This is the first part of 2 assignment project. You are only doing the first part for now. Please read the instruction very well. Its a 10 page project assignment. I have attach the grading rubric and other resources are listed on the assignment instructions. The class is all about Transforming Nursing and Healthcare Through Technology. Please choose any nursing project/Topics of your choice to make it easy. Please, I need the assignment on time to allow me time to fix any issues and verify the plagiarisms score. Thanks.  Transforming Nursing and Healthcare through Technology Essay Paper

Transforming Nursing and Healthcare through Technology by Developing a Small Nursing Informatics Project for One’s Organization: Implementation of an “Add-On” Computerized Clinical Decision Support System or CCDSS

The adoption of technology into healthcare took quite some time to become a reality. This is because the healthcare sector was one of those sectors that resisted for so long the influence of technology with the argument that it would replace the good judgment of a well-trained healthcare professional. These fears were however misplaced as the opposite would soon prove to be true. The turning point came with the Institute of Medicine’s (IOM’s) release in 1999 of a damning report titled To Err Is Human. In this report, it was found that annually about 98,000 patients were dying in the United States healthcare system as a result of preventable errors committed by healthcare personnel (Palatnik, 2016). It followed that a crucial recommendation for quality improvement in this situation was that technology should be embraced by the healthcare sector so that it can assist to reduce these human errors that were putting patient safety at risk. The movement towards assimilating innovative healthcare technologies started in earnest from then. But to do this effectively, there needed to be a legislative framework that would give the initiative legal force and grounding. That came in the year 2009 after the election of President Obama. He signed into law two important pieces of legislation namely the Health Information and Technology for Economic and Clinical Health (HITECH) Act and the American Recovery and Reinvestment Act or ARRA (Sweeney, 2017). These two mandated healthcare organizations to start using electronic health record or EHR systems o capture, store, and retrieve patient information and medical data (Alotaibi & Federico, 2017; McGonigle & Mastrian, 2017). At first, they had the provision for Meaningful Use (MU). This was an initiative to encourage organizations to adopt the EHR technology through incentives from the government. The purpose of this paper is to therefore present an initiative to implement one such nursing informatics technology project in an average sized organization offering mainly primary healthcare services in a rural community.

A Conversation with a Nurse Leader at the Healthcare Organization

In order to get a good look into the practice gap and need within the organization with regard to nurse informatics and technological application in general, I needed to have a conversation with one of the longest serving family nurse practitioners (FNP) who is also incidentally the nurse manager responsible for project implementation at the facility. The insight thus gained would be helpful in the making of the project charter and scope documents. Right from the start he was forthright in pointing out to me that the organization indeed has an electronic health record (EHR) system; but that it is an old one and does not have an integrated clinical decision support system or CDS. This had let to errors still being committed despite the facility having the EHR system. He gave me quite a number of these incidents that had occurred over the years as he was practicing at that same organization that he has now served for 15 years.

For instance, there had been incidents in which laboratory tests had been repeated for the same patient, medications serving the same purpose had been prescribed for the same patient, and procedures that had already been done had also been repeated at times. This is care fragmentation and it places the patient’s safety at risk as well as makes the cost of healthcare expensive for the patient unnecessarily. By prescribing the same medication a patient is on, one places the patient at risk of overdose and toxicity as well as the increased possibility of serious side effects. Repeating the laboratory and other tests also means that the patient will be billed for services that they had already had and paid for. To remedy this situation, therefore, the nurse manager thought that the gap of clinical decision making must be filled (Unruh & Hofler, 2016). Computerized Clinical Decision Support Systems or CCDSS are computer software programs that have specific algorithms that help the clinician to make the correct decisions.

If for instance the clinician was about to prescribe a drug the patient is already on, or order a test the patient had already done elsewhere; the CDS system would alert them to that fact (Holmström et al., 2020; Kuper et al., 2019; Olakotan et al., 2021; Taber et al., 2021). The clinical decision support or CDS system is therefore a tool for care coordination and the preservation of patient safety. Two of them are available, one that is integrated within the organization’s EHR system or the other that is outside the EHR system but linked to it. This latter one is usually referred to as the “add-on” CDS system (Kuper et al., 2019). In the case of our organization, therefore; the best solution would be the “add-on” CDS system since there were still no funds or even plans to overhaul the current EHR system.  Transforming Nursing and Healthcare through Technology Essay Paper

Developing the Scope and Charter Documents: The Elements Required

Every program manager understands that projects have timelines and costs that must be met in order to be completed satisfactorily. As per Sipes (2020), in the early stages of a project, there should be a project scope description and a project charter that both outline the program’s mission as well as its aims and objectives. The scope statement is the structure that specifies the program’s limits, and it has a significant impact on the timeline and resources required to complete the project on time and on budget.

