The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies

The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies

In the Discussion for this module, you considered the interaction of nurse informaticists with other specialists to ensure successful care. How is that success determined?

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Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is measured. Measuring patient outcomes results in the generation of data that can be used to improve results. Nursing informatics can have a significant part in this process and can help to improve outcomes by improving processes, identifying at-risk patients, and enhancing efficiency.

To Prepare:

  • Review the concepts of technology application as presented in the Resources.
  • Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages not including the title and reference page)

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:

  • 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.
  • Use APA format and include a title page and reference page.
  • Use the Safe Assign Drafts to check your match percentage before submitting your work.

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  • RUBRIC below
Excellent Good Fair Poor
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: 

·   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.

77 (77%) – 85 (85%) 

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.

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 informaticist in the project team.

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

68 (68%) – 76 (76%) 

The response describes the project proposed.

The response identifies the stakeholders impacted by the project proposed.

The response explains the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an explanation, with some supporting evidence of how this improvement would occur.

The response identifies the technologies required to implement the project proposed with an explanation why.

The response identifies the project team (by roles) and explains how to incorporate the nurse informaticist in the project team.

Includes: 2 peer-reviewed sources and 2 course resources.

60 (60%) – 67 (67%) 

The response describing the project proposed is vague or inaccurate.

The response identifying the stakeholders impacted by the project proposed is vague or inaccurate.

The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague or inaccurate, or includes little to no supporting evidence.

The response identifying the technologies required to implement the project proposed with an explanation why is vague or inaccurate.

The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague or inaccurate.

Includes: 1 peer-reviewed sources and 1 course resources.

0 (0%) – 59 (59%) 

The response describing the project proposed is vague and inaccurate, or is missing.

The response identifying the stakeholders impacted by the project proposed is vague and inaccurate, or is missing.

The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague and inaccurate, includes no supporting evidence, or is missing.

The response identifying the technologies required to implement the project proposed with an explanation why is vague and inaccurate, or is missing.

The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague and inaccurate, or is missing.

Includes: 1 or fewer resources.

Written Expression and Formatting – Paragraph Development and Organization:  

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.

5 (5%) – 5 (5%) 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

4 (4%) – 4 (4%) 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

3.5 (3.5%) – 3.5 (3.5%) 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

0 (0%) – 3 (3%) 

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

Written Expression and Formatting – English writing standards:  

Correct grammar, mechanics, and proper punctuation

5 (5%) – 5 (5%) 

Uses correct grammar, spelling, and punctuation with no errors.

4 (4%) – 4 (4%) 

Contains a few (1-2) grammar, spelling, and punctuation errors.

3.5 (3.5%) – 3.5 (3.5%) 

Contains several (3-4) grammar, spelling, and punctuation errors.

0 (0%) – 3 (3%) 

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) 

Uses correct APA format with no errors.

4 (4%) – 4 (4%) 

Contains a few (1-2) APA format errors.

3.5 (3.5%) – 3.5 (3.5%) 

Contains several (3-4) APA format errors.

0 (0%) – 3 (3%) 

Contains many (≥ 5) APA format errors.

 

Nurse Informatics: Improving Patient Outcomes and Patient Care Efficiencies by a Project of Upgrading the Electronic Health Record (EHR) System

Nurse informaticists have become important professionals within all healthcare settings. This is as a result of the implementation of healthcare policies that require all healthcare organizations to have electronic documentation and storage of medical data. This is data that was originally captured manually by writing on paper files. Patient personal and demographic data would be captured by hand at admission.

Later on, the clinician would interview the patient, perform a physical examination, order laboratory and other tests, and proceed to document their findings and diagnosis by pen and paper on the same paper file. The prescription written by hand would then have to be read by the nurse (correctly) who then had to send a nurse assistant physically with the paper file to the pharmacy to go and get the medications prescribed. It is not difficult to see how many opportunities there were in this manual system to commit errors and make mistakes.

By the end of the millennium, about 98,000 preventable patient deaths were occurring in United States hospitals as a result of human error by nurses and physicians. This revelation was made by a landmark report by the Institute of Medicine (IOM) published in 1999 and correctly named To Err Is Human. The report recommended that technology be tried in healthcare with the goal of reducing the likelihood of this human error element (Palatnik, 2016).

The events that followed in the next decade (2000-2011) in terms of healthcare policy related to implementation of technology in healthcare are phenomenal. Particularly, the signing of the American Recovery and Reinvestment Act (ARRA) and the Health Information and Technology for Economic Clinical Health Act (HITECH) in 2009 was historic (Sweeney, 2017).

These legislative policies brought about the Meaningful Use Program that required all healthcare settings to have and use an electronic health record (EHR) system that would now capture and store patient data and medical records safely. Incentives were provided for those who complied and penalties given to those who defied. It was essentially a carrot-and-stick approach by the federal government.

