DISCUSSION REPLIES

Leading Organization week 2 replies

Read the 4 peer responses and respond to the peers by expanding on your colleague’s post and explaining how the quality indicators selected by your colleague may influence your practice setting. Include 2 references each!!!

Peer Kristine:

Nurse-sensitive indicators are measures significantly influenced by nursing practice and reflect the outcomes of nursing care. The Nursing Database for Nursing Quality Indicators (NDNQI) is a national database for nursing data. NDNQI provides national benchmarks for several nurse-sensitive clinical indicators and RN satisfaction.

Two Nurse-Sensitive Indicators

Regulatory agencies are increasingly focused on ensuring that healthcare facilities provide evidence-based care and adjust reimbursement accordingly. Hospitals can be substantially penalized for a reportable severe event like a stage III hospital-acquired pressure injury (HAPI), or a patient fall with an injury.

The quality world has grown over the years from introducing the Quality Assurance Model, the American Nurses Association (ANA), and the Affordable Care Act, resulting in value and quality as the focus of the care delivered. Consistent with the initiatives of these and other organizations, the Institute for Health Care Improvement (IHI) introduced the Triple Aims with adding a fourth: patient-centered and reliable care, addressing social determinants of health (SODH), affordable care, and staff experience (Mate, 2022).

Patient safety and quality remain the top concerns of healthcare while recognizing preventable harm is a leading cause of death worldwide (Panagioti et al., 2019). Reducing any type of harm is best achieved by having a just culture and stopping errors before they happen. Hospital-acquired pressure injuries are preventable. Pressure injuries are costly. On an annual basis, the cost of a HAPI averages 10 billion dollars annually across the United States (Polancich et al., 2022). Nurses and providers have access to evidenced-based practice protocols and guidelines that could reduce the incidence of pressure injuries and as a result, regulatory agencies consider HAPI a never-to-happen‐event in the hospital setting.Patient falls with injury can impact a patient’s health and quality of life and harm healthcare costs. A fall can cost on average an additional $7,000 to $30,000 and extend a hospital stay by six to twelve days (Dykes et al., 2023). To help nurses and care providers, numerous healthcare agencies have developed guidelines to assist with fall prevention initiatives (Turner et al., 2020).

Articles

Working within an organization that participates in NDNQI, allows us the comparison of our data against the national average (mean) for HAPI and falls with injury. We have robust fall prevention groups for ambulatory, inpatient, and procedural. While numerous interventions are available in each setting, consistency is lacking from unit to unit and department to department and falls are still happening. Dykes et al. (2023) shared that leadership must be committed to the efforts and provide accountability while providing a leadership checklist that could be used in prevention efforts. Each inpatient unit has a skin champion who assists with skin and pressure injury surveillance for NDNQI and participates in our HAPI improvement team. These efforts have been the most frustrating. Education, monitoring, and feedback are in place, and yet concerns are still arising, and inconsistent data is being reported from our coding colleagues. Crumley (2023) suggests that having a dedicated effort focused on mobility would help not only HAPI rates but also falls. While our initial efforts were unsuccessful in implementing an early mobility program, it would behoove us to reexplore the initiative to improve patient care.

Peer Julius:

Psychiatric readmission rates and patient satisfaction with mental health are the two nurse-sensitive quality measures of patient care that have been chosen. The frequency with which patients with mental health disorders require readmission following their initial discharge is gauged by psychiatric readmission rates (Zhao et al., 2020).

Evaluating patients' opinions of their care, including contact with medical professionals, participation in treatment decisions, and overall experience, is part of assessing patient satisfaction with mental health care (Miglietta et al., 2018).

Donabedian's Model of Quality and Total Quality Management (TQM) are two of the early theories of quality improvement that had an impact on the creation of the two chosen quality indicators in mental healthcare. Lowering the rate of mental rehospitalization is consistent with TQM's objectives of minimizing mistakes, optimizing processes, and raising general quality. Healthcare professionals are guided by TQM principles as they gradually evaluate and enhance systems to raise patient satisfaction. According to Alzoubi et al. (2019), this entails having excellent communication, taking part in decision-making, and making sure patients are generally well.

