Limit your references to key
sources.
4. The paper should contain an Introduction that catches the
attention of the reader with interesting facts and supporting
sources of evidence, which need to be mentioned as in-text
citations. The Body should present the advantages and
disadvantages of telenursing from a patient perspective. The
Conclusion and Recommendations should summarize your
findings and state your position on whether Manuel should
accept the position should it be offered to him.
Student's Comments and Excerpts from Week Four Paper
I have the last paragraph stating the advantages and
disadvantages of Telenursing. please read it again.
here is a copy of the paragraph. I have spend many hours on
this paper and I think I deserve more points.
I will appreciate it.
here is copy of the paragraphs:
EHRs and advanced information technologies have many good

uses. A growing number of patients and consumers seek health
care and disease information that are made automatic in the
clinical applications to patients and medical staff with specific
information targeted their use and their role in that specific
situation has the potential to improve and probably detect a
decline in patient health status and to improve patient
satisfaction. For instance, patient portals that have the capacity
to allow patients to interact with the health care providers and
ambulatory care practices via the internet, often have better
outcome when compared to a traditional office visits (Hebda,
2013). Certainly, EHR reduces documentation time especially
when certain things are automated. More time spent with patient
result in more patient satisfaction especially when patient
receive comprehensive explanation of their condition. During
this precious time, the clinician can remember to cover all
points regarding a complicated disease if the health record is
accessible in clicks and patient can receive relevant information
with a click if needed. In many EHR, the patient can make flow
sheets of activities on their charts anywhere with an internet
access and record their clinical data such as blood sugar, fluid
intake amount, their daily weight and etc. Patients can ask their
physicians through a click about medications, side effects, and
any recommendations whenever and wherever they are. This
increase patient compliance and more personal and stronger
relationship between patients and doctors. EMR also give a
privacy assurance to the patient when HIPAA rules are flowed
which aim to prevent private or secure medical document from
being leaked. In long run, EMR is more advantageous to every
aspect of medical field and improves compliance, satisfaction,
productivity, and improves the medical community image
(Hebda, 2013).
Despite the conveniences, Telenursing still has its share of
downsides as well. According to Hebda, 2013, there are three
most common area of this sort. The first being electrical
glitches which the technology lies on its reliability. Research

show that nurses should be the major part of EMR because
majority of charting done by RN’s (Technology informatics
Guiding Educational Reform, 2012). When feedback is not
received in full from the sender, the data reliability decreases
especially when the nurse have little computer knowledge and
about how it interacts. Most nurses are basics clerks entering
data and Hebda, 2013, blames it on under staffing and overwork
issues. When data is unreliable, the second challenge takes over
which is physician resistance and acceptance of the data. Many
times I have been asked ‘are you sure this data entry is correct’.
Majority of responsibly lies on the physician who takes care of
the patient and nurses usually get away with mistakes. Also,
physicians do not trust nurses 100% due to the fact that most
nurses use common language rather than medical terms to
describe a situation and do not diagnose. Patient care needs
specifics to direct a symptom to a diagnosis. For these reasons,
doctors do their own assessment and work and leave the general
patient care such as inserting of IV, patient hygiene, and other
simple tasks. My personal experience as a nurse tells me that
even though I have a MD degree, I still do not use enough
medical terminology to describe, document, and relay medical
data to another physician and I blame it on the nursing
profession and its practices. The third factor that is important in
patient care is also not being practiced in its full extend is
assessment. Most nurses and medical staff rely on the previous
data to prescribe or manage an issue. Many times physical
therapist and respiratory therapist ask me or look at my charting
to decide and treat. They are simply a machine performing a
task. Certain non-verbal cues might slip through the cracks if
not enough time is given to do a complete assessment. Worse of
all is when a doctor treat a patient sole on his EMR record
without even touching the patient. From my reading somewhere
I can’t remember which said "I don't think you can start an IV
with it. There are places where we still have to have people
touching people. But it brings a higher level of care … than
we've been able to provide before." It is true that EMR has all

the information, data, analysis, and MAR but it cannot be
compared to a human touch.
The Term Meaningful use has major criteria’s that each has to
be met and those include: Coordination has to show
improvement, public health and the rest of the public has to
show improvement in quality of health, ensure privacy, security,
and stability of medical records, families has to be involved in
care, and finally and most importantly quality, efficiency and
health disparities has to show a reduction. Nurse informatics are
the key player in constructing the bridge in between the
transition to EMRs. Murphy's article states that this is the time
and opportunity to increase our knowledge and understanding of
better research, evidence based treatment and therapies,
innovations, and use of new technology to better care for
patients and for a better outcome (Murphy, p. 286, 2010).
Manuel will pay a major role in this transition by relaying the
relevant information to the proper group so they can fix and
improve the system better. Nurse informatics will continue to be
very important in planning and construction a solid ground for
the EMR process and without that foundation, the potential for
having mistake will be high. Most often nurses are the main
player of patient care and therefore super critical to entering
data and improving Electronic medical records. They can help
by gathering data for examining evidence-based practice, for
creating logarithms of care best suited for unique situations and
to overall advance. "Nurses need to be prepared to practice
nursing in the digital age and become meaningful users of EHRs
(Hebda, 2013). Current research has found that nurses'
perceptions of the overall quality of care and improvements in
the quality of the care delivered was positively related the
number of Telenursing present in their perspective unit (De-
soches, 2012). Technology Informatics Guiding Educational
Reform (TIGER) recommends the practice of informatics
competencies to all nurses and nurse in trainings to fully utilize
and engage in the unfolding of digital era in healthcare

