ASM1 — ASM1 TASK 1: INNOVATION PROPOSAL ADVANCING EVIDENCE-BASED INNOVATION IN NURSING PRACTICE — D031 PRFA — ASM1

  

A1. Explanation of Role No evident The submission discusses the use of telemedicine in an Emergency Department. The response is missing a plausible explanation of the innovative nurse leader role that is well-supported by a scholarly reference.

A2a. Organizational Characteristics Not Evident The submission briefly mentions how the emergency room serves as a trauma center as well as primary care services. The response does not plausibly describe organizational characteristics of the CoP, including type, setting, structure, and services provided.

A2b. Demographics not evident The submission succinctly explains how 20% of population is uninsured. The response does not clearly summarize the demographic characteristics of the population served that is effectively supported with quantitative and qualitative data.

A2c. Team Member Roles not evident The submission shares how two medical caretakers and one emergency room doctor work in the Emergency Department. The response is insufficient because it does not accurately describe informal and formal team member roles.

A2d. Shared Team Values not evident The submission shares how two medical caretakers and one emergency room doctor work in the Emergency Department. The response is missing a summary of the shared team values within the organization and the team that is supported by real examples. 

A4. Alignment to Strategic Initiatives not evident  The submission discusses the history and benefits of telemedicine. The response does not plausibly align the proposed innovation with other specific professional, regulatory, or governmental strategic initiatives.

A6. Innovation Goal not evident The submission aims to reduce the number of negative outcomes from Acute Coronary Syndrome by utilizing telemedicine service. The SMART+C goal is not fully applied and is missing C (Challenging) portion.

B1. Scholarly Sources not evident The submission provides a nicely developed evidence critique table. Source 4 is missing an APA formatted scholarly reference with a DOI or retrievable link and cannot be evaluated.

B2. Presentations of Findings not evident The submission provides a nicely developed evidence critique table. Source 4 is missing an APA formatted scholarly reference with a DOI or retrievable link and cannot be evaluated.

B3. Evidence Strength and Hierarchy not evident The submission provides a nicely developed evidence critique table. Four scholarly sources are accurately assessed for evidence strength and hierarchy. Source 4 is missing an APA formatted scholarly reference with a DOI or retrievable link and cannot be evaluated.

C2. Data Examples not evident The submission discusses how big data can be used to support the proposed innovation. The response does not provide examples of big and small data that are practical and relevant to the current healthcare setting.

2

Title of Evidence-Based Innovation Plan

Author Name (First, Middle Initial, Last)

College of Health Professions, Western Governors University

D031: Advancing Evidence-Based Innovation in Nursing Practice

Instructor Name

Date

Title of Evidence-Based Innovation Plan

Introduction (Introduce your innovation proposal in 2-3 sentences)

Explanation of Role

Organizational Characteristics

Demographics
Team Members Roles

Shared Team Values

Discussion of Internal and External Factors

Alignment to Strategic Initiatives

Purpose Statement

Innovation Goal

Relevant Sources Review

Table 1

Relevant Sources Summary Table

Scholarly Peer-Reviewed Sources

Published in Past 5 Years

that

Support the Proposed Innovation

Summary of Findings Relevant to Proposed Innovation

Evidence Strength

Level I–VII

Evidence

Hierarchy

APA formatted scholarly reference with a DOI or retrievable link.

Present a detailed summary of the findings and

how the findings support the proposed innovation.

Refer to

WGU Levels of Evidence

SCHOLARLY SOURCE 1

SCHOLARLY SOURCE 2

SCHOLARLY SOURCE 3

SCHOLARLY SOURCE 4

SCHOLARLY SOURCE 5

Synthesis of Literature

Recommendations

Data-Collection and Technology

Idea Generation Process

Data Examples

Big Data Support

Technology Enhancements

Interprofessional Collaboration and Disruptive Innovation

Disruption

Strategies to Mitigate Challenges

Leverage Benefits of Disruptive Innovation

Plan

Diffusion of Innovation

Innovation Action Plan Table

Table 2

Innovation Action Plan

Team Member Role

Essential Responsibilities to Implement Proposal

Timeline

Financial Implications

Interprofessional Communication Plan

Evaluation

Conclusion

Purpose and Rationale

Reflection

Strengths and Challenges

Future Initiatives

References

Create an innovation plan proposal using the attached “Evidence-Based Innovation Plan Template.”

