INTRODUCTION
Nursing informatic nurses must commonly read ERDs to determine the data contained in a table and to determine which data fields are in which table. Reading ERDs can also help determine dependencies between data fields. This information is crucial in understanding which table to add a data field into and which tables contain the data needed for a dashboard or report.
For this assessment, you will construct an ERD for a database management system (DBMS) using a diagramming application/digital drawing tool. Instructions for creating your free Lucidchart account are provided in the Supporting Documents below. If you are using a different diagramming application/drawing tool, you will need to find and use instructions for the tool you select. Your ERD will contain one parent table, one child table, and three lookup tables. After you have constructed your ERD, you will reflect on your experience in a written paper.
SCENARIO
You are a nurse informatics specialist at a regional health center in the Midwest where the emergency department (ED) has recently experienced an increased number of asthma-related symptom complaints from school-age children. An ED pediatric nurse practitioner noted a pattern in these complaints that indicated asthma symptoms were not being well managed. To address this community-wide issue, an interprofessional team of ED providers, community pediatricians, nurses, and health educators were called to brainstorm ideas.
The team is currently developing an asthma intervention program for children with asthma. To measure the effectiveness of their work, the team decided to collect and analyze data to establish a baseline before implementing the new asthma intervention program. This baseline data was collected using a paper-based data-collection form, which was distributed to the parents of all children attending schools in the county. This initial form was designed to gather information on personal identifying factors, demographics, relevant medical history, and asthma symptoms. A follow-up survey will be triggered by a clinical decision support (CDS) alert the team plans to put into the health information system. By establishing a baseline, the team can compare the initial data to additional data collected in the post-implementation survey.
The team received more than 500 responses to the initial survey and realized the team did not have the knowledge, skills, or abilities to manage the data for this project. Team members have come to you for help with designing a system to collect, manage, and analyze survey data. You have been given the data-collection survey form and have been instructed to create a DBMS to store this initial data set and the follow-up survey data. The team then wants you to create a CDS alert to support this project in the ED’s health information system.
You reviewed the form and created the attached “Code Sheet for ERD” with all the data elements on the form. On the code sheet, you clustered the data elements into tables. You determined there will be one parent table that contains the patient’s personal identifying information and demographics. You have also determined there will be one child table that will contain the repeated survey data—pre- and post-intervention. You also noted that the system will need three lookup tables for drop-down boxes. By creating the correct relationship between the parent and child tables, it will be possible to conduct statistical analyses that will determine the effectiveness of the educational program by comparing pre-intervention survey responses to post-intervention responses.
After clustering data elements and determining relationships, you will create a logical data model of the database. To create the data model, you will translate the data field names on the attached “Code Sheet for ERD” into an ERD through your drawing tool. Using the table names and field names, you will attach the tables together with appropriate crow’s foot notation, indicating cardinality or ordinality,) between the tables.
REQUIREMENTS
For this assessment you will create a logical ERD using a diagramming application/digital drawing tool, using the “Code Sheet for ERD” supporting document. You will then write a paper reflecting on your experience.
A. Create a logical ERD with a parent table, a child table, and three lookup tables by doing the following:
1. Create one parent table that incorporates the following components:
• table name
• primary key
• field names
2. Create one child table that incorporates the following components:
• table name
• primary and foreign keys
• field names
3. Create three lookup tables that each incorporate the following components:
• table names
• correct response options in the lookup table
4. Indicate the relationships between the tables with ordinality and cardinality using crow’s foot notation.
B. Reflect (suggested length of 4–5 pages) on your experiences modeling a database by doing the following:
1. Embed a screenshot of the ERD diagram you created.
2. Explain how your thinking regarding data modeling and database management systems evolved while working on this task, including specific examples.
3. Explain how the survey information could be shared if a patient is seen outside of the health system network by addressing the following points:
a. Explain how interoperability supports the sharing of information between electronic health record systems.
b. Explain a regulatory mechanism that ensures the privacy of protected health information (PHI) when sharing information.
4. Describe a CDS alert that could be created to support this project, and include the following:
• which clinicians would see the alert
• when the CDS alert would appear (i.e., trigger) for a clinician
• what the CDS alert would say
• the reasoning for or against the CDS alert being a hard stop for clinicians
5. Explain how the knowledge and skills you have acquired during this course inform your understanding of the roles and responsibilities of a nurse informaticist in a work setting.
C. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
D. Demonstrate professional communication in the content and presentation of your submission.
