| Course | NUR-6310 Nursing Informatics Systems Life Cycle |
|---|---|
| Module | Module 5 |
| Paper type | Informatics paper: implementation phase and change management |
| Length | About 1,090 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | M.S. in Nursing, Nursing Informatics |
| Updated | October 2026 |
Free sample paper for NUR 6310 Module 5
One Weekend, Three Hospitals: Leading the People Side of an EHR Go-Live in Ocean County
Student Name
M.S. in Nursing, Nursing Informatics, Thomas Edison State University
NUR-6310: Nursing Informatics: Systems Life Cycle
Mentor Name
Month Day, Year
One Weekend, Three Hospitals: Leading the People Side of an EHR Go-Live in Ocean County
The Change
The health system, its hospitals and every figure here are invented. The system runs three hospitals in Ocean County with 780 beds in all, about 3,200 nurses and 900 physicians and advanced practice providers. It is replacing three different electronic records, one at each hospital, with a single record. All three hospitals will switch over one weekend in April. The informatics nurse lead is responsible for nursing readiness: training, support and monitoring.
Technical readiness is on schedule. People readiness is not. A staff survey six months before go-live found that 58 percent of nurses expected the new record to make their work harder, and many remembered a painful upgrade at one of the hospitals four years earlier.
Change Is the Real Project
Lorenzi and Riley (2000) argued that most failures of information systems in health care are failures of managing change rather than of technology. People resist change for understandable reasons, including fear of losing competence, control or status, and resistance is information about what the change will cost them. The authors described models of change, including Lewin's sequence of unfreezing current habits, moving to new ones and refreezing them, and urged leaders to plan for the human side of implementation as carefully as the technical side.
Kotter (1996) described eight steps for leading change in organizations. Leaders begin by showing people why things cannot stay as they are, then gather a coalition with enough power to guide it, form a vision and a strategy, communicate the vision widely, remove obstacles so others can act, secure visible early wins, use those wins to drive further change and finally root the new ways in the culture. He argued that skipping steps, especially the first, produces only an illusion of progress.
Unintended Consequences
Ash et al. (2007) surveyed hospitals that had implemented order entry and identified nine types of unintended consequences: more or new work for clinicians, unfavorable changes in workflow, never-ending demands for system changes, continued reliance on paper, changes in communication patterns, emotional reactions, new kinds of errors, changes in power structure and overdependence on the technology. Most hospitals reported several types, and respondents judged many of them important. Some consequences were positive, such as clearer communication, but most created new problems that leaders had not planned for.
The list gives the go-live team a checklist of what to watch for.
| Unintended consequence | What the plan watches for |
|---|---|
| More or new work | Documentation time per shift, overtime in the first month |
| Workflow changes | Medication pass times, delays in discharge |
| Continued paper use | Paper lists and notes on units |
| Communication changes | Fewer phone calls, more messages that go unread |
| Emotional reactions | Staff distress, sick calls, resignations |
| New kinds of errors | Safety reports mentioning the record |
| Overdependence | Staff unable to work during downtime |
The Plan, Step by Step
Urgency and coalition. The chief nursing officers of all three hospitals present the reasons for one record, especially the safety risk of patients moving between hospitals with records that do not share information. A nursing guiding group of managers, educators and staff nurses from every hospital meets every two weeks.
Vision and communication. The vision is short: one patient, one record, wherever care happens in the system. The group communicates through unit huddles, short videos of nurses using the new record and a weekly question-and-answer email.
Empowering action. Each unit selects superusers, about one for every ten nurses, who receive 24 hours of training, help build the unit's order sets and documentation templates and test them. Their work gives staff on each unit a trusted local expert.
Training. Every nurse completes role-based training: eight hours in the classroom, followed by a practice environment with the unit's own patient types and a proficiency check that must be passed before access is granted.
Short-term wins. The guiding group shares stories from early testing, such as a nurse finding that the new medication administration screen is faster, and later from the first weeks after go-live.
Go-live support. For two weeks, each unit has superusers on every shift, wearing bright vests, with vendor experts in each hospital and a command center that triages issues around the clock. A daily huddle at 0700 and 1900 reviews problems and fixes.
Consolidating and anchoring. At 30, 60 and 90 days, the team holds optimization sessions on each unit to fix workflows that are not working, and superusers remain as a permanent network.
Readiness Checks
The plan includes three readiness checks. Ninety days before go-live, the guiding group reviews superuser coverage, training completion and order set build for every unit. Thirty days before, each unit runs a dress rehearsal: staff work a simulated shift in the practice environment with realistic patients, and problems are logged. Seven days before, a final check confirms that every nurse has passed the proficiency check and that downtime procedures, including printed medication administration records, are in place on each unit. Units that fail a readiness check receive extra support, and the go-live date for the whole system is reviewed if more than a small number of units are not ready.
