Hi, Please, read and respond to Peer 1 and 2 (100 words minimum). References should be in APA style.Peer 1: According to Olson, B.D., evidence-based research indicates that patient survivorship dramatically improves when antibiotics are given antibiotics within one hour of surgery (Olson, 2016). About 500,000 infections occur each year in surgical facilities. These infections cause over 4 million hospital days and contribute to more than $2 billion in added health care costs. The prevalence of these infections has been identified as one of the factors that contribute to healthcare costs. For most patients undergoing a clean-contaminated surgical procedure, a cephalosporine is the recommended antibiotic (Salkind & Rao, 2011). There are about 2,000 preventable deaths each year in hospitals, according to a report released by the Leapfrog Group. When hospitals score low on infection rates, it generally means they are not following clinical best practices. If an organization is having difficulties managing post-operative surgical infections, they should consider performing an independent accreditation of the day-to-day processes to evaluate the quality of their work. Typically when performing quality assessments, the organization is able to demonstrate continuous improvement in its operations (Olson, 2016). Deaths from medical mistakes and infections are rising at the worst hospitals in the US. The findings reinforce Americans’ need to check hospital ratings regularly. The study analyzed data collected from over 2,000 US hospitals since 2016. It found that many of the country’s most dangerous medical facilities have become even more dangerous for patients (O’Connell, 2019).Hospital infection rates have been a part of the healthcare industry for a long time. They are calculated by various public health agencies and healthcare facilities by collecting infection data and metadata. A hospital-acquired infection rate is a number that shows the rate of infections that occurred during a hospital stay. It is usually calculated for the entire hospital, though it can also be calculated for each unit. The rate of postoperative infection is a good indicator of quality care. It can also be used to evaluate the level of surgical care (Olson, 2016).ReferenceO’Donnell, J. (2019). Low-rated US hospitals are deadlier due to mistakes, botched surgery, infections. USA Today.Olson, B. D. (2016). Chapter 27: Project Management. Health Information Management: Concepts, Principles and Practice. 5th Edn. AHIMA press.Salkind, A., Rao, K. (2011). Antibiotic prophylaxis to prevent surgical site infections. American Family Physician. Peer 2:Why is it clinically important for patients to receive antibiotics within one hour of surgery?There is a growing amount of data that can be found which supports the use of antibiotics in a prophylactic manner in timely ways following surgery. For example, Crader & Varacallo (2021) highlight a benchmark 2008 study conducted by Hind & Hutchinson which found that after knee and hip replacement surgeries those who were given a prophylactic antibiotic saw an 80% reduction in infection when compared to the controlled group, which was not given antibiotics following their procedures.Jonge et al., (2017) quantitatively examined 14 papers, which included over 54,000 patients, all with the purpose of attempting to determine whether a prophylactic antibiotic given between 120-60 minutes was less effective than if the antibiotic was given between 60-0 minutes of surgery. Additionally, this study searched whether after 120 minutes, post-surgery infections were more likely. Although Jonge et al., (2017) did not find any support that an antibiotic given 120 minutes after surgery increased the likelihood of infection versus if it were administered 60 minutes or less, this quantitative study did shown rather definitively that prophylactic antibiotics given inside of a 120 minutes after surgeries does dramatically reduce post-surgery infection. Beyond the chief importance of insuring that patients heal successfully, infections lead to increased hospital stays, costs, etc., that can lead to all kinds of macro-level issues for hospitals, and even communities. For example, there is some evidence that higher levels of hospital-based infections leads to higher overall antibiotic-resistant infections in the surrounding communities (Monegro, Muppidi, & Regunath (2020). In clinical documentation what would be reviewed to report on hospital performance of this quality measure or which portion of the record would provide the most accurate information to confirm the administration