he completed encounter form, obtains the

patient’s vital signs and enters the patient’s chief complaint and other relevant data into the paper record. After the nurse completes these tasks, the physician begins his encounter with the patient and completes the exam. The physician documents the exam and writes orders, including medications, lab, radiology and referrals in the chart after the encounter is completed. If the physician writes an order for medication, she provides a written prescription to the patient before they leave the exam room. The physician then flags the chart (to indicate that the chart has orders) and then returns it to the nurse. Upon completion of the visit the patient stops at the clinic front desk and schedules any return visit. The nurse then executes the orders (facilitates scheduling of lab, radiology, medication prescriptions and so forth).

When lab and radiology results are ready, they are printed to the clinics printer and the nurse then places the printed results into the chart.     Patients are called with any abnormal lab and radiology results or sent a letter stating results are within normal limits. When patients need prescriptions refilled, they contact the receptionist who then places a hand written note at the nurse’s station in the clinic. The nurse then places the note in the patients chart and places it in a bin for the physician to review at the end of the day. Once the physician writes the refill prescription, she places the chart in the bin and the nurse contacts both the pharmacy and patient.

 

 

Key Workflow Problems

 

1. Patients frequently complain about having to fill out and update the registration forms and health history in the waiting room when they first arrive at the clinic for their appointment.
2. Paper charts occasionally become lost and staff spend a substantial amount of time searching for them.
3. Nurses complain that it is difficult to read the physicians handwriting and have made errors in transcribing orders.
4. It takes considerable time to sort through printed lab and radiology reports and place them in patients charts for the physician to review. It would be much easier to have all lab, radiology and other ready to go for each patient the day before.
5. Nurses complain that they spend an enormous amount of time checking patient’s drug allergies and validating correct dosages on medication orders. They often use Google to look up drug information.
6. Patients frequently lose their paper prescriptions written at the office and nurses spend a considerable amount of time having to call the pharmacy to validate them.
7. Patients often ask for information regarding their disease condition and nurses spend a considerable amount of time searching for reliable information on the Web to educate them. Evidence based guidelines are changing all the time and it is difficult to keep up with best practices.
8. Clinic physicians complain that there is not a good system of informing them if one of their patients has been admitted to the emergency room or admitted to the hospital. Emergency room staff complain that they do not have access to outpatient records and the patients past medical history when they are seen in the emergency room.
9. Clinic physicians and nurses complain that it is difficult to piece together the “patients story” in the paper chart. Much of the information is fragmented and caregivers need to see key metrics (trended lab, weight, BMI, and other data) in one place.
10. Patients would like to become more engaged in wellness and make less visits to the clinic for routine health monitoring such as tracking their weight, blood sugar, exercise program, adherence to a diet and so forth. Many also would like to become involved in various support groups but cannot leave their homes. And they would also like access to their own medical record so that they can review it at home.

 

Evaluation Criteria for Applications and Formal Papers

 

Levels of Achievement

Criteria Outstanding Performance           Excellent Performance Competent Performance              Proficient Performance                Room for Improvement

QUALITY OF WORK SUBMITTED –

1. The extent to which work meets the assigned criteria and work reflects graduate level critical and analytic thinking (0-30 Points) 30 to 30 points

Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics         25 to 29 points

Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics         20 to 24 points

Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.     16 to 19 points

Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.     0 to 15 points

Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.

QUALITY OF WORK SUBMITTED: Purpose of the paper is clear (0-5 Points)            5 to 5 points

A clear and comprehensive purpose statement is provided which delineates all required criteria.              5 to 5 points

A clear and comprehensive purpose statement is provided which delineates all required criteria.              4 to 4 points

Purpose of the assignment is stated, yet is brief and not descriptive.      1 to 3 points

Purpose of the assignment is vague.       0 to 0 points

No purpose statement was provided.

ASSIMILATION AND SYNTHESIS OF IDEAS

The extent to which the work reflects the student’s ability to-

1. Understand and interpret the assignment’s key concepts (0-10 Points) 10 to 10 points

Demonstrates the ability to critically appraise and intellectually explore key concepts.    9 to 9 points

Demonstrates the ability to critically appraise and intellectually explore key concepts.    8 to 8 points

Demonstrates a clear understanding of key concepts.    5 to 7 points

Shows some degree of understanding of key concepts.                0 to 4 points

Shows a lack of understanding of key concepts, deviates from topics.

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ASSIMILATION AND SYNTHESIS OF IDEAS 2. Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources (0-20 Points)         20 to 20 points

Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 3-4 course resources to support point of view.            15 to 19 points

Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 3-4 course resources to support point of view.            10 to 14 points

Integrates specific information from 1 credible outside resource and 3 to 4 course resources to support major points and point of view.    3 to 9 points

Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.     0 to 2 points

Includes and integrates specific information from 0 to 1 resource to support major points and point of view.

ASSIMILATION AND SYNTHESIS OF IDEAS 3. Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, and textbook) by comparing different points of view and highlighting similarities, differences, and connections. (0-20 Points)         20 to 20 points

Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.   18 to 19 points

Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.   16 to 17 points

Summarizes information gleaned from sources to support major points, but does not synthesize.            14 to 15 points

Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped. 0 to 13 points

Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.

WRITTEN EXPRESSION AND FORMATTING 1. Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance. (0-5 Points)              5 to 5 points

Paragraphs and sentences follow writing standards.        5 to 5 points

Paragraphs and sentences follow writing standards.        4 to 4 points

Paragraphs and sentences follow writing standards 80% of the time.       3 to 3 points

Paragraphs and sentences follow writing standards 70% of the time.       0 to 2 points

Paragraphs and sentences follow writing standards < 70% of the time.

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WRITTEN EXPRESSION AND FORMATTING 2. English writing standards: Correct grammar, mechanics, and proper punctuation (0-5 Points)               5 to 5 points

Uses correct grammar, spelling, and punctuation with no errors.               5 to 5 points

Uses correct grammar, spelling, and punctuation with no errors.               4 to 4 points

Contains a few (1-2) grammar, spelling, and punctuation errors.                3 to 3 points

Contains several (3-4) grammar, spelling, and punctuation errors. 3         0 to 2 points

Contains many (? 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

WRITTEN EXPRESSION AND FORMATTING 3. The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list (0-5 Points)          5 to 5 points

Uses correct APA format with no errors.               5 to 5 points

Uses correct APA format with no errors.               4 to 4 points

Contains a few (1-2) APA format errors.                3 to 3 points

Contains several (3-4) APA format errors.             0 to 2 points

Contains many (? 5) APA format errors.

Spacing Double

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