NURSP 2075 Introduction To Health Informatics

Selected quality measure:

The assignment focuses on successful utilization of an information technology in the health care environment, facilitated mainly by the nurses. The quality measure that has been selected for this assignment is reduction in the rate of health care associated infection or HAI by implementation of the EHR in the facility.

Data collection plan:

The aim of the data collection plan for Hand Hygiene Technology will be to detect the presence of the healthcare workers for hand washing activity. Every worker will have a specific band on wrist with an inbuilt RFID tag. Each band will have a RFID storage memory with unique 12 bit ID and 120 – 150 kHz active emitter (Amendola et al., 2014). When a band will reach near the sanitizer or soap, the stand alone AIDC or Automatic Identification Data Capture sensor will receive the unique id of the tag and the id will be inserted in a database system. The detection procedure will be enabled when the distance between the tag and the detector will be less than 10 cm and the ID will be captured when the tag will stay at that position more than 5 seconds (Haque et al., 2017). After capturing the data from the sensor the dedicated warless server will transfer the id to the master monitor which will be a monitoring computer with inbuilt Database Management Software. The detection and data transmission procedure will be executed in real time, which means whenever a data will be captured by the sand alone RFID detector the data will be transmitted to the master monitoring computer.  

Mapping of the data:

The ID of the tag will be stored in the database along with detection time and date within a single record. After insertion of data the record will fetch the employee name, department and shift timing of that day and will reassemble the record accordingly. Along with that, in a separate table the frequency of using soap or sanitizer of that employee will be calculated and stored (Srigley et al., 2015). From these two tables the administrator of the system can identify each detected data of Hygienic process and the hygienic practice of each healthcare staff. The report of infection can be compared with the EHR (Electronic Health Record) and the associated caregivers can be found. Then through joining the EHR and HandGiene database the facility can find the irresponsible caregivers who have avoided the Hand Hygiene protocols. Apart from that, combining the records of all the related tables the administration can also analyze the performance of the each caregiver in terms of their compliance with hand hygiene and cleanliness protocol in the healthcare facility (Marra et al., 2014). The proper normalization of the database relations can help in sorting and fetching the data with high space and time efficiency.

Role of the advanced registered nurse: 

An advanced registered nurse has a varied range of responsibilities in the health care facility, and similarly, implementing any notable change in the facility will also be associated with a varied range of responsibilities for a registered nurse as well. It has to be mentioned that this project discusses the implementation of the ICT or information and communication technology, which is a revolutionary technique in the health care environment (Arnold et al., 2014). On a more elaborative note, the ICT device or technology which is going to be implemented in the health care facility is an automated hand hygiene technology called Handgiene that utilizes RFID, wireless and Zigbee technology, coupled with Web-based data collection and reporting software. This particular technique has the potential to provide real time monitoring or feedback monitoring for all of the hand washing activities of the health care professionals engaged in patient acre all across the facility. This a revolutionary change to be implemented in the facility, and implementation of the change will require active advocacy, control and maintenance, each will have a significant contribution form the registered nurse (Dellefield et al., 2015).

First and foremost, implementation of an infrastructural change as such will require agreement from all the involved stakeholders, especially the administrative and management authorities of the facility. In this case, it will be the responsibility of the advanced registered nurse to advocate the need for a system such as “Handgiene” to implement better infection control, protocol adherence in the facility, and reduce the rate of Health care associated infection. As the implementation of such an ICT system will require a considerable monetary investment, the nurse will need to establish the need for such a system and the positive benefits associated with such a system with evidence and data (Kerzner&Kerzner, 2017).

Another very important responsibility of the nurse will be to influence and motivate the staff to receive the change in the system positively and understand the need for the system to curb the rate of health care associated infection in the facility. In this case, the registered nurse will have to employ motivation and persuasion skills to help the rest of the staff understand the need for such a system in the facility and agree to actively use it. Lastly, this is a monitoring software which will require an invigilator to use it, collect the data and analyse it or take action on it. The registered nurse might also need to participate in the selection of the monitoring committee or participate herself in the monitoring (Dellefield et al., 2015). The registered nurse will also have a strong responsibility to ensure that the correct data is being captured by the sensors, a few additional regulatory steps are needed to be taken by the registered nurse to ensure that each nurse is wearing the RFID tags so that the data being captured is correct.

