Intraoperative specimen handling is a critical part of patient care during surgical procedures requiring clear communication and competency among all surgical team members. Specimen management includes collection of specimens, test ordering, labeling, proper containment and storage, tracking, transporting, lab processing, and quality monitoring and reporting. An efficient and comprehensive electronic health record system is a key component to specimen management by providing access to clear documentation and applicable orderable sources and tests within the perioperative application.

A project group was assembled that included clinical users, perioperative and lab leaders, clinical informatics, multiple application analysts, information system leaders, project manager, education specialist, and EHR technical support. The team gathered information on what functions effectively and what were challenges, barriers, and improvements that were needed during collaborative workgroup meetings, unit rounding, staff input, and quality reporting.

Workflow documents were created defining the current specimen process and future state process that included the recommendations needed for enhancement of the current system. Specimen tracking was developed to allow perioperative staff to begin the tracking steps within the operative area and follow the specimen through to the lab results. Education was a collaborative effort with clinical and informatic education and shared with team members via written user guides and tip sheets, verbal lectures, and group and individual demonstrations. Quality reports were enhanced to include new tracking steps and specimen test status to allow for quick follow-up in real time by perioperative and laboratory leaders. Surgeons were also engaged through governance committees to share enhancements and clear communication expectation regarding specimen labeling and testing requested.

Multiple teams participated in this project to improve the specimen management process and ensure accurate results for improved safe patient care. This project demonstrated significant improvement in patient safety events and reduction in ordering errors.

Background: In clinical practice, nurses increasingly rely on evidence-based resources accessed through digital platforms to ensure quality and safety in patient care. Despite being digitally literate, entry-to-practice nurses often lack the specific digital health literacy needed to navigate and apply these resources effectively. Digital health literacy involves the ability to seek, find, understand, and evaluate electronic health information and apply this knowledge to solve health problems. As healthcare information technologies (HIT) evolve rapidly, the demands on entry-level nurses and nursing faculty intensify. Research shows that using digital resources enhances critical-thinking skills, leading to safer, higher-quality care. However, the swift adoption of HIT has created a gap in digital health literacy among novice nurses, underscoring the need to equip them with skills to navigate and leverage digital resources effectively.Purpose: The aim of this study was to evaluate how an educational intervention influences the digital health literacy, confidence, and satisfaction of undergraduate nursing students in utilizing digital resources for clinical decision-making.Methods: This study used a pre- and posttest experimental design with a convenience sample of second-semester nursing students enrolled in an adult health course at a southeastern university BSN program. Participants completed a pre-intervention survey to assess their confidence in navigating digital health resources. They were then assigned to either a control group without access to digital resources or an intervention group with access to these resources. Following a post-operative case study exercise, participants completed a post-intervention survey to evaluate their confidence and satisfaction with the assignment. Statistical analysis, including independent samples t-tests, was performed to compare pre- and post-intervention responses between control and intervention groups.Results: The sample consisted of 31 pre-intervention and 27 post-intervention students in the intervention group, while the control group had 23 pre-intervention and 13 post-intervention students. Both groups demonstrated similar baseline responses, with no significant differences in digital health literacy scores before the intervention. Post-intervention analysis revealed a significant improvement in the intervention group's ability to find information compared to the control group (t=3.52t, p=0.0013), indicating that the intervention effectively enhanced students' information retrieval skills. Additional significant changes were observed within the intervention group in confidence (t=4.75t, p<0.001) and familiarity with digital resources (t=3.53t, p=0.0012) from pre- to post-intervention.Conclusion: By addressing the digital health literacy gap among entry-level nurses, this study provides insights into how nursing students interact with digital resources and their expectations. The results suggest that targeted educational interventions can enhance specific aspects of digital health literacy, such as information retrieval, confidence, and familiarity with digital tools, which are essential for safe and effective patient care. This information can guide faculty in developing strategies to better prepare students for clinical decision-making in a digitalized healthcare environment.

Background: Bivalirudin, a potent anticoagulant used in critical care settings, demands precision in administration to mitigate risks. Current literature lacks substantial evidence on the safety and efficacy of nurse-driven protocols for low-volume, elevated risk administration of intravenous bivalirudin. This poster outlines a quality initiative aimed at assessing and enhancing the safety of bivalirudin administration through the implementation of nurse-driven protocols.

Objective: The primary objective of this quality initiative is to evaluate the impact of nurse-driven protocols on the safety and efficacy of bivalirudin administration specifically for the HITT and ECMO patient population in a critical care setting. By empowering nurses with a structured protocol and workflow, we aim to enhance patient safety, reduce errors, and optimize the utilization of this high-risk medication.

