Utilization of Electronic Health Record Software in a Nursing Program
Health informatics together with being knowledgeable as well as the use evidenced based practice, are essential components in the provision of quality and safe services in the nursing profession. Most nursing schools have persistently continued to educate the student using the traditional methods without consideration of the changes that are experienced both within and outside the healthcare system (Button, Harrington, & Belan, 2014). The remaining small portion then continues to struggle with various advancements including determination of the five core competencies for the healthcare personnel as stated by the Institution of Medicine (IOM), use of the electronic health records software in preparing their students on critical thinking as well as decision making, focusing on the use of evidence-based literature to guide the nursing practices as well as integration of the high fidelity simulations.
With only a handful number of nurses being equipped with the knowledge on these essential aspects of professional development, it forms a prerequisite of stagnation concerning change hence influencing the manner unto which such nurses will undertake their practices. This proposal addresses the nursing programs that are not utilising the electronic health records software in their program. This gap is evident from the above methods used in the teaching hence impeding the improvement in quality of services that such students will implement in their future practices. Such systems need to be incorporated into the teaching program to assist the students to be well conversant with them and get them ready for their working environments.
Over an extended period, one of the challenges that healthcare providers especially nurses has been effective implementation of the electronic health records systems in the real world area of practice. For effective implementation to take place, there is need for regular system update as well as proper user education which entails the gap that this article addresses. With the incorporation of the system in the education curriculum, the students will find easy time in practicing what they were taught.
Recent internal organizational trends leading up to the gap.
With the revolution in the healthcare system regarding technology use, most of the nursing schools need to assist their educators in incorporating the electronic health records system training not only in the curriculum but also in their lesson plans. The nursing schools are also rushing to get their nurse educators for training on the new technology since majority of the educators are older adults displaying the fact that majority of them might not have learnt the system during their training as well as their practice. The gap then sets in since both the nurse educator and the student nurse are new to the system and it seems they are both learning. The nurse educator did not have the EHRR system during their time of training, and now it turns to be mandatory for their students to be knowledgeable about the system (Button, Harrington, & Belan, 2014).
Other events leading to the gap entails the coming of software such as the SimChart which was significant in training on the EHR education yet majority on the nursing schools have not developed it or its equivalents (Hunt, 2017). At the same time, the system demands the need of an expert to train the nurse educators to master I s use before they pass it to their students. This transitions is slow to impair the implementation of the incorporation of the software into the nursing program.
Organizational background causes of the gap.
The adoption of the electronic health records technology has been on the widespread hence affecting the stakeholders of health including practising nurses as well as other healthcare providers that use the systems on a daily basis. With the system being new and facing resistance in adoption, government and other stakeholders came in to encourage the healthcare facilities to implement the technology which has made it to bore fruits at a very rapid rate. During this entire period of implementation, each facility could adopt any system that could meet their needs. With this in place, the nurse educators are then challenged on the system to pass to their learners since they are not universal yet learners need to be competent to be ready to work in various sectors. The gap then creeps in since the educators have to learn multiple electronic health records systems then harmonise them to fit the nursing curriculum to teach the nursing students both in class and in the clinical settings.
Alongside the need to learn various technology systems, there exists technostress by the nurse educators from the electronic health records software and other clinical courses. The stress originates from the fact that there exists impaired access to electronic health records training materials hence absence of support system to incorporate the software into the nursing program. The realization of the incorporation of the software into the system is further curbed by other factors such as lack of electronic health records technician support in the schools and lack of access of electronic health records during the clinical experiences hence the incorporation will be more theoretical than practical. This makes the nursing schools opting not to incorporating the software into the program since most of the support systems are lacking.
Target audience.
Nurse educators will be of great target since they are on the forefront of implementing the incorporated software. The nurse educators will be trained by information technology experts, informatics nurse specialist as well as the informatics innovators to gain the competencies that they will pass to the nursing students as well as the beginning nurses with no technological skills. The proposal will act as a role out program to guide the nurse educators in the implementation process. Furthermore, the nurse educators will be agents of change to the various nursing schools that they will be able to spread the incorporation hence broadening their field of teaching and training.
