Please review complete instructions on attached document

**use example document as a guide*

Review the resources provided by school ( attached articles) and use 1 or 2 in the assignment.

Use APA 7

**DEADLINE:

FRIDAY 3/26/2021 BY 08:00pm EST**

Assignment: Th

e

Impact of

Nurs

in

g

Informatics

on Patient

Outcomes

and

Patient Care Efficiencies

In the Discussion for this module

,

you considered the interaction of nurse informaticists with other

specialists to ensure successful care

.

How is that success determined?

Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is

measured. Measuring

patient

outcomes results in the generation of data that can be

used to improve

results. Nursing informatics can have a significant part in this process and can help to improve

outcomes by improving processes, identifying at

–

risk patients, and enhancing efficiency.

To Prepare:

·

Review the concepts of technology applic

ation as presented in the Resources.

References

Mosier, S. ,

Roberts, W. D. & Englebright, J. (2019

)

. A Systems

–

Level Method for Developing Nursing Informatics

Solutions. JONA: The Journal of Nursing Administration, 49(11), 543

–

548. doi:

10.109

7

/NNA.0000000000000815

.
References

Alexander, S., Ng, Y. C., &

Frith, K. H. (2018). Integration of Mobile

Health

Applications in Health

Information

Technology

Initiatives: Expanding Opportunities for Nurse Participation in

Population Health.

 

CIN:

Computers,

Informatics,

Nursing, 

36

(5), 209

–

213.

References

Sipes, C. (

2016). Project Management: Essential Skill of Nurse Informaticists.

 

Studies

in Health Technology and Informatics, 

225

, 252

–

256.

·

Reflect on how emerging technologies such as artificial intelligence may help fortify nursing

informatics as a

specialty by leading to increased impact on patient outcomes or patient care

efficiencies.

The Assignment:

(4

–

5 pages not including the title and reference page)

In a 4

–

to 5

–

page project proposal written to the leadership of your healthcare

organization, propose a

nursing informatics project for your organization that you advocate to improve patient outcomes or

patient-

care efficiency. Your project proposal should include the following:

·

Describe the project you propose.

·

Identify the stakehol

ders impacted by this project.

·

Explain the patient outcome(s) or patient

–

care efficiencies this project is aimed at improving

and explain how this improvement would occur. Be specific and provide examples.

·

Identify the technologies required to implement th

is project and explain why.

·

Identify the project team (by roles) and explain how you would incorporate the nurse

informaticist in the project team.

** Please follow the example provided by teacher** (se

e

attachment

)
·

Use APA

7

format and include a title page and reference page.

·

Please use 1 or 2 of the resources provided by the school… (See attached articles)

·

At least 4

–

6 references

**DEADLINE: FRIDAY 3/26/2021 BY 08:00pm EST**

Assignment: The Impact of Nursing Informatics on Patient

Outcomes and Patient Care Efficiencies

In the Discussion for this module, you considered the interaction of nurse informaticists with other

specialists to ensure successful care. How is that success determined?

Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is
measured. Measuring patient outcomes results in the generation of data that can be

used to improve
results. Nursing informatics can have a significant part in this process and can help to improve
outcomes by improving processes, identifying at
–
risk patients, and enhancing efficiency.

To Prepare:

·

Review the concepts of technology applic
ation as presented in the Resources.

References

Mosier, S. ,

Roberts, W. D. & Englebright, J. (2019). A Systems
–
Level Method for Developing Nursing Informatics
Solutions. JONA: The Journal of Nursing Administration, 49(11), 543
–
548. doi:
10.1097/NNA.0000000000000815
.

References

Alexander, S., Ng, Y. C., &
Frith, K. H. (2018). Integration of Mobile Health Applications in Health

Information Technology Initiatives: Expanding Opportunities for Nurse Participation in

Population Health.

CIN:

Computers,

Informatics,

Nursing
,

36
(5), 209
–
213.

References

Sipes, C. (
2016). Project Management: Essential Skill of Nurse Informaticists.

Studies

in

Health

Technology

and

Informatics
,

225
, 252
–
256.

·

Reflect on how emerging technologies such as artificial intelligence may help fortify nursing
informatics as a
specialty by leading to increased impact on patient outcomes or patient care
efficiencies.

The Assignment:

(4
–
5 pages not including the title and reference page)

In a 4
–

to 5
–
page project proposal written to the leadership of your healthcare
organization, propose a
nursing informatics project for your organization that you advocate to improve patient outcomes or
patient
–
care efficiency. Your project proposal should include the following:

·

Describe the project you propose.

·

Identify the stakehol
ders impacted by this project.

·

Explain the patient outcome(s) or patient
–
care efficiencies this project is aimed at improving
and explain how this improvement would occur. Be specific and provide examples.

·

Identify the technologies required to implement th
is project and explain why.

·

Identify the project team (by roles) and explain how you would incorporate the nurse
informaticist in the project team.

** Please follow the example provided by teacher** (se
e
attachment
)

·

Use APA

7

format and include a title page and reference page.

·

Please use 1 or 2 of the resources provided by the school… (See attached articles)

·

At least 4
–
6 references

**DEADLINE: FRIDAY 3/26/2021 BY 08:00pm EST**

Assignment: The Impact of Nursing Informatics on Patient

Outcomes and Patient Care Efficiencies

In the Discussion for this module, you considered the interaction of nurse informaticists with other

specialists to ensure successful care. How is that success determined?

Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is

measured. Measuring patient outcomes results in the generation of data that can be used to improve

results. Nursing informatics can have a significant part in this process and can help to improve

outcomes by improving processes, identifying at-risk patients, and enhancing efficiency.

To Prepare:

 Review the concepts of technology application as presented in the Resources.