The Donabedian paradigm has had a big impact on how healthcare quality is measured. Donabedian's paradigm encourages a comprehensive understanding of healthcare quality that considers elements other than the current care episode. Donabedian's model has contributed to the recognition that patient satisfaction is a complex outcome influenced by different aspects of care delivery by emphasizing the interaction between structure, process, and outcome (Tossaint-Schoenmakers et al., 2021).

Psychiatric readmission rates have the potential to impact mental health practices by emphasizing the need for continued follow-up care, community-based support, and efficient discharge planning. To lower the readmission rate, a comprehensive care transition, for instance, might be introduced at a mental health hospital for patients with schizophrenia (Zhao et al., 2020).

By allowing mental health professionals to form a therapeutic alliance and involve patients in their treatment choices, patient satisfaction with mental healthcare has an impact on mental health practice. A mental health clinic, for instance, may implement a feedback system to assess patient satisfaction on a regular basis and adjust programs as needed (Miglietta et al., 2018).

Peer Natalia:

To properly select nursing sensitive indicators of quality, one needs to understand what a nurse-sensitive indicator is. Tareq et. al. (2021), writes that nursing sensitive indicators are the criteria for changes in a person’s health status that nursing care can directly affect and forms the foundation for monitoring the quality of nursing care. An example of this would be establishing benchmarks. Furthermore, Nash (2019), states that hospitals routinely collect quality indicator data as a condition of accreditation set by the Joint Commission and required by the Centers for Medicare and Medicaid (CMS). Additionally, the Agency for Healthcare Research and Quality (AHRQ, 2021), write in their website that quality indicators are standardized, evidence-based measures of healthcare quality that can be used to measure and track clinical performance and outcomes. Additionally, the National Database of Nursing Quality Indicators (NDNQI) is the leading nursing-sensitive quality indicator database where the database measures nursing performance, patient, and workforce experience with health outcomes. Furthermore, some of the nursing sensitive indicators are developed by passing extensive feasibility test and the passing of a rigorous inspection to make sure it impacts patient outcomes. Armed with this knowledge we can now choose two nurse-sensitive indicators of quality. (1) Patient falls with and without injuries, (2) Nosocomial Infections: Catheter-associated urinary tract infection (CAUTIs), Central line catheter associated blood stream infection (CLABSIs), and Ventilator-associated pneumonia (VAPs).

Two Nursing-Sensitive Indicators

Per NDNQI a patient fall is an unplanned descent to the floor with or without injury. Patient falls can result in additional treatment, hospital admissions, prolonged stays, and delays in cancer treatments. Patients with cancer are more susceptible to falls due to neurological deficits they may be experiencing (Shah, 2020). Nosocomial infections are referred to healthcare-associated infections (HAIs) which are infection acquired during the process of receiving health care that was not present during time of admission. Patient fall is considered a process and outcome measure while nosocomial infection is considered an outcome. According to NDNQI, an outcome indicator is deemed to be nursing sensitive if there is a correlation between nursing workforce and nursing process and the outcome (Montalvo, 2007). Therefore, choosing patient falls and nosocomial infections relate to my current nursing practices, especially nosocomial infections as it relates to nursing-sensitive indicators. CLABIs and CAUTIs are prevalent HAIs and relatively preventable. Developing such HAIs increasing hospital stays, morbidity, and mortality. Patient falls, does the same to the patient; it increases their stay and prolongs their treatment. Since there is a causality and correlation between nursing process and the outcome it is evident why it is considered a nursing-sensitive indicator. Additionally, it is evident as to why CMS places emphasis on these indicators in their value-based purchasing and links hospital payments to patient outcomes.

Indicators and Practice Setting Influence

Both patient falls and nosocomial infections with CAUTIs and CLABSIs as outcomes shapes my practice setting influence as it directly correlates to what I do as an infection preventionist and as a nurse in general. Our goal is zero harm and to create an environment where the patient is cared for without further complications. A fall and a nosocomial infection are both complications that are fully preventable. Therefore, working towards improving measures, outcomes, and increase awareness should be the top priority of any nurse much like Florence Nightingale envisioned when she first began her data collection.