This proposal also targets the novice and beginning nurses who need not only the fundamental skills and knowledge but also the electronic health records system to be able to utilize the information technology in patient care. These team of nurses besides being qualified might not have had the opportunity to undergo training on technology and health informatics during their nursing education.
Alongside the novice and beginning nurses, there exist the nursing students who form a special target for the incorporation of the software into the nursing education. Through the program, the resistance from the students can be overcome by exposure, training and guidance through the new system before the implementation of the incorporation. The proposal will change their attitude towards the introduction of the technology software since they will be able to learn various advantages to them, for instance, being technologically equipped increasing their levels of being employed as well as the entire nursing profession as it will lead to better care to the patients.
Proposed solutions.
There is need for the nurse educators to come up with excellent relationships that are objective enough with the health information systems personnel at the healthcare agencies. This will see them gain training and support with the electronic health records and various systems related to it used in various healthcare settings. This will equip them with the skills as well as knowledge that will now enhance incorporation of such systems in the nursing curriculum as they will be competent to take their students through it.
Besides, the students should be taught a harmonized single health system. Such resolution could see the incorporation of the electronic health systems that can be modified to fit their various areas of practice (Bowling, 2016). This will allow the nurse educators only to seek training of the systems and incorporate such software in the education curriculum. In the long run, the incorporation of the technology into the nursing curriculum will be followed by practical implementation in the training of the nursing students.
Prior to the incorporation of the electronic health records software to the nursing program, there is need to develop a clinical scholar model by all nursing institutions (Weaver et al., 2016). With this model, the clinical instructors remain employees of the hospital with a commitment to assignment on certain clinical unit or course which in this case being the electronic health records system. The instructors will then be proficient with the system to facilitate its training when incorporated in the nursing programs. There is also need to build an integrated system of experience that will be embraced by the students based on its relevance and simplicity. Such as system will entail case studies that challenge the nursing students to document their care and come up with clinical judgments in various phases of care, simulations that assist nursing students to build and edit the records of their [patient as well as incorporating the records into the simulations and their practical simulation laboratories. Also, the system needs to encompass the records on the clinical rotations to enable them document to the care provision provided to their patients during their clinical experiences.
Expected Outcomes.
Through the collaboration with the health information systems personnel, the nurse educators will be capable of training and handling difficulties experienced by the students in using the software hence they will help in implementing the incorporation of the software to the nursing curriculum. When the students get exposed to a harmonized single system, they will be able to have gain certain minimal skills that are required for the education program then modify them as per the areas of practice they will get to.
Through a clinical scholar models, the transition of training to practice by the nursing students will be smooth enough. This is so because the learning and use of electronic software will not only be class and theory-based but tested within the clinical setups. The nurse educators will also be able to update students of the various modifications and changes in the use of electronic health records system as they are getting updates from the clinical agencies they are employed in. Furthermore, this arrangement will allow better access to resources within the clinical agencies.
The use of integrated approach to spearhead the incorporation should make the learners equipped with various scenarios from case studies, clinical experiences and simulation. The students will then be motivated and adopt the incorporated software with minimal resistance (Kowitlawakul et al., 2015). In the long haul, will have a prior experience to care of patients and use of the system both in the clinical environment as well as simulated environment hence the confidence to practice the same will be high upon graduating.
Evidence summary.
The relationship created between the nurse educators and the health information technology experts is critical in solving the issue of the failure of the nursing schools in incorporating the electronic health records software in the curriculum (Hunt, 2017). The association provides the nurse educators with modules, resources as well as the confidence which are all facilitators of the implementation process. At the same time, students can be provided with basic knowledge on the new curriculum to enable them to fit the various systems adopted by various clinical agencies. This can be obtained from a harmonized system that is incorporated in the nursing program.
The transition can be made much easier with the nurse educators remaining to practice their nursing career within the hospital or health care agency. This enables the clinical scholar model to be used making the teachers updating the students on the changes and modification in the nursing practice regarding informatics hence the incorporation will be in line with the trends and needs of the students and their clinical settings.
References:
Borycki, E. M., Frisch, N., Moreau, J., & Kushniruk, A. (2015, February). Integration of
electronic health records into nursing education: issues, challenges and limitations. In
ITCH (pp. 88-92).
