Background: The consequences of unmanaged technostress are profound, affecting individual well-being. Technology, despite its benefits for productivity and connectivity, can lead to symptoms associated with technostress. Employees experiencing technostress report higher levels of anxiety, frustration, and burnout, leading to decreased job satisfaction, reduced productivity, and increased absenteeism. Technostress is the stress experienced from the inability to cope with new technologies, and it manifests through information overload, privacy invasion, blurred personal and professional boundaries, and the constant pressure to upgrade digital skills. The American Psychological Association defines technostress as a form of occupational stress that is associated with information and communication technologies such as the internet, mobile devices, and social media. Technostress is seen in many organizations where affected employees become anxious or overwhelmed by working in computer-focused environments yielding a constant flow of new information. This has detrimental effects on individuals’ health, productivity, and work satisfaction. Problem statement: The healthcare industry is, by necessity, a technology-rich environment with direct connection of the patient to technology that informs about their physical status. Patient-generated information also flows among providers through technology called the electronic health record (EHR). Nurses, for example, have been noted to spend up to 35% of their shift interacting with the EHR for data retrieval and data entry for patients in their care. Interestingly, teaching associated with use of the EHR in nursing schools is the exception rather than the rule. In other words, some sources indicate that only 10% of student nurses have been taught to use an EHR before they graduate from nursing school. Thus, when they enter their post-graduate nursing role, they have little to no skills in managing the EHR technology with which they will spend 47% of their time in patient care delivery. Innovative approach: The academic EHR, when used as part of the nursing school curriculum, has been found to improve technology-based confidence and digital documentation skills. This approach to teaching EHR used prior to graduation can mitigate the effects of post-graduation technostress in newly graduated nurses. The academic EHR is an EHR that looks and feels much like a healthcare industry-based EHR found in most hospitals today, with the exception that the nursing faculty controls the patient-generated content so that it matches the curriculum-base objectives of the nursing program. Academic EHR skills development has been found to provide a smooth transition to the post-graduation nursing role. Purpose: The purpose of this poster is to present the implementation process of academic EHR installation, including use of the system development life cycle (SDLC) methodology, associated results of nursing student and faculty experiences as the students learn to use an academic EHR that is integrated into their nursing school curriculum, and how technostress can be mitigated in the post-graduation nursing role.

Learning outcome: To examine the value of integrated PDMP data in clinical practice, relevant PDMP interoperability and data sharing challenges, and nursing informaticists’ role in supporting PDMP utilization best practices.

Prescription drug monitoring programs (PDMPs) are state-run databases that provide clinicians with patient-level prescription data for controlled substances. This information promotes the safe prescribing of controlled substances and informs clinical decision-making for patients in need of these medications. Registered users can access a state’s PDMP either by logging directly into the state PDMP website/portal or through an access point integrated within the electronic health record (EHR). Although EHR integration is more complex due to the technical interfacing required between the two software applications, it offers a seamless and user-friendly workflow that supports clinical decision-making at the point of care. The inclusion of PDMP querying in incentive programs, such as the merit-based incentive payment system (MIPS) and the promoting interoperability programs (PIP) from the Centers for Medicare & Medicaid Services (CMS), underscores the increasing emphasis of PDMP accessibility and utilization.

However, significant challenges still hinder the effective use of PDMPs, particularly in achieving seamless interoperability and consistent data sharing. Different states have varying regulations regarding which drugs must be reported. States typically require reporting of certain federally scheduled medications, and additionally some states mandate reporting for certain non-scheduled drugs of interest. Some states mandate real-time or near real-time reporting, while others allow for delayed reporting. These inconsistencies can affect the timeliness of available data, resulting in fragmented data that healthcare providers may struggle to access. Furthermore, there are variations in how states authorize clinician access to PDMPs, with some offering limited permissions and others providing broader access. This disparity can compromise the ability to perform a complete medication history review, particularly for providers treating patients across state lines. These challenges make it difficult to effectively address controlled substance misuse and highlight the need for a national PDMP framework to standardize practices and facilitate comprehensive, interoperable data sharing across the country.

