I have an Annotated Bibliography assignment due 14 hrs

What is social interaction  in public spaces and play grounds ?
Does your neighbor’s playground promote active play for the whole family?

1: Evidence-Based Practices for the Design of Inclusive Playgrounds that Support Peer Interactions among Children with All Abilities
Fernelius, C. L. (2018). Evidence-based practices for the design of inclusive playgrounds that support peer interactions among children with all abilities (Doctoral dissertation, Utah State University).
https://www.proquest.com/openview/2f908d94a12ef54683952499004eed16/1?pq-origsite=gscholar&cbl=18750
https://digitalcommons.usu.edu/cgi/viewcontent.cgi?article=7951&context=etd

2: What Is the Relationship between the Neighbourhood Built Environment and Time Spent in Outdoor Play? A Systematic Review

Lambert, A., Vlaar, J., Herrington, S., & Brussoni, M. (2019). What Is the Relationship between the Neighbourhood Built Environment and Time Spent in Outdoor Play? A Systematic Review. International journal of environmental research and public health, 16(20), 3840. https://doi.org/10.3390/ijerph16203840
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6843675/

3: Neighbourhood Factors in Children’s Outdoor Play: A Systematic Literature Review

Visser, K., & Van Aalst, I. (2022). Neighbourhood Factors in Children’s Outdoor Play: A Systematic Literature Review. Tijdschrift voor economische en sociale geografie, 113(1), 80-95.
https://onlinelibrary.wiley.com/doi/full/10.1111/tesg.12505

4: Children’s outdoor playtime, physical activity, and parental perceptions of the neighbourhood environment

Faulkner, G., Mitra, R., Buliung, R., Fusco, C., & Stone, M. (2015). Children’s outdoor playtime, physical activity, and parental perceptions of the neighbourhood environment. International journal of play, 4(1), 84-97.

https://www.tandfonline.com/doi/abs/10.1080/21594937.2015.1017303

https://www.researchgate.net/publication/276178190_Children’s_outdoor_playtime_physical_activity_and_parental_perceptions_of_the_neighbourhood_environment

5: Can universal design support outdoor play, social participation, and inclusion in public playgrounds? A scoping review

Moore, A., Lynch, H., & Boyle, B. (2022). Can universal design support outdoor play, social participation, and inclusion in public playgrounds? A scoping review. Disability and Rehabilitation, 44(13), 3304-3325.

https://www.tandfonline.com/doi/abs/10.1080/09638288.2020.1858353

https://www.researchgate.net/publication/346927277_Can_universal_design_support_outdoor_play_social_participation_and_inclusion_in_public_playgrounds_A_scoping_review

6: Designing public playgrounds for inclusion: a scoping review of grey literature guidelines for Universal Design
Moore, A., Boyle, B., & Lynch, H. (2022). Designing public playgrounds for inclusion: a scoping review of grey literature guidelines for Universal Design. Children’s Geographies, 1-17.

https://www.tandfonline.com/doi/full/10.1080/14733285.2022.2073197

7: The relationship between green space and prosocial behaviour among children and adolescents: A systematic review
Putra, I. G. N. E., Astell-Burt, T., Cliff, D. P., Vella, S. A., John, E. E., & Feng, X. (2020). The relationship between green space and prosocial behaviour among children and adolescents: a systematic review. Frontiers in psychology, 11, 859.

https://core.ac.uk/download/pdf/326030649.pdf

I have an Annotated Bibliography assignment due 14 hrs

Health Care Distribution – Week 6

 Step 1 Read the scenario.
While we would like to think that everyone has equal access to health care, as nurses it is important to consider the reality of how health care is distributed. Identification of distribution patterns contributes to an understanding of barriers to accessing health care that include geographic realities (urban vs. rural) and socio-economic inequities (insured vs. uninsured).
Step 2 Post a response to the discussion board.
In your post, address the following prompts:

Discuss the meaning of distribution of health care within the health care delivery system.
Discuss how the distribution of health care affects access to care.

