Application: Design Considerations and Workarounds
When nurse informaticists are tasked with identifying the most appropriate technology to meet a specific need within a health care setting, there are many questions that must be asked.
Consider the following scenario:
Riverdale Hospital has come under recent scrutiny for their medication procedures. Many times, paper medication records are not up to date or have been misplaced. As a result, patients have increasingly received their medications at the wrong times. Though each nurse is performing to the best of his or her ability, the fast pace of the hospital has caused some to ineffectively manage patient records.
The lead nurse informaticist, Nancy, has decided that a bar code scanner could help streamline the documentation process while also improving patient quality and safety. Nancy knows that when selecting a bar coding system she must not only examine the hardware and software of the system but also consider the various human factors that can positively and/or negatively affect the outcomes of the system implementation. As such, Nancy asked three of the most reputable bar code vendors to bring sample systems to Riverdale Hospital.
In evaluating each system, Nancy role plays the process of scanning a patient’s bar code. She rolls the coding cart into the room to begin her mock demonstration. First, Nancy scans her identification card to gain access to the medication screen. To scan the patient’s bar code identifier, Nancy then pulls the medication cart to the patient so that the attached scanner reaches the bar code on the patient’s wristband. When the scan is complete, the computer displays a screen that houses the patient’s personal information. By navigating the screens, Nancy finds that she can use the computer to track medication administration. In addition, Nancy is able to view applicable vitals and medication history. As Nancy continues to examine this system, she reflects on the other hardware and software facets she should be sure to consider. She also thinks about how human factors will affect this and other vendor systems.
In this Assignment, you consider how hardware, software, and human factors can impact the implementation of an informatics system.
To prepare:
Part 1: Design Considerations
Identify two major design considerations associated with each of the following: hardware, software, human factors. (6 considerations in total)
Describe why informaticists should play close attention to each of these considerations when evaluating an informatics technology. In your description, include the potential dangers each of these pose to patient safety and quality of care.
Part 2: Employee Workarounds
Even with a carefully thought out design and implementation, nurses and other health care employees may adopt workarounds. With this reality in mind:
What benefits and/or consequences do you associate with workarounds?
When selecting an informatics technology, would you opt to purchase a system that mitigates the opportunity for workarounds; or do you believe that workarounds are sometimes necessary? Justify your response.
Note: Your responses should focus on informatics technologies in general, not just bar code scanners as portrayed in the scenario. You may, however, use specific examples such as bar code scanners and other informatics technologies to justify your responses.
This Assignment is due Thursday 07/07/16
Required Resources
Readings
Saba, V. K., & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York, NY: McGraw-Hill.
Chapter 2, “Computer Hardware”
This chapter discusses introduces the basics of computer hardware used for nursing informatics.
Chapter 4, “Computer Software”This chapter introduces computer software, as well as the programs that are most relevant to nursing informatics.
Chapter 11, System Life Cycle: A Framework”
In this chapter, the authors introduce the systems life cycle (SDLC) and its stages. These stages are often used by organizations for large-scale projects, such as implementing or upgrading health information technology.
Chapter 13, “System Life Cycle Tools”
Chapter 13 focuses on the tools needed to assist with each phase of the System Life Cycle. Successful implementation projects require clinical expertise as well as technical knowledge from nurse informaticists.
Chapter 9, “Computer Interaction ”
This chapter explains the need for nurses to be informed about human-machine interactions to prevent unintended consequences. Increased awareness of these factors can result in improved performance and outcomes in nursing informatics and other technologies.
Chapter 30, “The Role of Technology in the Medication-Use Process”
In this chapter, the authors discuss how new technologies that can create a safer environment for the patient. This is especially relevant for nurses involved in administering medication and educating patients on its use.
Gooder, V. J. (2011). Nurses’ perceptions of a (BCMA) bar-coded medication administration system. Online Journal of Nursing Informatics, 15(2).Retrieved from the Walden Library databases.
This article explores the outcomes of a bar-coded medication administration (BCMA) system, which included increased patient safety and accuracy of medication. The importance of assessing the impact of a BCMA system on nurses before implementation is also highlighted.
Preheim, G. J., Armstrong, G. E., & Barton, A. J. (2009). The new fundamentals in nursing: Introducing beginning quality and safety education for nurses’ competencies. The Journal of Nursing Education, 48(12), 694–697.Retrieved from the Walden Library databases.
This article discusses the Quality and Safety Education for Nurses (QSEN) initiative and its six competencies, including informatics, that are essential for nursing practice. The authors emphasize that nursing education should shift from task-training and development to more current skills and competencies for informatics and patient-centered care.
Quality and Safety Education for Nurses. (2012). Informatics. Retrieved from http://qsen.org/competencies/graduate-ksas/#informatics
Access this website to explore the knowledge, skills, and attitudes expected of informatics graduates.
Healthcare Information and Management Systems Society. (2015). Informatics competencies for every practicing nurse: Recommendations from the TIGER Collaborative. Retrieved from http://www.thetigerinitiative.org/docs/TigerReport_InformaticsCompetencies.pdf
This comprehensive report provides you with an overview of the TIGER collaborative as well as informatics competencies.
Media
Laureate Education, Inc. (Executive Producer). (2012a). Competencies for nurse informaticists. Baltimore: Author.
Note: The approximate length of this media piece is 10 minutes.
In this week’s media presentation, Gail Latimer, Dr. Patricia Button, and Dr. Roy Simpson overview the progress that the ANA and the TIGER initiative have made in outlining key informatics competencies. In addition, each presenter identifies competencies that he or she believes to be vital to working in the informatics field.
Laureate Education, Inc. (Executive Producer). (2012h). Selecting new technologies. Baltimore: Author.
Note: The approximate length of this media piece is 5 minutes.
Dr. Patricia Button and Dr. Roy Simpson discuss the critical process of selecting the right technology for a health care organization. The presenters discuss the factors to consider, as well as the key skills informaticists should have to successfully lead these processes.
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