The project charter is a concise framework that includes the authorization for the product to be developed. It specifies the project manager as well as the sponsor and is often signed by top executives of the organization (Sipes, 2020).The project charter is provided to the organizational top leadership as well as the departments involved in the realization of the project. According to Sipes (2020), the following will be required in order to properly produce the project scope and charter documents:

1. The objectives of the nurse informatics project
2. The necessary resources including the funds that will be required for the successful completion of the project

• The project team members by number, designation, and name

1. Identification of the project manager
2. Revelation of the project sponsor and what they have sponsored in the project
3. The length of time that the project will take to complete

• Appended signatures of the organization’s to executives that give the authority for the program to go ahead (Sipes, 2020).

A SWOT Analysis of the CCDSS Project

The tool that is referred to as the SWOT (strengths, weaknesses, opportunities, and threats) is a potent strategic management tool that is useful for planning purposes. By identifying the strengths and opportunities of the informatics project it will be possible for the project manager to maximize on these and potentially enable the project to succeed within time and budget (Wang, 2019). Also by outlining the weaknesses and threats that the project faces, the project manager and his team will be able to foresee project pitfalls and avoid them early enough. The CDS system crunches data and therefore utilizes data analytics to perform its work (Wang et al., 2018). The most outstanding strength for this project is that there is already a running EHR system on which the CDS system will be added on. Potential weaknesses on the other hand include that the EHR system on which the CDS system will be added is a bit old and becoming obsolete.

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Table 1

Strengths, weaknesses, opportunities, and threats for the CDS system implementation

Gap Analysis

A five-step methodology is used in the gap analysis for this transformation endeavor (Durdag, 2021). A gap analysis is also a technique that can be used to help solve an issue or gap in practice in the future. In other terms, it is also a strategic tool in the manager’s arsenal. The type of the clinical performance shortage will be easier to monitor and appreciate by utilizing gap analysis. It aids in the efficient and reliable execution of the EBP solution, in this case the health informatics shift to using an “add-on” clinical decision support. The starting point of the gap analysis is the prevailing situation at the facility which is the lack of a CDS system to aid in making correct clinical decisions. This is the first stage of the gap analysis.

The second stage is about what would be desirable and that is the availability of a CDS that can warn clinicians and nurses when they are about to make an error during decision making about a patient’s management. Evidence-based practice dictates that only an intervention that is backed by sufficient evidence from clinical inquiry should be used to provide the solution (Twa, 2016). In the case of this project, this is the addition of an “add-on” clinical decision support system. The third stage is to understand how the CDS system will be used by the end users for the benefit of the patients. A good system without proper and correct usage is useless. The fourth step in the gap analysis is having a plan and a backup plan on how the objective of the project will be achieved in the long term. For this, the nurse informaticist must be ready to troubleshoot and also to liaise with the vendor to solve teething problems and other issues promptly when they arise. The fifth and last stage of the gap analysis is about performing an in-depth assessment of effectiveness and integration of the new CDS intervention.  Transforming Nursing and Healthcare through Technology Essay Paper

It is simpler to picture and comprehend the method by which the upcoming transformation will be executed by creating a conceptual map of the gap analysis as described previously. The conceptual map emphasizes the linkages and interconnections that arise among concepts and methodologies. When a conceptual gap analysis map is introduced to this scenario, it becomes clearer and easier to understand, as does the core of the project. The conceptual map of the gap analysis model is a pictorial or diagrammatic representation of the five stages of the gap analysis. It lays down the interrelationships among the stages and also makes understanding the concept of gap analysis easier. This is what will also be done to this project as demonstrated by the concept map here below.

Figure 1

A conceptual map for the clinical decision support system (CDS) gap analysis

Work Breakdown Structure for the CDS Implementation Project

The work breakdown structure or WBS depicts the way a project can be dismantled and segmented. It is an organizational tool used by the project leader to show the extent and activities of the project, as well as who is accountable for what, when, and how (Sipes, 2020). The project leader can use the WBS to generate a Gantt chart or determine the critical path of a work. A work breakdown structure (WBS) divides a project into smaller jobs and must be finished before a Gantt chart can be generated, as the activities in it will determine the elements of the Gantt chart. The work breakdown structure for this change implementation endeavor will be the one shown here.

