| Course | NUR-8150 Information Systems and Technology Impacting Healthcare Delivery |
|---|---|
| Module | Module 6 |
| Paper type | Systems paper: cybersecurity and clinical downtime |
| Length | About 1,018 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for NUR 8150 Module 6
When the Screens Go Dark: Preparing Nursing and Patient Care for Ransomware at a 350-Bed Hospital
Student Name
Doctor of Nursing Practice, Thomas Edison State University
NUR-8150: Information Systems and Technology Impacting Healthcare Delivery
Mentor Name
Month Day, Year
When the Screens Go Dark: Preparing Nursing and Patient Care for Ransomware at a 350-Bed Hospital
Why a Nurse Leader Owns This Problem
The hospital in this paper is invented: 350 beds in New Brunswick, a trauma center, a stroke center and a labor and delivery unit with 3,000 births a year. Last year ransomware forced a hospital across the state line onto diversion for nine days. Our board asked whether we were ready. The information security team leads technical defense, but the chief nursing officer, who is DNP-prepared, was asked to lead clinical readiness: how patients will be cared for if the record, the pharmacy system, the laboratory interface and the monitors' central stations go down for days.
An internal review last year gave a sobering picture. The hospital ran a planned two-hour downtime for a system upgrade. On two units, nurses could not find the paper medication records, a laboratory result for a patient on heparin was delayed by an hour because no runner was assigned, and the emergency department reverted to handwritten triage notes that were later lost. No patient was harmed, but staff said they had never practiced for a longer outage. That review, and the neighboring hospital's nine days of diversion, frame this paper.
How Dependent We Have Become
Hospitals' dependence on electronic systems grew quickly. Adler-Milstein and Jha (2017) showed that HITECH payments roughly quadrupled the pace at which eligible hospitals took up electronic records. A decade later, almost no hospital keeps paper systems in daily use, and many nurses who joined in the past ten years have never charted on paper or given medicines without a barcode scanner. That dependence is what makes an attack on information systems an attack on patient care.
The Threat
Neprash et al. (2022) assembled the THREAT database, which logs ransomware events that struck American care providers. The 374 incidents they counted laid bare health records for close to 42 million people, and the number of attacks each year more than doubled, from 43 to 91. Almost half, 44.4 percent, disrupted care delivery, most often through electronic system downtime, but also through canceled scheduled care and ambulance diversion. Over time, attacks increasingly hit large organizations with several facilities and more often involved stolen as well as encrypted data.
The Effect on Patients
Choi et al. (2019) matched the federal breach registry to Medicare Compare quality data, building a five-year panel of 3,025 hospitals. Over a three-year window after each breach, Choi's team saw door-to-ECG intervals lengthen, by up to 2.7 minutes, while the share of heart attack patients dead within thirty days crept up, the largest estimate being 0.36 of a percentage point. The authors linked these changes to the security measures hospitals put in place after breaches, such as new passwords and log-in steps, which slowed clinicians down. The study shows that both attacks and responses to them can affect care.
For our hospital, the lesson is twofold: prepare clinical care for downtime, and design security measures with clinicians so they protect data without slowing urgent care.
| Evidence | Finding | Implication for our plan |
|---|---|---|
| Ransomware database | 44.4 percent disrupted care | Plan for multi-day downtime |
| Ransomware database | Attacks doubled 2016 to 2021 | Readiness is ongoing, not one-time |
| Breach remediation study | ECG times and mortality rose | Design security with clinicians |
| HITECH adoption | Rapid dependence on records | Retrain staff on paper processes |
The Downtime Plan
The plan has six parts.
First, downtime kits on every unit: paper forms for assessments, medication administration records, orders, flow sheets and admissions, stored in labeled boxes and checked quarterly.
Second, read-only access. A protected downtime computer on each unit prints a current census, medication lists and recent results every four hours, so care can continue from accurate information if the main system fails.
Third, critical workflows. Stroke, sepsis, trauma, labor and delivery, blood transfusion and code workflows are written for paper, with runners carrying laboratory results and pharmacy orders.
Fourth, the medication process. Pharmacy keeps a paper verification process, and automated dispensing cabinets have override procedures for emergencies.
Fifth, communication. An incident command structure, with the chief nursing officer responsible for clinical operations, uses radios and printed phone trees if email and the paging system fail.
Sixth, recovery. When systems return, a reconciliation team enters paper documentation, prioritizing medications, allergies and results.
Practicing for It
Downtime drills run twice a year on each unit and once a year hospital-wide, unannounced, for at least four hours. Newer nurses complete a paper charting module in orientation. After each drill, units report problems, such as missing forms or unclear handoffs, and fixes are tracked.
Drills are realistic. A drill on the labor and delivery unit, for example, simulates an emergency cesarean during downtime, with fetal monitoring printed at the bedside, blood ordered on paper and the newborn registered by hand. A drill in the emergency department simulates a stroke alert with no electronic imaging orders, timing each step against the usual door-to-needle target. Results are shared with each unit's staff within a week.
Working With Security
The chief nursing officer joins the information security committee so that new security steps, such as multifactor sign-in, are tested in clinical areas before go-live, with fast sign-in options such as badge tap for urgent workflows. This responds directly to the evidence that remediation can slow care.
Measures
The hospital will track downtime drill completion by unit, time to first medication dose and time to electrocardiogram during drills compared with normal operations, the share of nurses who complete paper charting training, the completeness of downtime kits and, in any real event, ambulance diversion hours, canceled procedures and reconciliation errors.