A.

 

Introduce your innovation proposal by doing the following:

1.  Explain the role of an innovative nurse leader.

2.  Summarize the community of practice (CoP) established during your CPE, including the following points:

a.  organizational characteristics, services provided, and size of the service area

b.  demographic characteristics of the population served

c.  team member roles—formal and informal 

d.  shared team values

3.  Focusing on the organization identified in your CPE, discuss the internal and external factors that prompted this proposal.

4.  Assess how your proposed innovation aligns to other professional, regulatory, and/or governmental strategic initiatives.

5.  Construct a purpose statement for your proposed innovation.

6.  Create a goal of the proposed innovation in SMART+C format (i.e., Specific, Measurable, Achievable, Relevant, Timed, and Challenging).

B.  Complete a review of relevant sources by doing the following:

1.  Identify five scholarly peer-reviewed sources published within the last five years that are relevant to your innovation proposal.

2.  Complete the Relevant Sources Summary Table in the attached “Evidence-Based Innovation Plan Template.””

3.  Identify the evidence strength and the hierarchy of each source, as outlined in the attached “WGU Levels of Evidence” document.

NOTE: Use the WGU Evidence Leveling Navigation Tool in the Supporting Documents to identify the evidence strength and hierarchy for each source.

4.  Synthesize your findings by identifying patterns, trends, and gaps in the literature as they relate to the proposed innovation.

5.  Develop recommendations for the proposed innovation based on the literature.

C.  Discuss the data-collection methods and technology used to identify and support the proposed innovation by doing the following:

1.  Explain the process you used to generate ideas for an innovation from the CoP.

2.  Provide examples of big and small data within your current healthcare setting.

3.  Discuss how big data could be used to support the proposed innovation.

4.  Describe technology enhancements required for the proposed innovation.

NOTE: A technology enhancement could be the development of a new technology or enhanced application of an existing technology.

D.  Discuss how to support interprofessional collaboration in the midst of disruptive innovation by doing the following:

1.  Analyze how disruption from the proposed innovation could impact individuals, processes, and organizations.

2.  Develop strategies to mitigate the challenges of disruption for individuals, processes, and organizations.

3.  Discuss how the proposed innovation can leverage benefits of disruptive innovation for cost-effective, quality healthcare outcomes.

E.  Discuss your pre-implementation plan by doing the following:

1.  Discuss diffusion of innovation as it relates to the implementation of your plan.

    NOTE: Refer to the COS for Roger’s Theory.

2.  Identify the roles and responsibilities of team members needed to implement your proposal using the Innovation Action Plan table in the attached “Evidence-Based Innovation Plan Template” including information that is practical, accurate, and relevant to the proposed innovation. ” 

3.  Discuss the financial implications of implementing the proposed innovation.

4.  Develop an interprofessional communication plan accounting for the logistics (i.e., the who, what, when, and where) of facilitating the innovation and its usability.

5.  Discuss how you will evaluate the effectiveness of your proposed innovation.

F.  Conclude your innovation proposal by doing the following:

1.  Reiterate the purpose and rationale for your proposed innovation.

2.  Reflect on your experience identifying an innovation for your setting.

3.  Discuss the strengths and challenges of the process used for developing this innovation plan.

4.  Discuss how you will apply what you have learned for future initiatives.

 

G.   Incorporate the following components of APA style and formatting in your paper:

•   bias-free language

•   APA-specific rules regarding verb tense, voice, and perspective

•   a title page and headers

•   in-text citations and references

•   APA-specific formatting rules for margins, spacing, numbering, and indentation for the title page and main body of your paper, including headers, bulleted and numbered lists, and tables and figures

 

19

Telemedicine Advancement in Emergency Rooms

Author Name Anchinalu M Mehari

College of Health Professions, Western Governors University

D031: Advancing Evidence-Based Innovation in Nursing Practice

Instructor Name Dr. Dillard Deborah

Date 9.30.22

Telemedicine Advancement in Emergency Rooms

Introduction (Introduce your innovation proposal in 2-3 sentences)

Rural emergency departments are in a difficult situation concerning treating patients with intense sicknesses. The absence of experts inside the facility is a downside and might have lethal results for our patients. Telemedicine is the most current innovation accessible and keeping in mind that costly, it gives significant advantages to ER patients and staff.