of antibiotics and its time?Both Crader & Varacallo (2021) and Jonge et al., (2017) both emphasize in their respective studies that consistency in regards to when the antibiotic was given, what antibitotic was given, and in what the results were, are all key areas of study pertaining to accurate representation of outcomes.If hospital consistently scores low on this measure, what does this indicate?Earlier this year (2021), the Centers for Medicare and Medicaid Services (CMS) penalized 774 hospitals for having high rates of patient infections and/or other potentially avoidable medical complications. The top 25% of all hospitals in the U.S. responsible for the highest rates of infections, and other preventable complications during a hospital stay, had their funding reduced by CMS.Generally speaking, as evidenced throughout this post, hospitals with higher rates of infection are providing less effective care. Also important to note, as the studies cited throughout this response indicate, there are many direct correlations between increased costs and complications during hospital procedures and/or stays.However, Cedars-Sinai Hospital makes a counterargument that just because a hospital has higher infection rates, that does not necessarily correlate to lessor care. A representative for Cedars-Sinai argued that “[punishing hospitals for higher infection rates] disproportionally punishes academic medical centers due to the “high acuity and complexity” of their patients” (Sullivan, (2021). Therefore, higher infection rates observed does not automatically equate to worse care.If a hospital is scoring low on this quality measure, which clinical quality management process could be used to help the hospital understand why the performance is low? Clinical quality improvement is no easy task in most regards. There are a number of proven, best-practice ways that both government and private-industry has established to improve on less-than-desired outcomes in a health provider context.If a hospital’s post-surgical infection rates are too high, one method outlined by the Agency for Healthcare Research and Quality (AHRQ) to approach a quality improvement process is to implement an improvement cycle. Simply put, an improvement cycle generally follows a P.D.S.A (plan; do; study; act) formula. All staff should be involved so that from the bottom-up to develop new and better ways to approach ongoing problems.References:Crader MF, Varacallo M. (2021, July 18). Preoperative antibiotic prophylaxis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442032/#de Jonge, S. W., Gans, S. L., Atema, J. J., Solomkin, J. S., Dellinger, P. E., & Boermeester, M. A. (2017). Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection: A systematic review and meta-analysis. Medicine, 96(29), e6903. https://doi.org/10.1097/MD.0000000000006903 Please reply to Peer 3: According to Platt, et al . (1990). Electronic health records are typically utilized to improve quality because they provide the most exact detail and efficiency, and they do not allow for considerable manipulation of the reports.Many hospitals export data from the EHR into a different data set with more analytic capability, and some combine data from multiple categories. This necessitates the creation of manual reports. Additionally, it was mentioned appropriately that EHRs cannot meet all reporting standards due to the granularity of metrics.On that score , EHR is also dependent upon the implementation of patient health literacy initiatives concerning self-reporting of medication allergies (Moskow, et al . , 2016). This is particularly relevant for populations most at-risk for low health literacy, including patients with linguistic and cultural differences(Moskow et al. ,2016). Just as patients with low health literacy may need addition support understanding labeling and dosage, patients with low health literacy may also need support in differentiating between true drug allergies versus side effects of medications to ensure that this information is documented accurately in the patient chart.References.Platt, R., Zaleznik, D. F., Hopkins, C. C., Dellinger, E. P., Karchmer, A. W., Bryan, C. S., … & Segal, M. R. (1990). Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery. New England Journal of Medicine, 322(3), 153-160.Moskow,J., Cook,N., Lippmann-champion, C. , Amofah ,S.A. & Garcia A.S.(2016) Identifying opportunities in EHR to improve the quality of antibiotic allergy data Journal of the American Medical Informatics Association, Volume 23, Issue e1, April 2016, Pages e108–e112, https://doi.org/10.1093/jamia/ocv139

