Academic Education Solution Consortium: A Partnership of Schools of Nursing

Academic Education Solution Consortium: A Partnership of Schools of Nursing Judith J. Warren, PhD, RN, BC, FAAN, FACMI Allen Hanberg, PhD, RN Carol Sternberger, PhD, RN, CNE Tammy Toscos, PhDc, MS

Objectives Describe the goals of the Academic Education Solution Consortium Participants will identify the benefits of consortium membership as they integrate an EHR into nursing curricula Discuss the use of the AES in conducting nursing assessment and simulations

Challenges from the Institute of Medicine Explores the issues of quality in health care and recommends the use of patient information systems and technology. One of the recommendations led to establishment of our SEEDS program. All health professional should be educated to deliver patientcentered care as member of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.

Academic Education Solution A live production EHR adapted to provide teaching and learning tools to assist health professional students to develop competencies to harness the power of information technology, thus improving the quality, efficiency and effectiveness of healthcare.

Goals of the Academic Education Solution Consortium History of the AES Consortium Operating rules and governance Social networking--ucern Examples of collaboration Members of the AES Consortium

Cerner s Academic Education Consortium AES Reference Site AES Client Use by Discipline Nursing (50%) HIM (20%) Allied Health (15%) Pharmacy (10%)

Governance Activities and Social Networking Facilitate Collaboration All members of the Consortium manage the content and functionality of the domain Approve content for assessment forms, goal statements, and order sets Standardize with evidence Develop reference text to support point of learning moments Create and share case studies Collaborate on developing new educational strategies Schools present and publish together

Benefits of AES Consortium Membership: Integration of the EHR into nursing curricula University of Utah, College of Nursing Indiana University Purdue University Fort Wayne, Department of Nursing University of Kansas, School of Nursing

The University of Utah: Spanning The Curriculum With A.E.S. Allen D. Hanberg, Ph.D., R.N.

The University of Utah Spanning The Curriculum With A.E.S. 1: Background 2: Unintended Consequences 3: A.E.S. & Simulation Based Learning 4: Pedagogy Drives Practice 5: Next Steps

Background Information Management By 2014 all Americans will have an electronic health record An essential competency of the Baccalaureate graduate Integral for the provision of care in technology driven work environments Establishes a foundation for evidence-based practice Ornes, L.L., & Gassert, C.A. (2007). Computer competencies in a BSN program. Journal of Nursing Education, 46(2), 75 78

Background Lessons Learned: Most of the documentation was usable as is Very flexible/customizable to our needs The Diffusion of a NEW Innovation: Was initially met with mixed responses. We identified AES champions to spearhead the movement. Identified an AES CoN Administrator from the first semester nursing curriculum.

Background Use data to monitor the outcomes of care processes Use improvement methods to design and test changes for continuous quality and safety improvement. Use information and technology to Communicate Manage knowledge Mitigate error Support decision making

Unintended Consequences Solving EHR and information technology educational needs. Unintentionally spearheaded early curriculum evaluation and reform Concepts rather than content Led the way for full curriculum reform Became a natural fit with simulation based learning

A.E.S. & Simulation Based Learning Simulation-Based Learning Provides effective learning through practice of clinical decision making during immersive patient care management experiences Addresses challenges associated with limitations of traditional clinical settings Results in Improved outcomes through interactive / contextual application of information technology and patient care management

SIMULATION & THE A.E.S. PEDAGOGY DRIVES PRACTICE Step 1: Know the curriculum Step 2: Know the program outcomes Step 3: Know content experts Simulation AES Step 4: Objective driven scenario Step 5: Evaluate objectives using curriculum components and content experts

SIMULATION & THE A.E.S. PEDAGOGY DRIVES PRACTICE Early Introduction to the concept of information management as a part of the immersive patient simulation experiences establishes the foundation to develop clinical decision making skills. Hanberg, A.D., Madden, C. (2010). Techknowlogy: Using Multimodal Simulation Strategies to Bring Data Management and Patient Care Technologies To Life. Clinical Simulation in Nursing., In Press

SIMULATION & THE A.E.S. PEDAGOGY DRIVES PRACTICE * Knowledge *Competency * Context * Experience Hanberg, A.D., Madden, C. (2010). Techknowlogy: Using Multimodal Simulation Strategies to Bring Data Management and Patient Care Technologies To Life. Clinical Simulation in Nursing., In Press

All students interact with the AES system Prior to During And After Simulation Threading of concepts: Professional Accountability Evidence Based Practice Communication Caring Leadership Gerontology Vulnerability SIMULATION & THE A.E.S. PEDAGOGY DRIVES PRACTICE Hanberg, A.D., Madden, C. (2010). Techknowlogy: Using Multimodal Simulation Strategies to Bring Data Management and Patient Care Technologies To Life. Clinical Simulation in Nursing., In Press

Pre Scenario: Retrieve relevant historical patient data and orders from A.E.S. Active Scenario: Retrieve current data (i.e. Lab, X Ray) Apply decision support tools available within A.E.S. Interact with Medication Dispensing Unit being linked to A.E.S. Post Scenario: Input interventions that occurred during the experience Document outcomes and response

Next Steps 1: Program Evaluation in process 2: Finish integration into graduate nursing programs 3: Research