Explanation of Role

Telemedicine will permit the ER to go with speedier choices in regard to a patient’s demeanor or need for prompt development. The ER will provide telemedicine for cardiac patients who need administration in no less than six months. The implementation of telemedicine for nervous system science and mental claims to fame will begin in the ensuing half year. Expanding access to doctors and specialists through telemedicine ensures that patients receive the best care at the optimal time and location. Mortality has been shown to drop by 30–35% as a result of telemedicine.

Discussion of Internal and External Factors

Due to the 20% uninsured population in the area, the emergency room serves as both their trauma center and primary physician. 12.4% of our people group also live in poverty. Making it inordinately difficult for some to manage the cost of medical care. Our office is a five-bed emergency room, which is the closest clinic by thirty miles. On an ordinary shift, there are two medical caretakers and one emergency room doctor every day. We don’t have trained professionals that can promptly see our patients in the ER.

Alignment to Strategic Initiatives

Before Coronavirus proved to be so uncontrollable, telemedicine was not a significant component of the clinical sector. Despite being around since the 1960s, it is rarely used. It took our current pandemic to bring the innovation that has been available to us for a long time to the forefront. 76% of American clinics consult with experts on the use of PCs and innovation. “Limited government medical care inclusion prevents telehealth administrations from expanding. With a few limited exceptions, such as stroke, the current regulation restricts the majority of telehealth services to patients located in rural areas and clear-cut environments (such as a clinic or doctor’s office), covers only a set number of services, and allows only continuous, two-way video meetings.

Purpose Statement

The purpose of the innovation action plan is to make certain that all of the actions that are connected to the innovation project are carried out in a timely and effective way as planned.

There are many reasons telemedicine is required in our local emergency room. The most significant is that the patient gets the right treatment perfectly positioned with impeccable timing. Telemedicine will carry the best consideration to our patients while working on understanding results and patient fulfillment.

Innovation Goal

The objectives of the innovation action plan and the aims of the innovation project must align. The objectives must be very specific, reachable, and clearly quantifiable.

We expect to reduce the number of negative outcomes from ACS (Intense Coronary Disorder) by 75% and increase overall inpatient fulfillment to 95% within 90 days of beginning telecardiology. The innovation’s objective is to promote emergency room telemedicine. The provision of the greatest caliber of treatment to our patients is the major objective for all parties involved.

Relevant Sources Review

Table 1

Relevant Sources Summary Table

Scholarly Peer-Reviewed Sources

Published in the Past 5 Years

that

Support the Proposed Innovation

Summary of Findings Relevant to Proposed Innovation

Evidence Strength

Level I

–VII

Evidence

Hierarchy

APA formatted scholarly reference with a DOI or retrievable link.

Present a detailed summary of the findings and

how the findings support the proposed innovation.

Refer to

WGU Levels of Evidence

SCHOLARLY SOURCE 1

Hamm, J. M., Greene, C., Sweeney, M., Mohammadie, S., Thompson, L. B., Wallace, E., & Schrading, W. (2020). Telemedicine in the emergency department in the era of covid‐19: Front‐line experiences from 2 institutions. Journal of the American College of Emergency Physicians Open, 1(6), 1630–1636. Retrieved January 5, 2021, from

https://doi.org/10.1002/emp2.12204

The article gave understanding to

challenges related

with telemedicine

particularly in rustic regions.

Challenges incorporate

security, no obvious physical

test by subject matter expert,

patient not feeling appreciated,

default from MCR.

Likewise talked about rustic

charging limitations by

MCR on telemed being

lifted during the

pandemic. Telemed can

lessen how much

PPE in the trauma center. Tablets,

PCs and cart-based telemedicine are

all gadgets that can be

managed the cost of the innovation

for telemed counsels

Level VII

Expert option

SCHOLARLY SOURCE 2

Rademacher, N., Cole, G., Psoter, K. J., Kelen, G., Fan, J., Gordon, D., & Razzak, J. (2019). Use of telemedicine to screen patients in the emergency department: A matched cohort study evaluating the efficiency and patient safety of telemedicine. JMIR Medical Informatics, 7(2), e11233. Retrieved January 4, 2021, from

https://doi.org/10.2196/11233

Tried different things with

337hours of face to face

screening and 315hours

of tele screening to

separate

adequacy and evaluate

the wellbeing of tele screening.