References

Mosier, S. , Roberts, W. D. & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics

Solutions. JONA: The Journal of Nursing Administration, 49(11), 543–548. doi:

10.1097/NNA.0000000000000815.

References

Alexander, S., Ng, Y. C., & Frith, K. H. (2018). Integration of Mobile Health Applications in Health

Information Technology Initiatives: Expanding Opportunities for Nurse Participation in

Population Health. CIN: Computers, Informatics, Nursing, 36(5), 209–213.

References

Sipes, C. (2016). Project Management: Essential Skill of Nurse Informaticists. Studies in Health

Technology and Informatics, 225, 252–256.

 Reflect on how emerging technologies such as artificial intelligence may help fortify nursing

informatics as a specialty by leading to increased impact on patient outcomes or patient care

efficiencies.

The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a

nursing informatics project for your organization that you advocate to improve patient outcomes or

patient-care efficiency. Your project proposal should include the following:

 Describe the project you propose.

 Identify the stakeholders impacted by this project.

 Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving

and explain how this improvement would occur. Be specific and provide examples.

 Identify the technologies required to implement this project and explain why.

 Identify the project team (by roles) and explain how you would incorporate the nurse

informaticist in the project team.

** Please follow the example provided by teacher** (see attachment)

 Use APA 7 format and include a title page and reference page.

 Please use 1 or 2 of the resources provided by the school… (See attached articles)

 At least 4-6 references

2

Nursing Informatics and Patient Outcomes and Care Efficiencies

Your Name

Walden University

N6051: Transforming Healthcare Through Information Technology

Dr. Karen Robson DNP, RN-BC, RAC-CT

March 28, 2021

Nursing Informatics and Patient Outcomes and Care Efficiencies

Type your paper here. The title references belong on a separate page. DO NOT USE WEBSITES SUCH AS WIKIPEDIA, ANSWERS.COM, STUDENTOFFORTUNE, ETC. USE YOUR COURSE MATERIAL. USE THE UNIVERSITY LIBRARY TO FIND JOURNAL ARTICLES. DO NOT USE PERSONAL PRONOUNS SUCH AS I, ME, US, THEY, ETC. This brief paragraph will introduce your paper and the main topic. The maximum length is 3-5 pages. Excess of five pages will result in a point deduction. The entire document is Times New Roman 12 font

Project

The response accurately and thoroughly describes in detail the project proposed.

Stakeholders

Start paragraph here…………………………. The response accurately and clearly identifies the stakeholders impacted by the project proposed.

Patient Outcomes/ Efficiencies

The response accurately and thoroughly explains in detail the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an accurate and detailed explanation, with sufficient supporting evidence of how this improvement would occur.

Required Technology

The response accurately and clearly identifies the technologies required to implement the project proposed with a detailed explanation why.

Project Team

The response accurately and clearly identifies the project team (by roles) and thoroughly explains in detail how to incorporate the nurse informaticist in the project team.

Conclusion

This should be one concise paragraph that summarizes the entire document. No new information or references should be included in the conclusion.

References

(These are examples for format only; these examples are not related to the content addressed for the assignment. Please use scholarly resources as well as course material to support the information you have shared. Please be sure to review the rubric for assignments; at least 5 scholarly resources are required for full credit.)

Agency for Healthcare and Research Quality (AHRQ). (n.d.). Medical errors and patient safety.

http://www.ahrq.gov/qual/errorsix.htm

Burgess, R. (2019). Rethinking global health: Frameworks of power. Routledge.

Millar, R., Freeman, T., & Mannion, R. (2015). Hospital board oversight of quality and safety: a

stakeholder analysis exploring the role of trust and intelligence. BMC Health Services

Research, 15(1), 1-12. doi:10.1186/s12913-015-0771-x

Project Management: Essential Skill of
Nurse Informaticists

Carolyn SIPES1
Chamberlain College of Nursing, NI Research Team

National Management Offices, 3005 Highland Parkway, Downers Grove, IL 60515

Abstract: With the evolution of nursing informatics (NI), the list of skills has
advanced from the original definition that included 21 competencies to 168 basic
competencies identified in the TIGER-based Assessment of Nursing Informatics
Competencies (TANIC) and 178 advanced skills in the Nursing Informatics
Competency Assessment (NICA) L3/L4 developed by Chamberlain College of
Nursing, Nursing Informatics Research Team (NIRT). Of these competencies,
project management is one of the most important essentials identified since it
impacts all areas of NI skills and provides an organizing framework for
processes and projects including skills such as design, planning, implementation,
follow-up and evaluation. Examples of job roles that specifically require project
management skills as an essential part of the NI functions include management,
administration, leadership, faculty, graduate level master’s and doctorate practicum
courses. But first, better understanding of the NI essential skills is vital before
adequate education and training programs can be developed.

Keywords: nursing informatics, project management, education, essentials,
TANIC, TIGER, NICA-L3/L4

1. Introduction: History and Definitions

In today’s high-tech world, expectations of the healthcare industry is that nurses will
have informatics competencies including project management skills which are critical
for improved quality outcomes and safety for patients. This is not only true for nurses
in graduate courses, clinical practice management roles but administrative and other
leadership roles as well. The expectation is that all of these roles as well as others
described below will bring well-developed skills to the job.

Nursing Informatics (NI) has evolved beyond the definition of data management
defined early on by Staggers, Gassert, and Curran [1] but is still considered by many as
the primary and only skill of a nursing informaticist. Today, the American Nurses
Association’s (ANA) expanded definition of NI suggests that, “Nursing Informatics
(NI) is the specialty that integrates nursing science with information and analytical
sciences to identify, define, manage and communicate data, information, knowledge
and wisdom in nursing practice. NI supports nurses, consumers, patients, the
interprofessional healthcare team, and other stakeholders in their decision- making
in all roles and settings to achieve desired outcomes.” (p. 1-2) [2].