Peer Marc:

Description of the nurse-sensitive quality measures from the National Database of Nursing Quality Indicators® (NDNQI®)

RN education/specialty certification

The RN education measure/specialty certification is a measure of the level of education and the number of nurses holding specialty certification at an organization. Boyle (2017) review of literature found a relationship between increased certification and better-quality outcomes. Body mass index (BMI) screening and follow-up nurse-sensitive quality measures. This measure qualifies for both NDNQI® but also for the Merit-based Incentive Payment System (MIPS). In an effort to reduce obesity, BMI screening is performed on patients and those that fall outside normal guidelines must have an action plan.

Influence of Early Quality Improvement Theories and Philosophies the Quality Indicators

One of the earliest quality improvement theories came from Florence Nightingale, the Environmental Theory. Nightingale’s work is the foundation of infection prevention and embedded into quality improvement activities such as catheter associated urinary tract infections (CAUTI) and central line associated blood stream infections (CLABSI) reduction efforts. Both of these measures are part of the NDNQI® reportable indicators of nursing quality along with National Healthcare Safety Network (NHSN).

Nursing Research Articles and How These Indicators May Influence Your Practice Setting

When thinking how nursing sensitive indicators affect oncology care advanced training and specialty certification quickly come to mind. Chemotherapy medications are both life saving and deadly. Inappropriate handling or administration can harm the patient and hospital staff. Ponto (2019) admits that research is limited on effects of certification on improving outcomes but that increased levels of certified nurses led to improvements in patient fall rates, skin integrity rates, and decreased length of stays. As more doctor prepared nurses (DNPs) enter the workforce, there is hope for continued research and publications of effects of certification and advance degree nurses on quality outcomes. The American Association of Colleges of Nursing (AACN) position statement has advocated for nursing education requirement of bachelor's degree with the pursuit of continuing education (American Association of Colleges of Nursing, 2023). Currently, my organization is undergoing Magnet redesignation. One of the requirements is that all nursing leadership and management be at a minimum baccalaureate prepared.

LINDA

LINDA’S Transforming week 2/discussion 1-Replies

Read a selection of your colleagues’ responses and to the colleagues by expanding upon your colleague’s posting or offer an alternative perspective. Include at least 2 references each

Peer Shannon:

Main Discussion Post

Initializing a quality improvement project through nursing informatics (NI) requires several vital details, and implementing management techniques will ensure a complete project evaluation. These effective management techniques include a GAP analysis and SMART objective identification. These methods will provide a clear direction to conduct a systems approach to improving the process. Although hypothetical, the NI improvement project will enhance the leadership background of the doctorally-prepared nurse practitioner (NP) student and drive evidence-based practices forward through technology.

GAP Analysis for reducing 30-day hospital readmission rates for CHF

The DNP-prepared NP will focus on congestive heart failure (CHF) in the tertiary setting to improve patient outcomes, thus reducing 30-day hospital readmission rates. As identified through a GAP analysis, it is apparent that CHF patients are at an unmitigated risk for cardiogenic shock. While sepsis is highly recognized and suspected, with patients demonstrating indicators of shock, cardiogenic shock is not as apparent and can be mistaken for sepsis (Jassir, 2023). Additionally, sepsis treatment for a CHF patient experiencing cardiogenic shock will exacerbate patient decompensation, leading to worsening patient conditions. Therefore, Comparing NI programs for sepsis and cardiogenic shock in CHF patients provides an opportunity for improvement through informatics (Buchlak, 2024). While the organization has artificial intelligence (AI) systems to identify sepsis, cardiogenic shock is omitted from these AI systems, providing an opportunity for process improvement through NI.