Fewer patients LWBS

during face-to-face. Both

accomplished a similar level

of productivity. For the chest torment patient that

presents to the emergency room, it

took into consideration faster

conference of

cardiologist and orders

being started sooner

than without telemed.

Patients were given a

survey to finish up

after tele screening, yet

the data was

uncertain at that point

of the report.

Level II

SCHOLARLY SOURCE 3

Kruse, C. S., Soma, M., Pulluri, D., Nemali, N. T., & Brooks, M. (2017). The effectiveness of telemedicine in the management of chronic heart disease – a systematic review. JRSM Open, 8(3), 205427041668174. Retrieved January 3, 2021, from https://doi.org/10.1177/205427041668174 7

A systematic review of 20

articles to decide

viability of telemed

in overseeing heart

sickness patients.

Further develops mortality by

40%, further develops wellbeing

results by 35%.

Shows up just little

rate successful in

working on quiet

fulfillment scores. Half

of the articles explored

showed a huge

decrease in

readmissions with

telemed. Fifteen out of

the 20 articles referred to the

diminished mortality and

further developed results

Level I

Systematic Review

SCHOLARLY SOURCE 4

Patients are only required to travel when they need procedures or advanced diagnostics. Technology allows the cardiologist to provide patient visits and monitor them through their implantable devices (defibrillators). Telemedicine is allowing earlier intervention for patients. MCR is one of the lowest payers of telehealth so some physicians are not embracing the technology.

Level VII

Expert opinion

SCHOLARLY SOURCE 5

Di Lenarda, A., Casolo, G., Gulizia, M., Aspromonte, N., Scalvini, S., Mortara, A., Alunni, G., Ricci, R., Mantovan, R., Russo, G., Gensini, G., & Romeo, F. (2017). The future of telemedicine for the management of heart failure patients: A consensus document of the Italian association of hospital cardiologists (a.n.m.c.o), the Italian society of cardiology (s.i.c.), and the Italian society for telemedicine and e-health (digital s.i.t.). European Heart Journal Supplements, 19(suppl_D), D113–D129.

https://doi.org/10.1093/eurheartj/sux024

30-35% reduction in

mortality, 15-20%

reduction in admissions.

Gave information on

different implanted

devices cardiac patients

have, ease of

synthesizing the info

back to the clinician,

patients have a more

active role in their

healthcare by using

smart devices. A

the drawback to telemed is

incorrect diagnosis due

to the incorrect data being

given to the physician by

the patient. Another

the drawback is a lack of

reimbursement.

Level I

Meta-Analysis

Synthesis of Literature

Since the new pandemic of 2020, telemedicine has become more famous than any other time. Despite the fact that using it has a lot of problems, there are significantly more benefits than risks. Telemedicine is the approach that represents things to come after evaluating various well-qualified emotions, audits, and assessments. The innovation permits patients to be found continuously and simply be expected to go for procedural arrangements. Telemedicine guarantees that patients are perfectly positioned, getting legitimate treatment with impeccable timing. The cardiologist will want to remote into implantable gadgets and notice the patient’s mood (Kuehn, 2016). One area that telemedicine could help with demonstrates restraint fulfillment. All I could make out was that there wasn’t enough information to close the gap between the fulfillment scores altering due to the innovation (Rademacher et al., 2019). Despite the fact that the technology has been available since the 1960s, we were forced to use it this year without much prior planning. The patient fatality rate has significantly decreased to 40%, according to the telemedicine publications, while general wellbeing outcomes have improved to 35%. Telemedicine allows for more precise and timely therapy for the patients (Kruse et al., 2017). Along with the improvement in death rates, confirmations and readmissions have decreased by 15-20% in some places when telemedicine has been used (Di Lenarda et al., 2017).

Recommendations

In our ER, telemedicine would begin in less than six months because MCR is now not restricting payments. This time frame takes into account that satisfactory agreements with physicians must be reached, there is more than enough opportunity to purchase the equipment, the trauma center staff must be trained on the hardware and cycles that are in place, and there is time for the organization to shape agreements regarding the legitimate use of the equipment. Additionally, there is opportunity and willpower to ensure appropriate availability, as well as time for the organization to advertise the technology and promote it. The innovation’s successes or problems will be evaluated and taken care of on a quarterly basis. Adding additional specialists from the fields of nervous system science, psychology, and orthopedics would be on the next gathering plan after evaluating the successes over the previous six months.