Methods: The initiative will adopt a pre- and post-implementation study (mixed method). Critical care nurses will undergo comprehensive education and training on bivalirudin pharmacology, dosage calculations, and safety protocols to include documented independent double checks at pump titration. Nurse-driven protocols will be evaluated in critical care units. Data will be collected on adverse events, dosage accuracy, and patient outcomes, utilizing electronic health records and incident reporting systems. Statistical methods will be employed for quantitative analysis, while qualitative analysis will identify factors influencing feasibility and practicality.

Results anticipated: 1) Time to bivalirudin steady state defined by two consecutive aPTTs with the target range and the percentage of aPTT values. 2) Evaluation of the incidence of adverse events related to bivalirudin under nurse-driven protocols. 3) Assessment of the effectiveness of nurse-driven protocols in achieving therapeutic goals.

Conclusion: This quality initiative is to contribute essential evidence to the literature, addressing the current gap in knowledge surrounding bivalirudin administration by nurses. The initiative aims to enhance patient safety and promote the responsible utilization of bivalirudin through nurse-driven protocols.

Purpose: This study in progress aims to measure changes in faculty members' confidence in using technology for teaching and assess the impact of the teaching with technology committee (TTC) on faculty members' technology skills and teaching practices.

Background/significance: Nurses are required to possess advanced digital literacy and technological skills. To ensure nursing graduates are prepared, nursing programs must integrate technology into their curriculum. This requires faculty who are confident and skilled in using technology. The TTC was organized to facilitate and mentor faculty in the use of technology to engage students meaningfully and meet program learning outcomes.

Methods: The study is a longitudinal, mixed methods study currently in progress. Data is being collected through online surveys distributed to graduate and undergraduate faculty members of a private liberal arts school in Northern Indiana. The survey includes demographic questions, questions about teaching practices, and the technology proficiency survey for educators (TPSE). Participants are completing three surveys: a pre-survey in January 2024, a post-survey in August 2024, and a second post-survey in January 2025. In addition to providing faculty mentoring, the TTC provides drop-in sessions to assist nursing faculty with various technological needs. These sessions cover polling software, learning management systems, exam software, basic word processing and spreadsheet tips, and other software needs.

Results: Data analysis will include descriptive statistics and inferential tests to determine differences between pre-survey and post-survey scores. Qualitative data will be analyzed to identify changes in teaching practices.

Conclusions: This study will provide insights into the effectiveness of the TTC, helping improve faculty's ability to use technology in teaching and understanding their needs and challenges in incorporating technology. The findings can inform future strategies for faculty development and technology integration in nursing education.

The rapidly evolving role of nursing informatics specialists necessitates a redefined approach to their academic preparation. This poster presentation addresses the need for innovation in nursing informatics education and career development by proposing a comprehensive revision and integration of the ANIA Graduate Informatics Nursing Faculty Guide and Toolkit.

Historically, nursing informatics education has struggled to keep pace with the dynamic changes in healthcare technology and data management. This gap underscores the importance of updating educational resources to better equip future specialists. Our project aims to identify and integrate innovative opportunities within the ANIA toolkit to ensure that nursing informatics programs align with current industry needs and future trends.

Key areas of focus include 1) revamping the existing curriculum to incorporate emerging technologies, data analytics, and advanced informatics tools and concepts; 2) defining and integrating core competencies required for modern nursing informatics roles, emphasizing practical, hands-on experience alongside theoretical knowledge; 3) encouraging collaboration between nursing informatics educators and professionals from other fields to foster a multidisciplinary approach to problem-solving and innovation; 4) expanding career development resources to include emerging roles and specializations within nursing informatics, thus providing clearer career trajectories for students; and 5) implementing robust mechanisms for evaluating the effectiveness of the revised guide and toolkit, ensuring continuous improvement and relevance.

Assessment and publication of outcomes: To gauge the impact and effectiveness of the revised ANIA toolkit, we will employ a multi-faceted assessment approach by collecting feedback from educators, students, and industry preceptors through structured surveys and interviews to assess the practicality and relevance of the revised curriculum and resources. Conducting evaluations before and after the implementation of the revised toolkit to measure improvements in student learning outcomes, competency development, and career readiness. Create a continuous feedback loop by establishing a feedback loop with stakeholders to make iterative improvements based on real-time data and evolving industry trends.

Results: Results from these assessments will be synthesized and published in peer-reviewed journals, industry reports, and educational conferences to share insights and best practices with the broader nursing informatics community. This dissemination of outcomes will facilitate further dialogue and refinement, contributing to the ongoing evolution of nursing informatics education and practice.