Health Care Distribution – Week 6

JOURNALENTRY..docx

JOURNAL ENTRY
Critical reflection on your growth and development during your practicum experience in a clinical setting helps you identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes.
Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum. 
O PREPARE
· Refer to the “Population-Focused Nurse Practitioner Competencies” in the Learning Resources, and consider the quality measures or indicators advanced practice nurses must possess in your specialty.
· Refer to your “Clinical Skills Self-Assessment Form” you submitted in Week 1 and consider your strengths and opportunities for improvement.
· Refer to your Patient Log in Meditrek; consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.
In 450–500 words, address the following:
Learning From Experiences
· Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
· Reflect on the 3 most challenging patients you encountered during the practicum experience. What was most challenging about each? 
· What did you learn from this experience? 
· What resources were available?
· What evidence-based practice did you use for the patients?
· What would you do differently? 
· How are you managing patient flow and volume?  How can you apply your growing skillset to be a social change agent within your community?
Communicating and Feedback
· Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
· Answer these questions: How am I doing? What is missing? 
·
· Rubric
· PRAC_6675_Week11_Assignment_Rubric

PRAC_6675_Week11_Assignment_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeAssimilation and Synthesis: Content Reflection

50 to >44.0 pts
Excellent
Reflection demonstrates a high level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Insightful and relevant connections are made through contextual explanations and examples.

44 to >39.0 pts
Good
Reflection demonstrates moderate level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Connections are made through explanations and/or examples.

39 to >34.0 pts
Fair
Reflection demonstrates minimal critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Minimal connections are made through explanations and/or examples.

34 to >0 pts
Poor
Reflection lacks critical thinking. Superficial connections are made with key course concepts and resources, and/or assignments.

50 pts

This criterion is linked to a Learning OutcomeAssimilation and Synthesis: Personal Growth

30 to >26.0 pts
Excellent
Expresses solid evidence of reflection on own work. Demonstrates substantial personal growth and awareness of deeper meaning through inferences, well-developed insights, and significant depth in awareness and challenges. Synthesizes current experience into future implications.

26 to >23.0 pts
Good
Expresses moderate evidence of reflection on own work. Demonstrates satisfactory personal growth and awareness through some inferences, insights, and challenges. There is mention of the future implications of student’s current experience.

23 to >20.0 pts
Fair
Expresses minimal evidence of reflection on own work. Demonstrates less than adequate personal growth and awareness through limited or simplistic inferences made, insights, and/or challenges that are not well developed. There is minimal thought of future implications of student’s current experience.

20 to >0 pts
Poor
Expresses inadequate evidence of reflection on own work. Personal growth and awareness are not evident and/or demonstrate an impersonal experience. Lacks personal insights, challenges, inferences, and/or future implications are overlooked.

30 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting

15 to >13.0 pts
Excellent
Well written and clearly organized using standard English; characterized by elements of a strong writing style; and basically free from grammar, punctuation, usage, and spelling errors.

13 to >11.0 pts
Good
Above average writing style and logically organized using standard English with minor errors in grammar, punctuation, usage, and spelling.

11 to >10.0 pts
Fair
Average writing style that is sometimes unclear and/or with some errors in grammar, punctuation, usage, and spelling.

10 to >0 pts
Poor
oor writing style lacking in standard English, clarity, language used, and/or contains frequent errors in grammar, punctuation, usage, and spelling. Needs work.

15 pts

This criterion is linked to a Learning OutcomeAPA

5 to >4.0 pts
Excellent
Contains no APA errors.

4 to >3.5 pts
Good
Contains 1–2 APA errors.

3.5 to >3.0 pts
Fair
Contains 3–5 APA errors.

3 to >0 pts
Poor
Contains more than 5 APA errors.