Bowling, A. M. (2016). Incorporating Electronic Documentation into Beginning Nursing
Courses Facilitates Safe Nursing Practice. Teaching and Learning in Nursing, 11(4), 204-
208.
Burke, M. S., & Ellis, D. M. (2016). Electronic Health Records: Describing Technological
Stressors of Nurse Educators. Nurse educator, 41(1), 46-48.
Button, D., Harrington, A., & Belan, I. (2014). E-learning & information communication
technology (ICT) in nursing education: A review of the literature. Nurse Education
Today, 34(10), 1311-1323.
Doyle, G. J., Garrett, B., & Currie, L. M. (2014). Integrating mobile devices into nursing
curricula: Opportunities for implementation using Rogers’ Diffusion of Innovation model.
Nurse education today, 34(5), 775-782.
Everett-Thomas, R., Valdes, B., Valdes, G. R., Shekhter, I., Fitzpatrick, M., Rosen, L. F., … &
Birnbach, D. J. (2015). Using simulation technology to identify gaps between education
and practice among new graduate nurses. The Journal of Continuing Education in
Nursing, 46(1), 34-40.
Gonen, A., Sharon, D., & Lev-Ari, L. (2016). Integrating Information Technology’s
competencies into academic nursing education–An action study. Cogent Education, 3(1),
1193109.
Hübner, U., Ball, M., de Fátima Marin, H., Chang, P., Wilson, M., & Anderson, C. (2016).
Towards Implementing a Global Competency-Based Nursing and Clinical Informatics
Curriculum: Applying the TIGER Initiative. In Nursing Informatics (pp. 762-764).
Hunt, D. D. (2017). The new nurse educator: Mastering academe. Springer Publishing Company.
Kinnunen, U. M., Rajalahti, E., Cummings, E., & Borycki, E. M. (2017). Curricula Challenges
and Informatics Competencies for Nurse Educators. Studies in health technology and
informatics, 232, 41-48.
Kowitlawakul, Y., Chan, S. W. C., Pulcini, J., & Wang, W. (2015). Factors influencing nursing
students’ acceptance of electronic health records for nursing education (EHRNE) software
program. Nurse education today, 35(1), 189-194.
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Miller, R. L. (2015). Rogers’ innovation diffusion theory (1962, 1995). Information seeking
behavior and technology adoption: Theories and trends, 261-274.
Weaver, C. A., Ball, M. J., Kim, G. R., & Kiel, J. M. (2016). Healthcare information
management systems. Cham: Springer International Publishing.
Implementation plan.
The implementation of the software will be guided by the Technology Informatics Guiding education Reforms (TIGER) initiative that outlines the activities that need to be undertaken by the nursing leadership in integrating technology into the nursing education (Hübner et al., 2016). Through this initiative, the ensuring schools that have not incorporated the EHR software into their nursing [programs will create virtual learning environment where the nurse educators and students will have accounts (Borycki et al., 2015). Through the use of the accounts, each will be having an avatar to represent them and facilitate their interaction amongst themselves. Through the virtual environments, the nursing students will be able to conduct various clinical procedures which will not only promote their use of technology but be another form of enhancing the nursing education.
The simulation will be incorporated into the electronic health records where the students will be able to assess and plan the care of the patient and document. The nurse educators will be able to trace the learning activities of their students through the same simulation and be able to determine the progress of each nursing student as they will have different accounts and avatars. From the simulated system of electronic health records, both the parties will be able to explore the virtual learning environment with the help of technology experts and be familiar with such environment which may be modified to be a health facility of just a unit depending on the number of students and the aim of the system that is to be taught.
A timeline.
The installation of the computer laboratory and creating of the virtual learning environment to be planned and achieved within one month. This will be followed by six months of training and availing of the environment for exploration and conduction of trials by both nurse educators and nursing students for six months. The software can then be incrporate3d to the curriculum upon being accredited by the concerned regulatory bodies. The program will be launched by assigning each system to the students in each semester so that as they get trained for the electronic health record, they work on other systems that may be encountered in various clinical areas. Throughout the nursing training period, the students will be exposed to computerised documentation systems in their usual nursing programs to enhance their experience hence supporting the implementation of the software into their program.