SMART Objectives to improve treatment of CHF patients with cardiogenic shock

Focusing on a process improvement project through NI requires the DNP-prepared NP to specify details related to CHF, cardiogenic shock, AI, and other technologies. As defined by Sipes, the project’s aim should be “specific, measurable, achievable, relevant, and timely" (2020, p. 56). Outlining these details for the quality improvement project develops an efficient approach to NI and organizational interventions, mitigating complications from CHF exacerbation. The SMART objective provides a solid foundation to begin an informatics improvement project for the organization. Recognizing cardiogenic shock with CHF patients in the tertiary setting is possible through supportive AI and advanced NI systems. Decreasing patient suffering is feasible through this hypothetical informatics project that supports clinical providers, bedside nurses, patients, and the organization.

Peer Stella:

Planning and developing a Doctor of Nursing Practice (DNP) doctoral project or dissertation involves several project management processes and techniques. While preparing for it, the most important management processes, and techniques guidance I will apply will be to tailor my planning and developing approaches to the specific needs of my healthcare research. These basic approaches are as follows:

Initiation and Planning:

According to Bhattacharya, S. (2018), Initiating the DNP project involves defining the scope, objectives, and stakeholders. I will employ techniques such as stakeholder analysis and a well-structured project charter. My planning should include a comprehensive Work Breakdown Structure (WBS) outlining project tasks, timelines, and resource allocation. For instance, developing a timeline for data collection, literature review, and analysis.

Risk Management:

Healthcare projects, including DNP dissertations, involve inherent risks (Schwalbe, K. 2018). I will plan to identify potential risks related to data collection, ethical considerations, and unexpected challenges in the healthcare environment I am focusing. I will utilize risk assessment tools like the Failure Mode and Effects Analysis (FMEA) to proactively address and mitigate potential issues.

Execution and Monitoring:

According to Kerzner, H. (2017) the execution phase, involves the implementation of the project plan and monitoring progress. Applying techniques like Earned Value Management (EVM) can help me assess the project's performance against the plan. This involves overseeing the implementation of interventions or data collection processes and ensuring alignment with the research objectives of my project as a DNP.

Change Management:

Healthcare environments are dynamic, and this makes changes inevitable. As sure to I will implement change management processes to address modifications in project scope, objectives, or methods. Using techniques such as impact analysis and communication plans will aid in managing changes effectively (Heagney, J. 2016). For my DNP dissertation, this could involve adapting the research methodology based on emerging insights or unexpected challenges.By integrating these project management processes and techniques as a healthcare professional pursuing my DNP it will enhance the efficiency and effectiveness of my doctoral projects. It will ensure a systematic approach to my research, minimize risks, and facilitate easy adaptability in the ever-evolving healthcare landscape.

LINDA’S Transforming week 2-replies part # 2

Read a selection of your colleagues’ responses and respond by expanding upon your colleague’s posting or offer an alternative perspective. Include two references each

Peer Ndubuisi:

Important Terminology and Concepts

Health information technology (HIT) can enhance the safety, efficiency, and overall quality of care delivery. However, inadequate usability of HIT systems can result in implementation failures, rejection, usage challenges, and, most critically, patient safety concerns (Marcilly et al., 2019).

Usability refers to the degree to which stakeholders deem a measure, process, or system acceptable and practically usable to accomplish their intended objectives (Herman et al., 2023). In informatics, usability often pertains to the design and functionality of software applications, websites, and other digital interfaces. Usability aims to ensure that these technologies are intuitive, efficient, and satisfying for users to interact with.

However, in my practice, usability is crucial in designing and implementing healthcare software systems for patient management, electronic health records (EHRs), and telemedicine platforms. For instance, when selecting an EHR system for a medical practice, usability considerations are paramount to ensure clinicians can efficiently navigate the software to document patient encounters, access medical records, and prescribe medications without undue cognitive burden or frustration.

Moreover, in patients' daily lives, usability impacts their interactions with health-related applications and websites. For example, a mobile health app designed to help patients track their medication adherence must have a user-friendly interface with clear instructions and intuitive features. If the app is difficult to use or confusing, patients may become discouraged and discontinue it, ultimately compromising their health management (Gilmore et al., 2023).

Peer Elmase:

Sustainability is a term that has gained immense importance in various fields, including healthcare and technology. Sustainability, in its essence, refers to the ability to maintain or endure over time without causing significant negative impacts on the environment, society, or economy (Ruggerio, 2021). It encompasses the concept of meeting the needs of the present without compromising the ability of future generations to meet their own needs.

