Knowledge Generation through Nursing Informatics DQ

Knowledge Generation through Nursing Informatics DQ

Knowledge Generation through Nursing Informatics DQ

In one of the reading assignments this week you reviewed Advanced Practice Nurse (APN) roles and the application of project management concepts, one of the major elements of NI, but new to most nurses. What type of application does this have for your practice?

I have attached the required reading in a word doc. You can use any other references you see fit. Please follow APA7 guidlines.

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Knowledge Generation through Nursing Informatics DQ

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THE NURSING PROCESS AND PROJECT MANAGEMENT Although the concept of project management seems foreign to many, there is a common thread that applies it to the different types of work that nurses do. That thread is the nursing process, one of the first core principles of nursing practice nurses learn to use when delivering the best evidence-based patient care. The idea that nurses will understand and be able to apply the five basic principles of project management comes from its similarity to the five steps of the nursing process that are discussed in previous sections. The steps are similar to some project management terms and tasks; one just needs to learn the semantics between the nursing process and project management concepts. However, nurses, especially as they achieve more advanced levels of practice, will find many similarities between the processes of project management and the nursing process—the main difference being that they are working with a project instead of patients. These similarities are further explored in Chapter 2. DEFINITION OF A PROJECT A project is a planned set of interrelated tasks that need to be completed by certain dates. The specific beginning and ending dates indicate that one is engaged in a temporary process that may last weeks and/or months, but is not considered long term, such as the previous example of Amy planning her sister’s wedding. Many projects found in health care organizations have a specific or dedicated PM who designs, plans, and implements/builds and then applies the electronic health records (EHRs), based on the skills the PM has developed over previous projects or in graduate school. The PM needs to work with a team consisting of a variety of people, each with an area of expertise in the applications that will be built and applied in the system. For example, if the project were a clinical application for documentation, the build team would be separated into various smaller teams, such as a clinical documentation team composed primarily of nurses who had experience in documenting clinical notes. Knowledge Generation through Nursing Informatics DQ

There would be a pharmacy team, medical team, and a list of other teams by department. These teams were brought together for the sole purpose of participating and assisting with the build of the system, and then would go back to their clinical jobs after the EHR has been installed. This process could take anywhere from 6 to 9 months to 1.5 years depending on the size of the installation. The project management processes and concepts described previously are very much like the nursing process discussed earlier and would represent some of the steps that Amy would need to understand for both her graduate practicum and her new role as manager. WHAT IS PROJECT MANAGEMENT? As discussed earlier, Amy told the CNO that she does not know what a project is, but was reassured that many tasks can take the form of a project, be they large or small, such as the practicum project or Amy’s sister’s wedding. They all require some sort of organization or framework and management to be successful. Undertaking Project Management—Examples For many, the idea of project management is daunting. The concept of being a PM is hard to comprehend, but actually taking on the role and being in charge is even more so. Understanding the basic concepts of project management, and how and where to apply them can be simple, regardless of the size or purpose of the project. As long as the basic project management concepts and organizational methods are understood and applied, it does not matter who takes on project management; the APN, DNP, CNO, or other health care professional, or those with other backgrounds such as nursing faculty. An APN may encounter any or all of these management philosophies on a project. Nursing faculty have to plan courses, set due dates, and essentially manage each course and task as if it were a small project. To summarize, project management is “undertaken to meet unique goals and objectives” (Nokes, 2007, p. 131) in a standardized way. Constraints PM and project management enthusiasts often discuss constraints. Constraints are limits, restrictions, and barriers to achieving the project goals and objectives. One of the most frequently discussed constraints is the ability to stay within the budget that was originally agreed to and most likely developed with consultation from the hospital’s chief finance officer (CFO). Managing the budget, schedule, and resources—those hired to work on the project—are responsibilities of the PM, just as they would be for any type of task. Amy will learn how to manage these items in her management course as she first learns to develop what is called the “scope document.” The scope document is developed out of the need for a documented plan that indicates when and how the plan will be carried out. Knowledge Generation through Nursing Informatics DQ

This type of plan also establishes boundaries of what will be done, how long it will take (time), how much it will cost, what resources/building supplies will be needed, and how many people it will take to get the work completed (resources). These three interdependencies—budget, schedule, and resources—are critical to a project’s success and are discussed further during the design phase (Chapter 3). If one of these elements is out of plan, it will affect the other two; as will be discussed later. PROJECT MANAGEMENT PROCESSES Project management is a process of coordinating and directing team members to meet the formal, defined, approved goals and objectives outlined for the specific project. Managing a project will be accomplished using the skills developed in graduate school or on other projects while also managing the constraints discussed previously to stay on time and on budget as you monitor quality as well as team and stakeholder satisfaction and performance. This is best accomplished when using consistent, standard processes in an organized way to meet the project goals and objectives. As mentioned, the standard processes used in project management are very similar to the steps in the nursing process. They include a list of activities or tasks that need to be completed in each step before the next step can be started. Design (initiation) Plan Apply (implementation) Regulate or control; supervise (monitor) Conclude While the overall project is being supervised, all steps must also be regulated or controlled. Although these five processes are the ones most frequently used, larger projects’ processes may be broken into six or more components or phases so that the project can more easily be controlled. Organizing the project with specific steps adds a structure and a framework that is much easier to track and to change, if indicated. PRINCIPLES OF PROJECT MANAGEMENT Basic principles and an understanding of project management are frequently acquired over a number of projects; learning what works well and where to focus key time and resources takes time and experience. Just as with any project, including the wedding previously discussed or Amy’s master’s practicum project, some of the first questions to ask during a critical analysis are: Why are we doing this project? Why do we need it? Who will benefit? Does it fit the organization’s strategic mission and plan? The APN’s role here is to help facilitate the discussions with end users who need the application in order to work effectively, information technologists, and other stakeholders. Additionally, if the APN has assumed the role of the PM, it will be important to fully understand the five project management processes and how to apply them as listed previously. Knowledge Generation through Nursing Informatics DQ

Not only is it critical that the APN in the role of PM be able to track, control, and closely monitor the five project management processes but to also understand other key responsibilities of project management, which are discussed in the following chapters. Those include regulating and controlling the project so that it is continually on time, on budget, and within scope of the project. PROJECT MANAGEMENT: WHY DO WE NEED IT? Historically, projects completed prior to 1950 were less organized and more haphazard than those undertaken today. According to Cleland and Gareis (2006), “It was in the 1950s, when project management was formally recognized as a distinct contribution arising from the management discipline” (pp. 1–4). Engineering was at the forefront of establishing project management. From the 1950s to today, the concept of project management has become a key management strategy in large corporations, such as IBM, Apple, Microsoft, other industries, and now, more recently, in health care where there is a need to put more formalized structure and organization to tasks carried out in organizations. Nurses use an organized approach when providing care to patients. Patient care management requires an organizational framework—organizing processes similar to those used in project management are used to manage patient care. Driving Forces That Develop Skills Initially recommended in the Institute of Medicine report (IOM, 2008) and with the advent of the American Recovery and Reinvestment Act (ARRA), which contained the Health Information Technology for Economic and Clinical Health Act (HITECH Act, 2009), came the mandate of what health care should do, including using EHRs to collect and monitor patient data, which further encouraged the use and development of technology by nurses, APNs, and other health care professionals.  Knowledge Generation through Nursing Informatics DQ