Assignment: The Role of the Nurse Informaticist in Systems Development and Implementation

Assume you are a nurse manager on a unit where a new nursing documentation system is to be implemented. You want to ensure that the system will be usable and acceptable for the nurses impacted. You realize a nurse leader must be on the implementation team.

To Prepare:

· Review the steps of the Systems Development Life Cycle (SDLC) and reflect on the scenario presented.

· Consider the benefits and challenges associated with involving a nurse leader on an implementation team for health information technology.

The Assignment: (2-3 pages)

In preparation of filling this role, develop a 2- to 3-page role description for a graduate-level nurse to guide his/her participation on the implementation team. The role description should be based on the SDLC stages and tasks and should clearly define how this individual will participate in and impact each of the following steps:

· Planning and requirements definition

· Analysis

· Design of the new system

· Implementation

· Post-implementation support

Respond one of your colleagues’ posts by offering a possible resolution to their  questions/concerns with supporting documentation.

at least 2 references in each peer responses! 

  

Nursing boards were created to establish guidelines for the scope of nursing practice. Each state has established its own board; thus regulations can vary by state. Advanced practice registered nurses must be familiar with their own state board’s regulations as it pertains to their practice, and advocate for the expansion of the nurse practitioner’s ability to practice and provide best care. 

Regulation 1

A main topic of conversation among nursing boards is the ability of advanced practice registered nurses (APRN’s) to practice independently of a collaborating physician. As discussed by Bosse et al., (2017), the ability of APRN’s to practice independently would help fill the gap in access to care associated with physician shortages and remote locations. Greater access to care has the potential to improve outcomes and reduce healthcare costs and complications. Currently, Missouri and Illinois both require APRN’s to maintain a collaborative practice agreement with a physician within a certain geographic range (Nurse Practice Act, 2018; Nursing & Collaborative Practice, 1996). The National Council of State Boards of Nursing (NCSBN) encourages APRN’s to advocate for independent practice in their states (Bosse et al., 2017). 

Regulation 2 

As technology plays an increasingly central role in the provision of healthcare, the use of technology must be addressed by regulatory boards. Telehealth is another solution to improving access to healthcare, especially in rural areas. Missouri permits APRN’s to practice virtually if the care is being provided to patients in remote areas (Utilization of telehealth, 2014). Illinois permits APRN’s to treat residents of the state via telehealth without geographical stipulations (Telehealth Act, 2018). 

Conclusion

As nurse practitioners, we can adhere to these regulations while also advocating for the advancement of the advanced practice registered nurse’s role in healthcare. Another opportunity for advocacy lies in the use of telehealth to improve access to care in rural areas. By providing exceptional care and demonstrating the knowledge and skills needed to practice independently, we can emulate the need to expand the scope of practice for nurse practitioners.  

  

1-You make a great point about using open-ended questions to get the most information out of Ms Li. I never considered this but it makes sense. This is is important in this situation as it will open up an opportunity for dialogue and will help Ms. Li feel more comfortable about opening up. By having this type of interaction with her, she will be more apt to share any abuse she may or may not be dealing with at home. Cultural competence is definitely vital in this situation.

  

2-Tamara, good point about the possiblitity that the patient may not be ready to take action right at the moment you are talking to them.  I had a patient one time disclose to me that she was in an abusive situation years ago. A community member from a volunteer organization had given her his business card and said she should call when she was reday for help. That young lady carried his card around for over one year and eventually did call.  In the end, she received the resources she needed. You never know when your patient will be ready to take action. As nurses, we have to keep reaching out and giving them the tools they need.

  

3-This is a good reminder to us, as nurses to be patient with individuals who may not be responding to education/ teaching in the way we initially hoped.  Cultural influences are introduced to us early in life and it’s often times what people fall back on in times of crisis. Just because a patient may not appear to “take our advice” it doesn’t mean thay may not reflect on the conversation later and be ready to begin positve, health-seeking behaviors at a later time.

  

4-It occurred to me that this age group likely has children and could make it a family affair of exercising and spending that time together. It could be a time where everyone is together in one place working as a team. This would also set a good example for children as the rise of obesity and health related problems is growing in this age group. Children follow what they know and if they only know a sedentary lifestyle than that is what they will likely pattern. I also think you make a great point about showing patients visual evidence of the risks and also the benefits. Most people are visual and we live in a world that is centered around tangible evidence so this would most likely have a big impact on the client.

  

5-I think one way to motivate patients is to properly educate them on the risks of not exercising with their health conditions. Most people need to know facts and need to know the “why” behind it. Helping them see that it doesn’t have to be a drastic change but rather a gradual change that they incorporate into their every day life and build on will help them not feel overwhelmed. Also, helping them set up a reward system for themselves would help. For instance, for every 5 or 10 pounds they lose, they get to buy themselves something new or at the end of the month, however much weight they lost, they get to spend that amount of money on something for themselves. Something tangible that they can set a goal and work toward would be helpful. Everyone needs an incentive to motivate them.

  

6-I believe so too! We as people tend to repeat what we are comfortable with. If we make the experience enjoyable people are more likely to repeat the task. Zumba classes have seem to have picked up in my area and may of the staff go to these classes together to keep each other motivated. Being a male in this line of work sometimes makes it hard to find someone to go to the gym with so i have had to reach out to some of my friends outside of the work place to help me stay motivated.

  

Note: It is recommended that you save your response as you complete each question.

  

Question 1 (1 point)

An older male patient reports urinary frequency, back pain, and nocturia. A dipstick urinalysis reveals hematuria. What will the provider do next to evaluate this condition?

Question 1 options:

  

   

a) 

Order     a PSA and perform a digital rectal exam

 

   

b) 

Refer     for a biopsy

 

   

c) 

Refer     the patient to a urologist

 

   

d) 

Schedule     a transurethral ultrasound

Save

Question 2 (1 point)

A 30-year-old male patient has a positive leukocyte esterase and nitrites on a random urine dipstick during a well patient exam. What type of urinary tract infection does this represent?

Question 2 options:

  

   

a) 

Complicated

 

   

b) 

Isolation

 

   

c) 

Uncomplicated

 

   

d) 

Unresolved

Save

Question 3 (1 point)

A high school athlete is brought to the emergency department after collapsing during outdoor practice on a hot day. The patient is weak, irritable, and confused. Serum sodium is 152 mEq/L and has dry mucous membranes and tachycardia. What is the initial approach to rehydration in this patient?

Question 3 options:

  

   

a) 

Hypotonic     intravenous fluid replacement

 

   

b) 

Intravenous     fluid resuscitation with an isotonic solution

 

   

c) 

Loop     diuretics and hypotonic intravenous fluids

 

   

d) 

Oral     water replacement

Save

Question 4 (1 point)

What is an important purpose of conducting an interview prior to beginning neuropsychological testing on an older adult suspected of having dementia?

Question 4 options:

  

   

a) 

To     assess the patient’s ability to cooperate with the testing

 

   

b) 

To     determine the patient’s degree of dementia

 

   

c) 

To     evaluate the patient’s feelings about family members’ concerns

 

   

d) 

To     find out whether a referral to a specialist is needed

Save

Question 5 (1 point)

A patient reports recurrent headaches occurring 1 or 2 times per month that generally occur with weather changes or when sleep patterns are disrupted and describes them as severe, with throbbing on one side of the head and sometimes accompanied by nausea. What is the recommended treatment for this type of headache?

Question 5 options:

  

   

a) 

Gabapentin

 

   

b) 

Propranolol

 

   

c) 

Rizatriptan

 

   

d) 

Topiramate