Nursing informaticists play a crucial role in addressing PDMP-related issues, as these issues intersect technology, patient care, and data management. By leveraging their expertise, nursing informaticists can work for improved PDMP-EHR integration, promote user-centered design, and champion consistent data-sharing standards to enhance the functionality and utility of PDMPs within the healthcare setting. Furthermore, informaticists must educate clinical staff on accessing and utilizing PDMP data effectively as usability issues and a lack of understanding may lead to underutilization of this valuable clinical tool. Nursing informaticists can significantly influence the future of PDMP utilization by prioritizing integration and advocating for best practices.

Introduction: ECU Health implemented mobile devices across nine hospitals, offering web-based calling through Banyan and Rover, an Epic application used for documentation. This implementation improved communication by allowing end users to bypass the unit manager or secretary and call team members directly. Secure messaging through the Rover application using secure chat replaced the previous platform, Cortext.

Purpose: The retirement of Impravata Cortext necessitated a new secure messaging platform. Clinical staff and physicians expressed concerns about only being able to use the secure messaging platform within Epic on their workstations, as they are often not at a computer. They also highlighted delays in patient care caused by having to call team members and wait for the call to be routed correctly.

Method: Discovery sessions were held at each facility to gather information for setting up the mobile devices. Clinical informaticists met with service line, nursing, and ancillary team delegates to learn about the current state and make decisions on the future state. Decisions included the phone directory, dynamic roles, and status displays. Timelines were established for go-lives and eLearning modules, and tip sheets were created and distributed. Ground control devices were placed in accessible locations for easy device check-in and checkout. The phased rollout began with smaller regional hospitals and ended with the larger medical center. Clinical informaticists provided onsite support and logged issues in Service Now. The go-live included mobile devices with Wi-Fi calling, a directory with dynamic role assignment, secure chat within Epic, and expanded Rover functionality. During the implementation, network issues were identified due to the addition of extra devices. SSIDs and APs were updated to support the increased load. Clinical informatics and the networking team partnered in rounds and testing to ensure the reported issues were resolved following extensive network assessments and resolution.

Results: Documentation time for nursing decreased by 24%. Flowsheet macros saved nursing over 7.5 million clicks since September. Rover usage increased to the 90th percentile, including nursing, therapists, lab, and ancillary staff. Team member satisfaction dramatically improved with the rollout of mobile devices, secure messaging, and Wi-Fi calling.

Conclusion: The implementation of mobile devices and secure messaging at ECU Health significantly improved clinical communication and workflow efficiency. The phased rollout strategy, combined with dynamic role assignments and comprehensive training programs, ensured a smooth transition and high user satisfaction. The success of this project demonstrates the potential of mobile health and telehealth technologies in transforming healthcare delivery. By adopting best practices in training and education, healthcare organizations can optimize technology use and enhance patient care across the continuum of care.

Introduction: In alignment with our commitment to enhancing operational efficiency and patient care, we standardized provider call schedules across our organization. This project, implemented successfully at six of our 14 hospitals, transitions from traditional paper-based schedules to an electronic system, significantly improving response times to emergencies and on-call needs.

Objective/purpose: Our objective is to empower providers and their teams to manage their schedules within Amion, mitigating the inefficiencies of manual scheduling and ensuring seamless integration with Epic's On-Call Finder. This integration enables hospital staff to access real-time on-call information within the electronic health record (EHR), allowing for swift identification of available providers and better patient care.

Improving Communication: Effective communication between healthcare providers and nursing staff is paramount to patient safety, as emphasized by national guidelines from organizations such as the Joint Commission and the Institute for Healthcare Improvement. Our initiative directly addresses these guidelines by fostering a culture of collaboration and proactive communication among providers and nursing staff. The findings of the Nursing Management Journal highlight how digital health technologies, such as electronic scheduling, improve communication and streamline workflows.

Clinical informaticist role: As clinical informaticists, we collaborated with stakeholders to develop effective communication channels using Amion. We ensured that essential information was communicated before implementation, allowing stakeholders to prepare for training sessions. Our efforts organized critical data required to establish schedules compliant with guidelines.

Workflow improvements: Transitioning to an electronic scheduling system enhances clarity and accountability, promoting an environment where providers take ownership of their schedules. We reduce miscommunication, streamline workflows, and improve patient care quality by leveraging technology. Expanding this initiative to remaining hospitals will create a more efficient healthcare environment, prioritizing staff satisfaction and patient outcomes.