Needed resources and personnel.
The TIGER Virtual Learning Environment will provide the health information technology modules and other associated software which are critical resources in the incorporation of the EHR software into nursing program. Depending on the number of students and nurse educators in the nursing schools, each nursing school will require a computer center where the learning environment will be accessed for both trialability, training as well as learning purposes (Hübner et al., 2016). Another essential resource would be health information technology expert especially those working in the clinical agencies which will train the nurse educators and assist them in the handling of various drawbacks as they train and assist the novice and the beginning nurses. There will also be need to live and on-demand webinars that may act as tutorials to get the parties ready for the incorporation of the software.
Proposed change theory.
With the incorporation of the electronic health records software involving various stakeholders including nurse educators, nursing students, clinical agencies, practising nurses as well as the information technology department among others, its implementation needs to take care of all these parties. For successful incorporation, all the frontline users of the system need to be significantly involved commencing with the nursing educators and the nursing students. The resistance that the adoption of the new software into the nursing program face can be related to the feeling that both the nurse educators and the nursing students have towards the system. The students may be feeling that the system is complex and may complicate their learning process since their focus of training is on the care provision to the patient rather than the logistics involved in the entire management. The nurse educators might also be feeling that the software is new to them hence impairing the workflow of training and teaching their students on various skills and knowledge on patient care.
Since the entire move is an adoption of new software that was not there earlier on, I suggest the use of the Everett Rogers model of innovative-diffusion to guide and make the software be embraced into the nursing programs (Doyle, Garrett, & Currie, 2014). This model determines the feeling that individuals develop while adopting new technology hence provides various qualities—relative advantage, compatibility with existing values and practices, simplicity, trialability and observable results, that ought to prepare the nursing students and their educators in embracing the incorporation of the technology software into their program and facilitate its implementation.
Relative advantage.
Relative advantage refers to the manner into which the innovation has to be seen as an improvement when compared to the old one so as the change to be adopted by an individual (Miller, 2015). With commitment of the nurse educators in their teaching and training role and the student nurses in the learning responsibility, both teams tend to resist change that interferes with these usual activities in their daily living. According to Rogers, face to face communication to the concerned parties is essential in that it allows both the nurse educators and the students together with other stakeholders to share the information and feelings that come with the transition in the teaching program. With this in mind, the implementation will take the form of creating implementation teams through which the advantages of the system will be displayed.
The advantages to presented before the audience will entail equipping the nursing students with knowledge and skills that fit the technological competencies in the clinical markets to meet the use of the electronic health records which has not been achieved using the old methods of training. To the students, the incorporation of the software will enable them to have both basic computer skills and knowledge on various systems that can fit the clinical agencies hence they will be highly marketable upon completion of their courses. Also, the incorporation of the software into the nursing program will not only be used in the nursing schools but also in the clinical areas that have not adopted the electron health records systems into their facilities. This will translate to increased demand for the nurse educators to train the nurses already in practice yet does not have the skills in the new technology. With all these critical advantages, both the nurse educators and the nursing students will be able to embrace the incorporation of the software in their learning program.
Through the meetings, the parties will be provided with additional awareness, knowledge and skills before the incorporation of the software to the program. This will allow resolution of some negative feelings that they may have developed and promote positive attitudes that will enable the use of the software in training.
Compatibility with existing values and practices.
Nurse educators and nursing students can promote the adoption of the new software into their program when they fathom the manner unto which the existing values and practices in the nursing training get along and are compatible with the new method of teaching and learning at large. Effective communication is vital to this understanding. According to McGonigle and Mastrian (2015), an adoption process like incorporation of the EHR software can work if nursing flow is incorporated in the designs and the resources already available in the nursing curriculum. With this effected, the nursing students and educators will be dealing with relatively familiar processes in the nursing curriculum.
The implementation plan will entail informing both the nurse educators and the students that the incorporation of the software, procedures entailed in its training, teaching processes as well as policies surrounding it involved fellow nurses and nurse educators. Besides, it will be of great need to make the super users, and expert trainers of the software are available to the nurse educators to handle difficulties and questions regarding the incorporation as well as training the nursing students using the new software in the nursing schools.
Simplicity.