(http://www.tigersummit.com).
I look forward to your response, as I will look to see if there are
any other points that I may able to add. I would encourage you
to reconsider resubmitting this paper for an increase in points.
You covered a lot of information; however, the main focus was
still not on telenursing.
I do not have a problem with having my faculty manager to
review as well.
Warm Regards,
Mattie Shiloh
Chamberlain College of Nursing NR361 Information
Systems in Healthcare
Telenursing…the Future Is Now Paper
Guidelines and Grading Rubric
Please see highlighted areas and red font as this will give you a
great overview!
Purpose
The purpose of this assignment is to explore the specialty of
telenursing as one example of the use of technology in various
practice settings. Advantages and disadvantages for the patient
and legal and ethical principles for the nurse of this technology
will be explored.
Course Outcomes
This assignment enables the student to meet the following
course outcomes:
CO #2: Investigate safeguards and decision-making support

tools embedded in patient care technologies and information
systems to support a safe practice environment for both patients
and healthcare workers. (PO #4)
CO #6: Discuss the principles of data integrity, professional
ethics, and legal requirements related to data security,
regulatory requirements, confidentiality, and client’s right to
privacy. (PO #6)
Points
This assignment is worth a total of 200 points.
Due Date
Your completed Telenursing…the Future Is Now paper is due at
the end of Week 4. Submit it to the basket in the Dropbox by
Sunday, August 3, 2014 at 11:59 p.m. mountain time. Post your
questions to the weekly Q & A Forum. Contact your instructor
if you need additional assistance. See the Course Policies
regarding late assignments. Failure to submit your paper to the
Dropbox on time will result in a deduction of points.
Background
Our text (Hebda, 2013) provides us with a broad perspective on
telehealth. However, the specialty of telenursing is only briefly
discussed. Healthcare is readily embracing any technology to
improve patient outcomes, streamline operations, and lower
costs. This technology includes the use of various applications
based in various environments where registered nurses
indirectly provide professional nursing care.
· Chapter 25: Telehealth (to prepare for the paper on telehealth)
Scenario
The following scenario serves as the basis for your paper:
Manuel, one of your colleagues, is considering leaving his
medical-surgical position where both of you have worked for
the past 12 years. In fact, he has an interview in two weeks for a
Telenurse Specialist position at a nurse-owned home health
agency. This agency monitors the elderly and those with chronic
illnesses to keep them from being readmitted to the hospital.

Manuel is doing some research on his own and knows that the
hours sound great and the pay is comparable. One advantage is
that he can work from home (telecommute) most of the time and
only interface with the agency for required meetings.
Manuel knows you are enrolled in this course. You have
discussed various concepts that you noted in your Syllabus
including technology, privacy, confidentiality, interoperability,
legal and ethical issues, and patients’ access to the World Wide
Web, just to name a few. Manuel has shared that he does not
know much about telehealth and the role of nursing in this
“new” technology. He has asked you to educate him on the
advantages and disadvantages to patients of telenursing.
Frankly, he does not understand what he might be doing on a
day-to-day basis. One concern is the technology that may be
involved.
Manuel has indicated that he realizes the final decision about a
career move will be his choice, but he is seeking your
knowledge based on concepts presented in this course. He wants
to be knowledgeable about the role of the professional nurse in
this practice setting prior to his interview.
You tell Manuel that you will need to do some research and that
you will get back to him about your conclusion and
recommendation. You have heard of telenursing and how it can
prevent patients with COPD (chronic obstructive pulmonary
disease) and CHF (congestive heart failure) from being
readmitted to the hospital, but you recognize that you will need
to do much more investigation.
Directions

related to APA.
Please do not include the scenario in your paper and keep your
TurnItIn score below 25%
sources.
5. NOTE: Review the section on Academic Honesty found in the
Chamberlain Course Policies. All work must be original (in
your own words) unless properly cited. This assignment will
automatically be submitted through Turnitin, a plagiarism
detection system.
6. Submit the completed paper to the Telenursing…the Future Is
Now Dropbox by Sunday, 11:59 p.m. mountain time at the end
of Week 4. Please post questions about this assignment to the

weekly Q & A Forum so that the entire class may view the
answers.
Grading Criteria
Category
Points
%
Description
Introduction
50
25%
The Introduction provides evidence of an information search
including in-text citations of the sources of evidence. It catches
the reader’s attention with interesting facts and supporting
sources.
Body
100
50%
Appropriate headings are used to delineate when the
introduction ends. More than three advantages and three
disadvantages are identified, discussed briefly, and supported
by citations.
Conclusion and Recommendations
25
12.5%
Appropriate headings are used, making clear the conclusion and
recommendations based on solid evidence, privacy rights, and
ethical principles, and so forth. Writing in the third person,
state your position regarding whether your colleague should
consider this position.
Scholarly Writing and APA Format
25
12.5%
· Title page, running head, and page numbers. (3 pts.)
· Introduction, body, and conclusion/recommendations sections
are clearly labeled. There is a logical flow between the sections.
(10 pts.)

· Grammar, punctuation, and sentence structure are correct. (2
pts.)
· Citations throughout demonstrate support of student’s ideas
and opinions. (5 pts.)
· Reference page includes all citations. (3 pts.)
· Evidence of spell and grammar check. (2 pts.)
Total
200
100%
A quality assignment will meet or exceed all of the above
requirements.
Grading Rubric
Assignment Criteria
A
Outstanding or Highest Level of Performance
B
Very Good or High Level of Performance
C
Competent or Satisfactory Level of Performance
F
Poor or Failing or Unsatisfactory Level of Performance
Introduction
50 points
Evidence of information search. Catches the reader’s attention
with interesting facts and supporting sources that include
citations to three or more scholarly sources.
46–50 points
citations to two scholarly resources.
42–45 points
Evidence of information search includes only one citation to
scholarly resource.
No attention catching “hook” noted.
38–41 points