1 Corresponding author: Dr. Carolyn Sipes, PhD, CNS, APN, PMP, RN-BC; Chamberlain College of Nursing,
Downers Grove IL. National Management Offices, 3005 Highland Parkway, Downers Grove, IL 60515;
email: csipes@chamberlain.edu

Nursing Informatics 2016
W. Sermeus et al. (Eds.)

© 2016 IMIA and IOS Press.
This article is published online with Open Access by IOS Press and distributed under the terms

of the Creative Commons Attribution Non-Commercial License.
doi:10.3233/978-1-61499-658-3-

252

252

mailto:csipes@chamberlain.edu

In order to meet the Institute of Medicine (IOM) mandate of developing the
nursing workforce of 2020, we must provide a mechanism to first assess and
understand competencies/skills needed by the workforce [3]. While project
management as NI skills are more the expectation of healthcare providers and nursing
leadership, there remains a lack of understanding of what these are and how they are an
essential competency of NI. McGonigle, Hunter, Sipes, and Hebda, suggest that even
today “there is a lack of understanding of exactly what nursing informatics is in the
way of skills needed or how they can and should be applied to practice” [4].

Presently, NI has a much broader definition, evolved from the 21 essential
competencies defined by Staggers, et al., to 167 basic skills defined in the TIGER-based
Nursing Informatics Competencies (TANIC) developed by Hunter, McGonigle, and
Hebda, and the 178 advanced items in the Nursing Informatics Competency Assessment
(NICA) – L3/L4 self-assessment tools developed by McGonigle, Hunter,, Hebda, and Hill
[1,6,7,10]. Chamberlain College of Nursing, Nursing Informatics Research Team (NIRT)
(Hunter, et.al, 2014) developed expertise designing competency skill-assessment
instruments as well as conducting research studies on competency utilization, and as
such, has implemented the tools for students to self-assess skills in the NI courses [7].

The ANA (2015) Nursing Informatics Scope and Standards outlined above
clearly defines specialty of NI as the skill to integrate sciences into nursing practice using
skills to “identify, define, manage and communicate data, information, knowledge …
(p.1-2).” The standards further suggest that NI supports judgments in all positions,
functions and settings; the support is achieved through the use of information constructs
and information methods and practices – attributes of a NI. [2] Although the skills are
now attributed to NI, historically these were originally defined as concepts of project
management defined by the engineering community in the 1950s.

Sipes references the history of project management through an article by Cleland
and Gareis, who relate that “…in the 1950s, project management was formally
recognized as a distinct contribution arising from the management discipline” (pp. 1–4)
[8, 9]. Sipes further discusses how engineering, at the forefront of project management,
has become a “key management strategy in large corporations, such as IBM, and more
recently, in healthcare, where there is a need to put formalized structure and
management to organizational tasks” (p.12). Sipes adds that nurses “….use a structured
approach when providing care to patients such as the nursing process. Patient care
management requires an organizational framework—processes similar to those used in
project management are used to manage patient care” (p.12) [8].

The three larger categories, defined in the tools, TANIC and NICA-L3/4, discussed
above, are computer, informatics knowledge, and informatics skills. The skill sets have
been extended to include major subcategories as systems integration, selection and
maintenance, quality improvement, data terminologies, impact analysis,
privacy/security, systems input/output, usability, data mining and structures and project
management.

Project management is one of the largest but least understood essentials of the NI
knowledge and skill set. It includes five major steps: Design/Initiation, Plan,
Implementation, Monitor/Control and Evaluation/Lessons Learned

In the discussion below, methods of how the tools, TANIC and NICA – L3/L4, are
applied in Chamberlain’s graduate courses to self-assess the NI students current skills on
four levels including the project management skills. As more information is shared, such
as in American Association of Colleges of Nursing (AACN) webinars presented by
Chamberlain NIRT, the competency self-assessment tools are being requested by

C. Sipes / Project Management: Essential Skill of Nurse Informaticists 253

healthcare leadership to integrate into job roles and requirements. More detail of project
management attributes applicable in job roles and requirements is presented below.
Many of the same project management attributes are also required for graduate students
as they develop and implement practicum projects as the master’s and doctoral levels.

2. Method

The methods to self-assess NI skills were implemented by Chamberlain in the
graduate NI specialty track in order for the faculty to better understand student skill
needs, As faculty analyze students’ results, they can determine gaps/needs in skill sets.
Then based on analysis of the information, curricula are developed to mitigate gaps
in skill levels needed by students and most importantly, as they enter the 2020
workforce. The model used in graduate courses is discussed below. Employing this
process further enhances the practicum experiences as it provides an organizational
framework in which to work.

2.1 Utilization of information from analysis

The NI competency self-assessment tools add clarity and specificity to better
understand exactly what skills are required as awareness of project management (PM)
skills become more evident. To determine NI skill levels in graduate student population
at Chamberlain, the TANIC and NICA – L3/L4 tools are integrated into master’s level
core courses. Students self-assess skills beginning the program and then again at the
end of their master’s graduate practicums. The application of project management
skills are fully implemented in the two Chamberlain graduate NI specialty practicums –
I and II. Students are required to apply skills as they develop and plan a project in
Practicum I, then implement and evaluate projects at a clinical site in Practicum II, thus
utilizing PM skills developed during practicums. These same skills are required in most
job roles in healthcare. They learn to apply skills which are needed to be successful in
both the practicums and their “real-world” projects.

3. Results

Feedback from students at the end of their practicums emphasizes the success of this
model as students realize the value of the skills they just implemented at a healthcare
site on an actual project. Now, they say they would not only use these skills in their job
roles but see how they can use them when managing everyday tasks. Today, project
management skills are more recognized as a need. The organizing framework of project
management is applicable in graduate level practicums, clinical practice, healthcare
administration and leadership. Below are examples of some of the roles that require
project management skills today.