By revising and integrating these elements provided in the ANIA Graduate Informatics Nursing Faculty Guide and Toolkit within our existing MSN nursing informatics program, we aim to create a more dynamic and responsive educational framework. This initiative will better prepare nursing informatics specialists to address contemporary challenges and seize emerging opportunities in their field.

The poster presentation will outline the proposed revisions, present preliminary feedback from stakeholders, and discuss the potential impact on nursing informatics education and practice.

The AACN Essentials (2021) calls for nursing students, in all levels of degree attainment, to attend to patient care by understanding the concepts of technology assisted care beyond the scope of healthcare settings to reach patients in various environments. Telehealth services, especially post-COVID-19 pandemic, are more essential to patient-centered care than ever before. The needs of nursing students necessitate the knowledge of and experiences with telehealth technologies to communicate with patients and the healthcare team, deliver health information and preventative care, enlist remote patient monitoring skills, and provide focus on the delivery needs of informatics in diverse communities and settings, along with equipment, broadband, and literacy needs of their clients.

With technological advances in healthcare, the use of genetics/genomics and the increased use of personalized healthcare are apparent in today’s healthcare setting. Nurses are at the forefront to assist patients in their understanding of genomic test results, gene mutations and disease likelihoods, and potential sharing of these disease transmissions to family members. Gaps in academic programs have exposed the lack of genetic and genomic education for the nursing population at the time of school programming. Immersive experiences, beyond textbook knowledge, to prepare and engage students for transition to practice, allow for a richer and deeper learning format.

An immersive telehealth simulation was created, utilizing a trained standardized patient, for both prelicensure and post-licensure masters’ degree nursing students. Within this scenario, students engage in telehealth services, providing counseling for clients post-genetic testing (assisting with result questions and health literacy) and remote monitoring of patient’s vital signs, needs, and home equipment usage. Students are provided all necessary equipment, and there are assignments of teams of 2-3 students per simulated session, with prework inclusive of telehealth basics (equipment usage, background assessment, camera etiquette, volume and presence for patient needs) and the patient’s electronic health record (utilizing a standardized simulated EHR), which is inclusive of patient history, background, labs, and genetic test results. The simulation is sectioned out within the semester so that several weeks of knowledge in informatics and post-genetic/genomics readings, lectures, and activities have previously occurred; basic information is introduced to each student before immersion activity.

The immersion has been a student satisfier in their academic trajectory. Student feedback shows an increase in knowledge and self-assessment with a further sense of critical thinking, including an understanding of the needs of the technological practicum and in patient interaction that would not occur in the clinical unit for a student, would be strictly observational, or would be shared by preceptor nurse story-telling alone. Post-telehealth immersion feedback in a debriefing session was shown to be most helpful in accentuating all experiences and learning within the immersion activity. The feedback from the standardized patient proved to be profoundly beneficial to student confidence levels and transferred over into personal reflection and within practice post-graduation (per evaluative survey findings).

Anxiety disorders are one of the most prevalent mental health disorders reported worldwide with approximately 3.8% to 25% of individuals experiencing some form of anxiety. Unfortunately, the high prevalence of anxiety disorders spurs issues of cost, quality, and delays in care. Common anxiety questionnaires aimed to aid in diagnosis often fail or misdiagnosis anxiety in up to 50% of affected individuals. A modern solution to improve anxiety diagnosis and treatment is enhancing precision medicine to improve patient outcomes through epigenetic methods of biomarkers and gene mapping. Nursing informatics (NI) offers strategic support to epigenetic research due to technology-savvy skills, data analytics knowledge, and clinical expertise as a nurse. Researchers can lean on their NI counterparts for data collection, data understanding, and transformation of the clinical data into information that can progress into wisdom.

Epigenetics is the study of changes that occur in DNA expression related to lifestyle, environment, and disease processes. The exposure of environmental toxins, stress, diet, and other factors change DNA expression through a process called methylation (DNAm). The process of measuring DNAm is a data-saturated task as there are over 3 billion nucleotide pairs and over 40 thousand genes possible that can be on 23 chromosomes in humans. Luckily, NI can support epigenetic research efforts by understanding and utilizing statistical and programming software that can handle big data analysis in a more efficient manner. Biomarkers studied in epigenetic research are traits measured and assessed as indicators for biological processes, diseases, and severity of illness. Biomarker and gene mapping can help researchers explain the etiology of mental illness, confirm diagnoses, and help identify individuals at higher risk for anxiety or stress. Exploring different biomarkers, gene expression, and sequencing associated with patients with different mood disorders in a database management system (DBMS) can help yield diagnosing insights, personalized patient care, and better outcomes.