Little or no evidence of information search. No citations
provided and/or there is no attention-catching “hook.”
0–37 points
Body
100 points
More than 3 advantages and 3 disadvantages from a patient
perspective are identified and supported by citations.
92–100 points
At least 3 advantages and 3 disadvantages from a patient
84–91 points
76–83 points
Only one advantage and one disadvantage from a patient
perspective is identified and supported by citations.
0–75 points
Conclusion and Recommendation
25 points
Conclusion is presented with recommendation based on solid
evidence, personal privacy rights, and ethical principles
supported by citations.
23–25 points
Conclusion contains evidence for recommendation, but may lack
persuasive use of privacy rights and/or ethical principles.
Includes citations.
21–22 points
Indicates conclusion and recommendation but does not address
privacy rights and/or ethical principles.
19–20 points
Fails to include conclusion or recommendation.
0–18 points
Scholarly Writing & APA Format
25 points
· Minimum of three sections including the Introduction, Body,

and Conclusions and Recommendations. Each section has at
least three sentences. (10 pts.)
pts.)
· Reference page includes all citations and no errors in format
are noted. (3 pts.)
23–25 points
· Some errors in APA title page noted.
· Some errors in grammar, spelling, punctuation, and/or
sentence structure noted.
· Citations are present but not in correct format.
· References are present, with some errors in format.
· Some red or green wavy lines within document.
21–22 points
· Minimal error in APA title page noted.
· Minimal errors in grammar, spelling, punctuation, and/or
· References are present, with minimal errors in format.
· Minimal red or green wavy lines within document.
19–20 points
· Multiple errors in APA formatting.
· Multiple grammar, spelling, and punctuation errors noted.
· Citations are missing.
· References are missing or incomplete.
· No evidence of proofreading prior to submitting paper.
0–18 points
Total Points Possible = 200 points
How to write
Introduction
catch the attention of the reader with interesting facts and

supporting sources of evidence which needs to be mentioned as
in-text citations.
The Body
==Advantages and disadvantages of telenursing from patient
prospective
==summarize your findings and state your position on whether
Manuel should accept the position
Outline of paper
Telenursing is the use of any technology to manage and relay
nursing care and conduct nursing practice in a meaningful way
(McConell, 2013). For many decades, the government made an
effort to hasten the adoption of electronic medical records
(EHRs) and other health information technologies in an effort to
curb the rising costs of health care. Finally, on September 2011,
President Obama proclaimed the National Health Information
Technology (HIT). This technology proclaimed that it connects
doctors, patients, and other medical and non-medical staff in a
way that is universal when all phases are complete. Tools like
electronic health records and electronic prescriptions helps
providers and the patient to connect with each other and obtain
information more readily and efficiently. This technology can
improve patient care, enable coordination between providers,
and reduce the risk of dangerous drug interactions. It can also
be used to prevent disease by recognizing early signs through an
either automated computer program which recognizes abnormal
numbers or a review of data when the patient encounters a visit
with a qualified health care provider. My goal in this paper is to
explain the basics of EHR, give Mr. Manual an overview of
what it is and how can we make sense out of this information,

and to give pros and cons of the process.
Paragraph # Meaningful use and how to legislation and
regulations
The National Legislation and Regulations run by the federal
government has placed standards on how the charting should be
done on EHRs. One of the major terminology effecting every
aspect of patient care is call “Meaningful Use” ( ). This
regulation puts a landmark financial incentive-penalty system
for the health care providers and hospitals based on the
meaningful use of their EHRs. The Obama administration
provided HITECH Act to help providers with assistant during
emergencies, for training and equipment’s, and for better public
communication. Combined, these programs build
the foundation for every American to benefit from an electronic
health record, as part of a modernized, interconnected, and
vastly improved system of care delivery" (ONC,
2011). It is designed to establish programs to improve health
care promotion and adoption of EHRs, advanced information
technologies, and private and secure electronic health
information exchange. Under this act, eligible health care
providers and hospitals can quality or Medicare and Medicaid
incentive payments when they adopt certain certified EHR
technology and use it to achieve specific objectives, i.e.
Meaningful Use. One of the other regulation that has been
passed identifies the technical capabilities required for certified
EHR technology. Medical facilities have to report to CMS a
required summary information on 38 clinical quality measures
through an electronic mean.
Paragraph # CHF
Effectively leveraging the use of health information technology

(HIT) is critical to
Improving health care quality, improving practice efficiency,
supporting an enhanced medical home, and responding to health
care emergencies, including disaster-related events. All of the
above are especially important in accomplishing when it comes
to core measures such as CHF. EHR has revolutionized health
care delivery for these patients and their families. EHR
Provides a continuous health care flow data especially
important for these group of people who need their test result to
be available on demand. When patients move from one place to
the other, a simple click could make a test result available. EHR
can also enhance communication between two cardiology
specialists to manage a case such as in Children’s hospital in
New York (Expedited transmission of MRIs or X-rays for a
second opinion, www.childrensHeathFund.org). A radiologist
reviews a spiral CT scan of a patient in California who has
about 3000ml of fluid around his heart and relays the
information via EMR which confirms his diagnosis legally and
the surgeon reviews it instantaneously in New York to decide
whether to do surgery or not (New York Children Hospital,
2011). So far the CHF foundation has over 500 providers who
are connected to each other for the best care of their patients.
Paragraph #pros
care and disease information and automated clinical
applications provide consumers and patients with information
resources and health care specific for them that have the
potential to improve or prevent declines in health status,
improve care, and improve patient satisfaction. For instance,
patient portals that have the capacity to allow patients to
interact with the health care providers and ambulatory care
practices via the internet, often have better outcome when
compared to a traditional office visits (Hebda, 2013). Certainly,
EHR reduces documentation time especially when certain things

are automated. More time spent with patient result in more
patient satisfaction especially when patient receive
comprehensive explanation of their condition. During this
precious time, the clinician can remember to cover all points
regarding a complicated disease if the health record is
being leaked.
In long run, EMR is more advantageous to every aspect of
medical field and improves compliance, satisfaction,
(Hebda, 2013).
Box 6-1 Advantages of an Information System
1. Better access to information
1. Enhanced quality of documentation through prompts
1. Improved quality of client care
1. Increased productivity
1. Improved communications
1. Reduced errors of omission
1. Reduced hospital costs
1. Increased employee satisfaction
1. Compliance with agency regulations
1. Common clinical database
1. Improved client perception of care
1. Enhanced ability to track records