3.1 Project Management as an essential skill of NI

National organizations discussed above deliberate how nursing leaders must have
computer and informatics knowledge and skills in order to be effective in their roles.

C. Sipes / Project Management: Essential Skill of Nurse Informaticists254

The skills discussed are project management competencies as well as others in
informatics. Yet, according to McGonigle, Hill, Hunter, Sipes, and Hebda, “trying to
reach the goals set forth by these organizations has been hindered by a lack of
procedures and assessments available for determining nurses’ informatics
competencies- what they actually require in order to be competent in their job roles” [4,
pp. 104-112]. The project management skills of NI can be applied universally in many
settings and job roles. Students developing projects for their practicums or research
studies and everyday tasks would benefit from a more formalized structure and
organization.

According to Sipes the partial list of project management skills and competencies
includes such tasks as: development/implementation of work plans,
design/development of systems, function as lead/project manager in all phases of the
systems life cycle, and development and implementation of all organizational
documents required as a project manager to successfully manage a project [8, pp.143-
158]. Examples of specific project management skills listed above are seen in
advertised job descriptions as well as graduate level courses, including those for the
role of nurse administrators, such as nurse executives (NE), nurse managers, nurse
practitioners (NP), clinical nurse specialists (CNS), informatics nurse specialist (INS),
chief nurse informatics officer (CNIO), chief nursing officer (CNO), and doctor of
nursing practice (DNP) student in the final practicum before graduation.

The project management skills needed by the NP and CNS are important in order
to set up and manage clinics and for a DNP graduate project. An INS would need the
skills above to support an electronic medical record (EMR) implementation and
informatics skills to perform system/workflow analysis for a new computer system.

4. Discussion

National organizations such as those previously discussed – the IOM, ANA and others
– identified a need to develop knowledge and skills including more advanced education
of the nursing workforce of 2020. Yet skill sets needed to provide better, safer patient
care and outcomes are sorely lacking. For example, some think that having the skill to
develop a slide presentation is the only “real” skill needed that qualifies as both an
informatics and PM skill. Or that data collection and analysis fulfills the job
descriptions for project management and informatics.

We must assess and understand current competencies/skills, then address gaps in
education by developing more relevant curricula that will meet needs of the workforce for
2020. To that point, McGonigle, Hunter, Sipes, and Hebda, suggest that even today
“there is a lack of understanding of exactly what nursing informatics is in the way of
skills needed or how they can and should be applied to practice” [4].

C. Sipes / Project Management: Essential Skill of Nurse Informaticists 255

4.1 Need to inform and empower

Today, to be a NI no longer requires just the skills to manage data and databases as
previously discussed. It requires much more and has evolved to nearly 200 advanced
skills – now more than ever expected by healthcare provider and organizational
leadership as well as masters and doctoral level students and faculty. One of the most
essential skills is project management. Education programs must be established that
meet the needs of nurses to develop these skills, as well as empower them to enhance
their practices.

5. Acknowledgements

A special thank you to Chamberlain College of Nursing faculty support from Drs. Toni
Hebda, Dee McGonigle, Kathleen Hunter, Taryn Hill, and colleague Jean Lamblin.

References

[1] N. Staggers, C . Gassert, & C. Curran, Informatics competencies for nurses at four levels of practice.
Journal of Nursing Education, 40 (7) (2001) 303-16.

[2] American Nurses Association Nursing informatics: Scope and standards of practice; p.1 -2 (2nd Ed.).
(2015). Silver Spring, MD: Author.

[3] Institute of Medicine (IOM): The Future of Nursing: Leading Change, Advancing Health.
Committee on the Robert Wood Johnson Foundation initiative on the future of nursing, at the
institute of medicine. (2010), Retrieved from http:wwwthefutureofnursing.org. p.140.

[4] D. McGonigle, K. Hunter, C. Sipes, & T. Hebda, Why nurses need to understand nursing
informatics, AORN Journal, September, (2014).100 (3).

[5] K. Hunter, D. McGonigle, & T. Hebda The integration of informatics content in baccalaureate and
graduate nursing education: A status report. Nurse Educator, 38(3):(2013).110 -113.doi:
10.1097/NNE.0b013e31828dc292

[6] D. McGonigle, K. Hunter, T. Hebda, & T. Hill, Self-Assessment of Level 3 and Level 4 NI
Competencies Tool Development. (2014) Retrieved from http://himss.files.cms-
plus.com/FileDownloads/Self- Assessment .

[7] Hunter, K., McGonigle, D., T. Hill, T. Hebda, & C. Sipes Self-Reported Assessment of Basic and
Informatics Specialist/Innovator Nursing Informatics Competencies: TANIC© and NICA L3/L4©.
Nursing Informatics Today, 29 (2), (2014). 4-6.

[8] C. Sipes, Project Management for the Advance Practice Nurse, Springer, New, York, September;
(2016) (p.12, 113).

[9] D. Cleland & R. Gareis, R. Global project management handbook; (2006) (pp.1-4). New York, NY;
McGraw- Hill Professional.

[10] T. Hill, D. McGonigle, K. Hunter, C. Sipes, & T. Hebda An instrument for assessing advanced
nursing informatics competencies. Journal of Nursing Education and Pra ctice, 4 (7), (2014) 104.

C. Sipes / Project Management: Essential Skill of Nurse Informaticists256

http://himss.files.cms-plus.com/FileDownloads/Self-Assessment

http://himss.files.cms-plus.com/FileDownloads/Self-Assessment

http://himss.files.cms-plus.com/FileDownloads/Self-Assessment

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3/22/2021 Rubric Detail – Blackboard Learn

https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16813466_1&rubric_id=_2258812_1 1/4

Rubric Detail
Select Grid View or List View to change the rubric’s layout.

