NURS FPX 8012 Assessment 4 Risk Mitigation

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Risk Mitigation Plan

Risk Management Plan

Risk identified by SAFER Guides Possibility of Occurrence (Frequent, Sometimes, Never) Potential for Harm (Severe, Mild, None) Mitigation to Address Risks
Data loss due to low resilience of software Sometimes Mild Need for a robust contingency plan 
Poor IT infrastructure Frequent Severe Invest in the infrastructure to upgrade the technology (Rhoades et al., 2022).
Low clinical workflow Frequent Mild Enhance staff productivity through training (DiAngi et al., 2019).
Misrepresentation of patient data  Sometimes Severe Integrate a reliable patient identification system (Riplinger et al., 2020)
Poor communication among staff Frequent Severe Use novel communication channels to reduce the communication barriers 
Electronic Health Data Leakage  Sometimes Severe Multifactor authentication to access the patient data (Bahache et al., 2022).

Ethical or Legal Issues Related to Identified Risks

NURS FPX 8012 Assessment 4 Risk Mitigation

Information about patients being misrepresented can have serious ethical and legal repercussions. Potential problems could be privacy violations, as the patient’s right to privacy may be violated if information about them is misrepresented in the healthcare industry. Patients have a right to expect that any information about them that is personal or medical will be kept private and not disclosed without their permission (Balynska et al., 2021). This confidentiality can be violated by misrepresenting the data that endanger the patient’s privacy. 

The inconsistency in the data may lead to medical malpractice in the healthcare organization. Moreover, giving false information about a patient due to low compliance with software may also constitute medical malpractice. Law and morality require healthcare professionals to give their patients accurate and truthful information. The nurses’ code of ethics emphasizes providing care services by adhering to ethical principles (Ilkafah et al., 2021). Poor communication between the healthcare personnel leads to wrong diagnosis and inappropriate course of treatment that endangers the patient. Professional misconduct also decreases the clinical outflow and hampers the success of healthcare organizations. 

When interacting with patients, healthcare professionals are responsible for acting honestly and with integrity. A breach of this duty that results in disciplinary action is the leakage of patient information. Violating patient data gives the patient the right to take legal action. Patients who experience harm due to the violation of Protected Health Information (PHI) may be entitled to compensation for their suffering, medical cost, and other damages. Healthcare professionals may face serious ethical and legal repercussions if they intentionally violate the privacy law of patient information (Choi et al., 2019). To guarantee that patients receive the right care and to prevent any potential legal or ethical issues, healthcare providers must protect patients’ accurate and truthful information in healthcare settings.

The potential negative impacts of not addressing the risks within a health organization lead to several problems, such as that poor-quality patient care, financial instability, and low staff morale. Patients’ safety may be compromised due to medication errors which lead to poor patient outcomes. A patient may take legal actions that harm a healthcare organization’s reputation. HIPAA violations are one compliance risk that should be addressed immediately to avoid penalties, lawsuits, and reputational harm. Risks to healthcare organizations can also affect their financial performance, as failing to address operational risks like ineffective staffing can result in higher costs. Hence addressing health organization risks is essential to ensure the safety of patients and staff, maintain compliance with regulations, and achieve financial stability. Health organizations must proactively identify and mitigate risks to prevent negative consequences and achieve their mission of providing high-quality patient care.

NURS FPX 8012 Assessment 4 Risk Mitigation

Justification of Actions to Address Identified Risks

Upgraded EHR systems can streamline healthcare processes, increasing efficiency and lowering costs through automated processes, reducing paperwork, and preventing errors. Improvements to EHR systems can give healthcare professionals real-time, data-driven insights that can help them make better decisions and improve patient outcomes (Rhoades et al., 2022). Staff members can save time and concentrate on more difficult tasks by streamlining workflows through effective training in EHR use in healthcare settings (Nuamah et al., 2020). Staff members must receive training on effective EHR use. This entails knowing how to enter and retrieve data and the system’s features and functions. Continual instructions and assistance can help staff members feel at ease with the system and utilize it actively.

Medical records can be made accurate and current with the help of a patient identification system. By using a unique patient identifier, healthcare professionals can prevent duplicating records or combining data from various patients, which can result in mistakes and confusion. To deliver safe and effective care as well as support clinical decision-making, accurate data is essential (Riplinger et al., 2020) 

Multifactor authentication (MFA) protects patient data under HIPAA rules and regulations. Healthcare providers are required by HIPAA rules and regulations to safeguard patients’ personal health information (PHI) from unauthorized access or disclosure. Implementing multifactor authentication is one way to improve the security of patient data. MFA is a security measure that asks authorized users to use a password or PIN to access patient health records. Healthcare providers can improve the security of patient data and lower the risk of data breaches and unauthorized Protected Health Information by implementing MFA (Bahache et al., 2022).