Construct a draft proposal for your project, and integrate it with the organizational balanced scorecard model. There is no page limit for this assessment.IntroductionNote: Each assessment of your capstone project is built on the work you have completed in previous assessments. Therefore, you must complete the assessments in this course in the order in which they are presented.Writing a project proposal is an essential skill for leaders. Presenting a proposal to senior executives requires that you identify the problem, the value to the organization of solving the problem, the relevant aspects of the problem, and your recommendations for action. Your recommendations should be conveyed in a concise but thorough manner, retaining the essential information needed by the decision makers.This assessment provides an opportunity for you to draft a proposal for your capstone project, which you will have to present to the prospective client.Overview and PreparationNote: This assessment incorporates and builds on the work you completed in Assessment 1.To prepare for this assessment, complete the following:Expand on your list of peer-reviewed or authoritative sources from Assessment 1 that substantiate your approach and method for the data review, such as accrediting body standards, accounting principles, federal laws, or Medicare conditions of participation. Add a minimum of five relevant, authoritative sources.Limit commercial website references to no more than two entries.Format your citations and references using APA style. Note: While an annotated bibliography is not a part of the graded assessment, you will need to integrate your sources into the proposal.Review the Balanced Scorecard Example [DOCX]. You will construct a balanced scorecard table in this assessment to convey the value of your project to the organization.Review this resource, which provides information on the steps to creating a balanced scorecard:Balanced Scorecard Institute. (n.d.). Building and implementing a balanced scorecard: Nine steps to success. http://balancedscorecard.org/Resources/The-Nine-St…Download and review the Assessment 2 Proposal Template [DOCX], which you will use to complete this assessment.RequirementsUsing the Assessment 2 Proposal Template [DOCX], draft a proposal for your data review project. After your proposal has been graded, integrate faculty feedback prior to sharing your proposal with the prospective client.Supporting EvidenceAdd a minimum of five relevant, authoritative sources, cited within the outline, in addition to the original citations from Assessment 1. Limit commercial website references to no more than two entries. Format your citations and references using APA style.ProposalNote: The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that your proposal addresses each point, at a minimum. You may also want to read the assessment scoring guide to better understand how each criterion will be assessed.Choose a framework appropriate for examining the type of data under investigation. Look at the following for examples, and explain the basis for your choice.For a compliance project, use the regulations.For an accrediting assessment, use the standards and site survey criteria.For the implementation of a new service line, consider using the balanced scorecard framework.Develop proposed structures (for example, pie chart, graph, spreadsheet, process map) for the visual display of summarized raw data.Reflect on what type of visual display structure will best fit your selected topic. Although you are just beginning to collect data, you will want to consider how to display it.Ensure that your data displays are clear and easily interpreted.Ensure that the proposed title includes the focus of the data, units of measurement, the organization’s name, and time frame.Explain how a project addresses and adds value in each of the four areas of an organizational balanced scorecard. (The four areas are business operations, finance, customer service, and organizational learning and growth.)Create a balanced scorecard table similar to the one presented in the Balanced Scorecard Example [DOCX].Consider a strategic systems perspective as you contemplate value to the organization and how the project aligns with the organizational mission, vision, and strategy.Find evidence to support your assertions and conclusions.Determine what additional information would strengthen your value proposition.Combine clear, coherent, and original writing, in APA style, with relevant and credible evidence from the scholarly and professional literature.Apply correct APA formatting to your source citations.Consider how or why a particular piece of evidence supports your main points, claims, or conclusions.Make sure your supporting evidence is clear and explicit.Competencies MeasuredBy successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:Competency 1: Transformation: Facilitate a change process that effectively involves patients, communities, and professionals in the improvement and delivery of health care and wellness.Choose a framework appropriate for examining the type of data under investigation.Develop proposed structures for the visual display of summarized raw data.Competency 2: Execution: Translate strategy to develop and maintain optimal organizational performance in health care settings.Explain how a project addresses and adds value to each of the four areas of an organizational balanced scorecard.Combine clear, coherent, and original writing, in APA style, with relevant and credible evidence from the scholarly and professional literature.Resources: Balanced ScorecardThe articles in this section provide useful and professionally relevant information about the balanced scorecard model, which may help you in drafting your project proposal in this assessment.Behrouzi, F., Shaharoun, A. M., & Ma’aram, A. (2014). Applications of the balanced scorecard for strategic management and performance measurement in the health sector. Australian Health Review, 38(2), 208–217.Kaplan, R. S., & Norton D. P. (1992). The balanced scorecard: Measures that drive performance. Harvard Business Review, 70(1), 71–79.Kaplan, R. S., & Norton D. P. (1996). Using the balanced scorecard as a strategic management system. Harvard Business Review, 74(1), 75–85.Kaplan, R. S., & Norton, D. P. (2004). Measuring the strategic readiness of intangible assets. Harvard Business Review, 82(2), 52–63.Resources: Project and Topic ExamplesThis article examines the role of IT with regard to patient flow in hospitals and the implications for efficiency and performance.Devaraj, S., Ow, T. T., & Kohli, R. (2013). Examining the impact of information technology and patient flow on healthcare performance: A theory of swift and even flow (TSEF) perspective. Journal of Operations Management, 31(4), 181–192.This article defines how competent health care providers can improve health care communication, access, and outcomes, and also encourage patients to participate more fully in their own care.Brusin, J. H. (2012). How cultural competency can help reduce health disparities. Radiologic Technology, 84(2), 129–147.This article aids providers in a better understanding of the patient’s perspective on health care quality within the context of data analytics.Russell, R. S., Johnson, D. M., & White, S. W. (2015). Patient perceptions of quality: Analyzing patient satisfaction surveys. International Journal of Operations & Production Management, 35(8), 1158–1181.Resources: Performance MeasurementThis article defines a framework in which information can be generated for use in reporting and informing the public about health care quality.van den Heuvel, J., Niemeijer, G. C., & Does, R. J. M. M. (2013). Measuring healthcare quality: The challenges. International Journal of Health Care Quality Assurance, 26(3), 269–278.This article examines different types of organizational activities related to performance measurement and how they lead to improvements.Elg, M., Palmberg Broryd, K., & Kollberg, B. (2013). Performance measurement to drive improvements in healthcare practice. International Journal of Operations & Production Management, 33(11/12), 1623–1651.Resources: Primary Research and Authoritative SourcesThis Capella resource helps to identify original research and contains links to different types of research.Primary Research.This Capella resource contains information on finding peer-reviewed sources, improving your topic, acquiring research skills, and evaluating source quality.Library Research and Information Literacy Skills.This library guide discusses advanced research techniques which will be helpful in finding and citing relevant, authoritative sources.Bibliography Mining and Cited Reference Searching.RefWorks is a resource research management tool that helps you collect, organize, and store citations from library databases and other resources. RefWorks.Resources: APA ResourcesThese Capella resources will help to build your understanding of APA style.APA Module.APA Style and Format.This resource discusses academic writing, the appropriate use of APA style, and how to avoid plagiarism and provide appropriate credit to your sources.Academic Honesty & APA Style and Formatting.

