Discussion Topic Follow Refer To Chapter 24 This Week

Discussion Topicfollowrefer To Chapter 24 For This Weeks Discussion Q

Discussion Topic Follow 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.

Paper For Above instruction

In response to the increasing patient safety issues related to electronic health record (EHR) documentation and medication management, designing effective training and competency evaluation strategies is imperative. This paper discusses two critical questions: first, the strategies to replicate the EHR production environment for nurses during training; and second, how to identify and incorporate relevant patient safety cases into simulations to enhance workflow and documentation proficiency.

Strategies for Fully Implementing the Practice Domain Replicating the EHR Environment

To effectively replicate the EHR practice environment, employing a comprehensive simulation-based approach is essential. According to Berman et al. (2017), high-fidelity simulations that mirror actual clinical workflows enable nurses to develop skills in a risk-free setting while enhancing familiarity with real-world systems. This involves creating simulation scenarios that mimic typical patient care situations, including medication orders, documentation processes, and order management, aligned with the hospital’s EHR interface.

Implementing a sandbox environment within the simulation center that mirrors the live EHR system allows nurses to navigate workflows, input orders, and document patient information as they would during actual clinical shifts. Such practice promotes cognitive fidelity, which according to Lavoie et al. (2010), improves transferability of skills from simulation to clinical practice. Additionally, integrating scenario-based learning that includes common medication errors and safety checks can reinforce best practices and error prevention strategies.

Scholarly support for this approach emphasizes the importance of realistic simulation environments. For example, Cant & Cooper (2014) argue that simulation fidelity directly correlates with learning outcomes, especially in complex systems like EHRs. Therefore, investing in high-fidelity simulations that emulate the actual workflow and interface enhances skill acquisition and confidence, ultimately reducing documentation errors and improving patient safety.

Identifying and Incorporating Patient Safety Events into the EHR Simulation

Identifying cases related to patient safety events involves analyzing incident reports, medication error data, and other clinical documentation to pinpoint frequent or grave issues. The Agency for Healthcare Research and Quality (AHRQ, 2011) recommends a systematic review of safety reports to identify patterns and specific cases that contributed to adverse events. These cases should then be adapted into simulation scenarios that mimic actual clinical situations nurses may encounter.

Incorporating these cases into the EHR simulation involves developing realistic clinical data that reflect typical errors, such as wrong medication doses, incorrect documentation, or delayed orders. This approach allows nurses to practice workflow management, recognize errors, and apply safety protocols in a controlled environment. Integrating de-identified real-case data ensures authenticity while maintaining patient confidentiality (Wagner et al., 2015).

Moreover, using case studies based on real events fosters critical thinking and reinforces the importance of proper documentation and adherence to safety guidelines. Simulations may include prompts that challenge nurses to identify discrepancies or safety issues, encouraging active engagement and error recognition skills. Such experiential learning aligns with the recommendations by Issenberg et al. (2005), who emphasize that simulation of real-world errors enhances learning transfer and safety behaviors.

Conclusion

Developing a simulation-based training program that accurately reproduces the EHR workflow and integrates pertinent patient safety cases is vital for improving medication management and documentation accuracy. Employing high-fidelity simulations and authentic case scenarios equips nurses with the skills needed to navigate complex clinical environments, thereby fostering safer patient care and mitigating errors. Ongoing evaluation and refinement of these simulation strategies, supported by scholarly best practices, are essential for sustained improvements in clinical competence and patient safety outcomes.

References

• Agency for Healthcare Research and Quality (AHRQ). (2011). Medical Safety Services and Tools. https://www.ahrq.gov/patient-safety/resources/resources/index.html
• Berman, A., Snyder, S., & Frandsen, G. (2017). Kozier & Erb's Fundamentals of Nursing (10th ed.). Pearson.
• Cant, R., & Cooper, S. J. (2014). Simulation-based learning in nurse education: systematic review. Nurse Education Today, 34(1), 39-49.
• Issenberg, S. B., Gordon, D. L., Gordon, S., et al. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Medical Teacher, 27(1), 10-28.
• Lavoie, P. M., et al. (2010). Enhancing clinical judgment through simulation: a review of the literature. Journal of Nursing Education & Practice, 1(2), 76-86.
• Wagner, S. J., et al. (2015). Utilizing real case data for simulation training in healthcare. Journal of Healthcare Quality, 37(3), 184-189.