| Course | NSG 421 Nursing Informatics |
|---|---|
| Unit | Unit 7 |
| Paper type | End-user change request |
| Length | About 780 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 421 Unit 7
One Field, One Screen: A Change Request to Carry the Pain Score From the Flowsheet Into the Medication Screen Instead of Typing It Twice
Student Name
Department of Nursing, Herzing University
NSG 421: Nursing Informatics
Instructor Name
February 27, 2026
One Field, One Screen: A Change Request to Carry the Pain Score From the Flowsheet Into the Medication Screen Instead of Typing It Twice
The Request
Problem. When a nurse gives an as-needed pain medication, the medication administration screen requires a pain score that has usually just been entered on the pain flowsheet. Nurses enter the same number twice.
Evidence. The duplicate was observed in a step-by-step workflow record of one administration (Unit 2, steps 4 and 13). It occurred seven times in one twelve-hour day shift for one nurse, the most frequent duplicate in a full-shift documentation log (Unit 3). Both records are held by the requester and available to the committee.
Ask. On the medication administration screen for as-needed pain medicines, fill the required pain score field with the most recent flowsheet pain score if it was entered within the last 30 minutes, showing its time, and let the nurse accept it or enter a new one.
Who receives it. The nursing clinical documentation committee, because it owns the content of nursing flowsheets and the nursing fields on the medication screen, and because the informatics nurse who chairs it can specify the change to the analyst team. The pharmacy and therapeutics committee is copied because the field sits on a medication screen.
What the requester will do. Help test the change in the test environment with three scenarios: a score entered 10 minutes before, one entered 45 minutes before, and none entered; and repeat the one-shift documentation count four weeks after the change on the same unit.
How success would be judged. The pain-score duplicate falls from seven a shift toward zero in the repeat count, with no increase in administrations lacking a recent pain score.
Why the Ask Is So Small
The evidence supported a larger request: the same documentation log found four kinds of duplicate entry, and the alert log in Unit 5 found repeated warnings and a meter interface delay. It would have been easy to ask for all of them. The request was kept to one change for three reasons. A single change to one screen can be built and tested quickly and its effect measured cleanly. A committee is more likely to approve a request whose scope and risk are obvious. And the other problems belong to different owners: the repeated warnings to pharmacy, the meter delay to the interface team, the wound flowsheet to the wound care committee. Each will get its own request, using the same shape.
The 30-minute limit is deliberate. A pain score from two hours earlier should not be carried into a new dose, because pain changes and the medication decision should rest on a current assessment. Showing the time of the carried value lets the nurse see how old it is before accepting it.
Risks the Committee Will Ask About
Three risks were anticipated and answered in advance. First, that nurses might accept an old score without reassessing. The 30-minute limit and the visible time address this, and the repeat count will include a check of administrations where the carried score was accepted, to see whether any were more than 30 minutes old. Second, that the flowsheet score might belong to a different kind of pain, such as a headache when the medicine is for incision pain. The carried value shows the location recorded on the flowsheet, so the nurse can see a mismatch. Third, that the change might affect reports built on the medication screen field. The analyst team will be asked to confirm, before building, which reports read that field, since a field that is filled differently can change what a report counts, as the trace in Unit 4 showed for another field. Naming these risks in the request saves a round of questions and shows the requester has thought beyond the time saved.
What the Request Avoids
It does not ask to remove the pain score from the medication screen, which some nurses suggested when asked. The score on the medication screen supports safe opioid administration and later review; the problem is typing it twice, not recording it. It does not describe the problem as nurses being slow or systems being bad, since documentation burden arises from how screens, rules, and workflows fit together rather than from any one of them (Moy et al., 2021). Framing it as a fit problem is also how sociotechnical models of health information technology recommend approaching changes (Sittig & Singh, 2010). The course text describes the end user's role in change requests in the same way: bring evidence, ask for something specific, and take part in testing (McGonigle & Mastrian, 2022). The unit and system are composite.
References
McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
Moy, A. J., Schwartz, J. M., Chen, R., Sadri, S., Lucas, E., Cato, K. D., & Rossetti, S. C. (2021). Measurement of clinical documentation burden among physicians and nurses using electronic health records: A scoping review. Journal of the American Medical Informatics Association, 28(5), 998-1008. https://doi.org/10.1093/jamia/ocaa325
Sittig, D. F., & Singh, H. (2010). A new sociotechnical model for studying health information technology in complex adaptive healthcare systems. Quality and Safety in Health Care, 19(Suppl. 3), i68-i74. https://doi.org/10.1136/qshc.2010.042085
NSG 421 Unit 7 instructions, in plain terms
Unit 7 asks you to write a change request for the electronic record based on evidence you gathered. Expect to state the problem, propose a specific change, present evidence, anticipate risks with answers, explain the scope and say what the request does not ask for. Students often ask how big a request should be and what evidence counts. Small, specific requests are more likely to be approved and built. Evidence from your own observation, such as step counts and duplicate tallies, carries weight. Risks such as stale data or lost safety checks must be addressed before the committee raises them. Say clearly what you are not asking for, which keeps the request focused. Write for a committee that sees many requests.
