Using the tool, assess the organization to the best of your capability.

            The evaluation tool chosen to assess a home health agency I am currently working for is the Performance of Routine Information System Management (PRISM) tool. The PRISM tool kit can be used globally to assess how timely and reliable Routine Health Information Systems (RHIS) are, identify areas that can be improved, and help to make evidence-based decisions. The PRISM tool can evaluate behavioral, technical, and organizational determinants. (United States Agency for International Development (USAID), n.d.).

            I chose the PRISM facility/office checklist tool, as, with home health, nurses are often on the road, and an office must function adequately to assist staff the best while they are on the road and come into the office. The PRISM facility/office checklist tool evaluates the resources available for RHIS, including equipment and hardware, infrastructure, supplies, and resources. The PRISM toolkit provides a worksheet that can be used to complete the evaluation. It assesses hardware such as computers, printers, modems, phones, faxes, Wi-Fi, etc. It evaluates the availability of available forms if the office has run out of them, and if they did run out, for how long. This tool also assesses staff and identifies who is responsible for what (USAID, n.d.).

Provide a summary of your evaluation.

            In evaluating the home health agency, I found that they have adequate hardware to support RHIS. They do not, however, have additional equipment available should a nurse need to come in to document or if something needs to be fixed with an existing computer. They also only had one working printer, which needed to be fixed. The agency does not supply nurses with devices for field documentation either. Some areas of improvement in the surrounding equipment could be made.

            There is room for improvement regarding staffing as well. The agency only has one full-time registered nurse, two PRN RNs, and two PRN LPNs. The agency has one full-time physical therapist and two PRN physical therapy assistants. The agency is seeking a candidate to fill the vacancies for a home health aide, an occupational therapist, and a medical social worker. The agency also has two additional office workers who assist with various administrative tasks such as scheduling, intake, insurance authorization, and answering phones. The agency recently filled all of the administrative positions now having a case manager, a director of clinical services, and an executive director. There is a human resources manager. However, she oversees another facility in another town. Having a human resource manager available regularly in the office would benefit staff and the company. Having additional nurses to see patients would also be beneficial to increase the business and cover needs, as the full-time staff often appears overwhelmed. Reporting forms in the facility were found to be adequately supplied. The start of care packets are currently on backorder; this happens occasionally.

Next, select one standard from the American Nurses Informatics Association and determine the alignment of the organization based on the evaluation information you gathered using the assessment tool.

            The American Nursing Informatics Association (ANIA) (n.d.) explains that the goal is to be driven by integrity to assist in providing high-quality, cost-efficient healthcare. They also discuss participation and advocacy to eliminate healthcare disparities. The mission is “To advance nursing informatics through education, research, and practice in all roles and settings.”

Provide two QSEN aligned recommendations for the organization to use for improvement of the present health information system.

            The Quality and Safety Education for Nurses (QSEN) (n.d.) offer a variety of quality improvement (QI) recommendations surrounding knowledge, skills, and attitudes. One QI recommendation set forth by QSEN that the home health agency aligns with is how they value the contribution of others and how it impacts care outcomes. The leaders at the agency often express appreciation privately and publicly for the work all staff does to help accomplish good patient outcomes. Another area the agency aligns with is the knowledge section of QI, which QSEN recommends. During weekly team meetings, leadership explains the importance of measuring and assessing the quality of care delivered. Most recently, the executive director spoke about the importance of adequately reporting and documenting infection to help assess what the agency is doing to prevent and care for infections.

What data would you use from the evaluation to support or not support alignment with the standard?

            The home health agency partially aligns with the goals stated by the ANIA. They operate with integrity; however, informatics is not at the forefront of their efforts. They currently need to get information technology (IT) staff available. Also, there are deficits in leadership’s ability to navigate the electronic health record (EHR) used for documentation. For documentation questions or software issues, field nurses are directed to call the software company directly for assistance.

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