Deck 10: System Implementation and Maintenance

Question 1

Considerable planning must be done before the go-live event. Which of the following are specific examples of planning elements?

A)Implementation strategy is determined
B)Decisions must be made regarding what information will be back loaded or preloaded
C)Support schedule is developed
D)Evaluation procedures are addressed
E)Procedure developed to request changes after the go-live event

Answer 1

Implementation strategy is determined
Decisions must be made regarding what information will be back loaded or preloaded
Support schedule is developed
Evaluation procedures are addressed
Procedure developed to request changes after the go-live event

Question 2

Which of the following is the best example of "feature creep"?

A)When an additional feature must be added to the system, the implementation committee approves the change after investigating its cost.
B)The system is totally customized for an individual organization to reflect the current workflow.
C)Staff nurses expect the new system will cut their workload relating to documentation in half.
D)The emergency department and intensive care unit supervisors meet and come up with a list of new features to be added to the system.

Answer 2

The emergency department and intensive care unit supervisors meet and come up with a list of new features to be added to the system.

Question 3

The implementation committee members analyze the base system as delivered from the vendor before the system is installed in the event that clarification or changes are necessary. Which of the following are analyzed throughout this process?

A)Technology
B)Vendor standing
C)Vendor compliance with regulatory requirements
D)Integration with other systems
E)Clinician support

Answer 3

Technology
Vendor standing
Vendor compliance with regulatory requirements
Integration with other systems

Question 4

A major consideration for organizations implementing new systems is the return on investment (ROI). ROI can be measured using tangible and intangible measures. Which of the following are examples of tangible measures?

A)Decreased costs for labor and non-labor expenses such as maintenance
B)Higher retention rate for care givers
C)Increased revenue
D)Alignment with business strategy
E)Greater compliance with regulations

Question 5

Once the go-live date of the system has been established, the production environment is in effect. Which planning is most necessary at this time?

A)A newly released software upgrade will be performed so the new system provides users with the latest technology.
B)A website is constructed so employees may answer questionnaires relating to system satisfaction and ask questions as needed.
C)A 24/7 support schedule is initiated to answer questions when necessary.
D)Information back loading is scheduled the day that the system is to go live.
E)The implementation of the system will begin in the emergency department and will move to other units when they signal that they are ready.

Question 6

A hospital is implementing a new electronic nurse charting system. When selecting members for the implementation committee, if all are available, which one of these should be given priority?

A)Informatics nurse specialist
B)Experienced consultant
C)Steering committee chairperson
D)Chief information officer

Question 7

Which of the following are examples of ongoing systems technical maintenance?

A)Problem solving and debugging
B)Performing a file backup
C)Maintaining a backup supply of hardware
D)Maintaining and updating the disaster recovery plan
E)Configuring, testing, and installing system upgrades

Question 8

Communication during the maintenance phase of the system's life cycle is crucial. Which of the following is most beneficial to the organization during the maintenance phase?

A)A newsletter for users is posted yearly in accessible sites for new information
B)A help desk provides 24/7 telephone user support for employees
C)Users given internet access and procedure manual to troubleshoot problems
D)A list of frequently asked questions (FAQs) posted on a password protected site

Question 9

An implementation is to go live in a limited number of client units but in all ancillary departments. The remaining client units would be scheduled to go live in groups, staggered over a specified time frame. What implementation strategy is being used?

A)Roll out
B)Modular
C)Occur all at once
D)Direct

Question 10

Back loading of some pre-existing data must be completed for the system to create accurate medication administration records and billing charges. How is this best accomplished?

A)Selected data from client records are loaded into the system by data entry specialists.
B)Each staff member is responsible for inputting medications for each patient for the 24 hours prior to going live.
C)When the system goes live, data from clients' medication administration records since admission are inputted for all clients.
D)A pharmacist selects needed data from client medication administration records and inputs the data immediately prior to going live.

Question 11

Which description best fits a work breakdown structure (WBS)?

A)A project planning software program is selected for use by the steering committee to assist in planning needed changes.
B)The implementation committee learns about the capabilities of a new wireless system.
C)A timeline is developed to determine who will do necessary tasks for the implementation of each project phase.
D)A committee is formed to guide the implementation of a new wireless system.

Question 12

Which instance is most helpful during system training?

A)Training software is provided for staff to practice inputting fictitious client information.
B)Training sessions are scheduled for the four to six week period prior to going live so all users can feel comfortable with the system.
C)Designated trainers are appointed based on their ability to expertly care of patients.
D)New users are trained through an online learning platform such as Blackboard.

