Patricia Hinton Walker is a coach, consultant, academician and author. As a former executive and faculty member in more than one university, she currently focuses much of her energy coaching executives, students and faculty interested in publishing, coaches seeking advanced certification and all individuals seeking improved health and wellness. She also continues to publish topics related to innovation, informatics, and leadership in health, education and coaching spaces! Phone: 240-426-8268
Early hospital information systems (HISs) placed computers at nursing stations, and the passage o... more Early hospital information systems (HISs) placed computers at nursing stations, and the passage of Medicare in 1965 set reimbursement rules that required documentation, first met by nurses using precoded cards and forms. In the 1970s, interactive terminals with visual displays became available; in the 1980s, microcomputers custom-tailored for nursing functions began to be installed at the patient’s bedside. Handheld portable devices began to appear for use at the point of care, and hospitals began to use bar codes for identification purposes. Nurses became increasingly involved in specifying information requirements for nursing services. In the 1980s, nursing information systems (NISs) were probably the most widely used HIS subsystem. They were used for bed assignment and control, nurse staffing recommendations based on patient classification systems, quality assurance programs, nursing care planning, and decision support. The 1980s also saw advances toward implementation of the Nursing Minimum Data Set and development of nursing education programs. In the 1990s, the American Nurses Association published documents defining the scope and standards of nursing informatics practice, and the American Nurses Credentialing Center had established a certification in nursing informatics as a practice specialty. In the 2000s, an international nursing terminology summit brought nurses and standards experts together to integrate nursing concepts and map nursing interface terminologies to SNOMED-CT, ultimately creating what in 2007 became an international reference terminology standard. The 2000s also saw the establishment of the Alliance of Nursing Informatics (ANI) and TIGER (Technology Informatics Guiding Education Reform); both continue to be active today.
The individual and collective discussions of the patient safety issue in the United States have m... more The individual and collective discussions of the patient safety issue in the United States have mounted from a low roar to a deafening din in the past 10 years. In this chapter the authors (1) discuss the context of patient safety over the past decade and the federal response to the problem, (2) briefly present Reason’s theory of human error, which frames much of the safety research, and (3) provide a glossary of terms.
Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a numb... more Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a number of military medical facilities throughout the Department of Defense (DoD). It has been used with anecdotal published positive impact with warriors experiencing polytrauma, post-traumatic stress disorder, and traumatic brain injury. It has also been effectively used to treat warriors with muscle and back pain from carrying heavy combat equipment in austere environments. This article highlights the history within the DoD related to the need for nonpharmacologic/opioid pain management across the continuum of care from combat situations, during evacuation, and throughout recovery and rehabilitation. The article describes the history of auricular acupuncture and details implementation procedures. Training is necessary and partially funded through DoD and Veteran's Administration (VA) internal Joint Incentive Funds grants between the DoD and the VA for multidisciplinary teams as part of a larger initiative related to the recommendations from the DoD Army Surgeon General's Pain Management Task Force. Finally, Uniformed Services University of the Health Sciences School of Medicine and Graduate School of Nursing faculty members present how this interdisciplinary training is currently being integrated into both schools for physicians and advanced practice nurses at the Uniformed Services University of the Health Sciences. Current and future research challenges and progress related to the use of acupuncture are also presented.
Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a numb... more Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a number of military medical facilities throughout the Department of Defense (DoD). It has been used with anecdotal published positive impact with warriors experiencing polytrauma, post-traumatic stress disorder, and traumatic brain injury. It has also been effectively used to treat warriors with muscle and back pain from carrying heavy combat equipment in austere environments. This article highlights the history within the DoD related to the need for nonpharmacologic/opioid pain management across the continuum of care from combat situations, during evacuation, and throughout recovery and rehabilitation. The article describes the history of auricular acupuncture and details implementation procedures. Training is necessary and partially funded through DoD and Veteran's Administration (VA) internal Joint Incentive Funds grants between the DoD and the VA for multidisciplinary teams as part of a larger initiative related to the recommendations from the DoD Army Surgeon General's Pain Management Task Force. Finally, Uniformed Services University of the Health Sciences School of Medicine and Graduate School of Nursing faculty members present how this interdisciplinary training is currently being integrated into both schools for physicians and advanced practice nurses at the Uniformed Services University of the Health Sciences. Current and future research challenges and progress related to the use of acupuncture are also presented.
