Electronic Medical Record (EMR) integration to nursing staff

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Electronic Medical Record (EMR) integration to nursing staff
The information technology age ensures that every aspect of life conforms to the IT arena. The nursing profession must radically transform to meet the evolving expectations through adoption of EMR. One of the most pertinent factors toward implementation of the EMR is communication. Implementation of EMR is a big decision that not only impacts on nursing business but the staff. Not every staff will have the confidence in mastering the EMR technology. Therefore, through research, it is established that helping the staff understand the value and urge nature of transitions forms itself as appropriate consideration towards implementation of EM since non-communication results to rumors that consequently results to unfounded fear and doubt. Through communication, it is installed in the nurses that EMR will serve as the key component towards transforming practice and operations workflow. Moreover, the nurses will understand that EMR will act as the ladder of improving the client base and taking the clinic towards the next phase of change, through improvement in quality (McCarthy & Eastman, 2013). Employment of transparency in the communication of transitions process through the adoption of weekly open meeting acts as the next gauge toward understanding the nature, requirement, and skill necessary for the implementation of EMR. Communication thus ensures that the feeling of distress, apprehensions and discomforts are discouraged thus ensuring that the driving force toward the implementation process is greater than the restraining force (Payen, 2013).

. Educating the staff through communication enhances the strengths of the driving force thus reducing the restraining force hence facilitating transition to the next phase.
Apart from communication, employment of leadership is another mechanism currently employed in educating the nursing staff towards implementation of EMR. A leadership oriented process i.e. through identification of a superuser ensures that that there is a smooth transition, and internal wrangles are quelled. Currently, superuser is appointed from the team (who is a clinician) and has the authority and the mandate of making important decisions through the practice. Moreover, the superuser has the authority of inferring accountability that is, all member of the nursing staff are held accountable for goals and behavior. According to Sheridan, acknowledging technological savvy individuals as manpower in the transition process and as the super user ensures that protocol is observed, and the transition process goes over in the managers presence or not (Sheridan, 2012). In other words through leadership process, all the staff members are actively engaged in the preparatory discussion, the technically savvy individuals are set as extra super users, and their feedback checked on real time basis and the naysayers are engaged in the process to verify the need for the transition. Payne suggests that employees are more predisposed to the acknowledgment of electronic transitions if the staff understands the benefits of such an electronic transitions (Payne, 2013). This ensures that the employees are actively involved from the planning and implementation phases of the process. Engaging the naysayers proves paramount in preventing backlash once they consider the importance of implementation of the project (Abell et al, 2015). Having the mantel of adoption of EMR in clinical practice through quelling of criticism is dictatorial in nature, through identification of protocols, a smooth transition occurs ensuring that every member is incorporated into the transition phase.
Process-based training proves as one of the best training mechanisms for the nurses. It is important to consider that learning to use a new system raises questions on workflow. By extension, the case of training on e-prescribing is just as pertinent as the training on technology-enabled medication refill process. E-prescription may consider the only provider, but the case of medication refill process may consider as well medical assistants and the nurses. Therefore, it is important that the nurses understand explicit responsibility as well as any case of hands off (Snyder, & Olive, 2014). A process-based form of training ensures that policies and procedures are updated, and the new sensibilities captured in an updated job narrative as well as the incorporation of best practices in the caring team operation through a change in processes as the nurses learn on a daily basis to integrate EMR on daily processes. Surfacing the concerns related to the implementation of the cause of training ensures that the anxiety associated with some nurses is not encountered on a busy day of clinic operation. Moreover, the nurses acquaint themselves with effective coding and documentation mechanisms thus easy retrieval of information (Snyder, & Olive, 2014). Thus, the transition occurs in a smooth direction, thus a standardized approach to training.
Moreover, application of mock clinic training sessions proves as another typical way of training the nurses. Typically closing a clinical set up for a mock training session that can last for several hours proves as a standardized form of training the nurses. In addition to simulated training, application of dry runs as a form of mock training is also important in the implementation of EMR principles to the nurse (Allen, et al, 2014). In the mock training setups (that are consequently followed by go-lives) administrators can act as the patients, transitioning from checking proceeding to exam then finally to check outs. In this scenario, understanding different kinds of patient scenarios through routine preventative cares as well as well child visits explains to the nurses how the system expect to change and how they can handle different Kindles of patients. According to Allen et al, the mock session should have patients with different medicals cases ranging from mere to chronic cases, i.e. the fist “patient” can have a cold that institutes a prescription, the second case can be specimen patient that requires a lab order, diagnosis or medication and the heard hypothetical patient should be a chronic case (Allen et al, 2014). Through such a mechanism, the nurses ensure that they handle hypothetical cases of patient conditions, and are well acquainted with a real case. Moreover, after the mock sessions, the nurses are exposed to debriefing sessions that can last for days (or several hours), during which the nurses expounds on the factors that do not work and the facets of the EMR model that worked during the mock training. This ensures that concerns are met and solved in the initial phase before a major take off thus reducing risk of failure.
Apart from mock sessions, application of voluntary trainers, part-time instructors and locums have proved as another fundamental way of training the nurses. This kind of specialist is very useful in training the nurses on the technical and complex aspects of the EMR models. Locum tenens and voluntary expert prove paramount in the transitioning process since they can prove as cost cutting measures, instead of actual lockdown or mock training that can compromise income and services, theses specialists provides the training at an appropriate time ensuring smooth flow of operations (McAlearney et al, 2012). This specialist can either apply the original paper documentation process that are scanned and electronically fed into the systems by the nurses or as well application of templates built that eases the burdens. The pending orders, in this case, are then approved by the supervising technician. With a specialist, the nurses have the chance to interact, and ask technical questions related to EMR (Topaz, Rao and Bowles, 2015). In some cases, the experts have established non-threatening competitions or tasks between nurses in a hypothetical EMR system and manual comparisons and the results compared. These takes the form of nurses performing physician related practice using the EHR system and on the other way physicians performing nurse related duties (Gardner and Jones, 2012) Such a situation provides exemplary cases of comparing the experiences in the selection process, a case of application of fun (McAlearney et al, 2012). Moreover, such scenes ensure that the nurses appreciate adoption of the EMR models in the nursing profession as well as enhancing knowledge base in EMR models.
Finally, ensure success, information technology experts must be available at any deemed moment to address any issues resulting from the EMR system. Moreover, clinical educators should also be availed to provide requisite training to new nurses and staffs. Still, the system must be in regulation to set standards and policies thus in evaluation compliance to set regulations as the HIPAA must be checked and necessary improvement made concerning information and data security.
   