Question 13

Which of the following strategies would be appropriate for identifying a potential candidate for implementation project leader?

A)Since this will be a complex implementation, focus on the candidate's technical skills and less on communication and leadership skills.
B)Restrict the selection to someone that is a member of the steering committee because of their understanding of the vision, goals, and expectations for the system.
C)Select the consultant that has been assigned to the project from the beginning as the leader.
D)Delay the selection of a leader until after the committee members are selected and then, with the help of the members, select one of the members as leader.
E)Select the chief information officer because of the position of authority and knowledge of the organization's information needs.

Question 14

What should be the end result of implementation of a new wireless information system in a 712-bed acute-care facility?

A)Retention of staff is enhanced
B)Staff can utilize the new technology effectively
C)Client satisfaction with care is enhanced
D)Client care outcomes are improved

Question 15

Which of the following are recommended for developing system procedures and documentation?

A)Create backup procedures to be used in the event that the system is not running either for reasons of scheduled maintenance or unforeseen circumstances.
B)If major modifications were made to the base system, use the vendor's system user guides.
C)Develop a data dictionary containing system terms and terms for mapping from one system to another.
D)During the training process, develop procedures for how the system will be used to support client care and associated administrative activities.
E)Create separate documentation that includes the downtime procedures and manual requisition forms and locate in an easily identifiable and accessible location.

Question 16

Which strategy might cause problems during implementation of a new information system?

A)Once the committee has given information to the vendor regarding system needs, a small addition is requested.
B)An open system is set up such that software upgrades can be implemented quickly and easily.
C)The vendor is asked to fully customize the information system for a specialty organization.
D)The committee verifies that the vendor provides annual maintenance with an additional contract.

Question 17

To be effective users of a new documentation system, the staff must be trained. Which shows the most effective use of training for a new computer system?

A)A training environment is set up off site.
B)Training is scheduled during the normal workday.
C)Training is provided with actual live software.
D)Actual client data are stored in the training system.

Question 18

_______________________ environment is another term that refers to the time when the new system is in operation.

Question 19

A group of tasks related to the analysis of hardware requirements must be addressed during the implementation phase. Which of the following are considered specific tasks?

A)Network infrastructure analysis
B)Review of workstation types
C)Input applications review
D)Printer decisions
E)Cabling capacity analysis

Question 20

Analyzing appropriate hardware requirements is necessary when implementing a new information system. Which of the following solutions is most appropriate?

A)Needs assessment information is compared to budget and hardware and software features.
B)Thin clients are placed in central locations to access the system.
C)Staff may elect to use their own personal digital assistants to send and receive client data.
D)Laser printers are connected to the system network for printing laboratory results.

Question 21

Which of the following best defines data dictionaries?

A)Data dictionaries contain lists and definitions of all terms used.
B)Data dictionaries contain actual data.
C)Data dictionaries have nothing to do with data quality.
D)Data dictionaries can be found in the nursing office.

Question 22

Which of the following makes training is most effective?

A)It occurs during the nurse's scheduled shift
B)When measurable objectives are employed
C)Training is conducted on the staff's day off
D)Another staff member conducts the session

Question 23

A group of staff nurses working on the hospice unit have notoriously been opposed to technology use. They assert technology is not essential for the care of people who are actively dying and have decided not to participate in the training process. What can be done by committee members to decrease resistance in this setting?

A)Data can be collected and stored electronically to develop evidence-based practice models which would be useful in alleviating the suffering of the dying.
B)Have the head nurse document the resistance in each person's file.
C)Have the director of human resources attend the next staff meeting to review position descriptions.
D)Terminate staff that refuse to participate in training.

Question 24

Although an information system may be replaced, which of the following answer best describes the impact on the information system's life cycle?

A)The life cycle is an ongoing process that never ends.
B)The life cycle and information system are unrelated.
C)The life cycle stops to upgrade the system.
D)The life cycle is altered with any upgrade.

Question 25

A timeline is defined as which of the following?

A)A visual plan that helps keep everyone on track and understand where others are in the project.
B)Part of the evaluation phase of the life cycle
C)A tool that measures outcomes
D)A best practice model

Question 26

Implementation of any system can be facilitated by the committee's understanding of the amount of time that is needed to successfully complete the project. To that end, what is an important staffing concept for administration to consider when appointing members to a technology committee?

