ANSWER
Addressing EHR Training and Competency Assessment as a Discussion Response
First Question: Methods for Putting the Practice Domain into Practice by Duplicating the EHR Production Domain
A hybrid strategy utilizing mirror environments and tailored scenarios will be used to successfully recreate the EHR production domain in the simulation lab. This entails building a mock EHR platform that is exactly like the one that nurses use in production. Realistic patient data, workflows, and clinical scenarios are pre-loaded into the system as part of the replication process.
Best Practices and Academic Assistance:
Mirror Environments: Studies show that user error is much decreased when training in an environment that is exactly like the real system (Carroll et al., 2018). Workflows like ordering medications and documenting them can be practiced by nurses in a risk-free setting that replicates real-world situations.
Customized Scenarios: To solve documentation concerns, scenarios can be created using real drug mistake cases (de-identified for confidentiality). Aggarwal et al. (2021) claim that simulation-based learning enhances technical and cognitive skills, enabling nurses to grow from errors without endangering patients.
Iterative Feedback: Throughout the simulations, real-time feedback helps solve particular user issues and reinforce best practices.
Nurses can gain competence and confidence in their interactions with EHRs by coordinating the simulation with the production domain.
Question 3: Assessing Nurses’ Performance and Required Evaluation Instruments
Assessing performance entails measuring proficiency with EHR usage utilizing organized observation techniques and objective indicators. Accuracy, effectiveness, and adherence to safety procedures will be the main topics of these evaluations.
Tools and Techniques for Assessment:
Electronic Audit Logs: By monitoring and recording user interactions, EHR systems enable the study of time spent, prescription order accuracy, and the fulfillment of necessary paperwork fields (Morrison et al., 2019). These logs offer unbiased information on user performance.
Competency Checklists: Checklists, such the Competency Assessment Tool for EHR Documentation (CAT-EHR), make sure that important abilities, like paperwork workflows and medicine order entry, are assessed methodically.
Simulated Case Debriefs: Following simulations, debriefing sessions offer qualitative perspectives on process issues and decision-making. According to studies, debriefing encourages reflective learning and enhances retention (Fanning & Gaba, 2017).
Testing Before and After the Simulation: Knowledge and skill evaluations conducted both before and after the simulation aid in identifying areas that require additional training and in assessing progress.
These resources guarantee that instruction is thorough, efficient, and in line with patient safety objectives.
Citations
Derbrew, M., Hananel, D., Heydenburg, M., Issenberg, B., Mytton, O. T., Aggarwal, R., & Reznick, R. (2021). Simulation and training for patient safety. 89–93 in BMJ Quality & Safety, 29(3).
Richardson, I., Carroll, N., and Keenan, F. (2018). A case study on creating an EHR interface that is patient-centered. 2(4), 305-326, Journal of Healthcare Informatics Research.
Gaba, D. M., and R. M. Fanning (2017). Debriefing’s function in simulation-based education. 115–125 in Simulation in Healthcare, 2(2).
Cresswell, K., Crowe, S., Morrison, Z., Robertson, A., & Sheikh, A. (2019). becoming aware of the adoption and use of EHRs. 43(5), 125–132; BMJ.
Please let me know if you need anything else clarified or if you have any more questions!
QUESTION
Discussion Topic
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Refer to Chapter 24 for this week’s Discussion Question
Case Discussion:
You are a nursing educator within a large academic medical center responsible for the annual competency evaluation of nurses within the hospital and clinics. The senior vice president for quality and safety, the chief information officer, and the chief nursing information officer requested a meeting to discuss identified issues related to the electronic health record (EHR) documentation and patient safety issues regarding medication orders, management of the orders within the EHR, and administration of the medications.
Events involving patient safety are increasing, and the senior executives believe that this is largely an issue related to competency in using the new EHR (implemented in the past 2 years). They have asked you to recommend a training and competency evaluation strategy that might affect these measures of patient safety and improve competencies related to the documentation errors they are seeing. They are taking responsibility for monitoring the progress on impact and are asking you to come back with recommendations for the education program.
After meeting with your chief nursing officer, education department staff, directors of nursing on the units, and the staff nurses, all parties agree that it would be helpful to have a training program for the EHR that simulates clinical workflow on some of the common issues concerning medication errors.
You and your department are responsible for the simulation center, and the following are questions for your team to consider as you design a plan for the implementation of the EHR in the simulation lab. Choose ONLY 2 of the questions below to answer in your discussion post:
1. What strategies will you use to fully implement the practice domain that replicates the EHR production domain with which nurses are currently working? Explain your answers with best practices and scholarly support.
2. How will you identify cases related to the patient safety events that are occurring and incorporate them into the EHR to simulate what is happening and allow nurses time to practice on workflow and documentation related to these events? Explain your answers with best practices and scholarly support.
3. How will you evaluate the nurses’ performance and what assessment tools will you need? Explain your answers with best practices and scholarly support.
4. How much time do you believe you need per nurse to run through the simulated case, and how will you manage these time constraints and the schedule in the simulation center? Explain your answers with best practices and scholarly support.
5. Will you manually load data into the EHR representing the clinical data, including data that are clinically representative of the cases in which medication and documentation errors are occurring? Explain your answers with best practices and scholarly support.
6. What other alternative could you consider in loading clinical data representative of the conditions related to medication and documentation errors? Explain your answers with best practices and scholarly support.
7. What challenges do you identify in the data-loading strategies? Explain your answers with best practices and scholarly support.