1. Enhanced ability to recruit/retain staff
1. Improved hospital image
1. Improved mandatory reporting capability
HEBDA, TONI LEE; CZAR, PATRICIA, HANDBOOK OF
INFORMATICS FOR NURSES & HEALTHCARE
PROFESSIONALS, 5th Edition, © 2013. Reprinted by
permission of Pearson Education, Inc., Upper Saddle River, NJ.
Paragraph #cons
specially when the nurse have little computer knowledge and

· Not user friendly ( people with limited computer knowledge
finds difficulty to manipulate system).
· All patient's information in different tabs and not on a
dashboard that links all the data
· No capability to verify new orders per shift by nurses
· Unable to track nosocomial infections with antibiotic therapies
for Infection Control Trending
Disadvantages
1. No one person or group controls the Web, just as no one
controls the Internet.
1. The quality of available information varies widely.
1. Documents may not supply sufficient depth in content.
1. Not all Web pages display a date of authorship or credentials
of the source.
1. Web sites may change without providing a “forwarding
address.”

1. The Web is vulnerable to hacker attacks.
1. The large amount of available information may be
overwhelming.
1. Excessive company time spent exploring sites that are
nonwork related.
1. Obsolete information may be out there.
Paragraph # Conclusion
The meaningful use criteria are divided into five initiatives: ( I)
improve quality, safety, and efficiency, and reduce health
disparities, (2) engage patients and families, (3) improve care
coordination, (4) improve population and public health, and
(5) ensure adequate privacy and security protections for
personal health information. Nurse informatics are the key
player in constructing the bridge in between the transition to
EMRs. Murphy's article states, "This is an incredible
opportunity to build upon our understanding of effectiveness
research, evidence-based practice, innovation and technology to
optimize patient care and health outcomes. The future of
nursing will rely on this transformation, as well as on the
important role of nurses in enabling this digital revolution"
(Murphy, p. 286, 2010). Manuel will pay a major role in this
transition by relaying the relevant information to the proper
group so they can fix and improve the system better. Nurse
informatics will continue to be very important in planning and
construction a solid ground for the EMR process and without
that foundation, the potential for having mistake will be high.
Nurses are often the center of patient care and critical to the
success of EHRs. They can help by gathering data for

examining evidence-based practice, for creating logarithms of
care best suited for unique situations and to overall advance.
"Nurses need to be prepared to practice nursing in the digital
age and become meaningful users of EHRs and advanced
information technologies. A growing number of patients and
consumers seek health care information and even health care on
the Internet (Hebda, 2013).
Current research has found that nurses' perceptions of the
overall quality of care and improvements in the quality of the
care delivered was positively related the number of Telenurse
present in their perspective unit (DesRoches, Miralles,
Buerhaus, Hess, & Donelan, 2011). Technology Informatics
Guiding Educational Reform (TIGER) initiative that aims to
enable practicing nurses and nursing students to develop
informatics competencies in order to fully engage in the
unfolding digital era in healthcare
References:
Center for Medicare & Medicaid Services. (2011). HER
incentive. Programs. Retrieved from
https://www.cms.gov/EHR/incentivePrograms.
Donelan, K. (2011). Health information technology in the
workplace: Findings from a 2010 national survey of registered
nurses. Journal of Nursing Administration, 41(9),357-364.
Hebda, T., & Czar, P. (2013). Handbook of informatics for
nurses & healthcare professionals (5th ed.). Upper Saddle River,
NJ: Pearson
Murphy, J. (2010). Journey to Meaningful Use of Electronic
Health Records. NURSING ECONOMIC$ , 28(4), 283-286.
National Institute of Nursing Research. (1993}. Report of the
NCNR Priority Expert Panel 011 Nursing Informatics; 1993,
volume 4; NIH Publication, 110. 93-2419.

Obama, B. (2011). Presidential Proclamation-National
Health Information Technology Week Retrieved from
http://www. wltitehouse.gov/the-press-
office/2011/09/12/presidential-proclaimation-national-health-
information-technolgoy-week.
Technology informatics Guiding Educational Reform (TIGER).
Retrieved from http://www.tigerswnmit.com.
National Library of Medicine. (n.d.). Evaluating Internet health
information: A tutorial from the NLM. Retrieved from
http://www.nlm.nih.gov/medlineplus/webeval/webeval_start.htm
l
NR361 Telenursing…the Future is Now Guidelines 2-4-14
LMD
1
Telenursing: The Future Is Now
Wally Nawbary
NR-361 - Nursing information Systems in Healthcare
August 2, 2014
Instructor: Mattie Shiloh
Running head: TELENURSING: THE FUTURE IS NOW
1

TELENURSING: THE FUTURE IS NOW
8
Telenursing: The Future Is Now
effort to hasten the practice of electronic medical records
(EMRs) and the technologies that supports it, in an effort to
way that is universal when all phases are complete. Many useful
commands like prescriptions that is printable and other medical
record notes help providers and the patients to connect with
each other and obtain information more readily and efficiently.
This technology can have significant effect on patient care,
increase cooperation and communication between medical staff,
and can double check the interaction and side effects of a
dangerous medication. It can also be used to prevent disease by
recognizing early signs through an either automated computer
program which recognizes abnormal numbers or a review of
data when the patient encounters a visit with a qualified health
care provider. My goal in this paper is to explain the basics of
EMR, give Mr. Manual an overview of what it is and how can
we make sense out of this information, and to give pros and
cons of the process.