Discussion Board 3From your reading assignment, let’s discuss the emerging health care market in the early 1800’s. America has gained independence and built a government based on democratic values. However, as America was slowing shifting from an agrarian society to the beginnings of the industrial period, the political philosophy Classical Liberalism took root.Political FactorClassical liberalism, among other things, postulates that everyone should have equal opportunity and the free market should not be constrained by large government. These ideals helped spawn the explosive growth in industrializing America.Economic FactorThe tenets of classical liberalism were also designed to impact the economy. The philosophy supported economic liberalism where the ability to practice medicine is free from government interference (e.g. licensing, medical standards and education). Everyone has a right to make a profit with minimal government interference. Social FactorPhysicians started charging a “fee” for their services (fee for service). Some physicians were retained to look after a group of people. This form of “contract practice” is a cornerstone of modern health insurance.Here is some more social context of the time: life expectancy from birth was a combined 38-40 years (males and females). Compare that to what it is now (78 -79 years).Most significant during this time period is the ongoing health care practice from Lay healers:Bone setterMid-wifeApothecaryBone setterIn the context of the time, treating a broken bone was performed by lay people that had the knowledge and experience to set fractures and manipulate joints. Often this treatment meant the difference between death from infection and amputation to gaining use of the bone again. Bone setters did not have formal training but carried on knowledge passed down through the generations.Bone setters could reduce closed fractures (realign bone fractures that don’t break the skin) by feel; without the use of X-ray.Bone setter have led to orthopedic technician, physical therapists, and chiropractors in contemporary time. However, many nations still recognize and use bone setters to fill resource gaps.Here is an illustration of a complex fracture that is realigned and supported by orthopedic hardware that is screwed into the bone. Modern orthopedic surgery sped up the healing time and effectiveness of bone fracture realignment.MidwifeThe midwife was a lay healer specifically focused on childbirth. Much has changed over the years! Midwives are now formally trained in women’s health, which includes pre; peri; and post-natal periods from conception to routine gynecological care. Midwifery reached its apex in the 1950’s. Take a peek at the popular BBC series Call the Midwife, which chronicles the midwifery in the 1950’s and shows how public health care was originally supported by faith-based groups. Watch out, you could get hooked-this is good binge watching material! Chummy Arrives at Nonnatus House – Call The Midwife – Series 1 Episode 2 – BBC One (Links to an external site.)ApothecaryThe apothecary prepared medicines (herbal and chemical), concoctions, and remedies targeting the public, and eventually physicians. This lay healer was trained through Guilds (professional organization made up of other apothecaries) and apprenticeships. Apothecaries are now are modern pharmacists.Germ TheoryGerm theory posits that diseases are caused by microorganisms. In the 1850’s, Louis Pasteur and Robert Koch proved the theory true. This had a huge impact on medical care. Among other things, proving germ theory contributed to evidence-based medical practice, which gave the physician profession a boost in their level of authority and status; their practice became grounded in the scientific method.NursingWith germ theory in mind, Florence Nightingale assembled a staff of women and went to care for wounded troops during the Crimean War. This war exemplified how sanitation is important to health, especially the healing of the wounded. Nurse Nightingale started a nursing school in London in 1860. Her aim was to train nurses that were needed to staff the proliferation of hospitals, render bed-side care, and take control of sanitation in the healthcare environment. More on nurses later.Medical AdvancesAt the end of the American Colonial Period, Europe was leading medical research (mostly in France). Coming to America from Europe were advances that include:Blood transfusionsDentistryCataract surgeryStethoscopeCodeineAspirinHypodermic needlesStethoscope: From this…To this…In the early 1800’s, physicians in America could not live on earnings from a medical practice. Often, the costs of providing medical care were more than what a physician could charge for medical services. Physicians supplemented their livelihood by becoming farms or druggists. It was not until America’s transportation infrastructure improved and expensive health care resources were placed at hospitals, did physicians see a return on their investment (medical education, equipment, treatment supplies).The concept that transportation played a role in keeping physician’s earning down is best described by this scenario:During this time in our history, most Americans lived in rural or remote areas. Someone had to go and find the physician and bring the physician back to the homestead to treat the patient (health care was mostly rendered in the home). A traveling physician had severely limited access to rudimentary laboratory tests and could only carry a few medications to treat the patient. Additionally, the time spent traveling to the patient’s home also severely limited the physician’s availability for others that may need the doctor’s services. America’s population gradually moved to urban areas in the pre-industrial period, leaving the farms to work in factories. Transportation infrastructure was established for these new urban areas, increasing access to urban medical services as physicians began to set up practices in populated areas-working out of their homes.The concept of the hospital played a role in improving physician earning by providing resources:During this time in our history, hospitals underwent a metamorphosis. Up until this point, hospitals were generally run by faith-based organizations to provide charity care for those marginalized by society (e.g., homeless, mentally ill, hospice type care). Some public hospitals were established by local governments to do the same. The biggest change for hospitals emerged as providing physician resources: hospitals attracted business from local physicians by creating laboratories, x-ray machines, pharmacy, surgical suites, and in-patient rooms to house and monitor patients. Hospitals became a one-stop-shop for physician resource (those tools of the trade used by physicians), so physicians began using hospitals to see their patients and if needed, began admitting their patients to stay in the hospital for more tests and to be monitored by nurses during recovery. That was the then, here is an explanation of the now:The concept of transportation is still significant today. Rural areas in America are under-served by the health care system. Twenty percent of Americans live in rural areas, but only 9% of physicians practice in rural areas. The disparity is so severe that there are government programs that provide incentives to new physicians to set up practice in rural areas. Some folks have to travel great distances for physician or hospital services.The concept of the hospital has maintained these tenets:Hospitals still provide resources to physicians (and shared by physicians) that are otherwise too expensive to setup and maintain in private practice. Examples include laboratory and pathology services, imaging services (x-ray, CT, MRI, and ultra sound), surgical suites (for general and specialized surgery and cath lab), and beds to admit their patients so nurses can monitor care (general beds, telemetry beds, and ICU beds). Off course this list is not exhaustive, many hospitals provide out-patient services like GI lab, cancer treatment, rehabilitation care, etc.Physicians still use the hospital as a resource, 99% of physicians that use hospitals do not work for the hospital (are not employed by the hospital). Instead, the hospital extends “admitting privileges” to a physician, which allows the physicians to use their resources and place their patients in a hospital be. The patient, or the patient’s health plan, is billed for the physician’s services, as well as a bill from the hospital.Discussion Assignment:Watch this 17.38 minute video:Why U.S. Hospitals Are Closing (Links to an external site.)This assignment has two parts:Answer 1 question. You have the option to answer Question #1 or answer Question #2. Only answer oneRespond to a classmate’s posting.Question #1: Have there been any hospital mergers in Kern County? If so, describe the hospital merger (describe only one merger-there are several).Here are some hints for your research: Tehachapi hospital AND Adventist Health; Memorial Hospital AND CHW/Dignity Health; Dignity Health AND Catholic Health Initiatives. Describe only one merger-there are several to choose from.Question #2: What happened to Westside District Hospital in Taft?

