Week 6 Assignment: EBPChange Process form
ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson.Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.
Name:_____________________
Star Point 1: Discovery (Identify topic and practice issue)
Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.)
Medical errors are among the significant issues affecting nursing practice. Some of the medical errors committed in nursing practice include missed or delayed diagnosis, incorrect recording or omission of patient information, and improper dose. Most of the errors occur when providing health care to the patients/clients like during documentation. Poor documentation is one of the root causes of medical errors (Akhu‐ Zaheya, Al‐ Maaitah, & Bany Hani, 2018). This creates the need for implementation of quality documentation interventions.
Briefly describe your rationale for your topic selection. Include the scope of the
experts, it revealed that over 250 000 deaths associated with various medical errors are annually in the United States (Makary & Daniel, 2016). They concluded they this nursing practice issue among the leading cause of death in the country. Also, this medical problem occurs in diverse healthcare settings, including the emergency department. It is also a threat to patient safety. Medical errors lead to various adverse outcomes, including severe injuries, incorrect diagnosis, under/overdose, and even death. Other significant consequences associated with medical errors include the increase in financial burden on patients, families, healthcare providers, and the healthcare system (Makary & Daniel, 2016). Therefore, healthcare organizations need to implement various effective measures to curb this nursing practice issue.
Star Point 2: Summary (Evidence to support need for a change)
Describe the practice problem in your own words and formulate your PICOT question.
Among the patients in the emergency medical units (P), what is the impact of electronic-based documentation (EHRs) (I) as compared to the paper-based documentation (C) on reducing the rate of medical errors (O)?
List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.
List and briefly describeother sources used for data and information. List any
otheroptional scholarly source used as a supplement to the systematic review in APA format.
Akhu‐ Zaheya, L., Al‐ Maaitah, R., & Bany Hani, S. (2018). Quality of nursing documentation: Paper‐ based health records versus electronic‐ based health records. Journal of clinical nursing, 27(3-4), e578-e589.
This research aimed to investigate the impact of the paper-based system on quality nursing documentation compared to the use of electronic health records (EHRs). A retrospective, descriptive, and comparative research design was applied to address the purpose of the study. Thus, researchers audited a total of 434 records. They included both the electronic and paper health records. The study's findings indicated that electronic health records enhanced efficiency in documentation due to its proper structure and process compared to paper-based. However, paperwork has some advantages over EHRs. For instance, they found out that paper-based records were better in terms of quantity and quality.
Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.
The study was aimed at reviewing the evidence regarding the impact of the implementation of electronic health records on enhancing healthcare quality. Among the variables studied included medication errors. Thus, the researchers employed a systematic review and meta-analysis to review the studies the focused on the topic. The studies were
Thus, the review revealed that the use of EHR reduced the documentation time significantly and lowered the medication errors. Therefore, the researcher concluded that the effective
implementation of the EHR system can improve the quality of health care offered by reducing medical medication errors and efficiency in documentation.
Strengths
1. The systematic review delivers a clear and comprehensive overview of the available evidence on workplace violence and enhances its reliability.
2. The objective of the systematic review is clearly stated.
3. A meta-analysis was conducted. This enhances the reliability of the evidence
Outline one or two evidence-based solutions you will consider for the trial project.
1. Implementing the EHRs on the emergency department
Star Point 3: Translation (Action Plan)
Identify care standards, practice guidelines, or protocols that may be in place
tosupport your intervention planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).
List your stakeholders (by title and not names; include yourself) and describe their roles
and responsibilities in the change process (no more than 5).
Nurses
Nurses are the ones who encounter the healthcare practice issue. Thus, they will be educated on
how to use electronic health records to document medical data.
ED nurse manager
This stakeholder will inform the patients about the need for EHRs and coordinate with the top
management to ensure the change process is successful.
Nurse educator/IT specialist
They will educate nurses on how to use EHRs.
HER vendor
The stakeholder will help in the budgeting process, acquisition, and implementation of the EHRs
Nurses will learn on how to use EHRs to record and manage patient health records. Also, they
will inform other healthcare professionals on the role of EHRs in improving documentation in
healthcare.
List your stakeholders by position titles (charge nurse, pharmacist, etc.).-Why are the
members chosen (stakeholders) important to your project?
Each stakeholder will play a vital role in the change process. For instance, the EHR vendor will
provide information regarding the price of the EHRs, which is necessary for cost analysis.
Secondly, nurses will be trained on how to use the technology to document medical records.
Thirdly, ED nurse managers will manage the application of EHRs on the ED unit to minimize
medical errors. Lastly, the IT specialist and IT nurse educators will take the teaching role.
What type of cost analysis will be needed prior to a trial? Who needs to be involved with
this?
The project's total cost will include the EHRs acquisition and implementation fees, plus the
training costs. The nurse educators, EHRs vendor, the ED unit manager, and hospital CEO will
Star Point 4: (Implementation)
Describe the process for gaining permission to plan and begin a trial. Is there a specific
group, committee, or nurse leader involved?
The hospital CEO and the ED nurse leader will be involved in the implementation process. The
ED nurse leader will identify the need for EHRs and seek permission from the senior
management staff to approve the project.
Describe the plan for educating the staff about the change process trial and how they will
be impacted or asked to participate.
First, the ED nursing staff will be informed on the importance of the EHRs on promoting the
documentation process. Secondly, the nursing educator will assess the nursing staff's training
needs and design a training program that is flexible and practical. Lastly, the training materials
Outline the implementation timeline for the change process (start time/end time, what steps
are to occur along the timeline).
The training program will be conducted during evening hours
1 -2nd September- Informing the ED nurses the need for EHRs.
3rd-5th September- Purchasing EHR system and training materials
6th – 14th September- Training of the nursing staff
15th-16th September- Evaluation of the training program
16th August- Reporting of the project outcomes
List the measurable outcomesbased on the PICOT. How will these be measured?
By the end of the training, the nurses will be able to use EHRs effectively in recording patient
health records and use various security measures to safeguard the patient's health records.
Evaluation
The expected outcomes will be assessed through interviews and observation
What forms, if any, might be used for recording purposes during the pilot change process.
What resources are available to staff (include yourself) during the change pilot?
Hospital hall
Financial resources
Computers
Time
Will there be meetings of certain stakeholders throughout the trial? If so, who and when
will they meet?
Yes. Nurse educators, unit managers, and the hospital CEO will convene at the meeting hall
before and after the trial.
Star Point 5: (Evaluation)
How will youreport the outcomes of the trial?
The outcomes will be reported through general hospital meetings, hospital newsletters,
What would be the next steps for the use of the change process information?
After reporting, the report will be passed on to relevant leaders. They include the ED nurse
leader, the hospital CEO, and the management board. They will assess the information to
determine whether to support the use of EHR to curb medical errors in the ED.
References
Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., & Specchia,
M. L. (2016). The impact of electronic health records on healthcare quality: a systematic
review and meta-analysis. The European Journal of Public Health, 26(1), 60-64.
Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the