How this NSG 421 Unit 7 example is built
The request opens with the problem, change, evidence and expected effect in short labeled paragraphs. The scope section explains why one field on one screen was chosen even though the logs found four kinds of duplicates. The risks section takes three concerns and answers each, such as requiring the score to be from the last 30 minutes to prevent stale data. The avoidance section lists two broader changes not requested and why. The request reads as something a committee could approve in one meeting. Every claim points back to a step or tally from earlier units, which gives a small request the weight of real data.
NSG 421 Unit 7 rubric: what full points look like
Herzing's rubric for a change request typically covers the problem statement, the proposed change, evidence, risk analysis, scope and professional writing. Evidence and risk analysis carry the most weight, since a committee approves requests that are supported and safe. Problem points reward a specific, measurable issue. Change criteria look for one clear modification. Evidence earns credit when it comes from observation with numbers. Risk points go to concerns answered before they are raised. Scope should be justified, including what is not requested. Concise committee-ready writing is expected. Carayon's human factors framework and AHRQ guidance on health IT change support the request.
Common NSG 421 Unit 7 mistakes, and how to avoid them
Change requests in Unit 7 often slip by asking for too much, such as redesigning the whole medication screen, which committees rarely approve. Another frequent problem is evidence from opinion rather than observation. Students often ignore risks, especially stale or carried-forward data. The proposed change is vague, such as make charting easier. What the request does not ask for is unstated, so the committee may assume more. The expected effect is not measurable, such as fewer clicks without a number. Earlier units' data are not cited. Nursing staff support, such as a unit council vote, is not mentioned. The build effort is ignored, though analysts weigh it. Finally, keep the ask small and the evidence strong, because graders reward a request a real committee would approve and an analyst could build.
Get a NSG 421 Unit 7 example written to your instructions
Send the Unit 7 instructions and the rubric from your NSG 421 classroom, with the problem the request is built around and whatever counts you hold. We write a custom example that puts the evidence first, keeps the ask to one change, names the receiving group and closes on what the requester can contribute. First custom sample free, back in 24 to 48 hours.
More NSG 421 papers and BSN samples
- NSG 421 Unit 1: Informatics support pathway map
- NSG 421 Unit 2: Charting workflow record
- NSG 421 Unit 3: Documentation burden log
- NSG 421 Unit 4: Data entry to report trace
- NSG 421 Unit 5: Alert response record
- NSG 421 Unit 6: Chart access boundary record
- NSG 421 Unit 8: Bedside technology evidence file
- NSG 633 Unit 7: Escalation chain trace
- NSG 660 Unit 7: Evidence presentation for colleagues
- NSG 120 Unit 7: Risk factor and prevention table
- NSG 121 Unit 7: Developmental variation notes
NSG 421 Unit 7 questions, answered
Who should the request be addressed to?
Whoever your course materials say receives them, which is often a unit council, a super user group or a help desk queue rather than an individual. The point of the section is that you name a channel that exists and explain the choice. Where your classroom describes no channel, say so and address the request to the nearest group the reading describes.
How small does the ask have to be?
Small enough that one person could say yes or no to it. Moving a field, changing a default, retiring a prompt or adding an option to a list all qualify. Anything requiring a project, a budget or a vendor conversation belongs to the graduate sequence, where the writer holds a different position and can argue for resources.
Do I have to submit the request for real?
Only if the instructions say so, and most sections treat it as a written exercise. If yours does ask you to submit something at a placement site, follow the site's own process and your instructor's guidance before anything leaves the classroom. The example is a document, and nothing in it should be sent anywhere on the strength of a sample.
Where can I find a free NSG 421 Unit 7 sample paper?
The full NSG 421 Unit 7 change request is free on this page, one field on one screen with evidence, risks and scope. A request built on your own observations can be prepared on request.
How do nurses request changes to the electronic health record?
Usually through an informatics committee, with a request that states the problem, the specific change, evidence from practice and how risks will be managed. This sample asks to carry a pain score forward rather than enter it twice.