Nursing Informatics EHR Implementation

MSN Nursing Informatics & EHR Implementation Plan

Assessment 2: Strategic EHR Implementation Brief (1,500–2,000 words)

---

Course and Assessment Context

Course level: MSN / APRN (Graduate Nursing – Nursing Informatics and Healthcare Technology)
Assessment name: Assessment 2 – Nursing Informatics & Electronic Health Record (EHR) Implementation Plan
Length: 1,500–2,000-word individual written paper (excluding title page and references)
Weighting: 30% of overall course grade
Submission format: Typed, double-spaced, 12-point Times New Roman, APA 7th edition, submitted as a Word document via LMS

---

Assessment Overview

Graduate-prepared nurses are expected to lead or actively support the implementation, optimization, and evaluation of electronic health record (EHR) systems within complex healthcare environments. Effective implementation requires alignment of clinical workflows, informatics standards, regulatory requirements, clinician engagement, and structured change management to protect patient safety and quality outcomes.

This assessment requires you to develop a focused, practice-oriented EHR implementation plan for a selected clinical setting, adopting the perspective of a nurse informaticist or advanced practice nurse leader.

---

Assessment Task Description

Prepare a 1,500–2,000-word EHR implementation plan for a specific healthcare organization or clinical unit. You may use your own practice setting (fully de-identified) or construct a realistic scenario grounded in current evidence and professional guidelines.

Your work must be framed from the perspective of a nurse informaticist or advanced practice nurse who has been tasked with designing a structured, evidence-informed plan to implement or significantly upgrade an EHR system.

---

Task Components

Your paper must address the following components using clear headings and subheadings.

---

1. Practice Setting and Problem Definition

• Briefly describe the clinical setting (for example, a 250-bed community hospital medical-surgical unit, an urban primary care clinic, a rural emergency department, or a long-term care facility).

• Identify the main informatics or documentation problem(s) the proposed EHR implementation or upgrade is intended to address, such as fragmented documentation, poor interoperability, medication errors, delayed results review, or limited clinical decision support.

• Explain why change is required at this time, drawing on current literature, safety data, regulatory drivers, or quality indicators relevant to EHR use in similar settings.

---

2. Stakeholders, Roles, and Governance

• Identify key stakeholders and user groups, such as bedside nurses, APRNs, physicians, pharmacists, allied health professionals, IT staff, executive leadership, quality and safety teams, and patients or families.

• Describe the specific roles and responsibilities of the nurse informaticist and advanced practice nurse during planning, design, implementation, and post–go-live phases.

• Outline a clear governance or decision-making structure for the implementation, such as a steering committee, clinical advisory group, or super-user network, including communication and escalation pathways.

---

3. Implementation Strategy and Phases

• Present a phased implementation strategy that includes planning and needs assessment, design and configuration, testing, go-live, and stabilization or optimization.

• For each phase, identify two to three concrete activities essential for safe and effective implementation, such as workflow mapping, clinical content standardization, data migration planning, simulation testing, downtime procedures, go-live support, and post-implementation audits.

• Explain how the strategy reflects current evidence on successful EHR implementation and mitigates unintended consequences such as alert fatigue, workarounds, and documentation burden.

---

4. Workflow, Clinical Decision Support, and Safety

• Select one or two high-risk or high-volume workflows in your setting, such as medication administration, discharge planning, sepsis screening, or chronic disease management, and compare the current state with the future state following EHR implementation.

• Identify at least two clinical decision support tools, such as evidence-based order sets, alerts, reminders, risk scores, or structured documentation templates, and explain how they support safety, quality, and efficiency.

• Discuss how the nurse informaticist will monitor for new risks, such as duplicate documentation or over-reliance on automation, and adapt system design or workflows to maintain patient safety.

---

5. Training, Change Management, and User Support

• Describe a practical training plan tailored to different user groups, including timing relative to go-live, delivery methods such as in-person sessions, e-learning, or simulation, and strategies for reinforcement.

• Explain how change management principles will be applied to address resistance, promote engagement, and support adoption among clinicians and staff.

• Outline the structure of go-live and post–go-live support, including super-users, at-the-elbow support, help desk protocols, and feedback channels, and explain how feedback will inform ongoing system improvement.

---

6. Evaluation, Data Use, and Sustainability

• Identify three to five measurable outcomes or process indicators to evaluate the impact of the EHR implementation, such as medication error rates, documentation completeness, turnaround time for test results, clinician satisfaction, or patient outcomes.

• Explain how EHR data will be collected, analyzed, and reported, and how nurses will be involved in reviewing and acting on the findings.

• Discuss at least two strategies for long-term optimization and sustainability, such as continuous education, periodic workflow review, and structured governance for future updates or upgrades.

---

7. Ethical, Legal, and Regulatory Considerations

• Analyze key privacy, security, and confidentiality requirements relevant to EHR implementation in your jurisdiction, such as HIPAA in the United States, GDPR in the UK or EU, or comparable legislation in Canada or Australia.