  Excellent Good Fair Poor

In a 4- to 5-page
project proposal
written to the
leadership of
your healthcare
organization,
propose a
nursing
informatics
project for your
organization
that you
advocate to
improve patient
outcomes or
patient care
e�ciency. Your
project proposal
should include
the following:

·   Describe the
project you
propose.

·   Identify the
stakeholders
impacted by this
project.

·   Explain the
patient

77 (77%) – 85
(85%)

The response
accurately
and
thoroughly
describes in
detail the
project
proposed.

The response
accurately
and clearly
identi�es the
stakeholders
impacted by
the project
proposed.

The response
accurately
and
thoroughly
explains in
detail the
patient
outcome(s)
or patient-
care
e�ciencies
that the
project
proposed is

68 (68%) – 76
(76%)

The response
describes the
project
proposed.

The response
identi�es the
stakeholders
impacted by
the project
proposed.

The response
explains the
patient
outcome(s)
or patient-
care
e�ciencies
that the
project
proposed is
aimed at
improving,
including an
explanation,
with some
supporting
evidence of
how this
improvement
would occur.

60 (60%) – 67
(67%)

The response
describing
the project
proposed is
vague or
inaccurate.

The response
identifying
the
stakeholders
impacted by
the project
proposed is
vague or
inaccurate.

The response
explaining
the patient
outcome(s)
or patient-
care
e�ciencies
the project
proposed is
aimed at
improving,
including an
explanation
of how this
improvement

0 (0%) – 59
(59%)

The response
describing the
project
proposed is
vague and
inaccurate, or
is missing.

The response
identifying the
stakeholders
impacted by
the project
proposed is
vague and
inaccurate, or
is missing.

The response
explaining the
patient
outcome(s) or
patient-care
e�ciencies the
project
proposed is
aimed at
improving,
including an
explanation of
how this
improvement

Name: NURS_5051_Module02_Week04_Assignment_Rubric

EXIT

Grid View List View

3/22/2021 Rubric Detail – Blackboard Learn

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  Excellent Good Fair Poor
outcome(s) or
patient-care
e�ciencies this
project is aimed
at improving,
and explain how
this
improvement
would occur. Be
speci�c and
provide
examples.

·   Identify the
technologies
required to
implement this
project and
explain why.

·   Identify the
project team (by
roles) and
explain how you
would
incorporate the
nurse
informaticist in
the project team.

aimed at
improving,
including an
accurate and
detailed
explanation,
with
su�cient
supporting
evidence of
how this
improvement
would occur.

The response
accurately
and clearly
identi�es the
technologies
required to
implement
the project
proposed
with a
detailed
explanation
why.

The response
accurately
and clearly
identi�es the
project team
(by roles) and
thoroughly
explains in
detail how to
incorporate
the nurse
informaticist
in the project
team.

Includes: 3 or
more peer-
reviewed
sources and
2 or more

The response
identi�es the
technologies
required to
implement
the project
proposed
with an
explanation
why.

The response
identi�es the
project team
(by roles) and
explains how
to
incorporate
the nurse
informaticist
in the project
team.

Includes: 2
peer-
reviewed
sources and
2

course
resources.

would occur,
is vague or
inaccurate,
or includes
little to no
supporting
evidence.

The response
identifying
the
technologies
required to
implement
the project
proposed
with an
explanation
why is vague
or
inaccurate.

The response
identifying
the project
team (by
roles) and an
explanation
of how to
incorporate
the nurse
informaticist
in the project
team is
vague or
inaccurate.

Includes: 1
peer-
reviewed
sources and
1 course
resources.

would occur, is
vague and
inaccurate,
includes no
supporting
evidence, or is
missing.

The response
identifying the
technologies
required to
implement the
project
proposed with
an explanation
why is vague
and
inaccurate, or
is missing.

The response
identifying the
project team
(by roles) and
an explanation
of how to
incorporate
the nurse
informaticist in
the project
team is vague
and
inaccurate, or
is missing.

Includes: 1 or
fewer
resources.

3/22/2021 Rubric Detail – Blackboard Learn

https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16813466_1&rubric_id=_2258812_1 3/4

  Excellent Good Fair Poor
course
resources.

Written
Expression and
Formatting –
Paragraph
Development
and
Organization:

Paragraphs
make clear
points that
support well
developed ideas,
�ow logically,
and demonstrate
continuity of
ideas. Sentences
are carefully
focused–neither
long and
rambling nor
short and lacking
substance.

5 (5%) – 5 (5%)
Paragraphs
and
sentences
follow writing
standards for
�ow,
continuity,
and clarity.

4 (4%) – 4 (4%)
Paragraphs
and
sentences
follow writing
standards for
�ow,
continuity,
and clarity
80% of the
time.

3.5 (3.5%) –
3.5 (3.5%)
Paragraphs
and
sentences
follow writing
standards for
�ow,
continuity,
and clarity
60%- 79% of
the time.

0 (0%) – 3 (3%)
Paragraphs
and sentences
follow writing
standards for
�ow,
continuity, and
clarity < 60% of the time.

Written
Expression and
Formatting –
English writing
standards:

Correct
grammar,
mechanics, and
proper
punctuation

5 (5%) – 5 (5%)
Uses correct
grammar,
spelling, and
punctuation
with no
errors.

4 (4%) – 4 (4%)
Contains a
few (1-2)
grammar,
spelling, and
punctuation
errors.

3.5 (3.5%) –
3.5 (3.5%)
Contains
several (3-4)
grammar,
spelling, and
punctuation
errors.

0 (0%) – 3 (3%)
Contains many
(≥ 5) grammar,
spelling, and
punctuation
errors that
interfere with
the reader’s
understanding.

