NR 642 Week 3 Needs Assessment Example

Course	NR 642 Informatics Nurse Specialist Concluding Graduate Experience I
Week	3
Paper type	Needs assessment
Length	About 1,100 words, 5 pages
Format	APA 7 student paper
School	Chamberlain University
Program	MSN, Nursing Informatics
Updated	October 2026

Free sample paper for NR 642 Week 3

Needs Assessment: What the Record, Watched Practice and Nurses' Own Accounts Show About Where PRN Pain Reassessments Get Filed

Student Name

College of Nursing, Chamberlain University

NR 642: Informatics Nurse Specialist Concluding Graduate Experience I

Instructor Name

Month Day, Year

What this page is doingThe assessment is grouped by how evidence was obtained, puts system data first and what people said last, treats workarounds as findings, gives each strand its window and blind spot and keeps the strand that disagrees.

Needs Assessment: What the Record, Watched Practice and Nurses' Own Accounts Show About Where PRN Pain Reassessments Get Filed

How the Evidence Is Arranged

Three strands, ordered by how the evidence was obtained: first what the systems recorded, then what was watched, then what people said. What people said sits last on purpose, because accounts of one's own documentation are the least reliable of the three. All figures are totals; no nurse can be identified.

Strand 1: What the System Recorded

Window: 1 July to 30 September 2026. Source: the quality analyst's quarterly pain committee report and a chart audit drawn from the same months.

A chart audit of 60 September administrations, 20 per unit, chosen by the analyst at random, found where the reassessment actually landed:

Measure	Count	Share
PRN opioid administrations on the three units	9,240
Intravenous doses with a Pain Reassessment row within 30 minutes	1,086 of 2,310	47%
Oral doses with the row within 60 minutes	4,204 of 6,930	61%
All doses with the row inside the window	5,290 of 9,240	57%
Where the reassessment was found	Count
Pain Reassessment row, inside the window	34
Routine pain assessment row, inside the window	7
Free-text nursing note, inside the window	5
Pain Reassessment row, after the window	3
Nothing found	11

So 46 of 60, or 77%, had a reassessment documented inside the window somewhere, against 34 of 60, or 57%, in the row the report reads.

The flowsheet's structure also counts as system evidence. The Pain Reassessment row sits in its own group, below about 40 other rows, while the routine pain assessment row sits near the top. The worklist creates no task after a PRN dose. The medication administration record shows a "reassess in 60 min" text line on the dose, which does not link to anything.

Blind spot: the report cannot see reassessments filed elsewhere, and the audit, at 60 charts, gives only a rough picture.

What this page is doingPutting the system's own record first, with the audit beside it, shows how much of the problem is location rather than practice before anyone is asked for an opinion.

Strand 2: Watched Practice

Window: three four-hour periods, on a day shift on each medical-surgical unit and an evening shift on the orthopedic unit, 15 to 24 September 2026. The student observed with each nurse's agreement and recorded nothing that identified a patient.

Fourteen PRN opioid doses were given during observation. In 11, the nurse reassessed the patient at the bedside within the window. In 8 of those 11, the score was filed in the Pain Reassessment row; in 2, in the routine row; in 1, not filed before the observation ended.

Workarounds, recorded as findings: on one medical-surgical unit, a paper "PRN tracker" taped to each medication cart, where nurses write the time a reassessment is due; on the orthopedic unit, due times written on the patient's whiteboard; four nurses across the three units set phone timers. Each workaround does a job the record does not do, which is to remind the nurse when the reassessment is due. Workarounds tend to appear where a system does not match the work (Koppel et al., 2008), and these three point to the same gap.

Blind spot: 14 doses, observed by a colleague, which may have made nurses more careful than usual.

Strand 3: What People Said

Window: short conversations with nine nurses, three per unit, 22 to 30 September. Each was asked what they did after their last PRN opioid dose, not what they would like the record to do.

Seven described reassessing at the bedside and charting "wherever the pain score goes," most often the routine row because it is at the top. Two said they chart the reassessment row only when they remember, usually at the end of the shift. None mentioned the worklist. Four mentioned the paper tracker or phone timers without being asked.

Blind spot: these are accounts, chosen by convenience, of what nurses remember doing, given to a colleague who works on one of the three units.

The Strand That Disagrees

Nurses said they always reassess. The record says 57%. Observation found reassessment at the bedside in 11 of 14 doses, and the audit found documentation somewhere in 46 of 60. The strands disagree in size but agree in direction: reassessment happens more often than the report shows, and a share of it is filed where the report cannot see it. The disagreement is kept because it is the finding. A nurse who sees the 57% and knows they reassess will distrust the report; a committee that sees the 57% will distrust the nurses. Both are reading a location problem as a practice problem.

What this page is doingKeeping the strand that disagrees, and explaining the disagreement, turns conflicting evidence into the main finding.

How the Strands Fit Together

Each strand corrects the others. The system data give scale, 9,240 doses, but cannot see notes or the routine row. The audit shows where entries land, but only for 60 doses. Observation shows why they land there, the flowsheet opening at the top, but only for 14 doses watched by a colleague. Conversations show what nurses believe, which explains why the 57% feels unfair to them. Read together, and despite their different windows and sizes, they point to the same place in the work: the minutes after the dose, when the record knows a reassessment is due and offers nothing.