Resistance and failure to incorporate the software into the nursing programs come with difficulty. The simpler the incorporation of the software the more willing both the nursing students and nursing educators will be to adopt it and embrace its incorporation. Before the incorporation, there is need to commence computer literacy classes to serve both the students and their educators. The classes will provide the two groups with the basic computer knowledge. After that, both the students and the nurse educators who might be novice to computers have their fears eased making them to view the incorporation and use of the electronic health records software a more straightforward issue.
In addition to the training in making the issues further simpler, there is need for creation of a buddy system where there is assigning of expert users of the software among the student nurses and the educators to those who are not. Both the provision of extra training and development of a buddy system can increase the skills and knowledge of both the nurse educators and their students hence reduce the fear of unknown making it easier to incorporate the software and make its implementation a success.
Trialability.
Those who can explore the new software prior to its incorporation are less resistant and more willing to be part of its incorporation (Miller, 2015). After the training sessions to the two groups, they will be given access to various software incorporated by other institutions to allow them to explore and get familiar with the software. At the same time, the computer laboratories created in these nursing schools will have the software running for some time to allow both the students and the teachers to ‘play around with it’. During such periods, the individuals will be able to navigate the software at their own pace hence easing the anxiety and difficulty that usually engulfs both the students and their teachers as they curbed by their busy schedules.
Observable results.
Observable results provide the adopter with evidence demonstrating the manner unto which the incorporation of the new software has been successful both in equipping nursing students as well as impacting the overall nursing education. There is need to provide evidence-based outcomes to both nursing students and the nurse educators. These include impacts and research studies pertaining the high employability for the nursing graduates with the technical skills as well as the overall revolution advantage of the having nurses with electronic health records system competencies, e.g. increased implementation of the system with such nurses on the practice and the improved care and safety of nursing services. All these will demonstrate to them the manner unto which the incorporation of the system, has worked for other institution and impacting the entire nursing profession. Besides, it will promote the theory since the strategy will display the positive outcome of the software hence reduce resisters and increase the number of adopters among the nursing school that will lead to widespread incorporation of the software to the nursing program.
Barriers to implementation.
The incorporation of the electronic health records software to the nursing program is vulnerable to challenges such as the resistance by the nurse educators and the entire nursing leadership. This is so because they are usually unsure of the process of integrating information technology into the nursing curriculum hence may not be familiar with what it entails. The students can also resist the change due to negative attitude towards the curriculum development (Gonen, Sharon, & Lev-Ari, 2016).
Limited funding and cost can also thwart the incorporation of the software. This is so because the purchasing of the computers and installation of a modern computer laboratory that can create a virtual learning environment is costly. The incorporation of the software also translates to employment of additional staffs by these nursing schools. All these require sufficient funding that may not be met by all nursing schools.
Another barrier is the existence of various software of electronic health records used by different hospitals. This makes it difficult to come up with software that will be fitting each hospital needs. This can be encountered by harmonizing the technology software to be able to provide the basic and relatively standardized competencies for the use of the system.
Conclusion.
Indeed, the radical transformation of the nursing profession marks the rapidly changing contexts of the healthcare environment. All the changes that occur in science, technology as well as the healthcare system are major expectations that nurses are looked up to for safe and quality healthcare provision. For the nursing field to meet the continuously changing expectations, the nursing education needs to be moved from the old methods of teaching and get transformed to incorporate the new software that meets the standards of the job market. All these can only be achieved when there is a faculty committee in the integration of the informatics and the electronic health records system in the entire nursing program for better preparation of the ensuring graduates to provide for the needs of the healthcare users.
The incorporation of the electronic health records software ought to have been driven from various directions with different professional organizations, it is through such moves that the integration will be stable, and the students will have opportunities to navigate the technology, do documentation of patient care in a simulated environment as well as aiding in the development of critical thinking skills that are key in nursing care provision. The competencies will also guide the nurse educators on the various modification which the incorporation of the electronic health records system can have to make it better.
The implementation plan needs to take the form of utilizing the already available recourses as well as addition of other essential resources. With the Everett Rogers theory of innovative adoption model, both the nurse educators and the nursing students can be moved from resisters to adopters hence a realization of a smooth transition in the incorporation process.