3/22/2021 Rubric Detail – Blackboard Learn

https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16813466_1&rubric_id=_2258812_1 4/4

  Excellent Good Fair Poor

Written
Expression and
Formatting – The
paper follows
correct APA
format for title
page, headings,
font,
spacing, margins,
indentations,
page numbers,
running head,
parenthetical/in-
text citations,
and reference
list.

5 (5%) – 5 (5%)
Uses correct
APA format
with no
errors.

4 (4%) – 4 (4%)
Contains a
few (1-2) APA
format
errors.

3.5 (3.5%) –
3.5 (3.5%)
Contains
several (3-4)
APA format
errors.

0 (0%) – 3 (3%)
Contains many
(≥ 5) APA
format errors.

Total Points: 100

Name: NURS_5051_Module02_Week04_Assignment_Rubric

EXIT

Author Affiliations: Vice President and Assistant Chief Nurse
Executive (Dr Mosier), Vice President of Care Delivery and Perfor-
mance (Dr Roberts), and Senior Vice President and Chief Nurse
Executive (Dr Englebright), HCA Healthcare, Nashville Tennessee.

The authors declare no conflicts of interest.
Correspondence: Dr Englebright, HCA Healthcare, One Park

Plaza, Nashville, TN 37203 (Jane.Englebright@hcahealthcare.com).
DOI: 10.1097/NNA.0000000000000815

JONA � Vol. 49, No. 11 � November 2019

Copyright © 2019 Wolters Kluw

JONA
Volume 49, Number 11, pp 543-

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ealth, Inc. All rights reserved.

T H E J O U R N A L O F N U R S I N G A D M I N I S T R A T I O N

A Systems-Level Method for Developing
Nursing Informatics Solutions

The Role of Executive Leadership

Sammie Mosier, DHA, MA, BSN, NE-BC, CMSRN, BC
Wm. Dan Roberts, PhD, RN, ACNP
Jane Englebright, PhD, RN, CENP, FAAN

Nursing leadership can play an essential role in the de-
velopment of nursing informatics solutions by virtue of
their broad understanding and oversight of nursing
care. We describe a systems-level method for creating
nursing informatics solutions with clearly defined struc-
ture and leadership from nursing executives. Based on
the guiding principles of clear lines of responsibility,
respect for expertise, and commitment to project
aims, this allows nursing executive leadership to orga-
nize, set up, and own the development of nursing infor-
matics solutions.

Data about nursing care have become a critical com-
ponent of operational and patient care decisions.
These data can potentially affect the productivity, ef-
ficiency, performance, effectiveness, cost, and value
of nursing care when properly collected and used.
The management and processing of data into knowl-
edge for use in nursing practice have become an im-
portant specialty within the last decade.1

Nurse executives are dependent on data for effec-
tive decision making. The American Organization of
Nurse Leaders has identified essential competencies
in informatics that are necessary for effective leader-
ship of this technology and data-informed environ-
ment.2 In the age of big data, nurse executives are
responsible for creation of the framework that allows
for nurses and other experts to apply their knowledge,

er H

such as through the creation of a data culture, the de-
velopment of data competencies, and the establish-
ment of data infrastructure.3

Together, nurse executives and nurse informaticists
are forging new solutions to improve nursing processes
and patient care. The challenge is in determining how
best to coordinate the efforts of subject matter experts
from nursing, informatics, and information technol-
ogy to design, develop, and deploy solutions to very
complex problems. Nursing leadership is well poised
to influence these processes by virtue of their broad
understanding and oversight of nursing care. While
not usually engaged in the development of nursing in-
formatics solutions, we propose that executive leader-
ship is necessary to this process.

Here we discuss our development of a systems-level
method, with clearly defined structure and leadership
from nursing executives, to create nursing informatics
solutions that enhance patient care. This article will
describe the method and provide case examples of
2 successful applications.

Methods
This project was conducted within a large network of
hospitals with affiliated facilities across the United States
and United Kingdom. The goal was to develop a method
for aligning leadership, clinical experts, informaticists,
and information technology experts to design, develop,
and deploy nursing informatics solutions.

The chief nurse executive (CNE) developed the
framework to harmonize the work efforts of dispa-
rate groups of clinical and informatics experts that
were necessary to design, develop, and deploy nursing
informatics solutions. The framework was based on
3 guiding principles: clear lines of responsibility and

543

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mailto:Jane.Englebright@hcahealthcare.com

authority, respect for each type of expertise necessary
to the project, and clear commitment to the aims of
the project.

Figure 1 depicts the structure. Clear lines of re-
sponsibility consisted of dedicated leadership for each
component of the process, starting with executive spon-
sorship and guidance. A steering committee of nurs-
ing executives set the vision, objectives, scope, and
guiding principles. The steering committee served as
a resource for the other teams and an arbitrator of
disputes between conflicting priorities. Teams of con-
tent experts and end-users were tasked with defining
good practice and ideal workflow to generate tech-
nology requirements. Technical experts were charged
with designing the technology solutions that could meet
requirements, support the workflow, present content
optimally, and incorporate decision support when pos-
sible. The clinical and technical teams work iteratively
to develop and test aspects of the proposed solution.

Subject matter experts provided critical input on
regulatory requirements, answering questions and
providing audit and review services. Project manage-
ment resources ensured the appropriate flow of decisions
and work products among the teams in the appropriate
sequence and ensured that any issues were escalated
to the steering committee expeditiously.

Respect for different types of expertise ensured
that each of the above responsible parties was able to
operate fully within their area of expertise. Technical
experts deferred to clinicians on content and workflow.
Clinical experts deferred to informatics experts on the

Figure 1. Structure.

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Copyright © 2019 Wolters Kluwer

best way to design input and output and the use of de-
cision support. Regulatory experts deferred to clinical
experts on content and workflow while providing
guidance on regulatory requirements, including eval-
uation of the final product.