Data-Collection and Technology

Idea Generation Process

At the point when I met with the development’s key partners, we had a zoom meeting and examined various developments that could be useful to our country’s crisis division. My round table incorporated our director, our social laborer, myself, our medical caretaker instructor, one

IT

staff part, one of our ER doctors, and the managerial secretary to record the gathering. I proactively explored various machines to present to the gathering. While all thoughts were invited, it was clear what development was the most ideal for our office.

Data Examples

Big Data Support

For more than 21,000 residents, our little five-bed emergency room is the only facility within 30 miles. There are no subject matter experts because we are a country’s local area. Making the invention available to our patients would only improve results understanding. With two facilities nearby and the previously stated level of destitution, we serve as a necessary facility for the majority of our residents. Since we only have five beds, we are staffed around-the-clock by one ER doctor and two nurses.

Technology Enhancements

The office has an ongoing Wi-Fi framework set up, as well as a telephone framework. What’s more, the telemedicine screen on wheels would be bought. Our office would likewise require a quicker Wi-Fi to oblige the constant video conferencing. Connections from the distant location to our equipment would also be set up to allow the cardiologist to remotely access our system. A typical 1800 responding mail would be set up to arrive right away at the ready-to-come cardiologist in the event of an emergency.

Interprofessional Collaboration and Disruptive Innovation

Disruption

It delays patient consideration, which is the sort of “disruption” I examine to see if we don’t do. Since there are no professionals available at our office, persistent thought is just eased back. We regularly deal with situations like this when treating patients. A cardiologist does not examine a STEMI patient until he is lying on the catch lab table. It takes a stroke sufferer some time to get to their ICU bed at another office before they visit a nervous system specialist. Unfavorable outcomes can cause trouble by presenting complaints from irate relatives. Knowing that we have access to telemedicine, we may bring patients to our office who may have previously visited multiple emergency clinics.

Strategies to Mitigate Challenges

There might be disturbances in the assistance that we should overcome. Techniques to battle the deficiency of wi-fi are laid out in an association that is challenging to disturb. Make a deal with the company that states they won’t be compensated for the time it is down and being fixed if assistance is interrupted. The machine is down for routine support or broken will be tended to by requiring every other month machine checks from a far-off area and quarterly surveys face to face by IT. The machine’s standard upkeep will be finished afternoon, which is ordinarily a slow time with less understanding traffic in the emergency room.

Leverage Benefits of Disruptive Innovation

When a patient consults a specialist via telemedicine, it prevents them from being transferred to another trauma center. A subsequent trauma center bill for the patient is generated when a patient is transferred from our emergency room to another. It keeps postponing necessary care until the specialist is viewed at the following office. Bypassing the trauma center and starting the patient’s treatment plan sooner, telemedicine will enable the patient to be transferred to the emergency room and brought to an appropriate floor. With the use of innovation, patients will travel from all around to the emergency clinic to receive the greatest care. Expanded patient base Means increased revenue. Our positions and those of our entire office are secured by the increased income. Additionally, increased revenue may increase in a different way.

Plan

Diffusion of Innovation

The steps of knowledge are needed for the diffusion of innovation, influence, choice, execution, and affirmation. This cycle is essential for individuals to take on a novel thought, change, item, or reasoning (Kaminski, 2011). The trailblazer and the early adopters need a minimal measure of persuading. They are inspired daring people who are ordinarily good examples and visionaries inside the office. The early larger part could do without things being confounded and needed slow consistent advancement toward an objective.

They are to a lesser extent a daring person and need to remain inside a financial plan while picking an answer that others do. The late greater part is wary, answers peer pressure, needs advancements verified before getting involved with them and dreads innovation. The late greater part is effectively impacted by slouches who allude to past approaches to getting things done. They need to keep up with the norm, not innovation-wise, and be dubious of anything new achieved. The objective is to move individuals inside the classes and endeavor to address everybody’s issues in every classification

Innovation Action Plan Table

Table 2

Innovation Action Plan

1 month

Team Member Role	Essential Responsibilities to Implement Proposal	Timeline
IT	PC learning online class for staff	2 weeks
Social worker	Community outreach event		1 month
Education	Train staff	1 month 2 weeks
Administration	Final stakeholder meeting to give final	3 weeks
Marketing	Getting word out

Financial Implications

It goes without saying that any technology has a price. This should be seen as a prognostication for the clinic and organization’s future. Depending on the type you choose, the machine can cost anywhere from $1000 to $20,000, not including the cost of any necessary programming. The machine will eventually pay for itself, even if the initial cost will be high. The insurance company pays for telemedicine consultations, but your market will also start to expand.