aspect of patient care is call “Meaningful Use” (Murphy, 2010).
This regulation enforces the term Meaningful Use with a
financial incentive-penalty system for hospitals and other
medical facilities and enforces the efficient use of EHRs. The
Obama administration provided HITECH Act to help providers
with assistant during emergencies, for training and equipment’s,
and for better public communication. All of these programs
builds a foundation for every individual to benefit to a
maximum stent form EMRs “as part of a modernized,
interconnected, and vastly improved system of care delivery"
(ONC, 2011). It is designed to establish programs to improve
health care promotion and adoption of EHRs, advanced
information technologies with a secure transfer of medical
information across the health care spectrum. With this act,
Medicare and Medicare will pay the eligible medical providers
and hospitals with payments if they practice the set
recommendation of the act providing and proving its objectives,
i.e. Meaningful Use. One of the other regulation that has been
An effective transition to the use of health information
technology (HIT) is crucial for improvement of health care
quality, efficiency of practice, improving home health and
prevention, and handling emergencies, including disaster-
related situations. All of the above are especially important in
accomplishing when it comes to core measures such as CHF.
EHR has revolutionized health care delivery for these patients
and their families. EHR Provides a continuous health care flow
data especially important for these group of people who need
their test result to be available on demand. When patients move
from one place to the other, a simple click could make a test
result available. EHR can also enhance communication between
two cardiology specialists to manage a case such as in
Children’s hospital in New York (Expedited transmission of

MRIs or X-rays for a second opinion,
www.childrensHeathFund.org). A radiologist reviews a spiral
CT scan of a patient in California who has about 3000ml of
fluid around his heart and relays the information via EMR,
which confirms his diagnosis legally, and the surgeon reviews it
instantaneously in New York to decide whether to do surgery or
not (New York Children Hospital, 2011). So far the CHF
foundation has over 500 providers who are connected to each
other for the best care of their patients.
care and disease information that are made automatic in the
clinical applications to patients and medical staff with specific
information targeted their use and their role in that specific
situation has the potential to improve and probably detect a
decline in patient health status and to improve patient
satisfaction. For instance, patient portals that have the capacity
to allow patients to interact with the health care providers and
ambulatory care practices via the internet, often have better
outcome when compared to a traditional office visits (Hebda,
2013). Certainly, EHR reduces documentation time especially
when certain things are automated. More time spent with patient
result in more patient satisfaction especially when patient
receive comprehensive explanation of their condition. During
this precious time, the clinician can remember to cover all
points regarding a complicated disease if the health record is

being leaked. In long run, EMR is more advantageous to every
aspect of medical field and improves compliance, satisfaction,
(Hebda, 2013).
especially when the nurse have little computer knowledge and

The Term Meaningful use has major criteria’s that each has to
be met and those include: Coordination has to show
improvement, public health and the rest of the public has to
show improvement in quality of health, ensure privacy, security,
and stability of medical records, families has to be involved in
care, and finally and most importantly quality, efficiency and
health disparities has to show a reduction. Nurse informatics are
the key player in constructing the bridge in between the
transition to EMRs. Murphy's article states that this is the time
and opportunity to increase our knowledge and understanding of
better research, evidence based treatment and therapies,
innovations, and use of new technology to better care for
patients and for a better outcome (Murphy, p. 286, 2010).
Manuel will pay a major role in this transition by relaying the
relevant information to the proper group so they can fix and
improve the system better. Nurse informatics will continue to be
very important in planning and construction a solid ground for
the EMR process and without that foundation, the potential for
having mistake will be high. Most often nurses are the main
player of patient care and therefore super critical to entering
data and improving Electronic medical records. They can help
by gathering data for examining evidence-based practice, for
creating logarithms of care best suited for unique situations and
to overall advance. "Nurses need to be prepared to practice
nursing in the digital age and become meaningful users of EHRs

(Hebda, 2013). Current research has found that nurses'
perceptions of the overall quality of care and improvements in
the quality of the care delivered was positively related the
number of Telenursing present in their perspective unit (De-
soches, 2012). Technology Informatics Guiding Educational
Reform (TIGER) recommends the practice of informatics
competencies to all nurses and nurse in trainings to fully utilize
and engage in the unfolding of digital era in healthcare
References:
nurses. Journal of Nursing Administration, 41(9), 357-364.

nurses & healthcare professionals (5th Ed.). Upper Saddle
River, NJ: Pearson
Health Records. NURSING ECONOMIC, 28(4), 283-286.
l
Obama, B. (2011). Presidential Proclamation-National Health
Information Technology Week Retrieved from http://www.
wltitehouse.gov/the-press-office/2011/09/12/presidential-
proclaimation-national-health-information-technolgoy-week.
Interview with Nursing Information Expert
Interviewer Form
Your Name: Wally Nawbary Date: 8/15/2014
Your Instructor’s Name: Mattie Shiloh
Directions: After completing your interview, you must use this
form to submit your assignment to the Dropbox. You may use
the form to capture information as you conduct your interview,
or fill it in later. The form is expandable and wi0ll enlarge the
textbox to accommodate your answers. Do not rely only on this
form for everything you must include! Please look in Doc
Sharing for specific instructions in the Guidelines for this

assignment.
Criteria
Fill in the answers in this column.
Demographics: Provide initials of the RN, official job title of
interviewer, and the date the interview was conducted.
SM RN, MSN, DNP (in progress)
Assistant director of nursing for MICU and critical care
Interview conducted on August 11, 2014
Required Questions
(answer EVERY question in this section)
1. Describe your career path to your current position. Include
information about education and experiences.
Mrs. SM stated that “my career path to my current position has
been challenging”. She has been “fighting her way up to this
position”. After obtaining her BSN degree from Rutgers School
of Nursing in New Jersey, she was hired at the University
Hospital where she faced many challenges by changing jobs and
moving to different departments to find a job that best suits her
desire. While working as EMR Trainer/Instructional Designer at
University Hospital, she managed to attend school at Rutgers
and obtain her MSN degree. From here on, she states that “it
was a deadlock for her career” and she stuck working part time
as an RN and EMR trainer.
It was years before Mrs. SM moved her way up from charge
nurse to assistant manager and finally to assistant director of
ICU. The main reason for this, she states, was “that Rutgers is
competitive teaching facility and one of the best in New Jersey
so everyone applies for the good position”. She stated that
Rutgers requires experience and multiple exams to be passed
before someone is considered for the position.
2. Discuss the value of best evidence as a driving force in
delivery of nursing care at your facility.
Evidence-based practice has been increasingly the prominent
approach to practice in Rutgers University, per RN SM. She
stated that it is crucial to use this system in University Hospital