In need of (2) substantive replies of 150 words each to (2) different post. INFO331 Management Information Systems Topic: Moore’s Law and Network EffectsPeer replies to further the conversationStudent replied to at least two (2) classmates’ posts and each reply includes at least three (3) to four (4) sentences relating the classmate’s post to at least one (1) question/point of the Discussion Prompt.Responses are substantive and encourage discussion by proposing a different point of view supported by an attribution to a source, personal example, or personal application. All responses include related follow up questions to promote continued discussion.Prompt: Moore’s Law and Network Effects1. What is e-waste? What is so dangerous about e-waste? Many well-meaning individuals thought that recycling was the answer to the e-waste problem. But why hasn’t e-waste recycling yielded the results hoped for? 2. What are network effects? Think about the kinds of technology products that you own, or websites you use, that are subject to network effects. What sorts of exchange do these products leverage (e.g., information, money, software, or other media)? Give several concrete examples and explain them as clearly as you can in your own words. 3. Find an article online that discusses the problem of e-waste, preferably one that also proposed a solution. In your own words summarize and critique the article. Do you think it is a viable solution? Why or why not? Be sure to include the url to your article. 4. Describe the impact that your chosen information system has on your organization. Be sure to consider both the positive and negative impacts. Over-dependence on an information system can be a negative impact, so also discuss whether your organization has any contingency plans for business continuity during system outages.Text Readings:Ch. 5 – Moore’s Law: Fast, Cheap Computing and What It Means for the ManagerCh. 6 – Understanding Network EffectsBook Title: Information Systems Version 1.3 – E-book links provided inside the classroom.Author: GallaugherPublication Info: FlatWorld KnowledgeISBN: FLATWORLD-ITSYSBook Title: Gallaugher, J. (2012). Information systems: A manager’s guide to harnessing technology (ver. 1.3). Irvington, NY: Flat World Knowledge.Forum Post 1:E-waste is the ever-growing pile of outdated, discarded electronics created mostly when people get rid of phones, tablets, or other electronic devices when new, updated versions are released. E-waste is so dangerous because the lithium-ion batteries that are contained in just about every electronic device now will leak lead, lithium, and mercury (Morton, 2019). Once these heavy metals are placed in landfills, they can seep into the ground, be distributed by subterranean water flows, and also be disseminated into the air. E-recycling simply doesn’t work because even our best efforts towards recycling the electronics we use, it’s like trying to empty the ocean with a spoon. The effort simply can’t keep up with our consumeristic, wasteful society. This is the essence of Moore’s law, which stated a rule of thumb about how quickly computers will gain processing power and infiltration into every corner of our society. Network effects refer to the value that is given to a service, platform, or software based on the number of users that utilize it. A great example of this is any e-commerce B2C model such as eBay, Craigslist, and Amazon. These sites and entire businesses would cease to exist if their users simply stopped using their products. E-commerce businesses leverage the exchange of money for a very wide range of goods and or services and software. Another great example of network effects are companies like Uber and Lyft. Their profit margins are directly related to the size of their customer base, therefore, their value is based on the population of their users (Stobierski, 2019). The article that I found came from BBC News, and talked about the environmental impact of e-waste, and broke down what percentage of our planet’s e-waste came from what technology. 