Commitment to the vision and guiding principles
established by the steering committee was a require-
ment for all colleagues participating in the project. A
clearly articulated set of guiding principles was used
in each work session to guide team members as they
designed, developed, and deployed the new solution.
Final success was measured on how well the solution
adhered to these guiding principles.

This framework was used to develop 2 distinct
nursing informatics solutions within a large hospital
system: Evidence-Based Clinical Documentation (EBCD)
and the Nursing Data Portal (NDP). These informat-
ics solutions were designed to meet the operational
goals of: 1) minimizing nursing documentation into
an evidence-based story of the patient; 2) creating a
more useful and usable patient-centric record that
guides and informs the provision of safe, effective,
and efficient care by the interdisciplinary team; and
3) rendering standardized and normalized data for
the purpose of performance visibility and evaluation
of nursing care of individuals and population at both
the process and outcome levels. Through adherence
to the framework, the resulting informatics solutions
constructed to contribute to the healthcare learning
environment through the continuous generation of
knowledge and feedback to clinical practice.

JONA � Vol. 49, No. 11 � November 2019

Health, Inc. All rights reserved.

Results

Evidence-Based Clinical Documentation
In the development of EBCD, clear lines of responsi-
bility began with the chief nursing officer (CNO) Coun-
cil (Figure 2). The CNO Council served as the steering
committee for EBCD, overseeing the progress of the
project teams. This group served as a champion of
the organization’s nursing agenda and provided guid-
ance and input into decisions related to patient care,
including operational issues and prioritization of clin-
ical projects. The CNO Council defined the guiding
principles for the process and product, ensured adher-
ence to the overall vision, and acted as an arbitrator
of conflicting viewpoints.

The Content Team was led by clinical leaders and
included ad hoc committees of clinical experts orga-
nized by specialty. Each ad hoc committee focused
on the specific tasks and questions relevant to their
area of expertise. Clinical experts with current patient
care experience were able to define the data flow
needed to support the previously developed ideal
workflows,4 use evidence reviews to develop content,
and identify the desired decision support.

Development of the decision support, creation of
a style guide, and review of existing screen designs
were the responsibility of technical experts. Regula-
tory subject matter experts addressed questions about
regulatory compliance, billing compliance, and risk
management and performed on-site assessment for
regulatory compliance. Throughout the entire process,

Figure 2. Evidence-based practice clinical documentation proje

JONA � Vol. 49, No. 11 � November 2019

Copyright © 2019 Wolters Kluwer H

the project management team managed to timeline,
maintained communication, designed implementa-
tion and education strategies, and assisted the collab-
oration between teams to resolve issues.

With the clear lines of responsibility defined and
respect for expertise established, the development of
EBCD progressed in alignment with the vision for this
project. The overall vision for this project was to cre-
ate a patient-centric record that guides and informs
the provision of safe, effective, and efficient care by
the interdisciplinary team and produces data to valu-
ate care of individual and population of care (Figure 3).
To achieve this vision, guiding principles were devel-
oped in regard to design and content.

The guiding principles of EBCD design were es-
tablished to ensure that the final product enhanced
and supported the process of patient care documenta-
tion, such as strict adherence to the style guide for
consistency and alignment with the previously defined
ideal workflows.4 The guiding principles of EBCD
content ensured that documentation entered through
this system would be meaningful to patient care or
necessary for regulatory or billing requirements and
that the resulting documentation would support the
ethical and competent clinician.

Nursing Data Portal
In the development of the NDP, the steering commit-
tee consisted of the CNO Council with representation
from CNEs and unit directors, the 2 primary end-
users for the product. Responsibility for content was

ct team.

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ealth, Inc. All rights reserved.

Figure 3. Flow of information for patient centric record.

designated to corporate clinical leaders and data
owners. Technical responsibility was shared between
the nursing analytics, data science, and information
technology teams. Other defined responsibilities were
assigned to subject matter expert teams, including pa-
tient experience, human resources, and financial and
executive leaders. Strong project management pro-
cesses facilitated the iterative flow of decisions and
tool development (Figure 4).

The focused expertise of these teams was key to
the success of this project. The steering committee iden-
tified 4 domains of performance (clinical outcomes,
patient experience, efficiency, and nursing engage-
ment) and provided final approval of the indicators
that would be used in the completed product. Techni-
cal experts were the backbone of all the data needs for
the final project. They created the data visualization
plan, transformed data to usable scoring methods,
harmonized time frames from disparate data sources,

Figure 4. Nursing data portal project team.

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Copyright © 2019 Wolters Kluwer

and aligned the data to other reports with the same
metrics. The various subject matter experts suggested
common metrics that were to be included in the final
product. These teams also validated all data post-
transformation prior to the creation of data visualiza-
tions. In essence, the subject matter experts verified
the work of the technical experts before any data were
released for viewing. Project management team mem-
bers designed the implementation and education strate-
gies for this project and also managed communication
and issue resolution among the teams to meet the pro-
ject timeline goals.

With the clear lines of responsibility established
and experts assembled for the various project compo-
nents, the development of the NDP progressed toward
its singular unifying vision: one common platform for
sharing nursing performance data (Figure 5). Through
the careful design of source system screens and data
pathways and requirements, nursing performance

JONA � Vol. 49, No. 11 � November 2019
Health, Inc. All rights reserved.

Figure 5. Platform to share nursing performance data.

metrics from multiple systems could be concisely
displayed on 1 page for maximum accessibility. The
vision of the NDP was achieved through adherence
to the guiding principle of easily understood data
and visualizations.

Discussion
Through the creation of a systems-level framework
that clearly defined responsibility, roles, and vision,
we successfully designed and implemented 2 large-
scale nursing informatics solutions. These informatics
solutions were different from each other—1 clinically
focused and 1 focused on leadership—but were built
upon the same systems-level framework. In this method,
there was a clearly defined role and responsibility for
nursing executive leadership from the beginning of
the project to the end.