Interprofessional Communication Plan

Each colleague’s responsibilities would be finished preceding execution, or we wouldn’t “go live.” The reason for the gatherings preceding starting the innovation is to guarantee that we are keeping focused and following through with our responsibilities. With the social laborer following our patients, we will have measurable information and patient reviews to reference our advancement’s viability. We will meet monthly to monthly the initial half year after the execution with all partners to examine various cases and their results, any issues with the machine or the innovation, or extra schooling that might be required.

Evaluation

It is important to recognize and evaluate the dangers that are connected to the innovation action plan. It is recommended that methods for risk mitigation be put into place to handle the hazards.

evaluation 

To guarantee that the innovative action plan is producing the desired results, it has to be subjected to consistent analysis. Feedback from relevant stakeholders needs to be included in the evaluation.

The group will roll out any improvements promptly to work on the interaction. This advancement can save many lives. Remaining in correspondence with all partners is of most extreme significance.

Conclusion

Purpose and Rationale

There is no question that our local emergency room needs telemedicine. We are a regional office with no professional capabilities. A qualified expert would administer continuing patient testing at their bedside, followed by a suggested treatment schedule for the patient. The significance of this development is shown by observations made in our province and the surrounding area as well as by information pertaining to the clinic. The cost of bringing technology to our emergency room is high, but the benefits to the patients and the anticipated income make the cost seem insignificant. A person’s life cannot be valued, and telemedicine has been shown to reduce patient death.

Reflection

The procedure for creating the advancement seemed straightforward. I’ve been at this job for 12 years, and I’m aware of our strengths and what we could contribute to make our association better. I’ve worked in the emergency room for more than 16 years, and over that period, a lot has changed. I am the house manager as well as the nurturer in my current position. I was astounded to learn that although telemedicine was designed in 1960, it wasn’t really used until Coronavirus.

Strengths and Challenges

One of the advantages was that we all agreed right away on the type of development that would work best for our office. The gatherings were scheduled and kept on schedule according to the arrangement. Each partner contributed their expertise and offered to assist others.

Setting up the Zoom meeting was the most difficult because I had never done it before. Additionally, attempts to get in touch with a cardiologist who might agree to join the call proved unsuccessful, although other partners frequently took part in the zoom meeting.

Future Initiatives

According to the new knowledge I have gained from my research, telemedicine might also be used to allow a medical caregiver Specialist to observe the less serious patients while a doctor is in the emergency room. Due to the fact that, as was mentioned earlier, we are some occupants’ first concern, I believe this could benefit our workplace. In addition to telecardiology, our association would greatly benefit from the addition of telepsychology and teleneuro. In the future, I’ll suggest changes along the same lines; thoroughly examine matters, organize my group, pay attention to information, and come together for the goal. Working together makes the fantasy possible.

References

Di Lenarda, A., Casolo, G., Gulizia, M. M., Aspromonte, N., Scalvini, S., Mortara, A., Alunni, G., Ricci, R. P., Mantovan, R., Russo, G., Gensini, G. F., & Romeo, F. (2017). The future of telemedicine for the management of heart failure patients: A Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.).
European Heart Journal Supplements,
19(suppl_D).

https://doi.org/10.1093/eurheartj/sux024

Fact Sheet: Telehealth. (2019, February 1). www.aha.org. Retrieved January 5, 2021, from

https://www.aha.org/factsheet/telehealth

Hamm, J. M., Greene, C., Sweeney, M., Mohammadie, S., Thompson, L. B., Wallace, E., & Schrading, W. (2020). Telemedicine in the emergency department in the era of Covid‐19: Front‐line experiences from 2 institutions.
Journal of the American College of Emergency Physicians Open,
1(6), 1630–1636.
https://doi.org/10.1002/emp2.12204