Figure 2

A phase-based work breakdown structure (WBS) for the clinical decision support system

Project Timeline Gantt Chart

Table 2

The project timeline Gantt chart for the CDS system

Responsibility or RACI Chart for the CDS Project

Table 3

Project responsibility or RACI matrix

Communication Plan for the CDS Project

As part of the communication plan, weekly evaluation sessions will be held in person and headed by the program manager. There will also be electronic contact and correspondence about project issues, which will be shared with each member of the team. An additional mode of communication that will be included is mobile phone calls, which will be subsidized in terms of airtime by the project budget. All talks will be documented and preserved for future reference. In this situation, the nurse informaticist is both the custodian of electronic patient information and the project manager. He is also in charge of patient healthcare information preservation and compliance with the Health Insurance Portability and Accountability Act, or HIPAA. This law requires that any innovative technical system utilized in healthcare (particularly EHRs and CDSs) must ensure that patient information confidentiality and security is guaranteed.   Transforming Nursing and Healthcare through Technology Essay Paper

The CDS Project Change Management Plan

The Rogers’ Diffusion of Innovations change model will guide the change management plan. This will ensure that the modification is implemented in a scientific and systematic manner throughout the timeline (Pashaeypoor et al., 2016). All modifications will be documented when they occur. As an example, minutes will be collected and documented during weekly meetings. Any changes to delivery timelines will be documented, and a contingency plan will be put in place in the case of a delay or an external affecting force.

A Risk Management Plan for the New Clinical Decision Support (CDS) Project

Risk management is the practice of creating ways to prevent bad events from derailing a program. In the eventuality that some or all of the equipment or the electronic infrastructure as a whole fails, a fallback mechanism must be in place. Patient data should be kept safe and still available and accessible on the eClinicalWorks cloud in the event of unforeseen failures or incidents. This project will not use any new technology, but rather will make use of existing CDS technology. Those team members involved were the system developer, the application analyst, the vendor, and the nurse informaticist (Mosier et al., 2019). The customized CDS algorithm was created with the organization’s specific needs in mind. Improvements and upgrades are scheduled to keep system components from becoming obsolete while in operation. The vendor will be available for consultation by the nurse informaticist (program manager) and follow-up technical advice for the next six months, according to the contract.

Conclusion

Change implementation is an inseparable requirement for quality management and improvement. This paper has presented a project of implementing the installation of a CDS system that is not integrated with the existing EHR system. Its aim is to help reduce errors committed by healthcare personnel within the organization when making clinical decisions. Some of these errors are very serious and ay cost the patient their life. They include double prescription of the same or similar drug as well as ordering again the same test.

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

Durdag, Y. (2021). Gap analysis: 5-step framework guide and template. https://www.grow-force.com/gap-analysis-template/

Holmström, I.K., Kaminsky, E., Lindberg, Y., Spangler, D., & Winblad, U. (2020). Registered Nurses’ experiences of using a clinical decision support system for triage of emergency calls: A qualitative interview study. Journal of Advanced Nursing, 76(11), 3104–3112. http://dx.doi.org/10.1111/jan.14542

Kuper, K.M., Nagel, J.L., Kile, J.W., May, L.S., & Lee, F.M. (2019). The role of electronic health record and “add-on” clinical decision support systems to enhance antimicrobial stewardship programs. Infection Control & Hospital Epidemiology, 1–11. http://dx.doi.org/10.1017/ice.2019.51

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

Mosier, S., Roberts, D., & Englebright, J. (2019). A systems-level method for developing nursing informatics solutions. The Journal of Nursing Administration (JONA) 49(11), 543-548. https://doi.org/10.1097/NNA.0000000000000815

Olakotan, O.O., & Yusof, M.M. (2021). The appropriateness of clinical decision support systems alerts in supporting clinical workflows: A systematic review. Health Informatics Journal, 27(2), 1-22. https://doi.org/10.1177/14604582211007536 

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

Pashaeypoor, S., Ashktorab, T., Rassouli, M., & Alavi-Majd, H. (2016). Predicting the adoption of evidence-based practice using “Rogers Diffusion of Innovation Model”. Contemporary Nurse. https://doi.org/10.1080/10376178.2016.1188019

Sipes, C. (2020). Project management for the advanced practice nurse, 2^nd ed. Springer Publishing Company.