Conclusion
Ransomware attacks on care organizations doubled in five years and nearly half disrupted care, while even the response to a breach can slow heart attack care. Because hospitals became dependent on electronic systems quickly, nurse leaders must prepare clinical care for days without them. This plan provides downtime kits, read-only access, paper workflows for critical care, a medication process, communication and recovery, practiced in unannounced drills and measured by how quickly urgent care continues, with security changes designed alongside clinicians.
References
Adler-Milstein, J., & Jha, A. K. (2017). HITECH Act drove large gains in hospital electronic health record adoption. Health Affairs, 36(8), 1416-1422. https://doi.org/10.1377/hlthaff.2016.1651
Choi, S. J., Johnson, M. E., & Lehmann, C. U. (2019). Data breach remediation efforts and their implications for hospital quality. Health Services Research, 54(5), 971-980. https://doi.org/10.1111/1475-6773.13203
Neprash, H. T., McGlave, C. C., Cross, D. A., Virnig, B. A., Puskarich, M. A., Huling, J. D., Rozenshtein, A. Z., & Nikpay, S. S. (2022). Trends in ransomware attacks on US hospitals, clinics, and other health care delivery organizations, 2016-2021. JAMA Health Forum, 3(12), Article e224873. https://doi.org/10.1001/jamahealthforum.2022.4873
What the NUR 8150 Module 6 instructions ask for
The role of system leaders in selecting and integrating technology, named in TESU's NUR-8150 catalog paragraph, includes protecting care when technology fails, and with no public syllabus, the final module prepares nursing for days without computers. Expect a DNP systems analysis that explains why cyberattacks are a patient safety issue, reviews evidence on attack trends and their effects on care, describes the organization's dependence on systems, builds a clinical downtime plan covering forms, information access, critical workflows, medications, communication and recovery, plans drills and training and sets measures. Some sections assign a privacy breach response, a HIPAA compliance review or a vendor risk assessment instead. Check whether your directions ask for an incident command structure, a budget or a policy draft, and keep technical security steps within a nurse leader's role.
Inside the NUR 8150 Module 6 example
An invented 350-bed hospital in New Brunswick, prompted by an attack on a neighbor, opens the paper. The HITECH study explains how quickly hospitals came to depend on electronic records. The ransomware database is reported with its trends and disruptions, and the breach remediation study shows effects on heart attack care. A four-row table turns each finding into a planning implication. The downtime plan is set out in six parts, followed by unannounced drills and orientation training. Work with the security committee responds to the remediation evidence, and readiness measures precede the conclusion. The notes explain how each study set a priority and why drills beat binders.
Reading the NUR 8150 Module 6 grading rubric
Cybersecurity papers are graded on framing cyberattacks as a patient safety issue, reviewing evidence on attacks and their effects on care, describing system dependence, a downtime plan that covers critical workflows and medications, drills and training and measures of readiness and performance. Mentors credit papers that place the nurse leader in clinical readiness while leaving technical defense to security teams. Recognizing that security measures themselves can slow care, and designing them with clinicians, is often noted as mature leadership. A recovery and reconciliation plan shows complete thinking. Neprash's and Choi's figures need to be exact, with APA headings that run from the threat to the drills. Naming who keeps the downtime kits stocked, and how often they are checked, is a detail graders notice.
Common NUR 8150 Module 6 mistakes, and how to avoid them
Students often write about firewalls and passwords instead of patient care; focus on how care continues during downtime. Another weakness is a plan that is never practiced; schedule drills and training. Do not forget medications, laboratory results and critical workflows such as stroke and labor. Plan recovery and reconciliation after systems return. Work with security so new steps do not slow urgent care. Measure readiness with drill results. A downtime or security paper of your own can begin with the brief, and draft one is free. Practice the stroke, labor and transfusion workflows on paper, since those are where minutes matter most.
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.
More NUR 8150 and Doctor of Nursing Practice sample papers
- NUR 8150 Module 1: EHR Burden Paper: Event Log Data, Clerical Load and a Plan to Return Clinician Time
- NUR 8150 Module 2: Implementation Risk Paper: CPOE Error Pathways, a Mortality Warning and a Safer Go-Live Plan
- NUR 8150 Module 3: Clinical Decision Support Paper: Alert Overrides, a Sepsis Model's Validation and Better Design
- NUR 8150 Module 4: Predictive Analytics Paper: High-Cost Patients, Algorithmic Bias and Fair Use of Data
- NUR 8150 Module 5: Telehealth Paper: Pandemic Use Patterns, the Digital Divide and an Equitable Virtual Care Plan
- NUR 7630 Module 2: Study Design and Bias Paper: The Hormone Therapy Reversal
- NUR 8420 Module 5: Outcomes Management Paper: Sepsis Measures, Sepsis-3 and Clinical Surveillance Data
- NUR 8000 Module 1: Role Paper: What the Practice Doctorate Adds
- NUR 8250 Module 5: Budget and Staffing Economics Paper: Nurse Staffing, Turnover Costs and a Unit Budget Case
NUR 8150 Module 6 questions, answered
Where can I find a free NUR 8150 Module 6 sample paper?
The ransomware readiness paper for a 350-bed hospital, from attack trends to a practiced downtime plan, is printed in full above.
How common are ransomware attacks on hospitals?
From 2016 to 2021, 374 attacks hit U.S. care organizations, exposing data of nearly 42 million patients, and yearly attacks more than doubled.
Do cyberattacks affect patient care?
Nearly half of ransomware attacks disrupted care, through system downtime, canceled care or ambulance diversion.
Can security measures slow care?
Yes; in the three years after breaches, hospitals were slower to obtain electrocardiograms and saw slightly higher heart attack deaths, changes the authors tied to new security steps.
What should a hospital downtime plan include?
Paper forms, read-only access to current data, written critical workflows, a medication process, communication tools, recovery steps and regular drills.