Additional systems and staff members: 

The change system that is going to be implemented in the facility would require the assistance of a few additional technological system. For instance, to successfully implement the system in the facility effectively, a specific database management system dedicated for the RFID technology is also needed to compliment the integration of the Handgiene. The need for corroborating the existing EHR system of the facility to identify the nurses not abiding the hand hygiene policy is going to be required. Similarly, it has to be mentioned that Handgiene software data and HAI rate audit data will need to be aligned as well to ensure that the impact of the technology on the reduction rate of HAI can be identified. The help of both clinical and administrative staff of the facility will also be required in implementing the change and monitoring the results of the software.

Professional, ethical, and regulatory standards: 

Another very important aspect in the introduction of the change in the facility is ensuring that the different professional, ethical and regulatory standards are being adhered to and addressed in the organization effectively. In this case, the technology being implemented has the potential to improve the infection control protocol adherence behaviour of the nurses and reduce the rates of HAI. Although, as any change implementation. In this case as well, the change implementation will be time consuming and it has a probability of affecting the patient care. As per the professional standards and ethical code of conduct of ICN, the registered nurse must ensure patient care quality to not be affected by any chance (International.aanp.org, 2018). Similarly, as per the regulatory standards, the RN must also ensure that all equipment and software installed must be ISO approved.

Stakeholder communication:

Stakeholder communication is a very important aspect of the successful implementation of change project. In certain cases, the need for making slight changes in the plan might present itself. In this case, the registered nurse will need to take the responsibility of communicating the necessary changes to all involved stakeholders, such as patients, nursing staff and administrative authorities effectively. In this case, the RN might take the assistance of personal emails to convey changes, or the nurse might also take into consideration conducting monthly meetings and discussion sessions involving one representatives of all eminent stakeholder groups (Kerzner&Kerzner, 2017).

Leadership skills and project management knowledge:

Proper leadership can help implement effective change management successfully and smoothly. In this case, the registerednurse will have to implement a transformational leadership skills into implementing proper change management. It has to be mentioned that incorporating an infrastructural change will require affirmation or interest from administration and the nursing staff (Powell et al., 2015). Hence, in one hand the RN will need to employ the charismatic traits and persuasion skills to convince the authorities to implement the change. Similarly, like a transformation leader with a vision and inspiring capability to help followers understand the need for change and envision similar goals, the RN would also need to convince the nursing staff to accept the change in the facility (Kash et al., 2014). Lastly, as this would a large scale project investing substantial money and manpower, certain project management knowledge, such as budget preparation and allocation, manpower allocation, and infrastructural capacity analysis for sustaining such a long term technological change is needed to be employed from the head RN leading the project.

References:

Amendola, S., Lodato, R., Manzari, S., Occhiuzzi, C., &Marrocco, G. (2014). RFID technology for IoT-based personal healthcare in smart spaces. IEEE Internet of things journal, 1(2), 144-152.

Arnold, K. E., Avery, L., Bennett, R., Brinsley-Rainisch, K., Boyter, M., Coffin, N., …& Herrera, R. (2014). National and state healthcare-associated infections progress report.

Dellefield, M. E., Castle, N. G., McGilton, K. S., &Spilsbury, K. (2015). The relationship between registered nurses and nursing home quality: An integrative review (2008-2014). Nursing economic$, 33(2), 95-108.

Haque, A., Guo, M., Alahi, A., Yeung, S., Luo, Z., Rege, A., …&Platchek, T. (2017). Towards Vision-Based Smart Hospitals: A System for Tracking and Monitoring Hand Hygiene Compliance. arXiv preprint arXiv:1708.00163.

International.aanp.org (2018). NP and AP Roles – ICN Nurse Practitioner / Advanced Practice Nursing Network. [Online]. Retrieved from https://international.aanp.org/Practice/APNRoles. [Accessed on 27^th Dec]

Kash, B. A., Spaulding, A., Johnson, C. E., &Gamm, L. (2014). Success factors for strategic change initiatives: A qualitative study of healthcare administrators’ perspectives. Journal of Healthcare Management, 59(1), 65-81.

Kerzner, H., &Kerzner, H. R. (2017). Project management: a systems approach to planning, scheduling, and controlling. John Wiley & Sons.

Marra, A. R., Camargo, T. Z. S., Magnus, T. P., Blaya, R. P., dos Santos, G. B., Guastelli, L. R., … & Monte, J. C. M. (2014). The use of real-time feedback via wireless technology to improve hand hygiene compliance. American journal of infection control, 42(6), 608-611.

Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., … & Kirchner, J. E. (2015). A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Science, 10(1), 21.

Srigley, J. A., Gardam, M., Fernie, G., Lightfoot, D., Lebovic, G., & Muller, M. P. (2015). Hand hygiene monitoring technology: a systematic review of efficacy. Journal of Hospital Infection, 89(1), 51-60.