Results: Implementing electronic schedules has significantly improved communication efficiency, evidenced by a marked increase in secure messages via Epic Secure Chat. This has facilitated quicker interactions between nurses and providers, improving response times to patient needs. Importantly, we observed a reduction in sentinel events related to patient communication, indicating enhanced patient safety outcomes. Both providers and nursing staff reported greater workflow satisfaction due to streamlined processes.

Key takeaways: Securing a physician champion is crucial for successful system implementation, emphasizing the importance of practical use. Establishing clear responsibilities for sending and receiving schedules, identifying schedule administrators, and maintaining IT connections are essential for the integrity and efficacy of the integrated scheduling system.

Conclusion: This initiative highlights the necessity of educating nursing staff and partnering with providers to promote continuous improvement in communication. This will ultimately enhance patient care outcomes across our organization. By integrating evidence-based practices, we pave the way for a more responsive healthcare system prioritizing quality and safety.

Background: The consequences of unmanaged technostress are profound, affecting individual well-being. Technology, despite its benefits for productivity and connectivity, can lead to symptoms associated with technostress. Employees experiencing technostress report higher levels of anxiety, frustration, and burnout, leading to decreased job satisfaction, reduced productivity, and increased absenteeism. Technostress is the stress experienced from the inability to cope with new technologies, and it manifests through information overload, privacy invasion, blurred personal and professional boundaries, and the constant pressure to upgrade digital skills. The American Psychological Association defines technostress as a form of occupational stress that is associated with information and communication technologies such as the internet, mobile devices, and social media. Technostress is seen in many organizations where affected employees become anxious or overwhelmed by working in computer-focused environments yielding a constant flow of new information. This has detrimental effects on individuals’ health, productivity, and work satisfaction.Problem statement: The healthcare industry is, by necessity, a technology-rich environment with direct connection of the patient to technology that informs about their physical status. Patient-generated information also flows among providers through technology called the electronic health record (EHR). Nurses, for example, have been noted to spend up to 35% of their shift interacting with the EHR for data retrieval and data entry for patients in their care. Interestingly, teaching associated with use of the EHR in nursing schools is the exception rather than the rule. In other words, some sources indicate that only 10% of student nurses have been taught to use an EHR before they graduate from nursing school. Thus, when they enter their post-graduate nursing role, they have little to no skills in managing the EHR technology with which they will spend 47% of their time in patient care delivery.Innovative approach: The academic EHR, when used as part of the nursing school curriculum, has been found to improve technology-based confidence and digital documentation skills. This approach to teaching EHR used prior to graduation can mitigate the effects of post-graduation technostress in newly graduated nurses. The academic EHR is an EHR that looks and feels much like a healthcare industry-based EHR found in most hospitals today, with the exception that the nursing faculty controls the patient-generated content so that it matches the curriculum-base objectives of the nursing program. Academic EHR skills development has been found to provide a smooth transition to the post-graduation nursing role.Purpose: The purpose of this poster is to present the implementation process of academic EHR installation, including use of the system development life cycle (SDLC) methodology, associated results of nursing student and faculty experiences as the students learn to use an academic EHR that is integrated into their nursing school curriculum, and how technostress can be mitigated in the post-graduation nursing role.

The thoracic transplant department recognized an opportunity to enhance the tracking of vital signs for post-discharge patients. Traditionally, patients have been asked to record their vital signs daily on a paper log sheet following specific guidelines supplied by their transplant provider. The guidelines also provided the patient with information as to when to notify their provider regarding abnormal readings. Nurses would frequently call patients to review their vital signs between visits and then manually transcribe this information into the EMR, which is a time-consuming process. Alternatively, clinicians would review the vital sign logs during clinic appointments, sometimes discovering abnormal results that had not been previously reported.

To address these challenges, the nursing team collaborated with their health IT counterpart and decided to develop a patient diary where patients can directly enter vital signs into their patient portal account. This tool has two primary objectives. The first objective is to electronically alert clinicians of abnormal vital signs; the second objective is to reduce clinician resources required for tracking and entering this data manually.

