Final Exam Study

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NR599 Midterm / Final Exam Study

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient care efficiency. Your project proposal should include the following:NR599 Midterm / Final Exam Study

Describe the project you propose.
Identify the stakeholders impacted by this project.
Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving, and explain how this improvement would occur. Be specific and provide examples.
Identify the technologies required to implement this project and explain why.
Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.
The response accurately and thoroughly describes in detail the project proposed.

The response accurately and clearly identifies the stakeholders impacted by the project proposed.

The response accurately and thoroughly explains in detail the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an accurate and detailed explanation, with sufficient supporting evidence of how this improvement would occur.

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The response accurately and clearly identifies the technologies required to implement the project proposed with a detailed explanation why.

The response accurately and clearly identifies the project team (by roles) and thoroughly explains in detail how to incorporate the nurse informatics in the project team.

Includes: 3 or more peer-reviewed sources and 2 or more course resources

Course resources

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)NR599 Midterm / Final Exam Study

Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)

Mosier, Sammie, DHA, MA, BSN, NE-BC, CMSRN, BC, Roberts, Wm., Dan PhD, RN, et al. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. Journal of Nursing Administration, 49, 543-548. https://doi.org/10.1097/NNA.0000000000000815

Alexander, S., Ng, Y. C., & Frith, K. H. (2018). Integration of Mobile Health Applications in Health Information Technology Initiatives: Expanding Opportunities for Nurse Participation in Population Health. CIN: Computers, Informatics, Nursing, 36(5), 209–213.

Sipes, C. (2016). Project Management: Essential Skill of Nurse Informaticists. Studies in Health Technology and Informatics, 225, 252–256.

Nursing Informatics Project Proposal for Quality Improvement (QI) in a Hospital Setting

Nursing informatics is currently a very crucial part of the healthcare infrastructure of any healthcare organization. It is involved with the management of information concerning patients. This information is stored electronically in a special system referred to as the electronic health record (EHR) system. EHR systems are sold by different vendors in the market but basically have the same functionality (McGonigle & Mastrian, 2017). They should be able to allow for the capture of the patient’s biographical data, biometrics, and history. The EHR system should also be able to allow the clinician to enter details of physical examination and prescribed therapies. In the same manner, nurses must be able to enter nursing care notes just as they would have written them on a paper-based cardex. To allow for these different functionalities, an EHR usually has different system subcomponents such as the computerized provider order entry or CPOE (used by the clinician to write treatment orders), the patient data management system or PDMS (can be used by nurses to enter their nursing notes about the patient’s care), electronic medication administration record or eMAR, clinical decision support (CDS), and bar code medication administration (BCMA) amongst others (Alotaibi & Federico, 2017). This paper is about the proposal of a QI nursing informatics project in the form of an upgrade to an existing EHR system for better performance, interoperability, and improved patient outcomes.

The Proposed Project

This project involves the installation of a new upgraded version of the existing EHR system in the organization. It is to replace the old EHR system that had several shortcomings impacting the quality of care, patient safety, and patient outcomes. Some of these drawbacks or bottlenecks that have been witnessed with old system include a lack of interoperability, loss of data after entering it when the system hangs up, and difficulties with access to the system during peak hours when many users are logged in at the same time. It has been agreed that the system is probably becoming obsolete and needs upgrading to keep up the quality of service delivered with the help of the system. The upgrading of the EHR system is to be undertaken as a QI initiative to meet specific quality benchmarks. These benchmarks are to be monitored through the EHR dashboard designed specifically to meet this organization’s specifications. They include quality, performance, and staff engagement benchmarks (Wang et al., 2018). Specific outcome measures to be monitored through the system’s dashboard will include the rates of patient falls, the rates of hospital-acquired infections or HAIs (like central line-associated blood stream infections or CLABSI and catheter-associated urinary tract infections or CAUTI), the rates of in-patient readmissions to the hospital, and the rates of pressure injuries amongst others.

