HCI 690 Outline project in terms of boundaries and limitations

HCI 690 Outline project in terms of boundaries and limitations


Emergency departments (EDs) are always called upon to care for patients at the emergency section in the health care system. The increased activities in the emergency departments have been leading to overcrowding. The need for emergency services exceeds the available resources for patient care in the emergency departments (McKenna et al., 2019). The overburdening of the emergency departments causes an acute decline in quality and safety at the department. This calls for the deletion of orders from the ED nurse order list to relieve the department’s burden.


Boundaries and Limitations

The state regulation is likely to impede the deletion of orders from the ED nursing list. These regulations affect the use of nurse-initiated protocols to begin a lifesaving treatment when patients arrive at the emergency department (Castner & Boris, 2020). These issues cause many patients to lie in the emergency section, causing overcrowding.

In the ED setting, the prescribing providers cannot oversee the patient because of other high-priority tasks. This limits commencement of interventions and tests that would positively impact patient outcomes.

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Mitigating Barriers

The stakeholders in the health care department impact the solution of the problems. They have the authority to examine the ED nursing orders from time to time and rate the orders in terms of emergency. Deleting the ED nursing orders would release the pressure of overcrowding at the ED, allowing the department to improve its safety and quality.

The CPOE director needs to heighten the computerization of the services at the department to increase admission and train the patients on using Meditech builder (Velt et al., 2018). This system aids the department in building a framework where all patients can access their health information and increase participation in their own care.


The state regulations and the current ED setting are some of the main projected barriers that would affect the project. However, utilizing the influence of stakeholders and the CPOE director would effectively mitigate the barriers.


Castner, J., & Boris, L. (2020). State laws and regulations addressing nurse-initiated protocols and use of nurse-initiated protocols in emergency departments: A cross-sectional survey study. Policy, Politics, & Nursing Practice21(4), 233-243. https://doi.org/10.1177%2F1527154420954457

McKenna, P., Heslin, S. M., Viccellio, P., Mallon, W. K., Hernandez, C., & Morley, E. J. (2019). Emergency department and hospital crowding: causes, consequences, and cures. Clinical and experimental emergency medicine6(3), 189. https://dx.doi.org/10.15441%2Fceem.18.022

Velt, K. B., Cnossen, M., Rood, P. P., Steyerberg, E. W., Polinder, S., & Lingsma, H. F. (2018). Emergency department overcrowding: a survey among European neurotrauma centres. Emergency Medicine Journal35(7), 447-448. http://dx.doi.org/10.1136/emermed-2017-206796


Outline the scope of your project in terms of boundaries and limitations. What major barriers or obstacles do you foresee for the scope of the project and how will you address them?
boundaries and limitations are going to limit my scope by the barriers or obstacles put up by the stakeholders and the meditech builder. by doing research on utilization of orders to be deleated from the ed nursing orders I will have a much stronger case supporting the deletion of these redundant and obsolete orders. Also I have the CPOE Director’s input on my research and proposal.

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