Given The Following Scenario, Use The Proposal Input Form ✓ Solved

Given The Following Scenario Use The Proposal Input Form

Given the following scenario use the proposal input form to create a 3 page double spaced paper. Must begin with an introductory paragraph that has a succinct thesis statement. Must address the topic of the paper with critical thought. Must end with a conclusion that reaffirms your thesis. Must use at least three scholarly or peer-reviewed sources.

Case 7: Concerns and Workarounds with a Clinical Documentation System.

Garrison Children's Hospital is a 225-bed hospital. Its seventy-seven-bed neonatal intensive care unit (NICU) provides care to the most fragile patients, premature and critically ill neonates. The twenty-eight-bed pediatric intensive care unit (PICU) cares for critically ill children from birth to eighteen years of age. Patients in this unit include those with life-threatening conditions that are acquired (trauma, child abuse, burns, surgical complications, and so forth) or congenital (congenital heart defects, craniofacial malformations, genetic disorders, inborn errors of metabolism, and so forth).

Within the past six months or so, Premier has implemented an electronic clinical documentation system in its adult hospital. More recently the same clinical documentation system has been implemented at Garrison in pediatric medical and surgery units and intensive care units. Electronic scheduling is to be implemented next. The adult hospital drives the decisions for the pediatric hospital, a circumstance that led to the adult hospital's CPOE vendor being chosen as the documentation vendor for both hospitals. A CPOE system was implemented at Garrison Children's Hospital several years prior to implementation of the electronic clinical documentation system.

A pressing challenge facing Garrison Children's Hospital is that nurses are very concerned and dissatisfied with the new clinical documentation system. They have voiced concerns formally to several nurse managers, and one nurse went directly to the chief nursing officer (CNO) stating that the flow sheets on the new system are grossly inadequate and she fears using them could lead to patient safety issues. Lunchroom conversations among nurses tend to center on their having no clear understanding of why the organization is automating clinical documentation or what it hopes to achieve.

The computer workstations are located outside the patients' rooms, so nurses generally document their notes on paper and then enter the data at the end of the shift or when they have time. The system support team, consisting of nurses as well as technology specialists, began the workflow analysis, system installation, staff training, and go-live first with a small number of units in the adult hospital and the children's hospital. The NICU and PICU did not implement the system until May and June of that year. System support personnel moved rapidly through each unit, working to train and manage questions.

The clinical documentation system was implemented to the great consternation and dissatisfaction of the end users (physicians, nurses, social workers, and so forth) at Garrison, yet the Premier clinicians are happy with it. Many Garrison physicians and nurses initially refused to use the system, stating it was “unsafe, added to workload, and was not intuitive. A decision to stop using the system and return to the paper documentation process was not then and is not now an option. Physician “champions were encouraged to work with those who were recalcitrant, and nursing staff members were encouraged to “stick it out with the hope that system use would “get easier.

Paper For Above Instructions

The implementation of electronic clinical documentation systems in healthcare settings has become increasingly prevalent, especially within pediatric units and intensive care environments. However, the case of Garrison Children's Hospital illustrates significant challenges associated with this technological transition. Nurses' dissatisfaction with the newly implemented clinical documentation system stems from inadequate system design and a lack of consideration for the unique needs of pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs). This paper argues that differences between pediatric and adult hospitals must be meticulously addressed when implementing clinical documentation systems to enhance patient care quality and staff satisfaction.

The primary issue at hand is the inefficiency and user-unfriendliness of the clinical documentation system employed at Garrison Children's Hospital. Though the system was designed to expedite documentation processes, nurses have found it to be counterintuitive and cumbersome, leading to increased workload and potential patient safety risks. The root causes contributing to this situation include inadequate training, lack of involvement from key end-users in the design process, and insufficiently accommodating the distinct workflows typical to pediatric care environments.

Studies indicate that involving healthcare providers in the design and implementation of clinical information systems can significantly mitigate resistance to change and improve system usability (Gagnon et al., 2014). For instance, it has been shown that when end users, such as nurses and physicians, contribute to the development of clinical documentation systems, the resulting technology better aligns with their workflow, ultimately leading to improved patient outcomes and user satisfaction (Henneman et al., 2016). In contrast, Garrison's implementation ignored the valuable insights of its nursing staff, which resulted in a detrimental system that hindered the quality of patient care.

Moreover, the unique challenges posed by PICUs and NICUs demand a tailored approach to system implementation. Research has indicated that pediatric units require different documentation, communication, and workflow processes compared to adult hospitals (Schmidt et al., 2019). This is due to the complexity of pediatric care, which involves intricate medical needs, various stakeholders, and immediate action in critical situations. Failing to recognize and accommodate these differences in the design phase of the clinical documentation system has led to a misalignment between the system's capabilities and the nurses' requirements in Garrison’s pediatric facilities.

The implementation timeline also played a role in exacerbating the discontent among nursing staff. The quick rollout of the system, prioritized by the adult hospital's needs, resulted in disrupted training schedules and insufficient support for nurses in pediatric units. As indicated by Garrison nurses, they were forced to invest additional time in manually documenting patient care on paper before entering the data into the electronic system post-shift. This not only added to their workload but also introduced potential errors during data transcription, which is consequential in sensitive environments like NICUs and PICUs (Carroll et al., 2018).

In addressing the concerns raised by the nursing staff, it is crucial for hospital leadership to actively seek feedback and suggestions for refining the clinical documentation system. One solution could involve establishing a task force composed of nurses from both the NICU and PICU, along with information technology specialists, to review and recommend necessary changes to the current system. Facilitating ongoing training sessions that focus on specific challenges faced in pediatric care can also promote a better understanding of the system's functionalities while enhancing user comfort and proficiency (Brewer et al., 2020).

Lastly, the importance of fostering a supportive organizational culture where nurses feel empowered to express their concerns in the implementation of clinical documentation systems cannot be overstated. Encouraging open dialogue between nursing staff and administrative teams is critical for resolving conflicts and improving overall system effectiveness. According to McGowan et al. (2019), promoting transparency and collaboration among stakeholders during system implementation correlates with enhanced job satisfaction and better adherence to new processes.

In conclusion, healthcare organizations like Garrison Children’s Hospital must acknowledge and prioritize the unique needs of their pediatric healthcare settings in the implementation of clinical documentation systems. Failure to do so not only hampers nursing efficiency but also jeopardizes patient safety. By incorporating nurses' insights, providing tailored training, and fostering a culture of collaboration, hospitals can ensure that their documentation systems meet the demands of pediatric care while maximizing nurse satisfaction and patient safety.

References

• Brewer, S. K., et al. (2020). Enhancing electronic health record usability in critical care environments. Journal of Healthcare Management.
• Carroll, K., et al. (2018). Patient documentation: The importance of clear communication in acute pediatric care. Journal of Nursing Practice.
• Gagnon, M. P., et al. (2014). Factors influencing the implementation of clinical information systems: A systematic review. International Journal of Medical Informatics.
• Henneman, E. A., et al. (2016). Working with CPOE in pediatric settings: Lessons from user experiences. Journal of Pediatric Nursing.
• McGowan, J. R., et al. (2019). Cultivating a culture of openness in nursing practice: Strategies for improvement in healthcare settings. Nursing Administration Quarterly.
• Schmidt, K. J., et al. (2019). The challenges of tailoring electronic health records for pediatric care: A systematic review. Journal of Pediatric Health Care.