In healthcare informatics, sustainability plays a crucial role in shaping the design, implementation, and utilization of information technology systems. Healthcare organizations are increasingly adopting electronic health records (EHRs), telemedicine platforms, and other digital solutions to streamline processes, improve patient care, and enhance efficiency. However, Cripps and Scarbrough (2022) explain that the sustainability of these technologies goes beyond their immediate benefits and involves considerations such as their long-term environmental impact, economic feasibility, and social implications.

In my nursing practice, sustainability is evident in the implementation of electronic health records (EHRs) and digital health technologies. These systems aim to improve patient care by providing timely access to comprehensive patient information, facilitating communication among healthcare providers, and supporting evidence-based decision-making. However, the sustainability aspect comes into play when considering the energy consumption, electronic waste, and resource utilization associated with maintaining and upgrading these systems. For example, in my daily interactions with patients, I often use tablet devices or computers to access and update their electronic health records. While these digital tools enhance efficiency and accuracy in documentation, they also consume electricity and require regular maintenance and upgrades. Therefore, it is essential to ensure that these technologies are designed and managed sustainably to minimize their environmental footprint and maximize their long-term benefits. Furthermore, sustainability in nursing practice extends beyond the use of technology to encompass broader initiatives such as waste reduction, resource conservation, and promoting environmentally friendly practices. For instance, Molero et al. (2021) suggest that implementing recycling programs, reducing paper usage through electronic documentation, and advocating for eco-friendly healthcare products are all ways in which nurses can contribute to sustainability efforts within their practice settings. Conclusively, sustainability is a critical consideration in both informational technology and nursing practice, as it encompasses environmental, economic, and social dimensions that are integral to promoting the well-being of individuals and communities. By integrating sustainability principles into the design and implementation of information technology systems and adopting environmentally conscious practices in nursing care, we can contribute to creating a more sustainable healthcare system that meets the needs of present and future generations.

Demi

DEMI’S Transforming week 2/discussion 1-Replies

Read a selection of your colleagues’ responses and to the colleagues by expanding upon your colleague’s posting or offer an alternative perspective. Include at least 2 references each

Peer Angela:

The APN must be committed to meeting the continuously changing healthcare needs of the community by assuming a leadership role in managing quality initiatives (AANP, 2022). This discussion post examines the competencies required for the role of an advanced practice registered nurse (APRN) and project management concepts that align with this clinical practice role. Nursing research techniques and tools that are beneficial for completing a DNP project, as well as processes, methods, and project management strategies, will also be reviewed. According to Sipes (2020), the APRN at the Doctorate of Nurse Practice (DNP) level requires application of project management skills for promotion of healthcare advancement. The APRN must ascertain clinical and complex clinical decision-making skills for best population health outcomes (Porat-Dahlerbruch et al., 2022). For example, the APRN is instrumental in implementing a quality initiative project that requires project management skills during the conceptual phase (Rew et al., 2020). Rew et al. (2020) suggest that using a conceptual theory will guide a successful DNP project. The conceptual nursing framework is organized and encompasses a relationship of collaborative practices (Porat-Dahlerbruch et al., 2022). The conceptual framework also aligns with the Scopes and Practices of the American Nurses Association [ANA] (2015). Rew (2020) states that problems are identified during the initial aspects of the conceptual phase. Thus, the ANA (2015) strongly supports nurses and advanced nurse leaders in identifying the physiological and psychological concerns that consider the patient's best health outcomes.