37% of waste came from small electronic equipment such as toasters, vacuum cleaners, and irons, 22% come from large electronic equipment such as washers and dryers, microwaves, and slow cookers, 17% come from temperature exchange equipment, 14% come from screens like televisions and PC screens, 9% from small IT devices like phones and tablets, and less than 1% come from lamps (Mahy, 2020). A solution that this article presents is teaching electronics owners how to repair their devices rather than simply throwing them away to upgrade or replace them. This solution offers a fairly viable solution because most small and large electronic equipment, which is what most e-waste is made up of, can increase in longevity if people took the time to learn how to repair them instead of just throwing them away. The downfall of this solution is that as electronics get more and more complex, the less common users can do to fix things themselves.https://www.bbc.com/news/business-51385344My information system has an integral impact on my organization. The negative impact that it could be considered to have is that if my system goes down, the ship will be without any means to defend itself, and be blind except for one standalone radar system. If the AEGIS computing infrastructure has an outage, we would be reliant on small arms and the 5inch gun topside. There is a very high level of dependency on my information system, but there are so many redundancies within the infrastructure that it would take an extremely unlikely set of circumstances to fully incapacitate the system. The multiple levels of redundancy cause another problem in and of itself; it makes it very difficult to catch system malfunctions and failures because so much of the system is automated. By the time we see a fault or a negative indication, there could be multiple levels of failure experienced within the system. Unfortunately, the contingency plan would consist of us leaving any active battle zone while we rush to recover the system. We do drills on major casualties all the time for this very reason!Thanks for reading,ReferencesMahy, E. (2020, February 17). Can we fix our way out of the growing e-waste problem? BBC News. https://www.bbc.com/news/business-51385344.Morton, A. (2019, April 15). Trashing Electronics: The Effects of E-Waste on Environment. Cleanlites. https://cleanlites.com/trashing-electronics-the-effects-of-e-waste-on-environment.Stobierski, T. (2020, November 12). What Are Network Effects?: HBS Online. Business Insights – Blog. https://online.hbs.edu/blog/post/what-are-network-effects.Forum Post 2:Good Afternoon Class,1. E-Waste or “electronic waste” can be described as any electronic device that has come to the end of its useful life. Electronics such as TV’s, VCR’s, cell phones, or iPads all have a life span, and when that time comes, they are refurbished or recycled. The most dangerous thing about e-waste is the material electronics are made of. For example, most electronics contain chemicals such as lead, mercury, beryllium, and brominated flame retardants. If these are not disposed of properly, those chemicals could become an environmental hazard. According to our lesson, E-waste recycling hasn’t yielded the results they hoped for because electronic waste is often shipped to other countries from the U.S. because we don’t have enough electronics recycler’s to address all of the e-waste. Predictably, the countries chosen are typically less developed, and less able to handle the problems associated to e-waste. 2. When looking at network effects I automatically think of “networking” in the sense of building my personal network and meeting new people. One website or platform I use for recruiting is social media i.e. Facebook and Instagram. Both are easy to use, and a lot of people already have accounts set up which makes it easy to connect with a large number of people in a short period of time. 3. An article titled “E-waste is the Toxic Legacy of our Digital Age” breaks down the numbers when it comes to electronics. According to the article, 1.5 billion new cell phones were made, while the average American keeps their phone for only 34 months before getting a new phone. They say only 20% actually gets collected properly leaving 80% to end up in landfills! One solution the article proposes, is making the products last longer. This would require people to fix and repair phones that stop working, which would actually create more jobs. I find it hard to argue that idea because it’s a logical choice that makes sense.URL: https://www.ifixit.com/Right-to-Repair/E-waste4. The information system I chose is My Navy Portal (MNP) and it makes a huge impact on my organization. MNP is used by virtually every person in the United States Navy at one point or another. It acts as a one stop shop and allows the user many different options that relate directly to their career. Obviously, it’s a positive impact to have such a platform, however the negative side is that it is government run which means it works about 75% of the time. From my experience, if MNP is down, there is no contingency plan other than stand-by to stand-by and check again tomorrow.