High workloads and burnout during the COVID-19 pandemic have strained the nursing workforce resulting in high turnover and staffing shortages. The burden of documentation related to increased patient acuity and turnover became more apparent with the excessive work expected from nurses on a day-to-day basis. Our hospital experienced similar challenges expressed by nurses during employee forums and rounding. Documentation associated with the admission and discharge process was identified as the most time-consuming.

Virtual nursing (VN) is an up-and-coming innovative approach to decrease the workload of staff nurses. Our goal in implementing a VN program was to help address workload issues in the inpatient medical and surgical areas. With this program, our organization was able to drive efficiency and give back time to bedside nurses. The virtual nurses helped fill gaps, restoring balance to the staff-patient ratio.

Operational and clinical outcomes were measured to determine the efficacy of our VN program. Patients admitted or discharged by the virtual nurse were asked to take a survey of their overall satisfaction with the virtual visit. A report was also created to identify the total length of each visit, how many visits were conducted each month, and if the virtual visit was for admission or discharge. The length of each virtual visit, in minutes, correlates to the amount of time bedside nurses are saving. Additionally, nurses from our pilot unit participated in a post-implementation satisfaction survey to identify the impact the program had on their workflow.

The idea of virtual nursing was presented by our senior vice president of operations in January 2023. The interdisciplinary project team, consisting of nursing leadership, nursing informatics (NI), information technology (IT), and capital projects coordinators worked collaboratively to discuss the logistics of the project. The project team, led by NI, decided to pilot the program on one medical-surgical unit. NI, with the assistance of nursing leadership, developed the workflow for the bedside and virtual nurse while the IT analyst created the EMR build and assisted with the bedside tablet integration. NI provided training to the bedside nursing staff for the first virtual nurse.

With the accelerated implementation of just 6 weeks from planning, the project went live for the pilot unit on April 10, 2023. In addition, we were able to reach our 100th visit in just three months with one virtual nurse. With generally positive feedback from patients and nurses, the project team decided to incorporate additional inpatient units. By October 2023, the virtual nurse program was live in five inpatient units. The October 2023 data showed that the virtual nurse spent a total of 1,915 minutes conducting virtual admissions and discharges. Not only did the virtual nurse complete the necessary admission and discharge documentation, she also provided patient education. The 1,915 minutes spent correlate with the amount of time this program has saved bedside nurses. From October 2023 to March 2024, there was a 48% increase in the number of minutes given back to nurses!

The integration of clinical decision support (CDS) is a best practice for the increased adoption of the electronic medical record (EMR). However, the interruptive nature of the alert requires clinicians to address the “pop-up” and act or acknowledge the alert during clinical workflows. Organ procurement organizations are certified by the Centers of Medicare and Medicaid Services and must abide by regulations.

The conditions of participation include outcome and performance measures. Organ referrals are time-sensitive workflows to ensure meeting both regulatory metrics as well as enhancing medical care through organ and tissue donation.

Using the Institute of Healthcare Improvement (IHI) model for rapid-cycle testing, the primary objective was to reduce the burden of interruptive alerts for nurses across a multi-state health system. A secondary aim was to improve timeliness of referrals without compromising referral rates.

Following the change from an interruptive alert to a passive banner notification, the total number of referrals increased from 300 to 334 over the same timeframe. Untimely referrals decreased by 59%. There was a statistically significant correlation in the increase in both timeliness (4.21%) and the referral rate (3.9%) once the banner was implemented.

Learning outcome: By the end of this poster presentation, participants will be able to effectively implement a workflow-integrated, problem-based approach to provider documentation to improve quality and accuracy, thereby enhancing patient handoffs and overall patient safety.

Purpose: This project explores the implementation of a workflow-integrated, problem-based approach to improve progress note documentation quality and problem list accuracy in the neonatal intensive care unit (NICU).

Design: In this quality improvement project, a convenience sample of 17 neonatal nurse practitioners (NNPs) was evaluated. For time efficiency and problem list documentation, performance was observed over a three-month period pre-intervention from August 1 through October 31, 2023, and post-intervention from December 6 through March 6, 2024. For note quality, two notes pre-intervention and two notes post-intervention were compared.

Methods: Data retrieved from the EHR through reporting and manually with the PDQI-9 tool was analyzed using a Wilcoxon test with SPSS.

Findings: The use of the workflow-integrated, problem-based approach to progress notes improved total PDQI-9 scores from 40.5588 to 44.0588. The average total number of problems added to the problem list increased from 4.451 to 21.157.

Conclusions: Using the workflow-integrated, problem-based progress note in the NICU led to improved note quality scores and more active clinical problems added to the problem list. While time efficiency did not show an improvement, it is anticipated to improve over a longer period as providers become more proficient in the EHR changes.