Although collaboration is not a new idea, new opportunities for collaboration exist in this 21st ... more Although collaboration is not a new idea, new opportunities for collaboration exist in this 21st century global-knowledge and information-driven economy. Technology has reduced time and space while enhancing communication, thereby opening the possibilities of exploring new boundaries in the area of interdisciplinary collaboration. The goal of this article is to assist leaders in changing the language of organizations so that new technologies can enhance collaboration. A systematic approach for leaders to use in assisting assist persons, groups, and organizations in integrating new technologies into their organizations locally and globally is offered, along with a summary of new, and several established, collaboration techniques.
Several of AHRQ's priority areas ... more Several of AHRQ's priority areas including disease prevention, health promotion, primary care, quality of care, service delivery, and patient safety are particularly relevant to nurse researchers. With much national attention focused on nursing-related issues such as staff shortages, training, mandatory overtime, working conditions, and autonomy, it is mandatory that nursing research be conducted to inform healthcare delivery and policy. Nurses also need to contribute to the health services literature so that an even balance of discipline perspective is represented. AHRQ's mandate is represented by the slogan "quality research for quality health care." Although our understanding has expanded of contributors to and determinants of evidence-based practice and the relationship between clinical care and improved outcomes, we have much to learn. Appreciating how and which components of nursing care influence patient outcomes represents an essential area of research in need of development. While clarifying nursing contributions to improved outcomes is not the sole purview of nurse researchers, it is plausible to assume that a clinical background in nursing combined with strong methodological skills can help policy makers and health system leaders understand how nurses can most effectively contribute to outcomes and quality improvement. AHRQ is clearly interested in capacity building of researchers from all relevant disciplines. Nurses, the largest provider of healthcare, need to build capacity and develop a much stronger presence in the health services research community of scholars.
Increasingly nursing will need to prove the cost effectiveness of alternative models of care. A c... more Increasingly nursing will need to prove the cost effectiveness of alternative models of care. A cost-effectiveness analysis, using a decision analysis format, compared a birthing center to a hospital for low-risk deliveries. Results indicate that a birth center is a cost-effective model of nursing care.
Journal of the American Psychiatric Nurses Association, 1995
ABSTRACT Nursing informatics combines computer science, information science, and nursing science ... more ABSTRACT Nursing informatics combines computer science, information science, and nursing science into a new specialty that offers opportunities and challenges for all nurses. In the information age, nurses will need to build their knowledge and skills to famil iarize themselves with the technology, resources such as the Internet, and software for databases, spreadsheets, projects, and graphics. Nurses must be able to partici pate actively when institutions choose information systems so that nursing's inter ests will be considered. (J AM PSYCHIATR NURSES Assoc [1995]. 1, 22-29)
In the context of market-driven health care reform, interest in cost and quality outcomes has inc... more In the context of market-driven health care reform, interest in cost and quality outcomes has increased. Quality, as defined by Donabedian, includes assessment of structure, process, and outcomes. However, the definition of quality in health care must be expanded to include the expectations and opinions of patients, their representatives, and society. The purpose of this article is to examine the outcome variable of costs in a specific nursing practice setting. Cost is frequently defined as the judicious use of resources consumed by structures and processes of care. This article presents activity-based costing methodology and results of a cost study of primary care and mental health services provided by advanced practice nurses (APNs) in a school-based health center. The application of the methods and outcomes of this pilot study has significant implications for the delivery of health care by APNs in a variety of settings, including community nursing centers, freestanding birthing centers, and rural and urban neighborhood centers. Because much of the health care delivered by APNs in these community-based settings includes health promotion, screening, counseling, and anticipatory guidance, it is important to explore methods such as activity-based costing to identify actual costs of care (versus charges) in emerging community-based practices where primary care is delivered by APNs.
The individual and collective discussions of the patient safety issue in the United States have m... more The individual and collective discussions of the patient safety issue in the United States have mounted from a low roar to a deafening din in the past 10 years. In this chapter the authors (1) discuss the context of patient safety over the past decade and the federal response to the problem, (2) briefly present Reason's theory of human error, which frames much of the safety research, and (3) provide a glossary of terms.