Project Management Process

Utilizing a project management process that fosters effective communication techniques, active listening, and insightful responses will reduce barriers throughout the planning, initiation, and termination phases (Porat-Dahlerbruch et al., 2022). The APRN must guide the healthcare delivery options while also respecting the rights of patients' decisions, which coherently align with the ethical practices of the ANA (2015). A project management design that tests nursing phenomena and answers complex clinical questions with evidence-based knowledge is an effective tool for implementing and completing a successful DNP dissertation (Porat-Dahlerbruch et al., 2022). Rew (2022) cites that resource tools and nursing research will guide a foundational DNP project. For example, the PICO question is imperative for understanding the clinical (P) problem, utilizing an (I) intervention, (C) comparing the variables, and identifying the (O) outcome. The APRN is responsible for translating evidence-based knowledge into clinical practice for promoting safe and quality care (AANP, 2022). Rew (2022) mentions that a sampling plan is essential for discovering outcomes and research design. Wheeler et al. (2022) support using qualitative designs to acquire lived experience data and quantitative designs to measure outcomes and test data validity. For example, the mental health population is gravely disposed to poor outcomes due to high rates of patients not following through with their post-plan of care treatments (Kyanko et al., 2022). A pilot study is instrumental in obtaining valid data relevant to patient’s perceptions and how they view their healthcare delivery options, which is imperative for stakeholder’s engagement during the project management process (Rew, 2022). In conclusion, a literature review, data analysis, and study findings would be completed on the identified problem, such as social determinants of health barriers that enable patients to access outpatient mental health services within impoverished communities (Kyanko et al., 2022). Determining the strength of the evidence and appraisal table might also be techniques used based on learned concepts of project designs (Wheeler et al., 2022). The research process and resource tools for the DNP project would follow the steps outlined by Rew et al., 2020 for project management. For example, developing the focus for a PICO question would be the first step (Wheeler et al., 2022). Next, methods for conducting a literature review, data analysis, and study findings will be completed. Determining the strength of the evidence and appraisal table might also be techniques used based on learned concepts (Wheeler et al., 2022). The research process for the DNP project would follow the steps outlined by Rew et al. (2020) for a successful project management design.

Peer Giovanna:

Initializing a quality improvement project through nursing informatics (NI) requires several vital details, and implementing management techniques will ensure a complete project evaluation. These effective management techniques include a GAP analysis and SMART objective identification. These methods will provide a clear direction to conduct a systems approach to improving the process. Although hypothetical, the NI improvement project will enhance the leadership background of the doctorally-prepared nurse practitioner (NP) student and drive evidence-based practices forward through technology.

GAP Analysis for reducing 30-day hospital readmission rates for CHF

The DNP-prepared NP will focus on congestive heart failure (CHF) in the tertiary setting to improve patient outcomes, thus reducing 30-day hospital readmission rates. As identified through a GAP analysis, it is apparent that CHF patients are at an unmitigated risk for cardiogenic shock. While sepsis is highly recognized and suspected, with patients demonstrating indicators of shock, cardiogenic shock is not as apparent and can be mistaken for sepsis (Jassir, 2023). Additionally, sepsis treatment for a CHF patient experiencing cardiogenic shock will exacerbate patient decompensation, leading to worsening patient conditions. Therefore, Comparing NI programs for sepsis and cardiogenic shock in CHF patients provides an opportunity for improvement through informatics (Buchlak, 2024). While the organization has artificial intelligence (AI) systems to identify sepsis, cardiogenic shock is omitted from these AI systems, providing an opportunity for process improvement through NI.

SMART Objectives to improve treatment of CHF patients with cardiogenic shock

Focusing on a process improvement project through NI requires the DNP-prepared NP to specify details related to CHF, cardiogenic shock, AI, and other technologies. As defined by Sipes, the project’s aim should be “specific, measurable, achievable, relevant, and timely" (2020, p. 56). Outlining these details for the quality improvement project develops an efficient approach to NI and organizational interventions, mitigating complications from CHF exacerbation. The SMART objective provides a solid foundation to begin an informatics improvement project for the organization. Recognizing cardiogenic shock with CHF patients in the tertiary setting is possible through supportive AI and advanced NI systems. Decreasing patient suffering is feasible through this hypothetical informatics project that supports clinical providers, bedside nurses, patients, and the organization.