Prepare an 8-10 minute audio training tutorial (video is optional) for new nurses on the importance of nursing-sensitive quality indicators.As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment Framework activity. Quality health care delivery requires systematic action. Completion of this will help you succeed with the assessment as you consider how the triad of structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and process (such as the delivery/coordination/education/protocols/practice style or standard of care) may be modified to achieve quality outcomes.The American Nursing Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI®) in 1998 to track and report on quality indicators heavily influenced by nursing action.NDNQI® was established as a standardized approach to evaluating nursing performance in relation to patient outcomes. It provides a database and quality measurement program to track clinical performance and to compare nursing quality measures against other hospital data at the national, regional, and state levels. Nursing-sensitive quality indicators help establish evidence-based practice guidelines in the inpatient and outpatient settings to enhance quality care outcomes and initiate quality improvement educational programs, outreach, and protocol development.The quality indicators the NDNQI® monitors are organized into three categories: structure, process, and outcome. Theorist Avedis Donabedian first identified these categories. Donabedian’s theory of quality health care focused on the links between quality outcomes and the structures and processes of care (Grove, Gray, Jay, Jay, & Burns, 2018).Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in data collection and analysis. In addition, monitoring organizations, including managed care entities, exist to gather data from individual organizations to analyze overall industry quality. All of these roles are important to advance quality and safety outcomes.The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop an 8–10 minute audio (or video) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses’ role in supporting accurate reporting and high quality results.Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making. 

