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Design Considerations

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Submitted By destane01
Words 1496
Pages 6
Design Considerations and Workarounds
Tamara Stratford
Walden University
Nurs 6401, Section 3, Informatics in Nursing and Healthcare
April 10, 2016

Introduction Healthcare organizations are drawing near the period of innovation by utilizing electronic health records (EHR) inside centers and clinics. In healthcare, technology has caused therapeutic improvements to happen at a bewildering rate. The legislature has heaved initiatives to move the spread of health information technology (HIT). Expansion and acceptance of a world-wide health information substructure are continuing, driving inclination to trade persistent medicinal data, electronically. The need for the EHR in the healthcare field is crucial due to the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 (McGonigle & Mastrian, 2012). The implementation of another information system or innovation is not generally a simple undertaking and is regularly met with resistance. There are many different factors that need to be considered to ensure the successful implementation of a HIT. The isolation of the impacts can be challenging but must be addressed before the new technology is initiated. The purpose of the paper is to discuss how the employment of an informatics system can be influenced by hardware, software and human factors.
Design Considerations With the emerging importance of computers and information technology in nursing practice, the new role of a nursing informatics specialist (NIS) was developed (American Nurses Association, 2015). The NIS must have a formal education in informatics, a certification and experience in using computers in the patient care setting. The NIS helps to facilitate the implementation of computer systems within the nursing field (McGonigle & Mastrian, 2012). The computer system can be confusing and misused but the users must feel comfortable and have competency when utilizing the system (McGonigle & Mastrian, 2012). This is most critical when it deals with patient care. The hardware and software of the system must be aligned with patient safety. The nursing task must be well emulated within the software of the system that is being used (McGonigle & Mastrian, 2012). The next couple sections will further discuss in detail the hardware, software and human factors that will impact the informatics system.
Hardware
The parts of a computer are defined as the hardware (Saba & McCormick, 2015). The structure of the hardware is made up items such as the random access memory (RAM), read-only memory (ROM), processor and other parts (Saba & McCormick, p.23, 2015). Inside the case of the computer is internal hard drive, universal serial bus (USB) connector adapter, modem, Ethernet adapter and other components (Saba & McCormick, p.23, 2015). Then there are devices that are part of the hardware that can be connected such a keyboard and mouse (Saba & McCormick, p.23, 2015). The most efficient technology should be selected to ensure it includes all of the necessary components to be the best fit for the organization. The hard drive must have the capacity to support the amount of data that will be stored or supported on the computer. If the correct type of hardware is not selected this could cause a system overload and the potential for failure. Two examples of hardware in reference to barcode-assisted medication administration (BCMA) would be the actual device used to scan the barcode on the patient and the medication and the internal drive on the computer on wheels (COW).
Software
Software is the directions that tells the hardware what to do. The purpose of the software is to decode the directions provided in the human language into the computer (Sabra & McCormick, 2015). Also software is warranted so that the computer system can be a working tool. Software is furnished as a set called programs (Sabra & McCormick, 2015). The programs decipher operations the client needs into dialect and directions that the PC can get it. There are three different types of software. System software is what starts up the computer, controls the input and output sectors and the activity of the programs selected (Sabra & McCormick, 2015). Utility software (program) is the power that drives the efficient operation of the computer system. And application software is programs for users to play games, do their work, watch different media and interact with others on the computer (Sabra & McCormick,2015). The correct software must be selected to ensure that all the correct data is captured and transferred into the patient’s EHR. This will help to improve patient safety and outcomes. One must first research which software will best fit their organization and make sure that the software will correlate with their expectations. The reasoning of this software or a program is to implement the correct one that will most fit the needs of the organization. An example of software or program is the ability of it to notify the medical personnel if the incorrect barcode is scanned and if the incorrect dosage of a medication was entered. Another example is the actual program or software that is chosen to interact with the barcode scanner.
Human Factors Human Factors are the link between the users and their tools, responsibilities and environment (Sabra & McCormick, 2015). The experts that research human factors use information and characteristics of human related to their behavior to design the best tool for people to use every day (Sabra & McCormick, 2015). The expectation of using human factor is to ensure that the nurse and their tool are able to carry out their task, decrease errors, increase patient safety and enhance the quality of life (Sabra & McCormick, 2015). An example of human factor is the ability of the user to understand the system and program and use it correctly. Another one is the computer literacy and the user’s experience. These factors can greatly influence the implementation of a new system. The user must know how to and understand the basics of using a computer. If the individual does not like the software or understand computers their negative experience could be transferred amongst the other employees in the organization.
Employee Workarounds Workarounds can be beneficial and harmful with designs and implementations. In relation to the BCMA, the user will be provided medication information that is current, reconciliation of medications and medication allergies (Sabra & McCormick, 215). Any new technology should always be geared towards improving the quality of care. The consequences in relation to BCMA would be not scanning the barcode on the patient but instead entering some type of identifiable information (Sabra & McCormick, 2015). The ineligible handwriting of physician that had to be interpreted when adding a medication to the patient’s profile. Any type of short cut will increase the chances of error and negative outcomes for patients. I do not believe that workarounds are necessary and would not purchase a system that allows some type of workaround. Even if it was something as simple as entering the number of tablets or vials needed to deliver the correct dosage. The allowance of minor workaround will lead to users trying to find others ways to do their work faster but probably not efficiently. When relating this to BCMA, a user will mistakenly enter two tablets when it’s supposed to be one. This could cause an overdose. The scanning of the medication packaging would only allow it to be scanned one time and would alert the nurse of an error if its scanned more than once.
Conclusion
The successful execution of a new system results in the improving the quality of care, patient safety and decreasing negative outcomes. In spite of the potential negative consequences of EHR, its usage is a troublesome and complex assignment whose achievement relies on upon numerous components. There are several factors that impact the implementation of a new system and must be considered during the planning process. According to Safdari, Ghazisaeidi, & Jebraeily (2015), project management is the most factor in the successful implementation of an EHR system. There needs to be more emphasis on human factors as well (Safdari et al., 2015). Having basic and advanced capabilities are required and expected as technology progressively touches and changes the nurse’s job.

References
American Nurses Association. (2015). Nursing informatics: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author.
Finney Rutten, L., Agunwamba, A., Greene, S., Mazor, K., Ebbert, Jon., St Sauver, J., & Dearing, J. (2014). Enabling patient-centered communication and care through health information technology. Journal of Communication in Healthcare, 7(4), 255-261. http://dx.doi.org/10.1179/1753807614Y.0000000067.
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones & Bartlett Learning.
Saba, V. K., & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York, NY: McGraw-Hill.
Safdari, R., Ghazisaeidi, M., & Jebraeily, M. (2015). Electronic Health Records: Critical Success Factors in Implementation. Acta Informatica Medica, 23(2), 102–104. http://doi.org/10.5455/aim.2015.23.102-104.
Shachak, A., Barnsley, J., Tu, K., & Jadad, A (2011). Understanding end-user support for health information technology: a theoretical framework. Informatics in Primary Care, 19(3), 169-172.

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