5 pts

Total Points: 100

·
JOURNALENTRY..docx

Net Present Value and Internal Return Rate

  Please do the Problem 10-19A  that’s attached the create a PowerPoint Presentation
Attached is Problems Series A section 10-19A of Ch. 10, Planning for Capital Investments of Fundamental Managerial Accounting Concepts. This scenario puts you at the task as a Senior Accountant for Donovan Enterprises to identify the preferred method and best investment opportunity for the company.
Create a PowerPoint presentation showing the comparison of the net present value approach with the internal rate of return approach calculated above. Complete the following in your presentation:

Analyze the results of the net present value calculations and the significance of these results, supported with examples. (This means to explain in Writing what the results mean to you or the business management.)
Determine which project should be adopted based on the net present value approach and provide rationale for your decision.  (This means to explain in Writing what the results mean to you or the business management.)
Analyze the results of the internal rate of return calculation and the significance of these results, supported with examples.  (This means to explain in Writing what the results mean to you or the business management.)
Determine which project should be adopted based on the internal rate of return approach and provide rationale for your decision.  (This means to explain in Writing what the results mean to you or the business management, one sentence will not earn many points.)
Determine the preferred method in the given circumstances and provide reasoning and details to support the method selected.  (This means to explain in Writing what the results mean to you or the business management, one sentence will not earn many points.)
Synthesize results of analyses and computations to determine the best investment opportunity to recommend to the president of Donovan Enterprises.  (This means to explain in Writing what the results mean to you or the business management, one sentence will not earn many points.)

Just a heads up, you will need to address these questions in more than a bullet point in your Presentation. If you provide a presentation with bullet points only and no verbiage, you will not earn full points for the assignment. You can always provide a written paper along with your presentation if you like or, include your explanations within your PowerPoint presentation.
Cite References and sources
Net Present Value and Internal Return Rate

Problem10-19A.docx

Problem 10-19A Using net present value and internal rate of return to evaluate investment opportunities

Dwight Donovan, the president of Donovan Enterprises, is considering two investment opportunities. Because of limited resources, he will be able to invest in only one of them. Project A is to purchase a machine that will enable factory automation; the machine is expected to have a useful life of four years and no salvage value.
Project B supports a training program that will improve the skills of employees operating the current equipment. Initial cash expenditures for Project A are $400,000 and for Project B are $ 160,000. The annual expected cash inflows are $ 126,000 for Project A and $52,800 for Project B. Both investments are expected to provide cash flow benefits for the next four years. Donovan Enterprises' desired rate of return is 8 percent

Required
a. Compute the net present value of each project. Which project should be adopted based on the net present value
approach? Round your computations to two decimal points.

b. Compute the approximate internal rate of return of each project. Which one should be adopted based on the internal rate of return approach? Round your rates to six decimal points

c. Compare the net present value approach with the internal rate of return approach. Which method is better in the given circumstances? Why?
Problem10-19A.docx