Describe the interdisciplinary team’s role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.

Competency 3: Evaluate the impact of patient care technologies on desired outcomes. 

Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.

Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients. 

Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.

Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies. 

Deliver a professional and effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
Follow APA style and formatting guidelines for citations and references.

Reference
Grove, S. K., Gray, J. R., Jay, G. W., Jay, H. M., & Burns, N. (2018). Understanding nursing research: Building an evidence-based practice (7th ed.). St. Louis, MO: Elsevier.Preparation
This assessment requires you to prepare an 8–10 minute audio training tutorial (with optional video) for new nurses on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:
Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care system.
Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.
Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview: 

What is your experience with collecting data and entering it into a database?
What challenges have you experienced?
How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?
What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process?

Watch the Informatics and Nursing-Sensitive Quality Indicators Video Examplar.
Recording Your Presentation
To prepare to record the audio for your presentation, complete the following:
Set up and test your microphone or headset using the installation instructions provided by the manufacturer. You only need to use the headset if your audio is not clear and high quality when captured by the microphone.
Practice using the equipment to ensure the audio quality is sufficient.
Review the for Kaltura to record your presentation.
View Creating a Presentation: A Guide to Writing and Speaking. This video addresses the primary areas involved in creating effective audiovisual presentations. You can return to this resource throughout the process of creating your presentation to view the tutorial appropriate for you at each stage.
Notes:
You may use other tools to record your tutorial. You will, however, need to consult Using Kaltura for instructions on how to upload your audio-recorded tutorial into the courseroom, or you must provide a working link your instructor can easily access.
You may also choose to create a video of your tutorial, but this is not required.
If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.edu to request accommodations.
Instructions
For this assessment, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.You determine that you will cover the following topics in your audio tutorial script:Introduction: Nursing-Sensitive Quality Indicator

What is the NDNQI®?
What are nursing-sensitive quality indicators?
Which particular quality indicator did you select to address in your tutorial?
Why is this quality indicator important to monitor? 

Be sure to address the impact of this indicator on quality of care and patient safety.

Why do new nurses need to be familiar with this particular quality indicator when providing patient care?
Collection and Distribution of Quality Indicator Data

According to your interview and other resources, how does your organization collect data on this quality indicator?
How does the organization disseminate aggregate data?
What role do nurses play in supporting accurate reporting and high-quality results? 

As an example, consider the importance of accurately entering data regarding nursing interventions.