REREFRENCE
Abell, C. H., Bragg-Underwood, T., Alexander, L., Abell, C. E., & Burd, V. (2015). Nurses’ Knowledge and Attitudes toward Implementation of Electronic Medical Records. International Journal of Faith Community Nursing, 1(3), 74.
Lavin, Harper E, & Barr N. (2015). Health Information Technology, Patient Safety, and Professional Nursing Care Documentation in Acute Care Settings. THE online Journal of Issues in Nursing. Retrieved http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No2-May-2015/Articles-Previous-Topics/Technology-Safety-and-Professional-Care-Documentation.htmlMcCarthy, C., & Eastman, D. (2013). Change management strategies for an effective EMR implementation. Himss.
Payne S.(2013). The Implementation of Electronic Clinical Documentation Using Lewin’s Change Management Theory. Canadian Journal of Nursing Informatics. Retrieved http://cjni.net/journal/?p=2882Sheridan, S. (2012).  The implementation and sustainability of electronic health record. Online Journal of Nursing Informatics (OJNI), 16 (3), Available at http://ojni.org/issues/?p=1992Topaz M, Rao A, and Bowles K, (2015). Educating Clinicians on New Elements Incorporated Into the Electronic Health Record: Theories, Evidence, and One Educational Project. Retrived http://www.nursingcenter.com/CEArticle?an=00024665-201308000-00005&Journal_ID=54020&Issue_ID=1594013
McAlearney, A. S., Robbins, J., Kowalczyk, N., Chisolm, D. J., & Song, P. H. (2012). The role of cognitive and learning theories in supporting successful EHR system implementation training A qualitative study. Medical Care Research and Review, 69(3), 294-315.
Allen, G. B., Miller, V., Nicholas, C., Hess, S., Cordes, M. K., Fortune, J. B., … & Ricci, M. (2014). A multitiered strategy of simulation training, kit consolidation, and electronic documentation is associated with a reduction in central line–associated bloodstream infections. American journal of infection control, 42(6), 643-648.
Snyder, E., & Oliver, J. (2014). Evidence based strategies for attesting to Meaningful Use of electronic health records: An integrative review. Available in the. Online Journal of Nursing Informatics (OJNI), 18(3).
Gardner, C., and Jones, S.  (June 2012). Utilization of academic electronic medical records in undergraduate nursing education. Online Journal of Nursing Informatics (OJNI), vol. 16 (2), Available at  http://ojni.org/issues/?p=1702