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Nurses Leaders and Use of EMR Assessment 2 Answer

Essay: Critical reflection Scenario-Based Essay

Type of Collaboration:
1,500 words

Aim: This assessment provides the student the opportunity to apply and evaluate leadership styles in a scenario involving a change process.


A recent state-wide quality improvement project has shown that an electronic medical record system improves com- munication between health care providers and many aspects the individual patient’s care. In order to share this knowledge, the state organisation has shared the results on a quality improvement website.

The Local Health District that you work for has recently had some critical incidents where communication has been cited as a root cause. These critical incidents occur in the context of a general increase of minor communication incidents over the last three years.

The Local Health district’s executive team including the senior Nurse Leaders have reviewed the information on the state’s quality improvement website.

The Nurse Leader of the two hundred bed hospital you work in calls the Nurse Unit Managers for a meeting and advises of the general trending increase in communication errors. The Nurse Leader advises that the computer hardware and systems will be available for installation in two months and that there is an expectation that all wards will have adopted the electronic medical record system within six months.

Discuss how an effective Nurse Unit Manager would lead this change to address this important patient safety issue. The essay will need to:

  • Discuss reasons, using support from the literature, to adopt the fully electronic medication system
  • Use Lewin’s model to outline a plan of change that includes milestones and timeframes
  • Choose and apply a leadership style to the plan of change.
  • Critically evaluate the choice and compare with at least one other leadership style
  • Describe two aspects of potential resistance and discuss how the resistance might be addressed.


Nurses Leaders and use of EMR


Nursing leaders have an engaging role to design, develop, implement and have an important role in clinical workflow knowledge, constant participation in the decision-making capacity, and also shapes up working environment through their active leadership role. The nursing leaders are actively working as the frontlines that could bring transition in the healthcare information systems. Nurses are actively involved in designing and in engaging practices to bring new changes to deliver high-quality results (Strudwick, et al, 2019). The purpose of the paper is to discuss the benefits of using electronic medical records and the role of nurses unit leaders in accepting the changes. Due to the constant efforts of bringing a change and even brainstorming with innovative ideas, the nurses bridge the gap through transitioning through upgrading their skills, education and take collaborative efforts to improve. The changes can be bought with the model of Lewin's theory and it is an appropriate application for the leadership style to build a plan of action that can be compared with another leadership style (Yen, 2017).


Electronic medical records (EMR) are the digital way of recording the paper values or the charts that are available to use at a clinician's office.   The EMR is also a collection of the medical information that records the set of details of the patient information. The information is legible and is arranged in an organized way through which the patient information can be recorded, easily retrieved, and used for the clinical details information for any health conditions.  EMR is used during the stages to create general information like patient information, past or present treatment, and medical history that can be collected through the individual medical practices (Stamps, et al, 2019). The use of Electronic Medical record systems can improve management practices, provide accurate,  up-to-date information about the patients along with the point of care. It is also a step to provide access to patient records and improve coordination, efficient care, and abide by the confidentiality clause while sharing electronic information. It is important to have inpatient outcomes and secure ways to manage information and reduce medical errors. The electronic medical record also contains notes and information that are collected through the clinicians working across the office, clinic, or hospital which have majorly used for the diagnosis and treatment. Electronic health records (EHRs) are a way to include the standard clinical data collected through the provider's office and to provide extensive patient care practices (Strudwick, et al, 2019). EHRs include all the minute details of the patient's information, be it past, present along with including the patient's care, treatments, and clinicians who are actively involved with the case and can access the information to provide continuity of care (Van Autreve, 2020). 


The model was propounded by Kurt Lewin and it is about the change model involving three steps: unfreezing, changing, and refreezing. During the initial stages, unfreezing, would involve the nurse unit manager to assist and make the employees explore their independence and let go there conditioned behavior. This step helps to overcome rigidity to change (Smith, 2019). It is also a stage of disequilibrium disrupting as per the status. It is a phase during which the nurses can accept the role of the technology replacement (Pavlic, 2020). At this stage, the funds can be arranged and for the technology updates to be introduced such as computers, printers, scanners, etc. It would be 4-6 weeks to attain a complete implementation.

In the next stage, it is a stage to bring changes and move along the changes. In this step,  movement or change can be bought (Muthee, et al, 2020). The stage of perception can be felt and is bought with constant changes in a sequenced manner. It is the feeling to bring changes in accordance with the thoughts and feelings while integrating the new technology changes. It can support the technical team and provide a broader perspective and confidence. The nurses can get trained and can use the services within the timeframe of 2-3 weeks. 