Change Management Strategies

NURS FPX 8012 Assessment 4 Risk Mitigation

A diverse and skilled team is vital to implement change in healthcare organizations. Financial and material resources play a key role in making a change. A healthcare organization’s ability to manage change effectively ensures that it adopts new procedures, techniques, and regulations that can enhance patient outcomes by lowering wait times, enhancing care coordination, and raising the standard of care (Milella et al., 2021). Change management can result in cost savings by increasing the effectiveness and efficiency of healthcare processes, cutting waste, and better-utilizing resources. It also ensures compliance with evolving organizational rules and policies is maintained.

The Lewin model of change is a popular framework for managing organizational change in healthcare settings. The model consists of three stages: unfreezing, changing, and refreezing (Harrison et al., 2021). The poor IT infrastructure and low software compliance insinuated the change so that EHR systems work effectively to maintain the consistency of patient data in databases. Effective communication and collaboration among the stakeholders are necessary to bring positive change in the healthcare organization. It improves patient outcomes and raises the standard of care as healthcare professionals use the Lewin model to plan, carry out, and assess changes within their organizations.

ADKAR (Awareness, Desire, Knowledge, Ability, and Reinforcement) model manages changes and achieves successful results (Balluck et al., 2020). Healthcare organizations must explain the change’s justification and how it will benefit patients, employees, and the organization. Healthcare organizations must stress the advantages of the change to staff to win their support. Healthcare organizations must inform their staff about upcoming procedures, infrastructure, or technology changes. Staff must receive training, coaching, or mentoring to implement the change. The last step is reinforcing the change by keeping an eye on it, giving feedback, and rewarding staff who have done a good job implementing it. 

The Allen Hospital showed flaws in its EHR management due to low staff training and poor IT infrastructure. So using the change mentioned above management strategies will improve patient outcomes, staff satisfaction, and organizational performance ultimately. The change will also enhance the collaboration between the stakeholders, who work for a shared vision. The stakeholder committed to raising the care standard by taking effective measures to tackle the identified risks in the organization.

NURS FPX 8012 Assessment 4 Risk Mitigation


Bahache, A. N., Chikouche, N., & Mezrag, F. (2022). Authentication schemes for healthcare applications using wireless medical sensor networks: A survey. SN Computer Science, 3(5).

Balluck, J., Asturi, E., & Brockman, V. (2020). Use of the ADKAR and CLARC change models to navigate staffing model changes during the COVID-19 pandemic. Nurse Leader, 18(6).

Balynska, O., Teremetskyi, V., Zharovska, I., Shchyrba, M., & Novytska, N. (2021). Patient’s right to privacy in the health care sector. Georgian Medical News, 321, 147–153.

Choi, S. J., Johnson, M. E., & Lehmann, C. U. (2019). Data breach remediation efforts and their implications for hospital quality. Health Services Research, 54(5), 971–980.

DiAngi, Y. T., Stevens, L. A., Halpern – Felsher, B., Pageler, N. M., & Lee, T. C. (2019). Electronic health record (EHR) training program identifies a new tool to quantify the EHR time burden and improves providers’ perceived control over their workload in the EHR. JAMIA Open, 2(2), 222–230.

NURS FPX 8012 Assessment 4 Risk Mitigation

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13(13), 85–108. NCBI.

Ilkafah, I., Mei Tyas, A. P., & Haryanto, J. (2021). Factors related to implementation of nursing care ethical principles in Indonesia. Journal of Public Health Research, 10(2).

Milella, F., Minelli, E. A., Strozzi, F., & Croce, D. (2021). Change and innovation in healthcare: Findings from literature. ClinicoEconomics and Outcomes Research, 13, 395–408.

Nuamah, J. K., Adapa, K., & Mazur, L. (2020). Electronic health records (EHR) simulation-based training: A scoping review protocol. BMJ Open, 10(8), e036884.

Rhoades, C. A., Whitacre, B. E., & Davis, A. F. (2022). Higher electronic health record functionality is associated with lower operating costs in urban—but not rural—hospitals. Applied Clinical Informatics, 13(3), 665–676.

Riplinger, L., Piera-Jiménez, J., & Dooling, J. P. (2020). Patient identification techniques – approaches, implications, and findings. Yearbook of Medical Informatics, 29(1), 81–86.