TSPost.docx

Determining Fairness of Targeted Recruitment
            Targeted recruitment is legal when laws are followed during the application of hiring employees. Fairness is a safe baseline to consider when connecting the responsibilities of staffing with the marketing efforts to recruit. Several concerns of bias arise when considering applying for targeted recruitment. Therefore, companies must analyze processes and apply appropriate reviews and standards matching staffing and recruitment to legal requirements. Recruitment begins with determining the best approach to reach the best applicants.
Purpose & Fairness
            Open recruitment lends a broad outreach to potential employees. Efforts to market to the public connect with all members within the specified channel to reveal KSAOs connected with the employer's needs (Judge & Kammeyer-Mueller, 2020). However, targeted recruiting works to link directly with specific segments within the larger pool of candidates. These efforts dial in on specific characteristics that support the needed functions within the organization.
            The subjects of person-environment fit (PEF) person-organization fit (POF), and person-job fit (PJF) determine the overall success of a business (Huang, 2022). Companies that have successfully identified foundational needs effectively target employees that match these KSAOs. Targeting potential recruits does not violate fairness or ethics so long as the company does not limit the hiring of candidates outside the target audience (MacKay & Saylor, 2020; Lev 19:13, NIV, 2022).
Concerns of Bias
            Some candidate categories that develop into biased/neglected recruitment are passive job seekers and employment discouraged (Judge & Kammeyer-Mueller, 2020). Targeted recruiting may have harmful side effects of improper hiring techniques for those outside the target audience given the direct efforts to recruit in specific categories. While the clear targeting in an advertisement is not unfair (to meet business needs), preventing fair opportunity at employment is unjust and illegal (Raghavan et al., 2020; Psa, 106:3, NIV, 2022).
Best Practices of Targeted Recruitment
            Organizations need employees with specific KSAOs to perform job tasks and business needs (Judge & Kammeyer-Mueller, 2020). Targeting the most qualified individuals begins with connecting in the channels where the audience exists in larger numbers. A company needs to communicate the PEF and PJF of the target audience to entice applicants to apply (Huang, 2022). Targeted recruiting requires analysis of employee and recruitment data reflecting the needs of the organization and KSAOs matching a unique and enjoyable PEF.
            However, the analysis must also match a non-bias, careful consideration of all potential employees (Raghavan et al., 2020). Any form of discrimination is both illegal and creates a vulnerability within company staffing. A target recruiting effort will set the standard across the employment program. Connecting with a specific group will result in achieving the desired applicant base but needs healthy emphasis on all available groups with the recruitment guide.
Recommendations & Conclusion
            A company must form a recruitment guide detailing all the processes for data analytics and efforts to apply marketing toward a target audience (Judge & Kammeyer-Mueller, 2020). Management must use caution when relating, solely to a target recruitment strategy. Fairness is a safe measure to ensure ethical foundations are applied equally when hiring new employees. The perception of unequal treatment will foster several problems for a company (legally and culturally). Target recruiting is not illegal and can develop many successful candidates. However, management will need to carefully consider the laws and proper application of hiring to ensure everyone is treated justly.
References
Huang, J. C. (2022). Effects of person-organization fit objective feedback and subjective perception on organizational attractiveness in online recruitment. Personnel Review, 51(4), 1262-1276.  .
Judge, T. A., & Kammeyer-Mueller, J. D. (2020). Staffing organizations (10th ed.). Burr Ridge, IL: McGraw Hill. Textbook ISBN: 9781260703054.
MacKay, D., & Saylor, K. W. (2020). Four faces of fair subject selection. The American Journal of Bioethics, 20(2), 5-19.  .
New International Version (NIV) Bible. (2022). BibleGateway.com.  .
Raghavan, M., Barocas, S., Kleinberg, J., & Levy, K. (2020). Mitigating bias in algorithmic hiring: Evaluating claims and practices. Proceedings of the 2020 conference on fairness, accountability, and transparency (pp. 469-481). 
TSPost.docx

Summarize the proposed change and your comparative analysis in a 4-5 page report.

Propose a change to one aspect of your local or regional health care system or program that would improve outcomes. Then, conduct a comparative analysis of other, non-U.S. health care systems, focusing on the proposed change. Summarize the proposed change and your comparative analysis in a 4-5 page report.RUBRIC
Competency 1: Identify the challenges and opportunities facing health care. 

Identify an aspect of a local or regional health care system or program that should be a focus for change.

Competency 2: Compare the effects of different health care finance models and policy frameworks on resources and patient outcomes. 

Define desirable outcomes, including who will pay for care and factors limiting achievement of those outcomes.
Analyze two non-U.S. health care systems or programs that offer insight into a proposed change for a health care system or program in the United States.

Competency 3: Evaluate the positive and negative influences of leaders on health care processes and outcomes. 

Determine the financial and health implications of makingand not makingproposed changes to a health care system or program.

Competency 4: Develop proactive strategies to change the culture of the organization by incorporating evidence-based practices. 

Explain why specific changes will lead to improved outcomes.

Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style consistent with applicable organizational, professional, and scholarly standards. 

Write clearly and concisely in a logically coherent and appropriate form and style.
Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

Summarize the proposed change and your comparative analysis in a 4-5 page report.