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

Taber, P., Radloff, C., Del Fiol, G., Staes, C., & Kawamoto, K. (2021). New standards for clinical decision support: A survey of the state of implementation. Yearbook of Medical Informatics, 159-171. http://dx.doi.org/10.1055/s-0041-1726502

Twa, M.D. (2016). Evidence-based clinical practice: Asking focused questions (PICO). Optometry and Vision Science, 93(10), 1187–1188. https://doi.org/10.1097/OPX.0000000000001006

Unruh, L., & Hofler, R. (2016). Predictors of gaps in patient safety and quality in U.S. hospitals. Health Services Research, 51(6), 2258-2281. https://doi.org/10.1111/1475-6773.12468

Wang, C. (2019). The strengths, weaknesses, opportunities, and threats analysis of big data analytics in healthcare. International Journal of Big Data and Analytics in Healthcare, 4(1), 1–14. https://doi.org/10.4018/ijbdah.2019010101

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

Transforming Nursing and Healthcare through Technology Essay Paper

Week 5: Data Science: Applications for Practice

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Data drives innovations in healthcare. Whether through exploring patient care practices, introducing new care techniques, or providing new lifesaving medicine, data drives the ability to offer these solutions in practice. Data is not compiled, applied, or analyzed using only one approach—therefore, it is important to explore the various strategies used and  consider implications, barriers, and impact of data science on nursing practice.

This week, you will analyze the use of data science applications and processes for healthcare organizations and nursing practice. You will also consider and examine approaches for implementation of data science.

This week also serves as the first week in which you will submit a portion of your small nursing informatics project. You will submit Part 1 of your project, and you will begin working on Part 2. Remember, while using project management skills and techniques, the goal of this project is to demonstrate your understanding of nursing informatics through the implementation, or potential implementation, of your proposed small nursing informatics project.

Learning Objectives

Students will:

• Analyze data science applications and processes for healthcare organizations and nursing practice
• Evaluate approaches for implementation of data science applications and processes for nursing practice
• Analyze use of predictive analytics for clinical practice
• Develop a small nursing informatics project
• Identify a small nursing informatics project
• Develop a project scope and charter for a nursing informatics project
• Perform a SWOT analysis related to a small nursing informatics project
• Create a GAP analysis for a nursing informatics project
• Analyze the work breakdown structure related to a small nursing informatics project
• Construct a project timeline for a small nursing informatics project
• Identify responsibility roles in small nursing informatics projects
• Develop a communication plan for small nursing informatics projects
• Develop a change management plan for small nursing informatics projects
• Develop a risk management plan for small nursing informatics projects

Course Project Overview: Developing a Small Nursing Informatics Project for Your Organization

You will use project management tools and strategies to propose how you would support and potentially implement a small nursing informatics project. While you may not have the opportunity to implement this proposed project, this project will allow you to apply the skills needed and the considerations that are required in deducing how a project of this scope might take place in your nursing practice. To complete this project, you will define a small informatics project that would be beneficial to your healthcare organization or nursing practice. You can discuss this with upper leadership, in your practice or organization, explaining that you will need to design, plan, and propose how to implement and evaluate a small informatics project that can be completed within a 9-week time frame during this course. This project will be completed in two parts.

Photo Credit: auremar / Adobe Stock

• Part 1 (Due in Week 5):
  • During Week 1: Identify and initiate a conversation with a nurse leader at your or healthcare organization or nursing practice. Be sure to mention that you will need to develop Scope and Charter Documents (2 pages).
    • Review Chapter 3 in the Sipes (2020) text. The questions and content you need to include in the examples are there. Be sure to differentiate between the Scope (page 61) versus the Charter (page 59).
• During Weeks 2–5, Project Design: Develop a Scope and Charter. The templates are available in the Sipes text. The first step, the conceptual step or phase 1, is to determine the “who, problem and purpose, and how” you will accomplish this task and what you will and will not do.
  • For the Scope document, include all elements for page 61 in the Sipes  text. You can use a Word document with table. Consult the “How to Write a Scope of Work Document” media piece provided in this week’s Learning Resources.
• Part 2 will be due in Weeks 9 and 10:
  • Use the nursing informatics and project management competencies and concepts to design and plan a project for your organization, in a 17- to 20-page paper, due by Day 7 in Week 9. If time allows based on the type of project, you will also implement and evaluate the outcomes. Each week you will develop and apply a component needed to complete the project.
  • Develop a 10- to 15-slide, narrated presentation of your project that you might present to stakeholders in your healthcare organization or nursing practice. You will also share your presentation with your colleagues in a Discussion forum by Day 2 in Week 10.   Transforming Nursing and Healthcare through Technology Essay Paper