since the core basis of teaching here is “based on quantitative,
experimental, and research based practices”. However, she
argued that It has been a “powerful evidence-based practice in
nursing that has supported the liberal humanistic concepts of
subjective marginalized nursing”. She agreed with my idea that
evidence based nursing practice believes strongly in superiority
of experimental science.
Per SM RN, Rutgers is still in adapting a full evidence based
nursing practice but there has been resistance from the older
generation nurses who have used to traditional nursing
practices. Rutgers uses the Hynes model to improve its evidence
based practices and solve patient's problems: clinical expertise,
patient preference for alternative forms of care, clinical
research evidence, and available resources decisions (adapted
from Haynes et al.6). So far, Mrs. SM reports that the
management is reporting significant improvement in patient
care and moving the hospital toward a magnum hospital.
3. What safeguards and decision-making support tools are
embedded in patient care technologies and information systems
that support safe practice at your facility?
4. Tell me about patient care technologies that have improved
patient care at your facility.
A model for evidence-based clinical decisions (adapted from
Haynes et al.6)
Haynes RB, Sackett DL, Gray JAM, et al. Transferring evidence
from research into practice. 1. The role of clinical care research
evidence in clinical decisions [editorial]. ACP Journal Club
1996 Nov-Dec;125:A14–6.
5. What groups of healthcare workers rely on you to collect
high-quality information or data and how is it utilized?
Optional Questions
(Answer only ONE question from the choices below.)
1. Please tell me what challenges you have faced in dealing with
other disciplines who may not “understand the needs of

nurses/nursing?”
2. Please share an example of how GIGO (garbage in, garbage
out) impacted a decision related to your information or data
collection.
3. Please give me an example of how the lack of
interprofessional collaboration impacted your role.
4. Please describe what a typical day on the job is like for you.
Follow-Up Questions
(Answer all of these. Please do not ask them during the
interview.
Instead, reflect and answer them afterwards.)
1. How will completing this interview impact your practice as a
BSN-prepared nurse? Give specific examples.
2. Resources (scholarly articles or texts). Indicate 2 scholarly
resources or texts used prior to the interview to familiarize
yourself with the individual’s organization, role, or any of the
questions you asked to make you a more knowledgeable
interviewer.
Resource #1:
Resource # 2:
Haynes RB, Sackett DL, Gray JAM, et al. Transferring evidence
from research into practice. 1. The role of clinical care research
evidence in clinical decisions [editorial]. ACP Journal Club
1996 Nov-Dec;125:A14–
Welcome to week 6! We certainly have made a lot of progress
thus far this session. This week, we will focus on patient safety
and technology.
Your reading will come from your text book, Chapter 1:

Informatics in the Healthcare Professions (pp. 14–19).
There is also an article that you will find useful: Turisco, F. &
Rhoads, J. (2008). Equipped for efficiency: Improving nursing
care through technology. California Healthcare Foundation.
Retrieved from
http://www.chcf.org/publications/2008/12/equipped-for-
efficiency-improving-nursing-care-through-technology
Also, your assignment, Interview With Nursing Information
Expert, is to be submitted to the Dropbox by Sunday ( August
17, 2014), 11:59 p.m. mountain time. Super users are excellent
choices, as well, for your interviews. Please ask questions
about this assignment in the Q & A Forum this week.
NR361 Interview Form.docx 7/30/13
LMD
2
Telenursing…the Future Is Now Paper
Guidelines and Grading Rubric
Please see highlighted areas and red font as this will give you a
great overview!

Purpose
The purpose of this assignment is to explore the specialty of
telenursing as one example of the use of technology in various
practice settings. Advantages and disadvantages for the patient
and legal and ethical principles for the nurse of this technology
will be explored.
Course Outcomes
This assignment enables the student to meet the following
course outcomes:
CO #2: Investigate safeguards and decision-making support
tools embedded in patient care technologies and information
systems to support a safe practice environment for both patients
and healthcare workers. (PO #4)
CO #6: Discuss the principles of data integrity, professional
ethics, and legal requirements related to data security,
regulatory requirements, confidentiality, and client’s right to
privacy. (PO #6)
Points
This assignment is worth a total of 200 points.
Due Date
Your completed Telenursing…the Future Is Now paper is due at
the end of Week 4. Submit it to the basket in the Dropbox by
Sunday, August 3, 2014 at 11:59 p.m. mountain time. Post your
questions to the weekly Q & A Forum. Contact your instructor
if you need additional assistance. See the Course Policies
regarding late assignments. Failure to submit your paper to the
Dropbox on time will result in a deduction of points.
Background
Our text (Hebda, 2013) provides us with a broad perspective on
telehealth. However, the specialty of telenursing is only briefly
discussed. Healthcare is readily embracing any technology to
improve patient outcomes, streamline operations, and lower
costs. This technology includes the use of various applications
based in various environments where registered nurses
indirectly provide professional nursing care.
· Chapter 25: Telehealth (to prepare for the paper on telehealth)