Early hospital information systems (HISs) placed computers at nursing stations, and the passage o... more Early hospital information systems (HISs) placed computers at nursing stations, and the passage of Medicare in 1965 set reimbursement rules that required documentation, first met by nurses using precoded cards and forms. In the 1970s, interactive terminals with visual displays became available; in the 1980s, microcomputers custom-tailored for nursing functions began to be installed at the patient’s bedside. Handheld portable devices began to appear for use at the point of care, and hospitals began to use bar codes for identification purposes. Nurses became increasingly involved in specifying information requirements for nursing services. In the 1980s, nursing information systems (NISs) were probably the most widely used HIS subsystem. They were used for bed assignment and control, nurse staffing recommendations based on patient classification systems, quality assurance programs, nursing care planning, and decision support. The 1980s also saw advances toward implementation of the Nursing Minimum Data Set and development of nursing education programs. In the 1990s, the American Nurses Association published documents defining the scope and standards of nursing informatics practice, and the American Nurses Credentialing Center had established a certification in nursing informatics as a practice specialty. In the 2000s, an international nursing terminology summit brought nurses and standards experts together to integrate nursing concepts and map nursing interface terminologies to SNOMED-CT, ultimately creating what in 2007 became an international reference terminology standard. The 2000s also saw the establishment of the Alliance of Nursing Informatics (ANI) and TIGER (Technology Informatics Guiding Education Reform); both continue to be active today.
The individual and collective discussions of the patient safety issue in the United States have m... more The individual and collective discussions of the patient safety issue in the United States have mounted from a low roar to a deafening din in the past 10 years. In this chapter the authors (1) discuss the context of patient safety over the past decade and the federal response to the problem, (2) briefly present Reason’s theory of human error, which frames much of the safety research, and (3) provide a glossary of terms.
Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a numb... more Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a number of military medical facilities throughout the Department of Defense (DoD). It has been used with anecdotal published positive impact with warriors experiencing polytrauma, post-traumatic stress disorder, and traumatic brain injury. It has also been effectively used to treat warriors with muscle and back pain from carrying heavy combat equipment in austere environments. This article highlights the history within the DoD related to the need for nonpharmacologic/opioid pain management across the continuum of care from combat situations, during evacuation, and throughout recovery and rehabilitation. The article describes the history of auricular acupuncture and details implementation procedures. Training is necessary and partially funded through DoD and Veteran's Administration (VA) internal Joint Incentive Funds grants between the DoD and the VA for multidisciplinary teams as part of a larger initiative related to the recommendations from the DoD Army Surgeon General's Pain Management Task Force. Finally, Uniformed Services University of the Health Sciences School of Medicine and Graduate School of Nursing faculty members present how this interdisciplinary training is currently being integrated into both schools for physicians and advanced practice nurses at the Uniformed Services University of the Health Sciences. Current and future research challenges and progress related to the use of acupuncture are also presented.
Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a numb... more Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a number of military medical facilities throughout the Department of Defense (DoD). It has been used with anecdotal published positive impact with warriors experiencing polytrauma, post-traumatic stress disorder, and traumatic brain injury. It has also been effectively used to treat warriors with muscle and back pain from carrying heavy combat equipment in austere environments. This article highlights the history within the DoD related to the need for nonpharmacologic/opioid pain management across the continuum of care from combat situations, during evacuation, and throughout recovery and rehabilitation. The article describes the history of auricular acupuncture and details implementation procedures. Training is necessary and partially funded through DoD and Veteran's Administration (VA) internal Joint Incentive Funds grants between the DoD and the VA for multidisciplinary teams as part of a larger initiative related to the recommendations from the DoD Army Surgeon General's Pain Management Task Force. Finally, Uniformed Services University of the Health Sciences School of Medicine and Graduate School of Nursing faculty members present how this interdisciplinary training is currently being integrated into both schools for physicians and advanced practice nurses at the Uniformed Services University of the Health Sciences. Current and future research challenges and progress related to the use of acupuncture are also presented.
