NR 711 Week 7 Project Risk Register Example

Risk Register for the Video Patient Monitoring Project on 4 West, Priced and Ranked by Expected Cost

Student Name

College of Nursing, Chamberlain University

NR 711: Fiscal Analysis and Project Management

Instructor Name

Month Day, Year

Risk Register for the Video Patient Monitoring Project on 4 West, Priced and Ranked by Expected Cost

How the Register Works

The register below holds nine risks for the video monitoring project on 4 West, from purchase through the first year of operation. Nine is deliberate. A register with forty rows is not read weekly, and a risk nobody reads about cannot be caught early. Each row gives the event in one specific clause, a likelihood band, a dollar exposure, the expected cost, an owner by role and a response with its own price and date.

Likelihood is expressed in three bands rather than decimals, because the inputs are judgments, and multiplying a guess to two decimal places only makes it look measured. Low means about one chance in ten over the period; medium means about three in ten; high means about six in ten. The expected cost multiplies the band's midpoint by the exposure and is rounded to the nearest $10. Rows are sorted by expected cost, so a quiet, expensive risk sits above a dramatic, cheap one (International Organization for Standardization, 2018).

The Register

Table 1

Risk Register, Video Monitoring on 4 West

Note. Note. Expected cost = band midpoint (10%, 30% or 60%) times exposure, rounded to $10. Totals: exposure $206,772; expected cost $53,660; response cost $3,700.

Reading the Top of the Register

The largest expected cost has nothing to do with the cameras. It is the risk that nurses go on ordering in-person sitters out of habit, which would leave the program paying for cameras and sitters at the same time. Its exposure is a quarter of the first year's expected sitter savings, about $45,500, and the likelihood is high, because changing an ordering habit on a unit with 58 nurses rarely happens in the first month. Programs that reduced sitter use did it with a review protocol that someone ran daily, not with technology alone (Burtson & Vento, 2015). The response costs about $1,370 in charge nurse time and is the best value in the register.

The second row is unlikely but would be expensive. If 5 West withdrew from the shared technician, 4 West would carry the full $210,240 a year, and its half share of $105,120 would become a new cost. A signed agreement costs nothing and removes most of the risk.

Responses That Cost About What They Save

One response is flagged on purpose. The wireless survey in row 8 costs $1,200 to remove an expected cost of $1,210, so on money alone it is close to even. It is kept for a reason the money does not show: a camera that drops out is an unobserved patient, which is the event in row 7. A response priced at about what it saves should be chosen for a stated reason, not by default.

Row 4, the weekend review, has no price because the backup is a house supervisor already on duty. It is still written as an action with a date, because a response written as an intention to monitor tends not to happen.

Exposure Against the Reserve

The project's contingency reserve is $4,800 and can pay only for capital items inside the scope. Of the nine rows, only row 3 is a capital risk, with an exposure of $6,000 and an expected cost of $3,600. The reserve covers the expected cost but not the full exposure: if the full exposure arrives, the overrun could exceed the reserve by about $1,200. This is reported now so the sponsor can decide in advance whether to raise the reserve or accept that an overrun would go to the capital overrun account.

The other eight rows are operating risks, with a combined expected cost of $50,060, and no reserve covers them. They fall on the program's net return, which the business case put at $67,030 over three years. That margin absorbs the expected cost of the operating risks once but not twice, which is why the response in row 1 matters more than any other line here (Project Management Institute, 2021).

How the Register Is Used

The nurse manager reviews the register every Monday in the first 90 days and monthly after that. A row closes when its trigger can no longer occur: row 3 closes when the open-wall survey is done, row 5 at go-live. A new row is added only with every column filled. The fall exposure in row 7 uses the hospital finance office's estimate of the added cost of a fall with injury, which is in line with published models of fall costs (Spetz et al., 2015).

Totals

The nine exposures total $206,772, the expected costs $53,660 and the responses $3,700. Spending $3,700 now to reduce an expected cost more than fourteen times larger is the case for acting on the register before go-live rather than after.

References

Burtson, P. L., & Vento, L. (2015). Sitter reduction through mobile video monitoring: A nurse-driven sitter protocol and administrative oversight. JONA: The Journal of Nursing Administration, 45(7/8), 363-369. https://doi.org/10.1097/NNA.0000000000000216

International Organization for Standardization. (2018). Risk management: Guidelines (ISO Standard No. 31000:2018).

Project Management Institute. (2021). A guide to the project management body of knowledge (PMBOK guide) (7th ed.). Project Management Institute.

Spetz, J., Brown, D. S., & Aydin, C. (2015). The economics of preventing hospital falls: Demonstrating ROI through a simple model. JONA: The Journal of Nursing Administration, 45(1), 50-57. https://doi.org/10.1097/NNA.0000000000000154