Introduction
The development of the practicum project in nursing informatics requires the identification and evaluation of various aspects. On the one hand, it is necessary to consider organizational issues like effective or failed leadership, management, and support. On the other hand, research and technical issues play an important role in this work. In Veronica’s case, nurses share common concerns about patient hands-off, the inability to obtain supplies from the Chief Financial Officer, and difficulties in care for geriatric patients.
These problems might have the same root, which is the lack of administrative support, and the use of electronic medical records (EMR) systems may be a solution to provide quality patient care in acute settings. Formative and summative assessments based on feedback and results will help understand if the offered intervention works well or if additional improvements are necessary. Communication with nurses via online interviews is one of the methods to achieve such goals as quality improvement and professional nursing cooperation. Reducing nursing errors and effective data storage and exchange are the objectives that can also be achieved if the EPIC EMR system is properly implemented.
Project Goals and Objectives
In this practicum project, the intention is to reduce nursing errors in patient hands-off due to poor administrative support by 20% within three months of implementing the EPIC EMR system. There are three main goals to be considered during the formative and summative phases of assessment: strong leader identification, understanding of patient care and hands-off, in particular, basics, evidence-based practice (EBP) implementation. The intervention for evaluation includes the Epic system to be integrated into nursing practice under professional leadership. It is expected to talk to stakeholders directly to understand their awareness of software, their readiness to use it regularly, and the presence/absence of a leader who can support and educate.
Methodology and Justification
Modern hospitals are usually equipped with multiple electronic systems with the purpose of shortening documentary work and having enough time for nurses to cooperate with patients. However, not all patients are treated by the same doctors and nurses due to the unpredictable nature of their diseases, needed resources, and other caring duties. Therefore, patient information should be properly shared and safely stored with time.
There are many ways how to coordinate nurses, and someone may guess that a good process begins with a good leader. Still, the initial part of the current methodology is to gather information from direct participants of a process – nurses. The next stage is to find a leader who could work with personal data and make an organizational evaluation. Finally, intervention is required to make sure that some changes are promoted, and the necessary results are achieved. Each strategy has its tasks, and formative and summative evaluations prove that the project meets all the criteria.
Communication
A pre-intervention stage consists of two steps – information gathering and the choice of a leader. One week is a time period for a researcher to find nurses, inform them about the practicum project’s goals and expected outcomes, and get their approval to participate in the study. Online interviews will be organized via Skype to make sure all the problems and recommendations are considered. Kim and Sim (2020) justify this strategy, underlying that communication skills affect people’s abilities to understand each other and their tasks and deliver what patients need. The implementation of new technologies is beneficial for nurses to manage their time and organize their knowledge.
The EMR decreases the need for nurses to communicate directly and use e-messaging tools to ask questions or deliver information (Haykal et al., 2020). At the same time, many issues remain poorly discussed or missed, which provokes a number of problems being unsolved. The objective to improve the quality of care and patient hands-off will be met if the staff continues paying close attention to the development of their communication skills and information that determines caring processes.
Leadership
The next problem of the case is the reduction of costs by the Chief Financial Officer and the inability to control overordering supplies that may be expired before their usage. This situation is provoked by different factors, but no effective leadership is evident. Today, nurses are aware of several leadership theories like transformational (focused on change), participative (focused on mutual decision-making processes), or transactional (focused on motivation through rewards or punishment) (Xu, 2017). When one person makes decisions concerning the organization of an entire organization, many additional questions, concerns, and misunderstandings occur.
Modern nurses want to be heard and their opinions to be taken into consideration when a new system is implemented into their work. To justify this step in the methodology, Strudwick et al. (2018) admit that nurses’ perceptions of EMR depend on the level of support from leadership, the quality of training, and the physical environment. Therefore, in an acute setting where EMR systems are planned, a leader plays a central role. This person prepares a team, educates or finds an expert to assist nurses, and listens to people who have to use this technology.
Technology
A final step in this project is the recognition of EBP and the implementation of the EPIC EMR system. Digital health systems are not new for many nurses, but some individuals need additional help to comprehend their roles and contributions to patient care. Epic is one of the fundamental software designed for American hospitals in 1979 to support large amounts of data transactions (Shull, 2019). There are many reasons for using this system in an acute setting, like easing of usage, flexibility, and cloud-based nature, which allows integration through all practice management systems in the United States.
Although not all nurses are aware of this system’s technical aspects, a leader may invite an expert to educate the staff and make the change less harmful and more favorable. Some time should be spent investigating the system and using it easily for patient care improvement and the reduction of errors related to patient hands-off and other nursing processes.
Formative and Summative Assessments
The success of any intervention depends on how well people evaluate all the steps and goals chosen for the project. In this case, the implementation of the EPIC EMR to improve the quality of care and reduce the number of nursing errors with patient hands-off. Formative assessment aims at monitoring nurses’ opinions and understanding of their tasks and the use of the offered electronic system. Feedback helps formulate, develop, and improve teaching and leadership techniques.
This type of evaluation will be conducted during the first and last weeks of the implementation process. Nurses will be asked to share their knowledge about EPIC and its influence on their practice. A questionnaire and weekly quizzes are methods to see what leadership theories are effective for a setting. Communication is an integral part of the assessment, and it is possible to prepare several open-ended questions for nurses to give their opinions about the offered practice. If more than 80% of the answers are positive, the intervention will be considered successful.
Summative assessment usually takes place when the intervention is over. It allows the creation a report about the work and the level of participation of all nurses. In this practicum project, the results of summative and formative assessments will be aligned to achieve a greater effect and understand the role of leadership and training. The use of EPIC EMR has a number of outcomes in patient care and the quality of communication between nurses and other staff. Summative assessments include tests or final reports, with statistical data being properly evaluated. Three months are offered to check the effectiveness of the intervention; thus, a report is based on the material gathered during the last three months after the first questionnaire (communication) is offered to a nurse.
Conclusion
In general, this project is based on research and methodology for nurses to reduce their errors during patient hands-off. Several leadership theories and nursing informatics concepts like the implementation of electronic medical records should facilitate many working processes. There are three main objectives in this practice – leadership improvement, EBP implementation, and hands-off control. All these tasks can be achieved under such conditions as purposeful communication with nurses, the choice of a leader, and attention to current knowledge of a topic. Many scholars justify the importance of communication and leadership theories in nursing practice, which makes this project credible for further development.
References
Haykal, T., Al-Dulaimi, R., Sidahmed, S., Velagapudi, R., Fahr, N., Saeed, S., & Bachuwa, G. (2020). Understanding the means of communication between nurses and resident physicians in the modern world: A community-based university hospital survey results. Journal of Community Hospital Internal Medicine Perspectives, 10(2), 107-110. Web.
Kim, A. Y., & Sim, I. O. (2020). Communication skills, problem-solving ability, understanding of patients’ conditions, and nurse’s perception of professionalism among clinical nurses: A structural equation model analysis. International Journal of Environmental Research and Public Health, 17(13). Web.
Shull, J. G. (2019). Digital health and the state of interoperable electronic health records. JMIR Medical Informatics, 7(4). Web.
Strudwick, G., McGillis Hall, L., Nagle, L., & Trbovich, P. (2018). Acute care nurses’ perceptions of electronic health record use: A mixed method study. Nursing Open, 5(4), 491-500. Web.
Xu, J. H. (2017). Leadership theory in clinical practice. Chinese Nursing Research, 4(4), 155-157. Web.