Paragraph

Read the prompts on page 69 of your textbook. Choose one and write one paragraph about it. Use at least 10 verbs in the Present Continuous and The Future Tenses. Write at least 10 sentences
1. Write about the differences in generations and their use of technology. Use examples from your own life or the lives of people you know.
OR
2. Interview a retired person. What is this person doing with his or her life now? What are this person’s plans for the future.
Paragraph

NURS_FPX6218_ErgleKathy_Assessment1_Attempt1.docx.pdf

1
Assessment 1: Proposing Evidence-Based Change
Kathy Ergle
Capella University
NURS-FPX 6218: Leading the Future of Health Care
Prof. Donna Ryan
November 09, 2022

Proposing Evidence-Based Change
A healthcare system is crucial to improve health, enhance the quality of life, and prevent
diseases. A good health system ensures timely access to effective care delivery. It integrates
clarity in roles, better information transfer, and best care collaboration for better health outcomes
(Kruk et al., 2018). In this assessment, I will propose a change in the local healthcare system to
improve care quality for people struggling with mental health issues. Moreover, the change will
be compared with two non-U.S. healthcare systems.
Executive Summary
Proposed Change
After heart and cancer problems, medication errors are the most common cause of high
death rates in the United States. Most errors occur due to faulty or ineffective processes in a
healthcare system (Carver & Hipskind, 2019). For example, the local health facility where I
work depends on paper records for patient medical information, rising the chances of medical
errors. Two other challenges that the healthcare system is facing due to paper records are
to the security of the medical records, poor decision-making, and ineffective information storage
(Honavar, 2020). All these challenges make up care process for patients unsafe. According to the
World Health Organization (WHO), unsafe care is one of the ten worldwide leading causes of
disability and mortality (World Health Organization, 2019). Therefore, the aspect of the local
healthcare system to paper records should be changed. The focus for change in the local
and regional healthcare system is the utilization of an electronic medical record (EMR) system
instead of paper records.
The expectation from the EMR system is to reduce medication errors, reduce time spent
on data recording, and improve information storage, decision-making, and security of medical

records through effective methods of data management (Vaidotas et al., 2019). According to the
expectations, the EMR system will reduce medical errors occurring due to manual medical
records. Also, the system will help providers store information in one place, and access the
complete medical history of patients without dual tests and waste of time, leading to effective
information and decision-making (Honavar, 2020). Moreover, the EMR system is encrypted and
provides access to only authorized stakeholders like relevant health providers and patients which
results in a secure medical record (Hodgson et al., 2021). Study shows that the use of EMR
reduced data recording time by 24.5% and 23.5% with equipment at the bedside and central
location, respectively (Vaidotas et al., 2019).
Desired Outcomes
The desired outcomes of the EMR system will be:
1. Decline in medical errors
2. Lesser time spent on data recording
3. Effective information storage and decision-making
4. Secure medical records
These outcomes are defined as the desired consequences of using the EMR system in the
local healthcare system. The rationale behind this definition is the evidence-based results of the
EMR system that are associated with a reduction in medical errors, effective information storage,
decision-making, and security of the medical record. The reduction in medical errors by using
EMR is supported by a comparative study conducted by Vaidotas et al. (2019). They compared
the occurrence of medication errors in two emergency departments and two other units of a
health setting. Two were using electronic records while the other was dependent on handwritten

records. The results showed lesser medication errors and improved patient safety in the
departments using electronic records.
The evidence by Hodgson et al. (2021) supports the enhancement of clinical factors and
patient outcomes, including the integration of patient information in one place and improved
decision-making regarding patient health by using an EMR system. Likewise, the research by
Chen et al. (2020) supports the effective information storage and security of medical records with
the implementation of EMR. According to the authors, cloud computing technology used in
EMR can store a large amount of health data in one place which makes it easier for providers to
store and access the information effectively. Moreover, the research asserts that the system is
secured with certain encryptions; its software is HIPAA compliant, and avoids access to
unauthorized personnel, leading to the security of patient medical records.
To implement the EMR system, eligible providers and healthcare systems are provided
with incentives by Medicaid and Medicare Services. Moreover, the Office of the National
Coordinator for Health Information Technology (ONC) pays local and regional systems of the
country to use the EMR system (HealthIT, n.d.).
Limiting Factors
There can be some factors that can limit the achievement of the desired outcomes.
1. Training issues for the technological use of EMR exist in some health settings.
For instance, lack of adequate training hinders the proper use of EMR by
physicians. They do not know how to use the advanced features of EMR due to
poor vendor training. Thus, better outcomes are not achieved properly. (Rahal et
al., 2021).