In the third stage, it is also called refreezing, which is the changes to be adaptive and make it a permanent habit (Hummel, et al, 2020). At this phase, the nurses would bring in the desired changes to be implemented and provide a new equilibrium practice to achieve higher performance. It is a milestone to overcome medical errors and work for better patient management. It takes approximately 4-6 weeks.


To bring a change in the 200-bed hospital, it is important to be more adaptive and the first step would be planning and implementation stages of using the electronic medical record. The second step for the leaders would be the acceptance stage, establish the changes, and to actively bring changes (Harris, 2016). Through the empowerment and by bringing a change, the organization can work at the rapid pace of development. The changes within the hospital can bring in increasingly technological shifts and can bring in new expertise, skillset, and demand leadership to empower changes. To transit, while accepting changes, the first proposed style of leadership is transformational that can bring changes by accepting the organization's culture and through supporting and involving the employees. 

The role of the transformational leader is to support the nurses and provide them training about the new technologies and to increase employee satisfaction. To support the robust system,  a leader can bring changes through the employee feedback and by understanding the complexity of the changes ad supporting knowledge up-gradation.  Due to the transformational leadership, the nurses would get better clarity about their roles, about the new culture, and also support in intellectual stimulation for the individual improvement (Das, 2016). Through the changes, the transformational leader along with the nurse unit manager can plan out all dimensions. 

The second style of leadership is Laissez-Faire, that allows the employees to take an independent decision and give them the freedom to explore and work accordingly. Through the Laissez-faire leadership, the nurses get the freedom to explore their learning’s and even to work freely. The style of leadership is majorly observed while handling the inexperienced nurse leaders. It is a hands-off approach, to provide the right direction to the teams and the inexperienced nurse leaders. Through laissez-faire leadership, the nurses get a better course of direction as they can do their role independently, without any leader supervision (Escobar, et al, 2016)


By implementing the electronic medical record, the potential resistance faced is the “acceptance- to-change” and to use the technology on a daily routine basis. The use of the EMR is to bring standard patient quality and care. Technologies are not easily accepted by the healthcare workers, due to the convenience of being adaptive to the manual work and resisting the technicalities (Bernstein,  et al, 2017). Through the successful technological projects within healthcare, the problem can be solved by overcoming the resistance and providing extensive training in using the technology. Healthcare workers can be resistant while accepting new technology and it can cause workflow disruption (Anyango, 2017). 

As EMR is the digital version of the paper charts, for the nurses and the health care workers, it can be tough to understand, record, and even take accurate decisions. For the nurses, on any busy day with the high volume of patients, it can be laborious to record every detail which can be erroneous as it requires a high assessment to take notes (Adeyemi, 2017). By getting trained and improving oneself, the nurses can feel overburdened and even technically challenged.

 The nurses can also resist due to the limited knowledge of the technical skills (Williams, et al., 2017). EMR requires high interface knowledge and the nurses need to achieve accurate computer literacy skills. For the nurses, in everyday scenarios, by acquiring high computer skills and also maintaining a cordial relationship with the patients can be a challenge. Adequate data entry, manually recording the prescription on the EMR, and detailing every minute details of patient information can be a cumbersome process. 

To achieve communication as a leader, the role of the unit nurse is to improve, provide standardized care, and even be more receptive (Das, 2019). The second way is to be adaptive and improve training, knowledge, and skills through the educator that can provide a comfortable opportunity with the technology. 


.To conclude,  the use of the electronic medical record within the healthcare set up would help the nurse unit manager to exhibit suitable leadership quality changes within the organization. EHR also includes the personal health records and it includes the diagnoses, medications, also involves the immunizations,  having an active family medical histories, and also the provider contact information—which has been designed as the setup, accessed, and can be managed by patients. Nursing leadership also plays a vital role in integrating organizational culture within their practices that could organize the flow of data efficiently and accurately.  The information can be maintained and managed by the health information that can be included in the private, secure, along with the confidential environment. The use of the EHR can be done within any set up like clinicians, home monitoring devices, and patients themselves. As per the Lewin model of changes, the process involves a change in perception that is needed as one is moving ahead towards the new and also the desired level of behavior that can bring a new behavior as the norm. The model involves the leader that includes knowledge and the concept involves forces that can be both negative and positive that can bring a change.

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