Journal of Practical & Professional Nursing Category: Clinical Type: Research Article
Clinical Excellence in Graduate Nursing Education: A Case Study of Information Technology Solutions
- Lauren St. John DNP, RN, FNP-BC, MCHC1*
- 1 Department Of Nursing, Associate Chair For Clinical Education, College Of Nursing & Health Innovation, The University Of Texas At Arlington, Texas, United States
*Corresponding Author:Lauren St. John DNP, RN, FNP-BC, MCHC
Department Of Nursing, Associate Chair For Clinical Education, College Of Nursing & Health Innovation, The University Of Texas At Arlington, Texas, United States
Tel:+1 419 654 6492,
Received Date: Dec 07, 2018 Accepted Date: Jan 17, 2019 Published Date: Jan 31, 2019
This case study describes the context leading one graduate nursing department to select and implement a web-based clinical management system (“the software”). Transition details and project deliverables are presented. Results support the conclusion that innovative software may allow programs to expedite clinical placement while promoting student success, eliminating cost and generating objective evidence to enrich clinical education.
Prior to implementing the software, the graduate programs had siloed clinical documentation stored among five electronic systems. Clinical coordination workflow included excess manual data entry and student communication regarding practicum requirements and placement concerns. Storage space and structure of the existing systems proved to be insufficient for the growing volume of students and placements. Consequently, potential for error existed with implications impacting student progression and financial aid. Situations like these can lead to student distress and loss of focus from education.
It was the universal consensus of leadership and personnel involved in clinical management that the graduate department had optimized clinical education processes and documentation potential with the resources in use and available within the university. A vision statement to focus the search for a software solution was drafted, to have a single management system for documenting clinical education that would seamlessly guide students from admission to graduation. This system was to be a long-term solution promoting success of the graduate programs and enabling the scalability requisite for expansion into other states.
SELECTING A SOFTWARE SYSTEM
Thorough market research of software designed to manage clinical education was conducted over approximately 2 years. Demonstrations were presented to faculty and staff by sales representatives of several well-established clinical management software companies. Additional sessions were organized with consultants and development specialists of the systems to discuss, with meticulous detail, the critical features and software potential relative to clinical education and student placement coordination.
Leadership involved in software selection prepared an executive summary of the research, comparing available software options in key deliverable areas of usability, flexibility, cost elimination, manual labor reduction, efficiency and other software uses apart from clinical data management. Despite the fact that many products advertised ability to perform similar functions and would replace the same systems currently in use by the graduate department, several objective differences between the potential systems were noted:
• Single step vs. multiple steps to accomplish equivalent functions;
• User-friendly, clear navigation vs. clarity issues in navigating single processes;
• Extent of configuration potential and software flexibility;
• Effect of configurations on ability to maintain functionality of other software features;
• Potential increase in manual labor resulting from above-mentioned limitations.
ANTICIPATED PROJECT DELIVERABLES
SYSTEM CONFIGURATION AND DEPLOYMENT
Refinement of the software to optimize features for the graduate programs remains an ongoing commitment and contractual agreement of the software consultants. Undergraduate nursing and public health programs in the university have also adopted the software, creating college-wide alignment potential within clinical programs.
THEORETICAL APPROACH TO CHANGE
The results of this case study reflect implementation of the software to a limited degree as completed during the first eight months of configuration and deployment. Cumulative developments are anticipated over time, warranting future data collection to evaluate longer-term outcomes of the software on clinical placement management within graduate nursing programs.
Within three months following deployment of the new self-placement process, more than eight hundred student placements were successfully vetted according to programmatic preceptor and site requirements and processed to full clinical clearance, including timely execution of affiliation agreements. Unsolicited student reports of subjective satisfaction with the software and redesigned clinical coordination process were also received. Comprehensive data collection to evaluate usability and other outcome areas is planned as a longer-term longitudinal study of the software implementation.
In the eight months following deployment of student logbooks and evaluation features, all users successfully carried out functions specific to their role using the software. Evaluations were sent through the software to preceptors, students, and placement supervisors for evaluating clinical performance, site appropriateness, and quality of the educational experience. Students successfully logged timesheets, patient encounters, and other clinical/practicum activities as anticipated, and faculty reviewed and provided feedback on student logbook records.
An observation at two months following deployment of the self-placement arm of the software demonstrates improvements in clinical coordination efficiency. The software allowed clinical placement staff to proactively clear students for clinical with an additional 3 months between the usual clearance date and the clinical start date. This time is anticipated to continue increasing, resulting in complete clinical clearances for a majority of students many months in advance of each clinical start date. This increase is directly attributable to streamlined documentation requirements and flow of clinical clearance processes for students and staff alike, generating time resources for clinical coordination staff to support students in identifying and securing placements appropriate for meeting course and program objectives.
MANUAL LABOR REDUCTION/EFFICIENCY
Students submit self-placement requests through the software via automatically generated links that align and update with course numbers and start dates for projected and actual enrollment. Custom self-placement forms and a wizard tool allow the clinical coordination staff to accurately review student placement submissions on any number of predefined qualifications, comparing the details of the submission to preceptor/course requirements established by graduate nursing program directors.
Agency affiliation agreements are stored in the software and student placement submissions are filed within the existing database of affiliated clinical facilities. Site-specific requirements and unique affiliation agreement terms noted by the contracts or coordination teams are viewable at the time of self-placement submission, promoting completion and compliance for every placement. The parent-child hierarchy of affiliations allows immediate allocation of a placement to the correct legal agreement and site.
Students are kept informed of their clinical clearance status in real-time via communication that occurs within the clinical placement record in the software. The correspondence related to each placement is thereby contained within a single source and has reduced the volume of email communication between students and coordinators regarding placement status updates. Customized reports and alerts prompt validation of compliance requirements and purification of the database from information duplicates, errors and omissions.
ADDITIONAL SYSTEM USES
Custom reporting capabilities of the software enable any clinical placement data to be compared with any data from the student records system. This fact indicates potential for cutting-edge clinical education research and outcomes analysis that is made possible by the flexible capabilities to view actual clinical education data in nearly any arrangement or combination of variables. Whether the desire is to compare student evaluation results with preceptor credentials, clinical site and preceptor attributes with student retention rates, or any other construction of analysis relative to clinical preceptorship and the student educational record, it is all possible.
OVERALL EFFECTIVENESS OF THE SOFTWARE SYSTEM
CONCLUSION AND FUTURE CONSIDERATIONS
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Citation: St. John L (2019) Clinical Excellence in Graduate Nursing Education: A Case Study of Information Technology Solutions. J Pract Prof Nurs 3: 009.
Copyright: © 2019 Lauren St. John DNP, RN, FNP-BC, MCHC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.