Upon patient discharge, the nurse is deemed the responsibility of assigning the diary for the patient which gains them access. During the ordering process, alert frequency and reading parameters are placed. It is also nursing’s responsibility to educate the patient on the use of this tool. Each day, patients receive an alert prompting them to enter their vital signs. If any results fall outside the specified parameters, an alert is immediately sent to the clinical team for prompt review, even outside the established schedule. These alerts enable the nursing team to respond quickly to abnormal vital signs and collaborate with the provider to formulate a plan of care. The logs are also easily accessible for all clinical team members within the EMR flowsheets.

Nurses have reported that this tool has been instrumental in identifying early signs of possible organ rejection, allowing for swift evaluation and the prevention of hospitalization or adverse outcomes. Tiase et. al. confer that use of this type of tool will assist in closing healthcare gaps and lead to better patient outcomes.

This study explores the effectiveness of virtual reality (VR) simulations compared to traditional face-to-face methods in alleviating anxiety and enhancing clinical skills among newly graduated registered nurses (NGRNs) at a large medical center.

Purpose: The transition from education to clinical practice often induces high anxiety for NGRNs, impacting patient care and retention. Currently, 100% of NGRNs utilize simulation in some form during their training, highlighting simulations’ critical role in development. Although VR has shown promise in nursing education, limited research addresses its potential to reduce anxiety in clinical practice. The research aims to evaluate whether VR simulations, through immersive, controlled learning experiences, provide a better method for reducing anxiety and fostering competency in clinical settings than traditional face-to-face simulations. The study will determine how VR training might improve skill acquisition and workflow integration during the early stages of professional practice.

Methods: A comparative mixed methods design will be used. The sample includes 13 NGRNs enrolled in the post-baccalaureate registered nurse residency and transition-to-practice programs. Quantitative data will be collected using pre- and post-intervention anxiety assessments (e.g., self-confidence with clinical decision-making scale (NASC-CDM) and competency evaluations (e.g., Creighton competency evaluation instrument). Qualitative feedback from focus groups and interviews will provide additional context regarding VR’s impact on participants’ anxiety levels and skills integration. This dual approach allows for both statistical analysis and in-depth insight into participant experiences.

Implications: This pilot study addresses the practice gap in anxiety management for NGRNs transitioning to clinical practice at a large medical center. Results could support the integration of VR simulations into their transition-to-practice programs by determining (feasibility) and (preliminary effectiveness) of this innovative approach. By examining both quantitative anxiety measures and qualitative experiences, the study will provide comprehensive data on whether VR offers advantages over traditional simulation methods for supporting NGRNs.

As NGRNs face increasing workplace demands and mental health challenges (exacerbated by COVID-19), evidence-based strategies for anxiety management and skill development are critical. By implementing and evaluating VR simulations through this pilot study, the medical center can begin to establish (best practices) for supporting NGRNs' psychological wellbeing and clinical competence during their critical transition period. Findings will directly inform decisions about (scaling up) VR integration across departments, with potential improvements in NGRN confidence, patient outcomes, error rates, and retention within the institution.

Purpose: Precision health (PH) is a cutting-edge healthcare strategy that tailors treatments to the unique characteristics of each person. These individual characteristics include data from testing and analysis of genetics, genomics, and other omics, such as proteomics, metabolomics, and microbiomics, as well as data generated from wearable devices, direct-to¬ consumer testing, patient-derived health data, social determinants of health (SDOH), and health literacy. PH has the potential to improve individual well-being while improving health equity.

Despite its potential benefits, there exists a notable lack of confidence and knowledge in PH, particularly within the nursing community. This deficiency can be attributed to the absence of a consistent definition and variability in educational approaches. A literature review confirmed a general lack of available competencies in PH, while a subsequent pilot study assessing nurses' PH knowledge, skills, and attitudes (KSA), conveyed that nurses feel discomfort with their own level of knowledge and skills related to PH. However, nurses strongly recognized the need to incorporate PH data into plans of care and treatment options.