2. Resistance to the use of EMR at the providers’ level. Physicians sometimes find
the use of new technology complex and challenging which makes them avoid the
technology (Singh et al., 2020).
Healthcare System Comparative Analysis
The two non-U.S. systems selected for the comparative analysis are the Australian and
United Kingdom (UK) healthcare systems.
The Australian healthcare system (acute and primary health settings) uses an electronic
health record system to reduce medication errors, and improve information storage, decision-
making, and record security (Schofield et al., 2019). The usability of the system depends upon
the health sector and the features being used. For example, the positive experience of health
providers in decision-making is more positive in hospitals while in the primary care sector the
providers have positive EMR experience regarding easy storage of information and reduction in
errors (Lloyd et al., 2021). Studies show that medication errors after the implementation of the
EMR system in an Australian healthcare system rose to the highest level (44.6%) initially due to
lack of technology use. But after 1.5 years, the percentage of errors reduced below 7.3%. The
type of errors varies as per job role. The healthcare system can use the study to promote
providers’ training to effectively use the EHR system for the reduction in errors right after the
implementation of the system (Qian et al., 2020).
In the UK, the healthcare system uses the electronic patient record system to improve the
storage and access of patient information (McMillan et al., 2018). Study shows that the
information is securely gathered in a digital form by using the EHR system. Also, it reduces the
time for documentation. The healthcare system encourages the engagement of health providers in
improving usability processes to improve the system use (Tapuria et al., 2021). The use of

electronic medical records (known as NHS care records) in the healthcare system of the UK
reduces some types of medication errors. The study suggests system optimization to reduce
medication errors to a larger percentage (Slight et al., 2019).
Lessons from Both Systems
The lessons that I learned from studying both systems provide indicators for the US
healthcare system. First, the system should organize training of health providers and increase
their involvement in the usability of the EMR system to reduce difficulty in using the system.
Second, the system should be optimized according to departmental needs to reduce medication
errors of all kinds.
The Rationale for the Proposed Change
Proposed Change leading to Positive Outcomes
The use of the EMR system in the U.S. healthcare system will improve medication errors,
information storage, and security of records because it helps providers manage patient data using
online technology (Adane et al., 2019). The process of data management through EMR is much
easier than manual data recording (paperwork). In paper documentation, keeping patient records
in one place is difficult and can cause human errors. In the case of online data recording chances
of documentation errors are, reduce and providers can easily access the medical history of
patients to know about hisher allergies. Thus, the possible errors to patient data and
health information can be reduced, improving outcomes (Vaidotas et al., 2019). Second, the use
of EMR reduces the time for paper documentation, gathers all patient medical history in one
place, and provides easy and timely access to health information. It makes the storage of
information effective and helps providers in decision-making regarding continuity of care
(Honavar, 2020). Moreover, the researchers showed that encryption methods in EMR make the

data of patients secure and safe from unauthorized access (Chen et al., 2020). The evidence
discussed above supports the rationale behind the proposed change and its contribution to
improved outcomes. The expectations to the use of EMR in the existing healthcare
system are reasonable as they are supported by credible evidence. The associated benefits of
using EMR are also evidence-based which is why the change within the system will be
completely practical.
Financial and Health Implications
The use of EMR will reduce the financial burden on hospitals in certain areas such as
administrative, nursing, and documentation costs. One study also showed an increase in
reimbursement by using the EMR system (Tsai et al., 2020). Another study showed the short-
term and long-term effects of implementing EMR. The effects include an increase in the cost of
software updates and maintenance. But the cost to paper documentation and staff in data
records decreased. Moreover, billing revenue increased with the use of the implementation of
EMR. According to the study, other health implications of using EMR were a reduction in
medication errors, increased confidentiality of data, better storage of information, increased
adherence to guidelines, and improved health outcomes (Gopidasan et al., 2022).
The implications of not making the proposed change may include the risk of medication
errors, lesser efficient decision-making regarding patient care, and risks associated with the
security of patient data. Poor care quality can increase readmissions and cost implications for
individuals and communities (Schopf et al., 2019). The United States government has to spend
more than $40 billion on patients affected by medication errors each year (Tariq et al., 2022).

