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HOW DO CAPSTONE PROJECTS IN NURSING INFORMATICS CONTRIBUTE TO THE ADVANCEMENT OF HEALTHCARE DELIVERY

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Nursing informatics is a growing field that applies information and technology to support nursing practice, research and improve patient care. Capstone projects are a core requirement for many nursing informatics graduate programs, allowing students to demonstrate their mastery of concepts through the application of skills and knowledge to solve real-world healthcare problems. These projects make valuable contributions by developing tools and solutions that directly support the delivery of care.

One of the key ways capstone projects advance healthcare is by addressing gaps and inefficiencies identified in current clinical practice through the creation of new technologies and applications. For example, a recent project developed a mobile application to streamline admission, transfer and discharge processes between emergency departments and inpatient units. By automating paperwork and communication, it helped reduce delays and errors. Another project designed a clinical decision support tool integrated into the electronic health record to assist nurses in assessing risk factors and managing care for patients with heart failure. Projects like these save healthcare providers time so they can spend more of it on direct patient care activities.

Capstone work also enhances healthcare delivery by improving access to and coordination of care. One nursing informatics student created a telehealth platform allowing remote patient monitoring and video conferencing with providers. This benefited patients in rural areas with limited transportation options or specialty care locally available. Another project implemented an information system across diverse care settings – from hospitals to home health – facilitating the secure sharing of patient data between providers. Seamless data exchange supports continuity as patients transition between levels of care.

Many projects focus on leveraging technologies like artificial intelligence, machine learning and predictive analytics to augment clinical decision making. For example, one analyzed large datasets to develop models that can predict risk of hospital readmissions, pressure injuries or medication errors based on a variety of patient factors. Having these predictive tools available at the point of care empowers nurses to implement preventative interventions earlier. Other work applies similar techniques to radiology images, using automation to flag anomalies faster and improve diagnostic accuracy. As data volumes in healthcare continue climbing, these types of informatics solutions will grow increasingly valuable.

Privacy and security of protected health information are also top priorities addressed through capstone work. A variety of projects have centered around strengthening existing safeguards, implementing new access controls and authentication methods, or educating clinicians and patients on best practices. One developed an electronic system and mobile app for obtaining informed consent during research studies in full HIPAA compliance. Others conducted security risk assessments or created policies and guidelines around topics such as email encryption standards when exchanging files containing sensitive patient data. As threats to cybersecurity increase, these contributions play an important role in maintaining public trust in healthcare technologies.

Nursing informatics students additionally help advance care delivery through projects focused on user experience, usability and adoption of systems. Several analyzed clinician interactions with electronic health records, identifying inefficient workflows or areas for improvement. Recommendations from one such capstone helped optimize screen navigation and streamline documentation directly at the point of care. Another implemented a comprehensive training and support program to address barriers hindering full utilization of a new EHR system rollout. Proper end user training and ongoing support are essential for successful integration of technologies into clinical workflows.

Capstone projects can contribute through knowledge creation and dissemination. Some involve conducting systematic literature reviews on emerging topics, compiling best practices and developing evidence-based guidelines. These synthesis works help translate research findings into applicable recommendations that can guide the field. Other students pursue original nursing informatics research for their projects – such as evaluating new apps, prototypes or technologies through studies. Findings are then presented at conferences and published in scholarly journals, expanding the body of evidence and lessons learned to continually advance practice.

Nursing informatics capstone projects make invaluable contributions to healthcare delivery across diverse areas including clinical workflows, access to and coordination of care, predictive analytics and decision support, privacy/security, user experience, knowledge generation and more. Through creative applications of informatics principles and technologies, students directly address real problems impacting patients and providers. Their work helps optimize delivery systems, empower data-driven decisions at the point of care and integrate information management seamlessly into clinical practice – all advancing the overall outcomes, safety, efficiency and patient-centeredness of healthcare.

DEFINE HEALTHCARE INFORMATICS

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Healthcare informatics is a multidisciplinary field that uses information technology and information science to support healthcare delivery, practice, research, and decision making. Some key aspects of healthcare informatics include:

  • Electronic Health Records (EHR): EHRs are digital versions of a patient’s medical charts. They contain the patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results. EHRs allow healthcare providers to access a patient’s information from any location, which improves care coordination and eliminates paper waste. EHRs also facilitate population health management by allowing doctors, nurses, and public health officials to track health outcomes, costs of care, preventive care rates, and disease-specific indicators across groups of people.
  • Health Information Exchange (HIE): HIE refers to the electronic movement of health-related information among organizations. It allows doctors, nurses, pharmacists, other healthcare providers and patients to appropriately access and securely share a patient’s vital medical information electronically—improving health care services, while supporting the coordination of care and efficient workflow. Through regional HIE networks, authorized healthcare professionals can now have immediate access to patients’ clinical information from other organizations, which leads to better-informed medical decisions, continuity of care, earlier detection of public health threats, and reduced healthcare costs.
  • Computerized Provider Order Entry (CPOE): CPOE systems allow physicians and other healthcare providers to electronically enter medication orders, radiology and laboratory test requests directly into the EHR system instead of writing out paper orders. This reduces prescription errors and adverse drug events by enforcing dosing rules and guidelines, checking for drug interactions, allergies, duplicate therapies and laboratory result interactions prior to placing the order. Studies have shown that medication orders entered through a CPOE system have 25-65% fewer errors than written or verbal orders. CPOE also streamlines workflows for nurses, pharmacists and other staff involved in order fulfillment.
  • Clinical Decision Support (CDS): CDS refers to technology that analyzes electronic health data to help healthcare professionals make clinical decisions. By tapping into vast clinical knowledge databases and the patient’s unique health information, CDS systems generate personalized clinical recommendations and alerts to assist providers in deciding the best evidence-based course of care for a patient. CDS improves guideline-concordant care, reduces practice variation, and can help avoid preventable medical errors. Examples include drug-allergy and drug-drug interaction alerts, reminders for maintenance of chronic conditions, and recommendations for screenings or diagnostic tests.
  • Telehealth and Telemedicine: Telehealth uses information and communication technologies like videoconferencing to deliver virtual medical, health, and education services at a distance. Providers are able leverage telehealth modalities to monitor patients with chronic conditions in their homes, conduct follow-up visits with postoperative patients, or provide specialty consults to patients in rural areas with limited access to specialists. Telehealth improves care access and outcomes while reducing costs by avoiding unnecessary transportation, missed appointments, and delays in treatment. During public health emergencies like the COVID-19 pandemic, telehealth has enabled the safe continuation of non-emergency care.
  • Personal Health Records (PHR): PHRs allow individuals to access and manage their lifelong medical record and share their health information electronically. Just like EHRs, PHRs contain individual health data like medications, allergies, immunizations, lab results, problems, procedures, and more. Unlike EHRs controlled by healthcare organizations, PHRs are owned, managed, and shared by consumers/patients themselves. PHRs empower patients to be more actively engaged in their care by giving them convenient access to their comprehensive health history from any internet-connected device.
  • Population Health Management: Through aggregating and analyzing clinical, social, behavioral, lifestyle, and economic data from populations of patients, healthcare organizations can identify groups at risk for certain diseases or conditions. Targeted interventions and care management programs are then implemented to improve outcomes for these at-risk populations. The goal of population health management is to proactively anticipate patients’ healthcare needs, prevent disease/illness, minimize health disparities and create healthier communities. It realigns financial incentives around keeping people healthy rather than reactively treating sickness.
  • Mobile Health (mHealth): mHealth uses mobile and wireless technologies like mobile devices, wearables and sensors to deliver health services and improve patient outcomes. Examples include smartphones or tablets to retrieve lab results and medical records, devices to monitor vital signs and transmit data to providers, apps for medication adherence, smoking cessation programs, chronic disease self-management and remote patient monitoring. mHealth extends care outside of clinical settings and empowers greater patient engagement, promoting healthier behaviors and lifestyles.
  • Healthcare Analytics: Healthcare analytics refers to the qualitative and quantitative techniques used to analyze healthcare data for better administrative and clinical decision making. By applying predictive modeling, data mining, machine learning and other advanced analytic methods to EHRs, claims, and other patient-level data, organizations can uncover important insights. Analytics help improve quality of care, identify at-risk patients, determine best practices, optimize utilization of resources, detect fraud and abuse, and reduce costs. Real-time data streaming analytics also enables precision care by supporting clinical decision support at the point of care.
  • Biomedical Informatics: Biomedical informatics applies computing and information science to expand biomedical knowledge and improve healthcare delivery through integrated basic, clinical and public health research. It spans topics like natural language processing, image analysis, bioinformatics for personalized medicine, simulations for surgical planning, AI for medical imaging interpretation, and more. Biomedical informatics aims to uncover new biological insights and develop next-generation diagnostic and treatment methods through computation.

Healthcare informatics leverages information technologies across the entire healthcare continuum to support improved outcomes, lower costs, enhanced experiences for providers/patients, and advanced biomedical knowledge discovery through research. It sits at the intersection of clinical care, public health, computer science, and information science. With the continued digitization of healthcare and explosion of available data sources, the role of informatics in optimizing value-based care delivery will only continue growing in importance.