NR 640B Week 8 Practicum Summary Example

Practicum Summary Paper: Five Objectives Judged Against Their Artifacts, the Setting Corrected After Eight Weeks and the Admission History Inventory Handed On

Student Name

College of Nursing, Chamberlain University

NR 640B: Informatics Nurse Specialist Practicum I

Instructor Name

Month Day, Year

Practicum Summary Paper: Five Objectives Judged Against Their Artifacts, the Setting Corrected After Eight Weeks and the Admission History Inventory Handed On

Objectives as They Were Written

Objective 1, Partly Met

The request moved from submission to approval during the practicum but was not built, because the freeze begins before its build slot. The timeline is complete up to approval and shows that the request spent 10 of 10.5 weeks waiting. Closure will happen after the student has left. Calling this met would overstate it.

Objective 2, Met in a Different Mix

The plan was three optimization meetings and one board meeting. The optimization meeting met only twice during the practicum, so the student attended two board meetings instead. The decision log is the most used artifact of the term: the preceptor has shared it with the chief nursing informatics officer as a record of reasons.

Objective 3, Met

The test script found two defects, both fixed before release. This objective most directly matched the implementation and testing competencies in the scope and standards (American Nurses Association, 2022).

Objective 4, Changed

The reporting team had no hours, so the student read the existing report specification and built a field list. The list became the seed of the week 7 idea, which is a better outcome than the original objective would have produced.

Objective 5, Met

The tip sheet was revised once after the trainer asked for a screenshot of the new total and fewer words, cutting it from two pages to one. It will be used at the November go-live.

The Setting, Corrected

In week 3, the path of a request was described as being ranked at the monthly optimization meeting. After eight weeks, that description needs correcting. Most of the real ranking happens before the meeting: the clinical analyst's sizing and the specialist's conversation with the requester decide what reaches the agenda and in what form. The meeting mostly confirms what has been prepared. Two of the 14 items discussed changed in the meeting; the rest passed as presented.

The week 3 account also understated the role of personal knowledge. The specialist's own file of why fields exist is one of the department's most important resources and is not held anywhere else. That is a risk the department has not named.

The Idea, Handed On

The bounded idea from week 7: by 12 March 2027, an inventory of the roughly 190 fields in the adult admission history, each marked for whether the same fact is already recorded by pharmacy or the admitting provider on day one, with any known reason the field exists, for the March optimization meeting. No build, no recommendations on particular fields, regulatory fields marked and left alone. The preceptor agreed on 20 October to supervise it in Practicum II, and the chief nursing informatics officer agreed to hold a March agenda slot on condition that it is finished by the last week of February. The 41-field list, the method and the definitions are on the informatics shared drive, so the inventory could be continued by anyone in the department if the student could not continue.

What the Preceptor Said at the End

In the final evaluation on 22 October, the preceptor rated the practicum as meeting expectations for a first informatics practicum and singled out the decision log and the test script as useful to the department. The preceptor's main development point was the one from midterm: asking clarifying questions of requesters directly, which the student did twice in the final weeks but not yet confidently.

What Would Be Done Differently

Asking the reporting manager for time in week 1, before the upgrade reports began, rather than in week 4. Writing the decision log from the first meeting in a shared format the department could reuse, rather than converting personal notes afterward. And spending more time on units early, in the first or second week rather than the sixth, since the two afternoons in week 6 changed the student's understanding of the admission history more than any document did.

Competencies, Tied to Activity

Assessment of information needs: following the fall-risk request and seeing the manager's choice change after one question.

Implementation and testing: the Braden test script.

Leadership and governance: the decision log, now used by the department.

Education: the tip sheet.

Data management: the field list, built from documentation rather than from a query.

Research and evaluation competencies were not developed this term, and the summary does not claim them, which matches the specialist's description of the role in week 4.

Judgment

The term showed that most informatics work is deciding what to build, and that documentation burden loses to safety in a straight ranking even when leaders name it as the top goal. Measuring burden is hard (Moy et al., 2021), and the inventory is a modest way to give burden items evidence they currently lack. Workflow research suggests that design looks different in use (Unertl et al., 2010); the two afternoons on a unit confirmed that for the admission history.

Limits

The verdicts are the student's, checked against the preceptor's evaluation; where the two differed, the preceptor's view is reported. Eight weeks in one department, with one preceptor, mostly in medical-surgical service lines. A practicum in critical care or ambulatory informatics would likely have produced a different picture of the role and of where burden sits.

References

American Nurses Association. (2022). Nursing informatics: Scope and standards of practice (3rd ed.). American Nurses Association.

Moy, A. J., Schwartz, J. M., Chen, R., Sadri, S., Lucas, E., Cato, K. D., & Rossetti, S. C. (2021). Measurement of clinical documentation burden among physicians and nurses using electronic health records: A scoping review. Journal of the American Medical Informatics Association, 28(5), 998-1008. https://doi.org/10.1093/jamia/ocaa325

Unertl, K. M., Novak, L. L., Johnson, K. B., & Lorenzi, N. M. (2010). Traversing the many paths of workflow research: Developing a conceptual framework of workflow terminology through a systematic literature review. Journal of the American Medical Informatics Association, 17(3), 265-273. https://doi.org/10.1136/jamia.2010.004333