Kaminski, J. (2011). Diffusion of Innovation Theory.
Canadian Journal of Nursing Informatics,

6(2). Retrieved January 22, 2021, from

Diffusion of Innovation Theory

Kruse, C. S., Soma, M., Pulluri, D., Nemali, N. T., & Brooks, M. (2017). The effectiveness of telemedicine in the management of chronic heart disease – a systematic review.
JRSM Open,
8(3), 205427041668174. Retrieved January 3, 2021, from

https://doi.org/10.1177/2054270416681747

Kuehn, B. M. (2016). Telemedicine helps cardiologists extend their reach.
Circulation,
134(16),

1189–1191.

https://doi.org/10.1161/circulationaha.116.025282

Quick Facts Lampasas County. (2019, June 1).

www.census.gov/quickfacts/lampasascountytexas. Retrieved January 5, 2021, from

https://www.census.gov/quickfacts/lampasascountytexas

Rademacher, N., Cole, G., Psoter, K. J., Kelen, G., Fan, J., Gordon, D., & Razzak, J. (2019). Use of telemedicine to screen patients in the emergency department: Matched cohort study evaluating efficiency and patient safety of telemedicine.
JMIR Medical Informatics,
7(2), e11233. Retrieved January 4, 2021, from
https://doi.org/10.2196/11233

Stefancyk, A., Hancock, B., & Meadows, M. T. (2013). The nurse manager.
Nursing Administration Quarterly,
37(1), 13–17. Retrieved January 10, 2021, from

https://doi.org/10.1097/naq.0b013e31827514f4

Williams, T., Baker, K., Evans, L., Lucatorto, M., Moss, E., O’Sullivan, A., Seifert, P., Siek, T.,

Thomas, T., & Zittel, B. (2016). Registered Nurses as Professionals, Advocates,

Innovators, and Collaborative Leaders: Executive Summary.
The Online Journal of Issues in Nursing,
21(3). Retrieved January 10, 2021, from

https://doi.org/10.3912/OJIN.Vol21No03Man05

FEEDBACK from the evaluator what needs to be corrected.

A1. Explanation of Role No evident The submission discusses the use of telemedicine in an Emergency Department. The response is missing a plausible explanation of the innovative nurse leader role that is well-supported by a scholarly reference.

A2a. Organizational Characteristics Not Evident The submission briefly mentions how the emergency room serves as a trauma center as well as primary care services. The response does not plausibly describe organizational characteristics of the CoP, including type, setting, structure, and services provided.

A2b. Demographics not evident The submission succinctly explains how 20% of population is uninsured. The response does not clearly summarize the demographic characteristics of the population served that is effectively supported with quantitative and qualitative data.

A2c. Team Member Roles not evident The submission shares how two medical caretakers and one emergency room doctor work in the Emergency Department. The response is insufficient because it does not accurately describe informal and formal team member roles.

A2d. Shared Team Values not evident The submission shares how two medical caretakers and one emergency room doctor work in the Emergency Department. The response is missing a summary of the shared team values within the organization and the team that is supported by real examples. 

A4. Alignment to Strategic Initiatives not evident  The submission discusses the history and benefits of telemedicine. The response does not plausibly align the proposed innovation with other specific professional, regulatory, or governmental strategic initiatives.

A6. Innovation Goal not evident The submission aims to reduce the number of negative outcomes from Acute Coronary Syndrome by utilizing telemedicine service. The SMART+C goal is not fully applied and is missing C (Challenging) portion.

B1. Scholarly Sources not evident The submission provides a nicely developed evidence critique table. Source 4 is missing an APA formatted scholarly reference with a DOI or retrievable link and cannot be evaluated.

B2. Presentations of Findings not evident The submission provides a nicely developed evidence critique table. Source 4 is missing an APA formatted scholarly reference with a DOI or retrievable link and cannot be evaluated.

B3. Evidence Strength and Hierarchy not evident The submission provides a nicely developed evidence critique table. Four scholarly sources are accurately assessed for evidence strength and hierarchy. Source 4 is missing an APA formatted scholarly reference with a DOI or retrievable link and cannot be evaluated.

C2. Data Examples not evident The submission discusses how big data can be used to support the proposed innovation. The response does not provide examples of big and small data that are practical and relevant to the current healthcare setting.