• Describe how the plan addresses data protection, user authentication, audit trails, and role-based access control.

• Discuss equity and access considerations, including digital literacy, language barriers, and the impact of EHR implementation on vulnerable populations.

---

8. Integration of Evidence

• Support the implementation plan with recent, peer-reviewed literature, using a minimum of five sources published between 2018 and 2026.

• Explicitly connect evidence to specific elements of the plan rather than citing sources in a general or descriptive manner.

---

Formatting and Submission Requirements

• Word count: 1,500–2,000 words, excluding title page and reference list.

• Use clear headings and subheadings aligned with the task components.

• Use APA 7th edition for in-text citations and reference list.

• Include a title page with course code, course title, assessment title, student name, student ID, instructor name, and submission date.

• Submit the assignment as a Microsoft Word document via the designated LMS link by the published deadline.

---

Academic Integrity

All submitted work must be original and authored by the student. Proper acknowledgment of sources through accurate citation and referencing is required. Plagiarism, fabrication, or other forms of academic misconduct will be managed according to institutional policy and may result in penalties, including failure of the assessment.

---

Marking Rubric (100 Points)

1. Problem Definition and Context (15 points)

• Excellent (13–15): Clear, precise description of the clinical context and informatics problem with strong evidence-based justification and insight into organizational drivers.

• Competent (10–12): Adequate description with some supporting evidence; urgency or context may lack depth.

• Developing (7–9): Incomplete or vague description; limited evidence.

• Inadequate (0–6): Poorly defined context or problem with minimal justification.

2. Stakeholders, Roles, and Governance (15 points)

• Excellent (13–15): Comprehensive stakeholder identification with clearly defined roles and effective governance structure.

• Competent (10–12): Most stakeholders identified; governance structure present but underdeveloped.

• Developing (7–9): Limited stakeholder identification and vague roles.

• Inadequate (0–6): Stakeholders and governance largely absent.

3. Implementation Strategy, Workflow, CDS, and Safety (25 points)

• Excellent (22–25): Coherent, phased strategy aligned with evidence; strong integration of workflow redesign and CDS to enhance safety and quality.

• Competent (18–21): Logical strategy with some evidence-based justification.

• Developing (13–17): Partial strategy with limited linkage to evidence or safety.

• Inadequate (0–12): Fragmented or unrealistic approach.

4. Training, Change Management, User Support, and Evaluation (25 points)

• Excellent (22–25): Comprehensive training, change management, and evaluation plan with measurable outcomes.

• Competent (18–21): Appropriate strategies with some evaluation detail.

• Developing (13–17): Generic training and limited evaluation planning.

• Inadequate (0–12): Little evidence of structured planning.

5. Ethics, Regulation, and Use of Evidence (10 points)

• Excellent (9–10): Context-specific ethical and regulatory analysis with strong integration of current evidence.

• Competent (7–8): Ethical and legal issues discussed with moderate evidence use.

• Developing (5–6): General discussion with limited evidence.

• Inadequate (0–4): Ethical and regulatory considerations largely absent.

6. Organization, Academic Writing, and Referencing (10 points)

• Excellent (9–10): Clear, well-organized writing with accurate APA formatting.

• Competent (7–8): Generally clear with minor APA or writing issues.

• Developing (5–6): Uneven organization and noticeable APA errors.

• Inadequate (0–4): Poor organization and incorrect referencing.

Nurse informaticists anchor successful EHR implementations by aligning clinical workflows with technical design, ensuring that system configuration reflects real-world nursing practice rather than default vendor settings. Prioritizing high-impact workflows such as medication administration and diagnostic reporting, combined with cautious deployment of decision support tools, reduces alert fatigue and improves adoption. Engagement of frontline nurses as super-users, supported by scenario-based training and at-the-elbow go-live assistance, accelerates stabilization and continuous optimization. Clear outcome measures such as medication error rates, documentation timeliness, and clinician satisfaction create a feedback loop linking EHR functionality to patient safety and care quality.

References

Finnegan, H., Jones, M. and Patel, R. (2025). Twenty-five years of electronic health record implementation: Process-focused recommendations for safer digital transformation. Journal of Medical Internet Research, 27(1), e60077.
Wilks, J., Taylor, L. and Cheng, A. (2025). Best practices in training nurses to use electronic health records: Beyond the classroom model. Canadian Journal of Nursing Informatics, 20(1), pp. 1–15.
Ahmed, S., Malik, F. and Rahman, N. (2021). Role of nurse informaticists in the implementation of electronic health records in low- and middle-income countries. African Journal of Primary Health Care & Family Medicine, 13(1), a3029.
Lee, Y.H., Park, J. and Kim, S. (2019). Impact of electronic health record implementation on quality of care and patient safety: A systematic review. BMC Medical Informatics and Decision Making, 19(1), 12.
Jones, K., Miller, A. and Green, P. (2018). Nursing informatics competencies and organizational readiness for EHR adoption. Computers, Informatics, Nursing, 36(9), pp. 450–457.