References American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Retrieved January 18, 2010, from. http://www.aacn.nche.edu/education/pdf/bacc Essentials08.pdf. Chase, S. K., & Pruitt, R. H. (2006). The practice doctorate: Innovation or disruption? Journal of Nursing Education, 45(5), 155-161. Cioffi, J. (2001). Clinical simulations: Development and validation. Nurse Education Today, 21(6), 477-486. Ellaway, R. H., Topps, D., Lachapelle, K., & Cooperstock, J. (2009). Integrating simulation devices and systems. Studies in Health Technology & Informatics, 142, 88-90. Fetter, M. S. (2009). Improving information technology competencies: Implications for psychiatric mental health nursing. Issues in Mental Health Nursing, 30(1), 3-13. doi:10.1080/01612840802555208. Gaba, D. M. (2004). The future vision of simulation in health care. (Supplement). Quality and Safety in Health Care, 13, i2-i10. doi:10.1136/ qshc.2004.009878. Gassert, C. A.,&Sward, K. A. (2007). Phase I implementation of an academic medical record for integrating information management competencies into a nursing curriculum. In K. A. Kuhn, J. R. Warren, & T. Y. Leong (Eds.), MedInfo 2007. Amsterdam: IOS Press. (pp 1392e1305). Hanberg, A.D. (2008). The diffusion of high fidelity simulation in nursing education: Barriers and recommendations for best practice (Doctoral dissertation). Retrieved from Dissertation Abstracts International-B, 69 (06). ISBN: 9780549677314. Jeffries, P. R. (2007). Simulation in nursing education: From conceptualization to evaluation. New York: National League for Nursing. Jeffries, P. R., & Rogers, K. J. (2007). Theoretical framework for simulation design. In P. R. Jeffries (Ed.), Simulation in nursing education: From conceptualization to evaluation. New York: National League for Nursing. McDowell, D. (2007). Computer literacy in baccalaureate nursing students during the last 8 years. CIN:Computers, Informatics, Nursing, 25(1), 30-36. McNeil, B. J., Elfrink, V., Beyea, S. C., Pierce, S. T., & Bickford, C. J. (2006). Computer literacy study: Report of qualitative findings. Journal of Professional Nursing, 22(1), 52 59. Norman, L., Buerhaus, P. I., Donelan, K., McCloskey, B., & Dittus, P. (2005). Nursing students assess nursing education. Journal of Professional Nursing, 21(3), 150 158. Ornes, L. L., & Gassert, C. A. (2007). Computer competencies in a BSN program. Journal of Nursing Education, 46(2), 75 78. Prion, S. (2008). A practical framework for evaluating the affect of clinical simulation experiences in prelicensure nursing education. Clinical Simulation in Nursing, 4(3), e69 e78. doi:10.1016/j.ecns.2008.08.002. Seropian, M. (2003). General concepts in full scale simulation: Getting started. Anesthesia & Analgesia, 97(6), 1695-1705. Seropian, M. A., Brown, K., Gavilanes, J. S., & Driggers, B. (2004). An approach to simulation program development. Journal of Nursing Education, 43(4), 170-174. Simpson, R. L. (2007). Information technology: Building nursing intellectual capital for the information age. Nursing Administration Quarterly, 31(1), 84-88. Wesch, M. (2009, January). From knowledgeable to knowledge-able: Experiments in new media literacy. E-Filtered: The Academic Commons Magazine. Retrieved January 18, 2010, from http://www.academiccommons. org/commons/essay/knowledgable-knowledge-able.

Questions?

From Spark to Bonfire Integrating an EHR into Nursing Curricula Tammy Toscos PhDc Carol Sternberger PhD, RN, CNE

SPARK Looking for a way to use area institution s EHR Firewalls galore Inflexible Increased restrictions for student documentation during clinical

Discovering Cerner AES SEEDS article Visited Cerner Toured University of Kansas

FUEL Managing Change Workflow Overwhelmed Faculty Familiar push back Where to Begin? Good first experience critical for technology acceptance

OXYGEN Support via monthly meetings Pedagogical decisions Creating standardized approach Sharing solutions Continuum of Expertise Junior schools: early struggles Senior schools: vision of potential Cerner Health Conference Annual face to face meeting

BONFIRE

Grant Funding Parkview Health Grant fund used to integrate Cerner AES Paid initial Application Service Provider fee Semester fees

Flaunting Pride of AES Integration Project

Conclusion It is a crime to graduate nursing students who don t know how to interact in this complex and information intensive environment. Abbott, as cited in Birz, 2005

Tammy Toscos Carol Sternberger toscost@ipfw.edu sternber@ipfw.edu

Simulation and the EHR: A Meaningful Partnership Judith J. Warren, PhD, RN, BC, FAAN, FACMI Christine A. Hartley Centennial Professor Director of SEEDS Program University of Kansas School of Nursing Director of Nursing Informatics University of Kansas Center for Health Informatics

SEEDS: Simulated E-hEalth Delivery System

Our patients James Robinson Enrique Hernandez Sam Jayhawk Jane Whitecloud Steve-O Karma Maria Hernandez Kristin Reed Alyssa James

One Nursing Unit Contains All Simulation Patients

Asynchronous Interprofessional Simulation Nursing and Physical Therapy

Synchronous Interprofessional Simulation: Pediatric Medical Students/Residents and Nursing Students