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*Note to Reader

Although this was a group project, my participation was the design, development, and delivery of the database itself. I also participated in the writing assignment. The existing paper has been rewritten to represent my voice and experiences.

Running head: USING MICROSOFT ACCESS 2

Using Microsoft Access: Constructing a Database

Steve LeBeau, Melissa Horn, Ashley Shelter, Carla Rosselot, and Jill Martin

Walden University

NURS 6411 Section 2, Information and Knowledge Management

November 9, 2014

USING MICROSOFT ACCESS

Using Microsoft Access: Constructing a Database

Microsoft Access is a relational database management system program used by

consumers to facilitate entering data, manipulate data, and producing reports (Cox & Lambert,

2013). Over the course of ten weeks, Team B has developed a database using Microsoft Access

to aid in entering and storing data needed during shift-to-shift nursing report. The purpose of this

paper is to further explore the development of the database by identifying the output deliverables

as well as the input requirements, the representation of the tables, the description of how

integrity is ensured, the security measures of the database, the successes and failures during

development, and the changes that would be done in the future when creating another database.

Outputs of the Database

Output is defined as the result of inputting data, processing the data into output

information (McGonigle & Mastrian, 2012, p. 28). The output of the database is to locate a

patient’s vital signs in order to give a reliable patient report to the oncoming shift. Examples of

output information include average, mean, maximum and minimum systolic blood pressure,

diastolic blood pressure, oxygen saturation, and heart rate. This database can provide basic

information to the oncoming shift, however, for the purpose of this project vital signs are the

main focus and priority.

Inputs for Desired Output

Inputs refers to the data entered into the database system (McGonigle & Mastrian, 2012).

For this database, several inputs were needed in order to achieve the desired output of retrieving

vital signs. Most importantly, the patient’s unique identifier must be entered into the database to

form the primary key. This unique attribute is the medical record number (MRN) which was

auto-assigned to each patient by Microsoft Access. Other inputs needed so that the data is

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complete are: patients’ last names, patients’ first names, date and time of vital signs, systolic

blood pressures, diastolic blood pressures, mean arterial pressures, oxygen saturations,

intravenous drips, drip rates, and supplemental oxygen by liters.

Tables

Four of the five tables in the database represent an SBAR acronym shift reporting tool

used by nurses during shift-to-shift reports and when reporting to a physician. The four main

tables include the Patients’ Current Situation, the Patients’ Background, the Patients’ Vital Signs

(Assessment), and the Patients’ Response to Treatment. The fifth table titled the SBAR_Link is a

bridge or linking table that stores the foreign keys to the other four tables. The linking table is

critical because the table will form relationships between the other four tables so that they can

communicate between each other using data integrity rules for relationship database

development. Without the bridging table, the other four tables simply become an unstructured

spreadsheet. The tables were generated using Microsoft Access table wizard. Meaningful use

questions were added and data information was manipulated into the correct subject headings.

Drop down screens with check boxes, YES/NO selections, and drug answers were added to

eliminate data redundancies and assure that end users provided correct information.

The format used for inputting patient information was a form entry screen. The vital sign

information is entered into the entry form screen and then populates the main Vital Sign Table.

Once stored in the Vital Sign Table, the user runs a query for that specific patient. Access to the

patient’s Vital Sign Table is accomplished through the SBAR_Link table by using the above

mentioned foreign key relationships formed when building the database. Proper use of data

integrity rules will grant Microsoft Access control of the collected data on any patient thereby

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turning a simple spreadsheet into a powerful relational database that can manipulate data into

structured information.

Queries are used to generate information so that practitioners can make informed

decisions. In our SBAR database, running a query generated the patient’s average, minimum,

and maximum vital signs for the shift ensuring an accurate end-of-shift report. In another query

report a much broader view of the patient’s vital signs for the day is illustrated thereby allowing

the practitioner a more complete view of the patient’s hemodynamics history for the day. For

example, the query was directed to collect and display a patient’s blood pressures and

oxygenation demand for the day. Concurrently, the query also was directed to display the amount

of drips and oxygen used by the patient throughout the day; hour-by-hour. The medications used

and their rates of infusion are present in the drug column. The correct medication has a built in

constraint using a drop down screen to choose the vasopressor or vasodilator. The rate of

administration on the vasoactive drip and oxygen supply correlate with the posted blood

pressures and oxygen saturations to give the prescribing practitioner vital information needed to

make adjustments such as new systolic blood pressure and oxygen parameters while on

vasoactive drips.

Integrity of the Data

Data integrity is satisfied when the established framework in relational databases is

followed using correct entity subject naming conventions and constraints that form a relationship

between the dependent table and the foreign key of the related table (Coronel & Morris, 2015).

Flags, or special codes, can be used to avoid nulls when data cannot be entered. According to

Coronel and Morris (2015) constraints may be placed on a column of the table to prevent

duplicate entries that are not unique or null. When using Microsoft Access, constraints can be

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placed on fields by specifying data types such as AutoNumber or Text (Cox & Lambert, 2013).