Cost-Benefit Analysis
The overall spent cost of the implementation of EMR was $31 billion till 2018. It is now
considered a necessity for better patient outcomes. In 2019, the cost went to $27 billion which
highlights the benefits of EMR usage in the settings (Nguyen et al., 2022). The cost-benefit
analysis in different health settings showed a positive impact of EMR implementation on hospital
revenue, positive net financial benefit after 3 years, and benefits for the pharmaceutical market.
Other advantages included improvement in population health and patient experience (Nguyen et
al., 2022).
Conclusion
The use of the EMR system in the U.S. healthcare systems can reduce medication errors
and improve information storage, decision-making, and security of medical records. The
comparative analysis of two non-U.S, healthcare systems provide lessons to EMR use in
U.S. health settings. Also, the financial and health implications of making and not making the
proposed change are discussed in the research work.

Appendix
Table 1: Health Care System Comparative Analysis
OutcomesHealth Care
System of Australia
Health Care
System of Norway
Health Care
System of U. SReduction in medical errors
Long-term reduction
in medication errors
with the use of EMR
Reduced come kinds
of medical errors
Increased chances of
medical errors due to
paper documentation
Effective informationstorage and decision-making
Positive experience
with EMR regarding
easy storage of
information and
decision-making
Improved
information storage
and decision-making
with the use of EMR
Ineffective way of
information storage
and poor decision-
making while using
paper documentation
Secure medical records
The positive
experience of
keeping records safe
with EMR
Secure information
collection with EMR
Patient data on
papers is not secure
and anyone can
access the
information

10
References
Adane, K., Gizachew, M., & Kendie, S. (2019). The role of medical data in efficient patient care
delivery: A review. Risk Management and Healthcare Policy, Volume 12(12), 67–73.
https://doi.org/10.2147/rmhp. s179259
Carver, N., & Hipskind, J. E. (2019, April 28). Medical error. Nih.gov; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK430763/
Chen, C.-L., Huang, P.-T., Deng, Y.-Y., Chen, H.-C., & Wang, Y.-C. (2020). A secure electronic
medical record authorization system for smart device application in cloud computing
environments. Human-Centric Computing and Information Sciences, 10(1).
https://doi.org/ 10.1186/s13673-020-00221-1
Gopidasan, B., Amanullah, S., & Adebowale, A. (2022). Electronic medical records – A review
of cost-effectiveness, efficiency, quality of care, and usability. Journal of Psychiatry
Spectrum, 1(2), 76. https://doi.org/ 10.4103/jopsys.jopsys_17_22
HealthIT. (n.d.). Is federal financial support available for implementing electronic health records
(EHRs)? | HealthIT.gov. Www.healthit.gov. Retrieved April 12, 2021, from
https://www.healthit.gov/faq/federal-financial-support-available-implementing-
electronic-health-records-ehrs
Hodgson, T., Burton-Jones, A., Donovan, R., & Sullivan, C. (2021). The role of electronic
medical records in reducing unwarranted clinical variation in acute health care:
Systematic review. JMIR Medical Informatics, 9(11), e30432.
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Proposing Evidence-Based Change
Executive Summary

Proposed Change
Desired Outcomes
Limiting Factors

Healthcare System Comparative Analysis

Lessons from Both Systems

The Rationale for the Proposed Change

Proposed Change leading to Positive Outcomes
Financial and Health Implications
Cost-Benefit Analysis

Conclusion
Appendix
References

NURS_FPX6218_ErgleKathy_Assessment1_Attempt1.docx.pdf