Assignment: Developing a Small Nursing Informatics Project for Your Organization, Part 1

You will use project management tools and strategies to propose how you would support and potentially implement a small nursing informatics project. While you may not have the opportunity to implement this proposed project, this project will allow you to apply the skills needed and the considerations that are required in deducing how a project of this scope might take place in your nursing practice. To complete this project, you will define a small informatics project that would be beneficial to your healthcare organization or nursing practice. You can discuss this with upper leadership, in your practice or organization, explaining that you will need to design, plan, and propose how to implement and evaluate a small informatics project that can be completed within a 9-week time frame during this course. This project will be completed in two parts.

Photo Credit: auremar / Adobe Stock

The Assignment: (10–11 pages)

This week, you will finalize Part 1 of your Small Informatics Project, using all documents completed during Weeks 1–4.

• Identify and initiate a conversation with a nurse leader at your nursing practice or healthcare organization. Discuss what you will need to develop Scope and Charter Documents.
• Conduct a SWOT analysis which will provide information for the Scope and Charter. You can use a Word document and insert a table. Directions can be viewed in the Week 3 media piece, How to Perform a SWOT Analysis, found in this week’s Learning Resources. Some of the content is relevant to both the project for this course as well as organization of your doctoral dissertation. Overall, the first step for any project, work or your dissertation, requires a plan: what you will and will not do. That information is defined in a charter and scope.
• Create a visual using the Gap Analysis map of the identified gap, documenting the flow from the point of origin to the destination. After watching the Week 3 media piece, How to do a GAP Analysis, identify the gap and analyze the flow or lack of flow of information as the gap in a process. The visual map will include the flow from the point of origin to the destination.
• Create a Work Breakdown Structure (WBS) using PowerPoint slides or another method. Be sure to review the media piece, What Is a Work Breakdown Structure? in the Week 3 Learning Resources.
• Create a Project Timeline Gantt chart, which defines who is responsible, due dates to start /finish activities. (You might also use this as you track your dissertation IRB submission for your proposal). You can find an example on pp. 95–96 of your text, using PowerPoint slides, or another method. Be sure to review the Gantt Charts, Simplified media piece in this week’s Learning Resources.
• RACI (responsibility chart) which outlines who will be responsible for which tasks, if working with a team. An example can be found in the Sipes text on pages 102–103.
• Communication plan – Include documentation of all communications, status reports, changes made, and next steps, especially if others will be responsible for helping you acquire documents such as IRB site documents if applicable. An example can be found in the Sipes text on page 109 and on pages 141–143.
• Change management plan – Document all changes as they occur (e.g., meetings moved, revisions of drafts of project, due dates moved due to changes, changes in scope of project, change in team members). An example can be found in the Sipes text on page 106, 108, 138 and on pages 156–157.
• Risk management plan– After viewing the Week 4 media piece, “Risk Analysis How to Analyze Risks on Your Project,” document the impact of COVID-19 on current processes and potential for change. Be sure to also document how risk may be mitigated if possible. An example can be found in the Sipes text on pages 103–105.

Compile all updated and current documents from Weeks 1–4 to submit.

Include a description and application to practice for each of the tools you developed. Include the rationale in your submission. Address the following:

• How and why it was developed and its function (all activities will be identified in the WBS)
• How it will be applied to your project? Is it new technology?
• Who was involved in changes and what are their responsibilities? (This is the stakeholders, leadership, end users – (use the RACI chart)
• In what way has this changed with the onset of the pandemic, if at all? This might be the gap analysis, change management plan. What were the changes?
• Are health information system/application upgrades scheduled or planned? Why or why not?

Resources

Sipes, C. (2020). Project management for the advanced practice nurse (2nd ed.). Springer Publishing.

Sipes, C. (2016). Project management: Essential skill of nurse informaticists. Studies in Health Technology and Informatics, 225, 252–256.

Transforming Nursing and Healthcare through Technology Essay Paper