Communication During the First Weeks
During the go-live weeks, the command center sends a short update at the start of each shift listing known problems and their workarounds, so that nurses do not have to discover the same problem one by one. Units that solve a problem share the fix through their superusers. The chief nursing officers walk the units daily in the first week, which tells staff that leaders know the change is hard.
Monitoring After Go-Live
The command center logs every issue by type, and the informatics nurse lead reviews them weekly against the nine types of unintended consequences. Documentation time per shift is measured through the record's own audit data. Safety reports that mention the record are reviewed within 24 hours. Staff complete a short pulse survey at two and six weeks.
Limits
Kotter's model comes from business and has limited testing in health care. The unintended consequences study looked at order entry rather than a full record replacement. A single-weekend switch leaves no unit to learn from first, which increases risk even with strong support.
Conclusion
The technology was ready before the people were. Lorenzi and Riley's view of change, Kotter's eight steps and evidence on unintended consequences shaped a plan that builds urgency, gives every unit a superuser, trains to proficiency, supports staff around the clock and watches for the problems that most implementations meet.
References
Ash, J. S., Sittig, D. F., Poon, E. G., Guappone, K., Campbell, E., & Dykstra, R. H. (2007). The extent and importance of unintended consequences related to computerized provider order entry. Journal of the American Medical Informatics Association, 14(4), 415-423. https://doi.org/10.1197/jamia.M2373
Kotter, J. P. (1996). Leading change. Harvard Business School Press.
Lorenzi, N. M., & Riley, R. T. (2000). Managing change: An overview. Journal of the American Medical Informatics Association, 7(2), 116-124. https://doi.org/10.1136/jamia.2000.0070116
What the NUR 6310 Module 5 instructions ask for
Helping an organization advance through a system's life cycle is the core of TESU's catalog description of NUR-6310, and as TESU gives the syllabus only to enrolled students, module five takes shape as an implementation paper. A paper like this describes the change and the readiness of the people affected, explains a change management model accurately, uses evidence on unintended consequences of health IT, plans training, superusers, communication and go-live support step by step and sets up monitoring for problems after launch. Some sections ask for a go-live checklist or a training plan only. Look at whether the brief names a change model, such as Lewin, Kotter or Rogers, whether a staff readiness survey is expected and whether the plan must include downtime procedures. Plans that include readiness checks before launch tend to read as more credible.
Inside the NUR 6310 Module 5 example
An invented three-hospital Ocean County system changing records over one weekend opens the paper, with a survey showing that most nurses expect the change to make work harder. Lorenzi and Riley's overview frames change management as the real project, and Kotter's eight steps give a sequence. A national survey's nine unintended consequences become a seven-row monitoring table. The plan follows Kotter's steps with superusers, training to proficiency and around-the-clock support. After them come monitoring, the plan's limits and its closing paragraph. Annotations point to the monitoring table built from research and the model applied step by step. Readiness checks at 90, 30 and 7 days show how the team decides whether units are ready.
Reading the NUR 6310 Module 5 grading rubric
Implementation papers earn credit for describing people's readiness as well as technical readiness, accurate use of a change model applied step by step, evidence on unintended consequences turned into monitoring, specific training and support plans and attention to the weeks after go-live. Mentors notice when training ends with a proficiency check rather than attendance. A superuser network kept after go-live shows thinking beyond launch, and readiness checks show that the date depends on people as well as software. Admitting that a single-weekend switch carries extra risk shows judgment. Models and studies should be cited from their original sources, with the steps or types listed as the authors described them.
NUR 6310 Module 5 help: mistakes that cost marks
Implementation plans often stop at the go-live weekend; plan for the next 90 days. Another common gap is training measured by attendance rather than proficiency. Choose a change model and apply each step. Watch for the known unintended consequences, not only system errors. Keep superusers in place after launch. Run readiness checks before the date, and share known problems at the start of every shift once the system is live. Adapt the Ocean County plan to your setting; a first version of yours costs nothing.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 6310 Module 5 questions, answered
Where can I find a free NUR 6310 Module 5 sample paper?
The implementation paper for an invented three-hospital Ocean County go-live, from staff readiness to the monitoring table, is shown above.
What are Kotter's eight steps for leading change?
In order: a felt need to change, a powerful guiding team, a vision with a strategy, wide communication, removal of obstacles, early wins, momentum built on them and new habits rooted in the culture.
Why do health information system projects fail?
Lorenzi and Riley argued that most failures come from poorly managed change rather than technology.
What are unintended consequences of order entry?
Ash and colleagues described nine types, including new work, workflow changes, continued paper use, emotional reactions, new errors and overdependence on technology.
What does a superuser do?
A trained staff member who helps build and test the system, supports colleagues at go-live and remains a local expert afterward.