Multiple contemporaneous articles have demon-
strated the supportive role of nursing leadership and
informatics.5,6 Specific leadership roles, such as chief
nursing informatics officers and nursing informatics
executives, have emerged as central to the support of
transformation and the use of appropriate technology
solutions in clinical practice.7,8 Outside these specific
roles, there is a need for nurse leaders, including CNEs,
to have knowledge about informatics and its role in
patient care.9 Nurse leaders should be allowed oppor-
tunities to both gain these competencies and apply
their knowledge to decision making regarding infor-
matics system and nursing care.9-11

Our systems-level method demonstrates the role
of specific leadership in guiding the ideation, design,
development, data mapping and visualization, and
application of the products developed during the in-
formatics and technology life cycle. Each of these

JONA � Vol. 49, No. 11 � November 2019
Copyright © 2019 Wolters Kluwer H

components is integral to the functionality, adoption,
and use of the final solution. Nursing executive lead-
ership must not only develop a clear structure, time-
line, and goals for the entire process but also provide
valuable insight into product development. This lead-
ership contributed to the effectiveness of these solu-
tions as part of the continuous feedback loop within
a learning healthcare environment. The knowledge and
understanding of clinical practice gained through these
solutions can be applied to subsequent applications
and efforts to refine and innovate within nursing care.

Furthermore, our method maximizes the exper-
tise of those most knowledgeable about individual
components. The clarity of roles ensured that critical
input was provided by the appropriate team mem-
bers. For instance, technical experts and informatics
professionals focused on the best way to design input
and output and the use of decision support while cli-
nicians were responsible for content and workflow.

An added benefit of this method is improved adop-
tion of the resulting solutions. Leadership engagement is
a key component of implementation processes.12-14 In
our method, leadership are engaged early and often in
the design process, ensuring that the solutions also met
the needs of leaders. Leadership engagement allowed
for local needs and workflow considerations to be in-
corporated into the design, improving end-user uptake.

In summary, we have developed a systems-level
method that allows nursing executive leadership to
organize, set up, and own processes related to the de-
velopment nursing informatics solutions. Our organi-
zation has used this structure for several projects with
positive results. Use and adaptation of the strategies
of this method may offer a way for nursing leadership
to guide and influence future solutions.

References

1. Murphy J. Nursing informatics: the intersection of nursing, com-
puter, and information sciences. Nurs Econ. 2010;28(3):204-207.

2. American Organization of Nurse Executives. AONE Nurse
Executive Competencies. Chicago, IL: AONE; 2015. https://

www.aonl.org/sites/default/files/aone/nurse-executive-
competencies . Accessed July 25, 2019.

3. Englebright J, Caspers B. The role of the chief nurse executive in
the big data revolution. Nurse Lead. 2016;14(4):280-284.

547

ealth, Inc. All rights reserved.

https://www.aonl.org/sites/default/files/aone/nurse-executive-competencies

https://www.aonl.org/sites/default/files/aone/nurse-executive-competencies

https://www.aonl.org/sites/default/files/aone/nurse-executive-competencies

4. Mosier S, Englebright J. The first step toward reducing docu-
mentation: defining ideal workflows. Comput Inform Nurs.
2019;37(2):57-59.

5. Remus S. The big data revolution: opportunities for chief nurse
executives. Nurs Leadersh. 2016;28(4):18-28.

6. Liebe JD, Hüsers J, Hübner U. Investigating the roots of suc-
cessful IT adoption processes—an empirical study exploring the
shared awareness-knowledge of directors of nursing and chief in-
formation officers. BMC Med Inform Decis Mak. 2016;16:10.

7. Institute of Medicine. The Future of Nursing: Leading Change,
Advancing Health. Washington, DC: The National Academies
Press; 2010.

8. Hussey PA, Kennedy MA. Instantiating informatics in nursing
practice for integrated patient centred holistic models of care:
a discussion paper. J Adv Nurs. 2016;72(5):1030-1041.

9. Simpson RL. Chief nurse executives need contemporary infor-
matics competencies. Nurs Econ. 2013;31(6):277-287; quiz 2887.

10. Healthcare Information and Management Systems Society
(HIMSS). Transforming Nursing Practice Through Technology

The Journal of Nursi
Instructions f

Instructions for Authors can be f
below. To ensure that your manu
with new submission procedures
document carefully before manu
manuscripts must be submitted e
system.

Please visit http://JO

548
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and Informatics: A Position Statement. Chicago, IL: HIMSS;
2011. https://www.himss.org/position-statement-transforming-
nursing-through-technology-and-informatics. Accessed July 25,
2019.

11. Oakes M, Frisch N, Potter P, Borycki E. Readiness of nurse ex-
ecutives and leaders to advocate for health information systems
supporting nursing. Stud Health Technol Inform. 2015;208:
296-301.

12. Sandström B, Borglin G, Nilsson R, Willman A. Promoting the
implementation of evidence-based practice: a literature review
focusing on the role of nursing leadership. Worldviews Evid
Based Nurs. 2011;8(4):212-223.

13. Aarons GA, Sommerfeld DH. Leadership, innovation climate,
and attitudes toward evidence-based practice during a state-
wide implementation. J Am Acad Child Adolesc Psychiatry.
2012;51:423-431.

14. Gifford WA, Davies B, Edwards N, Graham ID. Leadership
strategies to influence the use of clinical practice guidelines.
Nurs Leadersh. 2006;19:72-88.

ng Administration
or Authors

ound online at the address
script is in compliance
, you should read this
script preparation. All
lectronically through this

NA.EdMgr.com.

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https://www.himss.org/position-statement-transforming-nursing-through-technology-and-informatics