DEMI’S Transforming week 2-replies part # 2

Read a selection of your colleagues’ responses and respond by expanding upon your colleague’s posting or offer an alternative perspective. Include two references each

Peer Angela:

It is essential to update terminology to effectively care for patients and adjust to technological improvements in an evolving nursing profession (Booth et al., 2021). Improving patient care and effectiveness requires a thorough understanding of these concepts and their implications for nursing practice and information technology (Booth et al., 2021). This discussion post is to discuss the significance of usability and the application of informational technology in nursing practice. If an EHR system is user-friendly and intuitive, nurses can spend more time interacting with patients and less time struggling with technology. Usability pertains to how easily technology can be employed to achieve objectives. Byson (2021) cites that usability is operable for implementing data collection and minimizing poor data quality and compromised decision-making (Byson, 2021). Software configuration management is descriptive of usability for improving fragmented and unorganized system developments in healthcare, such as slow working and out-of-date technology (Li et al., 2021). In this writer’s workplace, it is imperative to place data in a logical sequence to facilitate safe and quality data entry points via technology (Bryson, 2021). Usability allows this writer to integrate the simplicity of data for ease of use (Li et al., 2021). Usability in nursing informatics refers to the ease with which healthcare professionals can effectively use technology and software in their daily practice (Lopez et al., 2022). Usability is fundamental and practical in the everyday operations of nursing practice. For example, usability encompasses learnability, efficiency, memorability, reducing errors, and improving patient satisfaction (Lopez et al., 2022). For example, the daily workflow for providing safe and effective care is contingent on the impacts of patient care and workflow effectiveness through using and applying electronic medical records [EMRs] (Lopez et al., 2022). Usability in technology serves a purpose once a series of standard operations are performed, observed, and tested for efficiency, such as entering and allocating digital data (Lopez et al., 2022). EMRs with usability allow the clinical provider to interact with patients at the bedside and improve the patient care experience.

In conclusion, usability determines how easy it is to pick up and use something (Booth et al., 2021). Usability is attributed to learnability, efficiency, memorability, errors, and satisfaction (Lopez et al., 2022). The most effective tool for determining usability is performance and quality testing (Lopez et al., 2022).

Peer Giovanna:

Sustainability is a term that has gained immense importance in various fields, including healthcare and technology. Sustainability, in its essence, refers to the ability to maintain or endure over time without causing significant negative impacts on the environment, society, or economy (Ruggerio, 2021). It encompasses the concept of meeting the needs of the present without compromising the ability of future generations to meet their own needs.In healthcare informatics, sustainability plays a crucial role in shaping the design, implementation, and utilization of information technology systems. Healthcare organizations are increasingly adopting electronic health records (EHRs), telemedicine platforms, and other digital solutions to streamline processes, improve patient care, and enhance efficiency. However, Cripps and Scarbrough (2022) explain that the sustainability of these technologies goes beyond their immediate benefits and involves considerations such as their long-term environmental impact, economic feasibility, and social implications.In my nursing practice, sustainability is evident in the implementation of electronic health records (EHRs) and digital health technologies. These systems aim to improve patient care by providing timely access to comprehensive patient information, facilitating communication among healthcare providers, and supporting evidence-based decision-making. However, the sustainability aspect comes into play when considering the energy consumption, electronic waste, and resource utilization associated with maintaining and upgrading these systems. For example, in my daily interactions with patients, I often use tablet devices or computers to access and update their electronic health records. While these digital tools enhance efficiency and accuracy in documentation, they also consume electricity and require regular maintenance and upgrades. Therefore, it is essential to ensure that these technologies are designed and managed sustainably to minimize their environmental footprint and maximize their long-term benefits.Furthermore, sustainability in nursing practice extends beyond the use of technology to encompass broader initiatives such as waste reduction, resource conservation, and promoting environmentally friendly practices. For instance, Molero et al. (2021) suggest that implementing recycling programs, reducing paper usage through electronic documentation, and advocating for eco-friendly healthcare products are all ways in which nurses can contribute to sustainability efforts within their practice settings.

Conclusively, sustainability is a critical consideration in both informational technology and nursing practice, as it encompasses environmental, economic, and social dimensions that are integral to promoting the well-being of individuals and communities. By integrating sustainability principles into the design and implementation of information technology systems and adopting environmentally conscious practices in nursing care, we can contribute to creating a more sustainable healthcare system that meets the needs of present and future generations.