Scenario
The following scenario serves as the basis for your paper:
Manuel, one of your colleagues, is considering leaving his
medical-surgical position where both of you have worked for
the past 12 years. In fact, he has an interview in two weeks for a
Telenurse Specialist position at a nurse-owned home health
agency. This agency monitors the elderly and those with chronic
illnesses to keep them from being readmitted to the hospital.
Manuel is doing some research on his own and knows that the
hours sound great and the pay is comparable. One advantage is
that he can work from home (telecommute) most of the time and
only interface with the agency for required meetings.
Manuel knows you are enrolled in this course. You have
discussed various concepts that you noted in your Syllabus
including technology, privacy, confidentiality, interoperability,
legal and ethical issues, and patients’ access to the World Wide
Web, just to name a few. Manuel has shared that he does not
know much about telehealth and the role of nursing in this
“new” technology. He has asked you to educate him on the
advantages and disadvantages to patients of telenursing.
Frankly, he does not understand what he might be doing on a
day-to-day basis. One concern is the technology that may be
involved.
Manuel has indicated that he realizes the final decision about a
career move will be his choice, but he is seeking your
knowledge based on concepts presented in this course. He wants
to be knowledgeable about the role of the professional nurse in
this practice setting prior to his interview.
You tell Manuel that you will need to do some research and that
you will get back to him about your conclusion and
recommendation. You have heard of telenursing and how it can
prevent patients with COPD (chronic obstructive pulmonary
disease) and CHF (congestive heart failure) from being
readmitted to the hospital, but you recognize that you will need

to do much more investigation.
Directions
related to APA.
Please do not include the scenario in your paper and keep your
TurnItIn score below 25%
sources.

5. NOTE: Review the section on Academic Honesty found in the
Chamberlain Course Policies. All work must be original (in
your own words) unless properly cited. This assignment will
automatically be submitted through Turnitin, a plagiarism
detection system.
6. Submit the completed paper to the Telenursing…the Future Is
Now Dropbox by Sunday, 11:59 p.m. mountain time at the end
of Week 4. Please post questions about this assignment to the
weekly Q & A Forum so that the entire class may view the
answers.
Grading Criteria
Category
Points
%
Description
Introduction
50
25%
The Introduction provides evidence of an information search
including in-text citations of the sources of evidence. It catches
the reader’s attention with interesting facts and supporting
sources.
Body
100
50%
Appropriate headings are used to delineate when the
introduction ends. More than three advantages and three
disadvantages are identified, discussed briefly, and supported
by citations.
25
12.5%
Appropriate headings are used, making clear the conclusion and
recommendations based on solid evidence, privacy rights, and

ethical principles, and so forth. Writing in the third person,
state your position regarding whether your colleague should
consider this position.
Scholarly Writing and APA Format
25
12.5%
· Introduction, body, and conclusion/recommendations sections
are clearly labeled. There is a logical flow between the sections.
(10 pts.)
pts.)
· Reference page includes all citations. (3 pts.)
Total
200
100%
A quality assignment will meet or exceed all of the above
requirements.
Grading Rubric
Assignment Criteria
A
Outstanding or Highest Level of Performance
B
Very Good or High Level of Performance
C
Competent or Satisfactory Level of Performance
F
Poor or Failing or Unsatisfactory Level of Performance
Introduction
50 points

citations to three or more scholarly sources.
46–50 points
citations to two scholarly resources.
42–45 points
Evidence of information search includes only one citation to
scholarly resource.
No attention catching “hook” noted.
38–41 points
Little or no evidence of information search. No citations
provided and/or there is no attention-catching “hook.”
0–37 points
Body
100 points
More than 3 advantages and 3 disadvantages from a patient
92–100 points
84–91 points
76–83 points
Only one advantage and one disadvantage from a patient
perspective is identified and supported by citations.
0–75 points
Conclusion and Recommendation
25 points
Conclusion is presented with recommendation based on solid
evidence, personal privacy rights, and ethical principles
supported by citations.
23–25 points
Conclusion contains evidence for recommendation, but may lack
persuasive use of privacy rights and/or ethical principles.
Includes citations.

21–22 points
Indicates conclusion and recommendation but does not address
privacy rights and/or ethical principles.
19–20 points
Fails to include conclusion or recommendation.
0–18 points
Scholarly Writing & APA Format
25 points
· Minimum of three sections including the Introduction, Body,
and Conclusions and Recommendations. Each section has at
least three sentences. (10 pts.)
pts.)
· Reference page includes all citations and no errors in format
are noted. (3 pts.)
23–25 points
· Some errors in APA title page noted.
· Some errors in grammar, spelling, punctuation, and/or
· References are present, with some errors in format.
· Some red or green wavy lines within document.
21–22 points
· Minimal error in APA title page noted.
· Minimal errors in grammar, spelling, punctuation, and/or
· References are present, with minimal errors in format.
· Minimal red or green wavy lines within document.
19–20 points
· Multiple errors in APA formatting.
· Multiple grammar, spelling, and punctuation errors noted.

· Citations are missing.
· References are missing or incomplete.
· No evidence of proofreading prior to submitting paper.
0–18 points
Total Points Possible = 200 points
How to write
Introduction
catch the attention of the reader with interesting facts and
supporting sources of evidence which needs to be mentioned as
in-text citations.
The Body
==Advantages and disadvantages of telenursing from patient
prospective
==summarize your findings and state your position on whether
Manuel should accept the position
Outline of paper
effort to hasten the adoption of electronic medical records
(EHRs) and other health information technologies in an effort to
way that is universal when all phases are complete. Tools like
electronic health records and electronic prescriptions helps

providers and the patient to connect with each other and obtain
information more readily and efficiently. This technology can
improve patient care, enable coordination between providers,
and reduce the risk of dangerous drug interactions. It can also
be used to prevent disease by recognizing early signs through an
either automated computer program which recognizes abnormal
numbers or a review of data when the patient encounters a visit
with a qualified health care provider. My goal in this paper is to
explain the basics of EHR, give Mr. Manual an overview of
what it is and how can we make sense out of this information,
and to give pros and cons of the process.
Paragraph # Meaningful use and how to legislation and
regulations
aspect of patient care is call “Meaningful Use” ( ). This
regulation puts a landmark financial incentive-penalty system
for the health care providers and hospitals based on the
meaningful use of their EHRs. The Obama administration
provided HITECH Act to help providers with assistant during
emergencies, for training and equipment’s, and for better public
communication. Combined, these programs build
the foundation for every American to benefit from an electronic
health record, as part of a modernized, interconnected, and
vastly improved system of care delivery" (ONC,
2011). It is designed to establish programs to improve health
care promotion and adoption of EHRs, advanced information
technologies, and private and secure electronic health
information exchange. Under this act, eligible health care
providers and hospitals can quality or Medicare and Medicaid
incentive payments when they adopt certain certified EHR