Although collaboration is not a new idea, new opportunities for collaboration exist in this 21st ... more Although collaboration is not a new idea, new opportunities for collaboration exist in this 21st century global-knowledge and information-driven economy. Technology has reduced time and space while enhancing communication, thereby opening the possibilities of exploring new boundaries in the area of interdisciplinary collaboration. The goal of this article is to assist leaders in changing the language of organizations so that new technologies can enhance collaboration. A systematic approach for leaders to use in assisting assist persons, groups, and organizations in integrating new technologies into their organizations locally and globally is offered, along with a summary of new, and several established, collaboration techniques.
Several of AHRQ's priority areas ... more Several of AHRQ's priority areas including disease prevention, health promotion, primary care, quality of care, service delivery, and patient safety are particularly relevant to nurse researchers. With much national attention focused on nursing-related issues such as staff shortages, training, mandatory overtime, working conditions, and autonomy, it is mandatory that nursing research be conducted to inform healthcare delivery and policy. Nurses also need to contribute to the health services literature so that an even balance of discipline perspective is represented. AHRQ's mandate is represented by the slogan "quality research for quality health care." Although our understanding has expanded of contributors to and determinants of evidence-based practice and the relationship between clinical care and improved outcomes, we have much to learn. Appreciating how and which components of nursing care influence patient outcomes represents an essential area of research in need of development. While clarifying nursing contributions to improved outcomes is not the sole purview of nurse researchers, it is plausible to assume that a clinical background in nursing combined with strong methodological skills can help policy makers and health system leaders understand how nurses can most effectively contribute to outcomes and quality improvement. AHRQ is clearly interested in capacity building of researchers from all relevant disciplines. Nurses, the largest provider of healthcare, need to build capacity and develop a much stronger presence in the health services research community of scholars.
Increasingly nursing will need to prove the cost effectiveness of alternative models of care. A c... more Increasingly nursing will need to prove the cost effectiveness of alternative models of care. A cost-effectiveness analysis, using a decision analysis format, compared a birthing center to a hospital for low-risk deliveries. Results indicate that a birth center is a cost-effective model of nursing care.
Journal of the American Psychiatric Nurses Association, 1995
ABSTRACT Nursing informatics combines computer science, information science, and nursing science ... more ABSTRACT Nursing informatics combines computer science, information science, and nursing science into a new specialty that offers opportunities and challenges for all nurses. In the information age, nurses will need to build their knowledge and skills to famil iarize themselves with the technology, resources such as the Internet, and software for databases, spreadsheets, projects, and graphics. Nurses must be able to partici pate actively when institutions choose information systems so that nursing's inter ests will be considered. (J AM PSYCHIATR NURSES Assoc [1995]. 1, 22-29)
In the context of market-driven health care reform, interest in cost and quality outcomes has inc... more In the context of market-driven health care reform, interest in cost and quality outcomes has increased. Quality, as defined by Donabedian, includes assessment of structure, process, and outcomes. However, the definition of quality in health care must be expanded to include the expectations and opinions of patients, their representatives, and society. The purpose of this article is to examine the outcome variable of costs in a specific nursing practice setting. Cost is frequently defined as the judicious use of resources consumed by structures and processes of care. This article presents activity-based costing methodology and results of a cost study of primary care and mental health services provided by advanced practice nurses (APNs) in a school-based health center. The application of the methods and outcomes of this pilot study has significant implications for the delivery of health care by APNs in a variety of settings, including community nursing centers, freestanding birthing centers, and rural and urban neighborhood centers. Because much of the health care delivered by APNs in these community-based settings includes health promotion, screening, counseling, and anticipatory guidance, it is important to explore methods such as activity-based costing to identify actual costs of care (versus charges) in emerging community-based practices where primary care is delivered by APNs.
The individual and collective discussions of the patient safety issue in the United States have m... more The individual and collective discussions of the patient safety issue in the United States have mounted from a low roar to a deafening din in the past 10 years. In this chapter the authors (1) discuss the context of patient safety over the past decade and the federal response to the problem, (2) briefly present Reason's theory of human error, which frames much of the safety research, and (3) provide a glossary of terms.
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Papers by Patricia A . Hinton Walker