A)Committee member must equally divide duties to complete tasks.
B)Committee members should meet more than once a week to complete tasks.
C)All member of the committee need a comprehensive technology background.
D)Relevant committee members can be given alternate work assignments to accommodate the increase in committee work.

Question 27

The notion of staggering the implementation of the system is determined during the planning phase by committee members. The rationale behind staggering the implementation of the new system can be related to which of the following statements?

A)The decision to incorporate a roll out model of implementation can be used to identify issues before the entire system goes live.
B)Staggering allows staff members to become more familiar with the new technology.
C)Budgetary constraints are the main factors in determining whether a system should be staggered or fully implemented.
D)Nurses and staff need additional time to accept an unwanted technological change.

Question 28

The ________________________ environment is a term that refers to the time when the new system is in operation.

Question 29

When selecting the chair of the technology committee who is charged with leading the committee members and decision making regarding implementation of the new system, the best person suited for this role would be which of the following?

A)The vice president of nursing
B)Informatics nurse specialist
C)Information technology programmer
D)Staff nurses affected by the system implementation

Question 30

Which of the following critical elements apply to the development of the timeline prior to implementation of the system?

A)Necessary tasks
B)Scope of each task
C)The members' roles and responsibilities in accomplishing the tasks
D)Driving forces of the market
E)Development of crib sheets

Question 31

Which of the following is a key element for a successful system implementation?

A)Effective training
B)Incorporating data dictionaries at every terminal
C)Providing a help desk during the day shift
D)Finding a ancillary staff member to assist in trouble shooting the new system

Question 32

There are often unforeseen issues that emerge during the implementation phase of the life cycle. Which of the following may be considered a barrier?

A)Staff training
B)Poor communication
C)Employ a qualified nurse informatics specialist to lead the change.
D)Incorporate the suggestions of point-of-care staff

Question 33

Which of the following statements is true about the test environment?

A)The findings of the system test always indicate how well the system will perform in the live environment.
B)The test environment is not exactly the same as the live environment, because the live environment is much larger and more complex.
C)The test environment is unnecessary with the progress made in technology.
D)The test environment is done for training purposes.

Question 34

Soon after the go-live event, ____________ from the implementation evaluation should be acted on in a timely manner.

Question 35

To change the culture of any work environment, the nurse as a leader can promote innovation and minimize resistance through which of the following?

A)Demanding staff listen to rationale behind the changes
B)Planning a strategy to support people and process changes
C)Asking staff to trust their colleagues
D)Understanding that the change is for their benefit

Question 36

Which of the following is not an example of a function?

A)Upgrading
B)Order entry
C)Results reporting
D)Documentation

Question 37

Successful implementation of a system can be facilitated by addressing significant barriers presented by staff. Which aspect of resistance should be addressed by committee members during the planning phase?

A)Staff members need to control the workflow and do not want changes imposed on them.
B)The impact of the change on off shift personnel
C)The nurse to patient ratio
D)Emotions of staff

Question 38

Any significant change in the workplace can lead to discomfort and resistance. Which of the following statements can decrease staff resistance to the implementation of a new system?

A)"Give it time, you will like it."
B)"Perhaps you need more staff development programs."
C)"We know what we are doing.The committee has worked on this project for months."
D)"If you find that its functions are not user-friendly, the committee can make the appropriate changes."

Question 39

_________________ creep is the unexpected and uncontrolled growth of user expectations as the project progresses.

Question 40

Clinical operation disruption is can be minimized through which of the following?

A)Identification of the processes and their changes are included in training.
B)Following the IT liaison's demands for perfection
C)Making the changes during the night shift
D)Spending money on a consultant.

Question 41

A large portion of ongoing maintenance is related to technical and ____________________ issues.

Question 42

Which of the following statements is true about the life cycle?

A)The life cycle has a beginning and an end.
B)The life cycle is ongoing.
C)The life cycle is not relevant to system purchase or upgrades.
D)The life cycle has six distinctive steps.

Question 43

Which of the following considerations point to the need for a new system?

A)Poor performance
B)Frequent down times
C)Up to date programming language
D)No vendor support
E)Outmoded technology

Question 44

The ongoing maintenance of the technical issues is the role of which of the following departments?

A)Nursing
B)Information services department
C)Computer programmers
D)Vice president of technology

Question 45

A _________________________ is an excellent and low-tech method to solicit feedback after a system has been implemented.