Workflow research recommends combining methods in this way, since no single source captures how work happens around a system (Unertl et al., 2010).

What this page is doingShowing how each strand corrects the others explains why all three were needed and none was enough.

Ethics and Privacy

The quality department classed the work as improvement. The audit was drawn by the quality analyst inside the hospital's systems and shared only as totals, never as chart numbers. Observation notes recorded times and actions, not names, and nurses could decline to be observed; none did. Totals were shared with the unit managers only after the pain committee chair had seen them.

What the Strands Never Catch

None of them shows whether pain was relieved, whether sedation was assessed properly or whether the 11 audited administrations with nothing found were truly unassessed. Eleven of 60 is the closest figure to missing care, and it is too small a sample to rely on.

What the Assessment Supports

A documentation location problem, made worse by a flowsheet layout that puts the right row low and the wrong row high, and by the lack of any prompt from the record. It supports a project that sends nurses to the right row at the right time. Evidence on electronic pain documentation describes the same scattering of entries across fields (Samuels & Kritter, 2011).

References

Koppel, R., Wetterneck, T., Telles, J. L., & Karsh, B.-T. (2008). Workarounds to barcode medication administration systems: Their occurrences, causes, and threats to patient safety. Journal of the American Medical Informatics Association, 15(4), 408-423. https://doi.org/10.1197/jamia.M2616

Samuels, J. G., & Kritter, D. (2011). Pain management documentation: Analyzing one hospital's computerized clinical records. CIN: Computers, Informatics, Nursing, 29(9), 512-518. https://doi.org/10.1097/NCN.0b013e31821a1582

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

What the NR 642 Week 3 assignment asks for

Group the evidence by how it was obtained, not by who gave it. Start with what the systems record: counts, timings, empty fields, warnings clicked past and the layout of the screens involved. Then watched practice, where printed sheets, private spreadsheets and notes taped to monitors are recorded as findings rather than anecdotes. Put what people said last, and ask what they did on a recent occasion rather than what they want. Give each strand its time window, its source and a sentence on what it could never catch. Report totals so no clinician can be identified. If the strands disagree, keep the disagreement and explain it, because it is often the most useful finding in the assessment.

How the NR 642 Week 3 example is put together

The sample's first strand gives 5,290 of 9,240 doses with the dedicated row in the window, 47% for intravenous and 61% for oral, and a 60-chart audit finding 34 in the right row, 7 in the routine row, 5 in notes, 3 late and 11 with nothing. It notes that the right row sits below about 40 others and that the record creates no task. Observation of 14 doses finds 11 reassessed at the bedside but only 8 filed in the right row, plus three kinds of workaround. Nine nurses describe charting wherever the score goes. The disagreement between nurses and the report is explained as a location problem, and the assessment covers ethics, privacy and what no strand can catch.

Reading the NR 642 Week 3 grading rubric

Assessments lose most when they lead with a staff survey asking what people want, which returns wishes rather than evidence. Next is system data presented without its window or blind spot, so readers assume it captures everything. Workarounds are often mentioned in passing as anecdotes rather than recorded as findings, though they show exactly where a design fails. Many students drop the strand that disagrees, which removes the most informative result. Figures that could identify individual clinicians raise ethical problems and cost marks. A write-up silent on its blind spots, such as whether care was actually given, claims more than the data hold. Ethics and privacy arrangements left unstated raise further questions.

NR 642 Week 3 help: mistakes that cost points

Pulling system data, observation and conversation into one assessment takes planning, especially when the strands seem to contradict each other. We can help you order your strands, describe each window and blind spot and record workarounds as findings. We can also help you explain a disagreement between strands without taking sides. The evidence comes from your site, and the reading of it is yours. It often helps to talk through the strand that disagrees with someone outside your unit, who can see the location problem behind the conflict more easily than colleagues on either side.

Get a NR 642 Week 3 example written to your instructions

Send the rubric or the assignment file your section posted, along with a note on what your site would realistically release: usage reports, totals, permission to observe. A worked needs assessment is written around what you can actually obtain and returned inside 24 to 48 hours, the first one free.

More NR 642 papers and MSN samples

NR 642 Week 3 questions, answered

Can I get usage data out of the system?

Sometimes, and it is worth asking early because the answer shapes the assessment. Reports on how often a screen is opened, or how many entries are left blank, usually exist somewhere and are held by an analyst rather than by a manager. Ask for totals, say what you would use them for, and record what was refused as part of the method.

Do I need permission to watch somebody work?

Nearly always, and the people being watched should know first. Sections generally expect the document to say who agreed, in what form, and what the observer was and was not recording. Watching a screen means seeing patient information, so most sites want that arranged rather than assumed, and an assessment saying how it was arranged reads as competent.

How much evidence is enough here?

Enough that a reader who doubted you would have to take on the evidence instead of your judgment. Where the usage data and the watching agree, most sections treat the point as settled. One frustrated colleague settles nothing, and neither does a long document in which every strand leads back to the same conversation.

Where can I find a free NR 642 Week 3 sample paper?

You can read the whole needs assessment on where PRN pain reassessments are filed, with all three evidence strands, right here.

Why does the NR 642 Week 3 assessment put what nurses said last?

Accounts of one's own documentation are the least reliable strand, so they are read against what the record and observation already show.