Description: The journey towards building confidence and expertise in PH begins with nurses taking ownership of the process and developing standardized PH definitions and education. To address this gap, the American Nurses Association convened a workgroup of experts to produce nursing competencies in PH. These competencies will guide nursing educators in curriculum development for nurses. Nurse informaticists must familiarize themselves with the developed competencies along with the principles and practices of PH; design electronic health records (EHRs) that enable the accurate documentation of SDoH, genetic testing data, and other sources of health data provided by direct individual patient reporting; and facilitate interdisciplinary collaboration to ensure regulatory compliance and patient privacy.

Evaluation/outcome: Informatics nurses have a pivotal role in integrating PH data into technological solutions. Becoming familiar with the developed nursing competencies will help them ensure usability and accessibility of PH data. Beyond designing EHRs to enable the accurate documentation of PH data, the informatics nurse must look at PH through the lens of technology and imagine the potential.

Learning outcome: Define precision health.

Purpose: Hypertension is a primary risk factor for many disease processes, making accurate and comprehensive documentation of blood pressure (BP) measurements important for both effective medical management and health plan compliance. Manual processes for assigning BP-related CPT codes can result in documentation gaps, impacting the quality of reported data and potentially leading to missed opportunities for improved patient care. This study aimed to evaluate the impact of implementing our organization’s first clinical rules engine (CRE) within our electronic health record (EHR) system to automatically assign blood pressure CPT codes to charts of patients with an essential hypertension diagnosis to improve BP control capture rates in health plan reports.

Description: A set of six clinical rules were developed to identify patients with both an I10 essential hypertension ICD-10 code and blood pressure measurement documented in their chart. The CRE automatically added corresponding CPT codes for the most recently documented systolic and diastolic blood pressure values to a patient’s chart when the rules criteria were met. This automated process was integrated directly into the EHR workflow, minimizing the need for manual CPT assignment. We analyzed BP control capture rates before and after implementing the CRE to measure its effectiveness in improving reportable data quality.

Evaluation/outcome: At the time of this submission, we are three weeks out from initial implementation. Preliminary results demonstrate an increase from 2.86% to 87% in capture of blood pressure values of patients with essential hypertension through CPT code assignment. The 13% of patients not captured by the CRE has been determined to be a result of the current code level of our electronic health record, which limits our ability to prevent user workflows from interfering with the CRE function. Final results are pending and will be available by the time of the conference. This improvement in data capture will support improved health plan reporting in addition to reducing the administrative burden for staff. Integrating a CRE for CPT code assignment significantly enhances the capture of BP control data in patients with essential hypertension, facilitating better compliance with health plan requirements and providing a more complete view of patient care needs. Automation of this process minimizes manual errors and supports clinical staff by reducing their documentation task burden, thereby improving both data quality and enabling for more efficient care delivery.

Introduction/background: Nurses must adapt to an evolving digital landscape, with electronic health records (EHRs) becoming central to their workflow. Yen et al. (2020) report that nearly half of nurses feel “frustrated” with electronic health record (EHR) systems, underscoring the need for strategies that address these burdens. Hobensack et al. (2022) argue that nursing informatics principles are essential in reducing documentation load by optimizing workflows and improving system usability. Additionally, Moy et al. (2021) highlights the importance of time and motion studies in assessing EHR efficiencies. This study investigates whether a redesign using a group box format—a nursing informatics principle—affects EHR system load times.

Method: A systematic time-motion study was conducted to assess the effects of a redesigned template on EHR load times. Load times refer to the period required for an electronic documentation tool to become fully operational for data input once activated by the clinician. A prototype redesign template was first developed within a controlled environment and uploaded to a web server for initial testing. Researchers conducted onsite studies, again following detailed procedural guidelines, to measure load times within the live production environment of the EHR system.

Results: Initial testing in a controlled environment showed a three-second reduction, while onsite studies in two inpatient facilities found a 0.4-second decrease. When this time saving was extrapolated to the number of times the documentation tool was accessed by nursing staff in 2023 (n = 5.52 million), it equated to an approximate 613-hour cumulative time saving for inpatient nursing units.

Conclusion: Thoughtful system design informed by nursing informatics principles can enhance EHR usability and support nursing workflows. Even marginal improvements in system performance can yield significant cumulative time savings, allowing nurses more time for direct patient care. Limitations of this study include variable interface systems and Wi-Fi connectivity differences across facilities. Future research will focus on additional nursing informatics interventions to further reduce the documentation burden in clinical settings.