Tracking and evaluating APRN practice patterns using a nurse-developed mobile application and the ANA adopted framework

Purpose:
Discussing the development of a mobile application to track advanced nursing practice registered nurse (APRN)practice patterns and work towards outcomes, using lessons learned from a completed research study and based on the Data Information Knowledge Wisdom (DIKW) information technology framework.

Relevance/Significance:
APRN roles or work related to revenue generation and cost has been well documented but some work roles/competencies are broad in scope, knowledge based and difficult to quantify. Many of these competencies are value based activities and healthcare leaders may not understand the impact these competencies have on performance over time. APRNs should use methods to demonstrate and quantify these work competency/roles and link it to impact on patients/clients, and organizations.

Strategy and Implementation:
An information technology (IT) approach using the American Nurses Association (ANA) adopted DIKW framework to develop an application to track APRN practice patterns. A 5 month study was completed to understand practice patterns, 14 CNSs participated; For 6 work/competency roles, CNSs ranked quality as the most important, followed by clinical work and research work ranked 4 of 6 options. Of 9 quality initiative focuses, mean (SD) time spent was highest for heart failure, even though only 2 CNSs were involved (2227 minutes/month/CNS) followed by venous thromboembolism (1215 minutes/month/CNS) and pressure ulcer (460.4 minutes/month/CNS). This research study and feedback from participants on barriers for tracking were used as a back drop to develop an IT strategy which includes a desktop and mobile application to create a platform to track, monitor and evaluate individual and group practice patterns.

Evaluation:
The application is deployed and is used by 30 APRNs. Each individual is tracking outcome related activity. Outcomes being actively worked on and reported by these individuals include reported metrics such as patient safety indicators (PSI), hospital acquired conditions (HAC), nurse sensitive quality indicators, and nurse residency activities.

Implications for Practice:
Nursing's knowledge or value based work can and should be captured and communicated. APRN knowledge and value based work must be tracked to enhance the understanding of their unique role and contributions in the health care matrix in addition to revenue generating activities.