Nurse informatics was then designed as a specific course that would produce nurse professionals with the required competencies for health information management (HIM). These are the professionals who became known as nurse informaticists and who are the custodians of the EHR systems in all healthcare organizations (McGonigle & Mastrian, 2017; Darvish et al., 2014). It follows that they are also the professionals responsible for overseeing any project related to informatics within healthcare organizations.

In other words, they are the ones with the project management competencies to guide such projects to completion (Sipes, 2016). The purpose of this paper is to detail a nurse informatics project spearheaded by the nurse informaticist and aimed at improving patient outcomes and patient care efficiencies.

The Proposed Project

The proposed project to be managed by the nurse informaticist is the installation of a new interoperable and intelligent EHR system to replace the old one that is now a decade old. This is because the old EHR system has effectively become obsolete with the rapid advancements in technological innovation. There are some components that the old system did not have that the new system will have.

These components and the functionality of the system in general are expected to improve patient outcomes and patent care efficiencies through better and more effective data management. For instance, care fragmentation will be prevented by the interoperability of the system. What this means is that in the event that the patient is seen by a different provider in the same accountable care organization (ACO) network, their entire medical record will be accessed easily through the interoperability function of the EHR systems.

Also, the new updated EHR dashboard will allow the nurse informaticist to monitor and collect data on different performance and quality metrics such as fall rates, readmission rates, and mortality rates amongst others.

Some of the systems that the new version of the EHR will have and which will facilitate the betterment of patient outcomes include

  • the bar code medication administration (BCMA),
  • computerized provider order entry (CPOE),
  • electronic medical record (EMR),
  • automated medication dispensing cabinets (ADCs),
  • clinical decision support system (CDS),
  • electronic medical administration record (eMAR),
  • electronic incident reporting,
  • and patient data management systems (PDMS)

amongst others (Alotaibi & Federico, 2017). Together, these system components make up the new innovative and interoperable EHR system.

The Stakeholders to be Impacted by the Project

  This project as envisioned will impact a wide array of stakeholders. They include the employees such as nurses, physicians, pharmacists, and dieticians amongst others. They also include the patients, their relatives, the vendors (of the EHR system), and regulatory agencies (such as the state board of nursing and the Joint Commission on Accreditation of Healthcare Organizations or JCAHO).

The impact on clinicians and nurses who will use the new system everyday all the time is in the fact that they will need training and upskilling to be proficient with the system. Vendors will need to provide after sales service in terms of troubleshooting and technical support. As for the patients, they will notice that there is improved efficiency in the delivery of the services (what is expected). Alternatively, they may notice sluggishness in the service delivery at first as a function of the non-familiarity of the system by the providers.

The Patient Outcomes and Patient Care Efficiencies Targeted for Improvement

Some of the outcomes and patient care efficiencies that the project looks forward to improving are the patient turnaround time, a shorter admission process, fewer cases of readmission, a lower rate of falls, and reduced incidences of hospital-acquired infections or HAIs. Because the new system will be faster (faster speeds), the time taken to admit a patient will be substantially reduced and this will also reduce the turnaround time enabling many patients to be seen at the same time.

Having clear typed prescriptions through the CPOE will for instance ensure that prescriptions are not misread. This will ensure that the patient gets their medications and other interventions faster through the ADCs, BCMA, and eMAR. As a result, total recoveries will increase and preventable readmissions will reduce.

The rates of accidental falls and HAIs will also go down because the dashboard metrics for these quality indicators will be monitored and deviations acted upon promptly through quality improvement (QI) initiatives (Wang et al., 2018).

The Technologies Required and the Project Team Members

The technologies required to implement this project are mainly software technologies. This is because the computer programs that have the commands to run the EHR system can be installed in any contemporary computer hardware. Most importantly, these software technologies make use of novel storage power of cloud computing.

This gives the capability to store large gigabytes of data in the cloud without requiring extensive physical computer storage space. This is very desirable for healthcare organizations as they will need to transfer the existing data into the new system and at the same time require more space for continuing storage.      

 The nurse informaticist does not need to be incorporated into the team. She is the actual team leader and project manager who puts together the team. The other team members include the software application developer who actually writes the system commands for the EHR. Then there is the analyst who puts together stakeholder input and matches them to the system functionality. And the other important member of this team is the quality assurance test engineer.

He or she will be responsible for testing the system’s operability and functionality before it is handed over to the organization’s employees (Vant, 2017). The team works together under the coordination of the nurse informaticist who is the project manager (Sipes, 2016); so that the project may be completed on time and within budget.   

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

Darvish, A., Bahramnezhad, F., Keyhanian, S. & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global Journal of Health Science, 6(6), 11–18. https://doi.org/10.5539/gjhs.v6n6p11

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

Palatnik, A. (2016). To err is human. Nursing Critical Care, 11(5), 4. https://doi.org/10.1097/01.CCN.0000490961.44977.8d

Sipes, C. (2016). Project management: Essential skill of nurse informaticists. Nursing Informatics, 252-256. https://doi.org/10.3233/978-1-61499-658-3-252

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics (OJNI), 21(1). https://www.himss.org/library/healthcare-informatics

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

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