For example, in order to ensure the integrity of the database, only one MRN can be assigned to

each patient. The data type for this field was selected as AutoNumber in order to be certain that

each patient would be assigned a unique MRN.

Successes and Failures

While developing the database, there were several hiccups the team faced. Team B had

difficulty identifying the primary keys (PKs) of each table. Because the PKs were not initially

identified correctly, the foreign keys (FKs) were subsequently not assigned appropriately as well.

Once the error were identified, the team successfully assigned the correct PKs to each table

through practice and perseverance. Another issue was managing the queries and achieving a

successful run. The single line query table for vital signs gave the biggest challenge. The

problem was initially caused by running the single line query from the broad-based patient

query. The solution was to run the single line query from the Patient Vital Sign table. Another

problem with vital sign averages displayed five decimal places to the right was resolved in the

Property Sheet dialogue box by switching the format from percent to standard. Once corrected

the query ran with decimal points two places to the right.

Despite the minor failures, the team had many successes during the creation of the

database. The team was able to run queries and reports without errors or anomalies once the

proper PKs were assigned. The purpose of the database was also successfully achieved as the

database served its purpose of storing and retrieving patient data regarding vital signs for shift-

to-shift reporting.

Field verification with required and unique testing was used. The Test Validation Rules

button ran with no errors reported. In the Field Properties table in the design view of Microsoft

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Access, the required property is set to no by default. This means the user cannot pass by this

field in the entry form without entering data. To assure that the information needed for a

meaningful query run produces the information the required field is changed by clicking on the

field next to the heading and selecting the yes rule which now changes that field into a

mandatory answering field (Cox & Lambert, 2013). Setting the field to yes assures that every

entry must have a value and the field cannot be a null (Cox & Lambert, 2013).

Security Measures to Restrict Access to the Database

According to Coronel and Morris (2015) database security is of great concern due to the

advancements in technology and information management. The establishment of policies and

procedures is necessary with database management as well as implementing and upholding those

standards. End users have specific roles and security passes that allow users access at specific

assigned levels. Coronel and Morris (2015) noted that policies may be set that require all users

to have a password that must be changed every six months or as deemed appropriate in the

organization. The policy may have standards that define the passwords characteristics such as

the minimum or maximum number of alphanumeric characteristics in the passwords physical

appearance.

Changes for Future Database Development

When developing the database, Team B had difficulties creating the multiple table

relationships that would ultimately answer the desired question regarding the retrieval of data

needed for shift-to-shift report. When developing future first-time databases, it may be better to

start with a simpler database than to take on such a task of grandeur. Once basic concepts are

tested through practice and experience a more complex databases will likely become less

confusing.

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Summary

The output of this database is the vital signs of a patient. Inputs needed to achieve this

outcome include the patient’s MRN, name, and vital signs by date and time. Microsoft Access

includes built-in constraints such as selecting data types in order to maintain the integrity of the

database. Assigning PKs and FKs was a daunting task at first, but through practice with the

program, the team turned this failure into a success. The ability to run queries also posed some

barriers but with some adjusting, this was successfully accomplished. Other successes included

completing the database without anomalies or errors in 1:1 and 1: M relationships. When

developing a first-time databases in the future, a simpler database to start would be

recommended and build on experiences gained until all of the group is more comfortable with

creating databases.

*Note to Reader

The below object is the actual working database. Microsoft Access must be available on your

computer in order to view the project.

MUST HAVE MICROSFT ACCESS TO OPEN

User Friendly Spreadsheet Active Database

*Note

Professor’s comments on project

Hi Team B:

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Great job on the team database project! The plan for the database included Purpose of the database. Types of data to include. Field names in correct order.

TABLE DESIGN IN DATABASE included: Field names in correct order. Data types correctly chosen. Sorted records correctly. Correct data entered.

However, the table “Patient’s Vital Signs” was not related to any other table in your database. This means the data was duplicated in the other tables, and there was a lack of relationship between the tables to produce the results.

REPORT DESIGN IN DATABASE Includes: Shows report title. Shows field names. Shows records.

To those new to relational databases it can be a difficult topic and knowledge contents to grasp. If you struggled somewhat with the many new concepts, this is normal, however it is essential to understand the concept of relational database design as every single Health Information Technology, clinical information system and all business systems contain a relational database in the backend for data capture.

You should be very proud of the work that you have done this semester.

Grade 96/100

Dr. M…….

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References

Coronel, C. & Morris, S. (2015). Database systems: Design, implementation, and management

(11th ed.). Stamford, CT: Cengage Learning.

Cox, J. & Lambert, J. (2013). Step by step: Microsoft Access 2013. Richland, WA: Microsoft

Press.

McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge

(Laureate Education, Inc., custom ed.). Burlington, MA: Jones & Bartlett Learning.

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