LaDonna Henderson

Frostburg State University

Required all public and
private healthcare
providersto adopt and
demonstrate meaningful
use of electronic medical
recordsin order to
maintain their existing
Medicaid and Medicare
reimbursement levels.

(University Alliance, 2016).

 Admission paperwork sent to unit
Unit secretary prepares patient chart and delivers to assigned nurse
New Patient to be kept in locked cabinet outside patient's room
Admission

Nurse completes pre-printed plan of care for each identified nursing

diagnosis and places it in patients paper chart
Per policy, each shift the nurse reviews, updates, and initializes the
Plan of Care individualized plan of care

Other disciplines such as nutrition, physical therapy, etc. update the

paper plan of care as appropriate
Inter- Other disciplines must be physically present to utilize the paper plan
disciplinary of care
Utilization
 Admission paperwork sent to unit
Unit secretary prepares patient chart and delivers to assigned nurse
New Patient to be kept in locked cabinet outside patient's room
Admission

Utilizing Cerner PowerPlan functionality, nursing diagnosis order

sets are identified and added to patients plan of care
Per policy, each shift the nurse reviews, updates, and initializes the
Plan of Care electronic plan of care

Electronic nursing care plans are immediately viewable in EMR

Inter- Collaboration and shared communication delivered in real-time
disciplinary
Utilization
PAPER NUSING CARE PLANS
Stored in bulky binders
Typically several pages in length
Used inconsistently
Minimal interdisciplinary collaboration
Duplication of information already in EHR

ELECTRONIC NURSING CARE PLANS

Available immediately
Easily accessed and viewable
Increased cooperation in achieving defined
patient goals
Real-time interdisciplinary collaboration
Less charting duplication
 1-2 months: Integrate
6-12 months:
Now: Cerner system Nursing Order Care 3-6 months: Conduct
Ongoing evaluation
currently in use at Set with the current implementation
of user needs and
hospital PowerPlan training
feedback
functionality
 Every workflow redesign effort
should begin with a change
management plan. Engagement
of the end user is a critical aspect
of change management and,
therefore, technology adoption.
(McGonigle & Mastrian, 2015, p.
239).
Implementing change within an organization can be both an
exciting and challenging endeavor. Nurses face change on
multiple levels every day and often rely on routine and
established practices to provide safe and effective care. Attempts
to introduce change may cause fear, anxiety and resistance.
Lewins theory provides a framework to help understand how
change affects the organization, identify barriers for successful
implementation and is useful for identifying opposing forces that
act on human behavior during change, therefore overcoming
resistance and leading to acceptance of new technologies by
nurses. (Sutherland, 2013).
Theory in Action
Cerner Corporation. (2016). PowerPlan. Retrieved from http://www.cerner.com/solutions/
hospitals_and_health_systems/acute_care_emr/powerplan/?langtype=2057

Elsevier. (2013, September 5). Cerner to integrate Elseviers evidence-based clinical content.
Retrieved from https://www.elsevier.com/about/press-releases/clinical-solutions/ cerner-to-
integrate-elseviers-evidence-based-clinical-content

HealthIT. (2014, March 19). Improved diagnostics & patient outcomes. Retrieved from
https://www.healthit.gov/providers-professionals/improved-diagnostics-patient-
outcomes

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Sutherland, K. (2013, June 5). Applying Lewins change management theory to the
implementation of bar-coded medication administration. Retrieved from
http://cjni.net/journal/?p=2888

Tisel, A. (2013, August 2). The evidence-based care plan. Retrieved from
http://nursing.advanceweb.com/Features/Articles/The-Evidence-Based-Care-Plan.aspx

University Alliance. (2016, June 20). Federal mandates for healthcare: Digital record-keeping
requirements for public and private healthcare providers. Retrieved from http://
www.usfhealthonline.com/resources/healthcare/electronic-medical-records-mandate/
#.V_RP7mUdVdk