The Stakeholders Impacted by the Project

There are several stakeholders who are impacted by this project. These include the following:

The patients: These are the main stakeholders because they are the recipients of the improved services that are envisaged by the upgrading of the EHR system. With te improvement, their safety will be guaranteed, services will be faster and seamless, and time spent in the hospital will reduce. This reduction in time spent will translate to reduced hospitalization costs and hence produce a direct benefit to the patients.NR599 Midterm / Final Exam Study
The healthcare staff including clinicians (physicians, APRNs, and physician assistants), pharmacists, and nurses (RNs): These are the staff that have to use the system and who are directly affected by the functionality of the system. If the system is slow, hangs up, or proves difficult to access as has been witnessed with the current old system; these staff members get frustrated and may be prone to committing errors due to this. What this means is that non-functionality of the system impacts the performance of the staff.
The organization’s leadership: This is represented by the directors who are the policy makers in the organization. An improved EHR system that has better functionality will enable the organization to reach and achieve its strategic objectives and vision a contained in its long term strategic plan. Revenue will also increase as a result of improved services that are faster and more efficient.
The community: The community that forms the catchment area of the hospital are the other stakeholders. With the improvement in the services at the hospital, word-of-mouth will spread and those who were seeking services elsewhere because of delays occasioned by the old system will come back. They will benefit from services that are not only near but also safe, effective, efficient, timely, patient-centered, and equitable.
The Patient Outcomes and Patient Care Efficiencies the Project is Expected to Improve

This system upgrade for the existing EHR system is expected to improve several patient outcomes, some of which are described below:

Reduced hospitalization costs: When the services offered to the patient become faster, the net effect will be that the care and treatment given to the patient will be quicker, timely, and patient-centered. Interventions will take effect immediately and patients will get better faster leaving the hospital earlier than expected. They will then pay less than if they stayed longer.
Reduced readmission rates: With the care made more efficient and timely by the new EHR system, interventions will be more focussed and timely. Thus means that treatments will be more effective and management of conditions will be more thorough. As such, the likelihood of preventable readmissions will go down.
Improved patient safety: With a smoothly functional system, the healthcare employees using it will have less frustration and will therefore experience psychological safety. The emotional stability and wholeness will make them less prone to committing avoidable errors and patient safety will thus be improved.
The Technologies Required to Implement the Project

There are technologies that must be present for the proposed project to be implemented effectively and according to plan and specifications. They include:

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A new EHR software system designed to meet the organization’s specific needs and to be interoperable.
Computer hardware that is compatible with the system being installed.
A user-friendly graphical user interface (GUI) that will make it simpler and less complicated for the staff to interact with the system.
A responsive remote server and back-up system for the EHR system to prevent system slow-downs and hang-ups.
Capacity for frequent upgrades and updates to prevent the system from being rendered obsolete.
Roles of the Project Team Members Including the Nurse Informaticist

The project implementation team members will be as follows (Vant, 2017):

Nurse informaticist

She will be the project manager because of her training and education in informatics. This makes her the most appropriate person with both medical and informatics knowledge to see the project through completion without errors.NR599 Midterm / Final Exam Study

The Application Developer

He is responsible for designing the software exactly the way the organization would like it to be. He is a computer software engineer and does not necessarily need to have a medical background.

The Application Analyst

This team member is a collector and collator of all information from the various stakeholders that need to be technically translated into the system.

The Quality Assurance Test Engineer

He is expected to have a medical background. This is preferable a he is the one who will test the system to see if it functions the way it is supposed to.

References

Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631

McGonigle, D., & Mastrian, K.G. (2017). Nursing informatics and the foundation of knowledge, 4th ed. Jones & Bartlett Learning.

Vant, A. (2017). Four crucial members of an EHR implementation team. EHR In Practice. https://www.ehrinpractice.com/four-crucial-members-of-an-ehr-implementation-team-154.html

Wang, Y., Kung, L., & Byrd, T.A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3–13. https://doi.org/10.1016/j.techfore.2015.12.019

NR599 Midterm / Final Exam Study

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