technology and use it to achieve specific objectives, i.e.
Meaningful Use. One of the other regulation that has been
Paragraph # CHF
Effectively leveraging the use of health information technology
(HIT) is critical to
Improving health care quality, improving practice efficiency,
supporting an enhanced medical home, and responding to health
care emergencies, including disaster-related events. All of the
above are especially important in accomplishing when it comes
to core measures such as CHF. EHR has revolutionized health
care delivery for these patients and their families. EHR
Provides a continuous health care flow data especially
important for these group of people who need their test result to
be available on demand. When patients move from one place to
the other, a simple click could make a test result available. EHR
can also enhance communication between two cardiology
specialists to manage a case such as in Children’s hospital in
New York (Expedited transmission of MRIs or X-rays for a
second opinion, www.childrensHeathFund.org). A radiologist
reviews a spiral CT scan of a patient in California who has
about 3000ml of fluid around his heart and relays the
information via EMR which confirms his diagnosis legally and
the surgeon reviews it instantaneously in New York to decide
whether to do surgery or not (New York Children Hospital,
2011). So far the CHF foundation has over 500 providers who
are connected to each other for the best care of their patients.
Paragraph #pros

care and disease information and automated clinical
applications provide consumers and patients with information
resources and health care specific for them that have the
potential to improve or prevent declines in health status,
improve care, and improve patient satisfaction. For instance,
patient portals that have the capacity to allow patients to
interact with the health care providers and ambulatory care
practices via the internet, often have better outcome when
compared to a traditional office visits (Hebda, 2013). Certainly,
EHR reduces documentation time especially when certain things
are automated. More time spent with patient result in more
patient satisfaction especially when patient receive
comprehensive explanation of their condition. During this
precious time, the clinician can remember to cover all points
regarding a complicated disease if the health record is
being leaked.
In long run, EMR is more advantageous to every aspect of
medical field and improves compliance, satisfaction,
(Hebda, 2013).
Box 6-1 Advantages of an Information System
1. Better access to information
1. Enhanced quality of documentation through prompts

1. Improved quality of client care
1. Increased productivity
1. Improved communications
1. Reduced errors of omission
1. Reduced hospital costs
1. Increased employee satisfaction
1. Compliance with agency regulations
1. Common clinical database
1. Improved client perception of care
1. Enhanced ability to track records
1. Enhanced ability to recruit/retain staff
1. Improved hospital image
1. Improved mandatory reporting capability
Paragraph #cons
specially when the nurse have little computer knowledge and

· Not user friendly ( people with limited computer knowledge
finds difficulty to manipulate system).
· All patient's information in different tabs and not on a
dashboard that links all the data
· No capability to verify new orders per shift by nurses
· Unable to track nosocomial infections with antibiotic therapies
for Infection Control Trending

Disadvantages
1. No one person or group controls the Web, just as no one
controls the Internet.
1. The quality of available information varies widely.
1. Documents may not supply sufficient depth in content.
1. Not all Web pages display a date of authorship or credentials
of the source.
1. Web sites may change without providing a “forwarding
address.”
1. The Web is vulnerable to hacker attacks.
1. The large amount of available information may be
overwhelming.
1. Excessive company time spent exploring sites that are
nonwork related.
1. Obsolete information may be out there.
Paragraph # Conclusion
The meaningful use criteria are divided into five initiatives: ( I)
improve quality, safety, and efficiency, and reduce health
disparities, (2) engage patients and families, (3) improve care
coordination, (4) improve population and public health, and
(5) ensure adequate privacy and security protections for
personal health information. Nurse informatics are the key
player in constructing the bridge in between the transition to
EMRs. Murphy's article states, "This is an incredible
opportunity to build upon our understanding of effectiveness
research, evidence-based practice, innovation and technology to
optimize patient care and health outcomes. The future of

nursing will rely on this transformation, as well as on the
important role of nurses in enabling this digital revolution"
(Murphy, p. 286, 2010). Manuel will pay a major role in this
transition by relaying the relevant information to the proper
group so they can fix and improve the system better. Nurse
informatics will continue to be very important in planning and
construction a solid ground for the EMR process and without
that foundation, the potential for having mistake will be high.
Nurses are often the center of patient care and critical to the
success of EHRs. They can help by gathering data for
examining evidence-based practice, for creating logarithms of
care best suited for unique situations and to overall advance.
"Nurses need to be prepared to practice nursing in the digital
age and become meaningful users of EHRs and advanced
information technologies. A growing number of patients and
consumers seek health care information and even health care on
the Internet (Hebda, 2013).
Current research has found that nurses' perceptions of the
overall quality of care and improvements in the quality of the
care delivered was positively related the number of Telenurse
present in their perspective unit (DesRoches, Miralles,
Buerhaus, Hess, & Donelan, 2011). Technology Informatics
Guiding Educational Reform (TIGER) initiative that aims to
enable practicing nurses and nursing students to develop
informatics competencies in order to fully engage in the
unfolding digital era in healthcare
References:

nurses. Journal of Nursing Administration, 41(9),357-364.
nurses & healthcare professionals (5th ed.). Upper Saddle River,
NJ: Pearson
Health Records. NURSING ECONOMIC$ , 28(4), 283-286.
Obama, B. (2011). Presidential Proclamation-National
Health Information Technology Week Retrieved from
http://www. wltitehouse.gov/the-press-
office/2011/09/12/presidential-proclaimation-national-health-
information-technolgoy-week.
l
NR361 Telenursing…the Future is Now Guidelines 2-4-14
LMD
1

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