WGU C854: Nursing Informatics Capstone (2026/2027)
System Optimization Proposal & Evidence-Based Rationale
Complete Guide
Section 1: Foundations of System Optimization
1. In the context of Nursing Informatics, what is the difference between
"Implementation" and "Optimization"?
A) Implementation is buying the software; optimization is paying for it.
B) Implementation is the initial "go-live" of a system; optimization is the
continuous refinement of the system to improve workflow, usability, and clinical
outcomes.
C) Implementation is managed by IT; optimization is managed solely by clinical
staff.
D) Implementation takes 6 months; optimization takes 2 weeks.
ANSWERS> B - Optimization is an ongoing process that occurs after the initial
implementation to ensure the technology adapts to the changing needs of clinical
practice.
2. What is the primary goal of a System Optimization Proposal in a capstone
setting?
A) To prove the student can code in SQL
B) To identify a specific clinical workflow bottleneck and propose an EHR
modification that resolves it, backed by data.
C) To replace the entire existing EHR system with a new vendor.
D) To increase the hospital's IT budget by 20%.
,ANSWERS> B - The capstone focuses on incremental improvement. You must
identify a real problem (e.g., redundant documentation) and propose a targeted
EHR solution.
3. Which informatics framework is best utilized to assess how nurses interact with
the EHR and where system friction occurs?
A) Diffusion of Innovations Theory
B) The Systems Life Cycle (SLC)
C) The Technology Acceptance Model (TAM)
D) The Data-Information-Knowledge-Wisdom (DIKW) continuum
ANSWERS> C - TAM specifically evaluates perceived ease of use and perceived
usefulness, which are critical when assessing why an EHR workflow needs
optimization.
4. When formulating an optimization proposal title, which format is most aligned
with WGU capstone standards?
A) "Why Epic is Bad"
B) "Optimizing the Electronic Health Record to Reduce Nursing Documentation
Time in the Medical-Surgical Unit"
C) "A History of Nursing Informatics"
D) "How to Use Computers in Healthcare"
ANSWERS> B - A strong capstone title must be specific, identify the intervention
(optimizing the EHR), and state the measurable outcome (reducing
documentation time) within a specific population/setting.
Section 2: Identifying the Clinical Problem & Data Collection
, 5. A nurse informaticist notices that nurses are spending 30 minutes per shift
documenting intake and output (I&O) because the flowsheet requires navigating
through five different screens. What is the best method to quantify this problem
for the proposal?
A) Asking nurses how they "feel" about the workflow
B) Conducting a time-motion study and analyzing EHR audit log data
C) Reviewing the hospital's annual financial report
D) Counting the number of keyboards on the unit
ANSWERS> B - Objective data (time-motion studies and EHR audit logs) provides
the empirical evidence required to justify the optimization proposal.
6. What is "click burden" in EHR optimization?
A) The physical sound of the mouse
B) The excessive number of mouse clicks required to complete a single clinical
task, leading to cognitive fatigue and wasted time.
C) A virus that infects the hospital network
D) The number of times a patient clicks the call light
ANSWERS> B - Reducing click burden is a primary target of optimization proposals,
as it directly impacts nursing workflow efficiency.
7. Which of the following is an example of a qualitative metric used to build an
evidence-based rationale?
A) The number of clicks required to administer a medication
B) The average time spent logging in
C) End-user survey responses indicating high frustration with the current
admission workflow
System Optimization Proposal & Evidence-Based Rationale
Complete Guide
Section 1: Foundations of System Optimization
1. In the context of Nursing Informatics, what is the difference between
"Implementation" and "Optimization"?
A) Implementation is buying the software; optimization is paying for it.
B) Implementation is the initial "go-live" of a system; optimization is the
continuous refinement of the system to improve workflow, usability, and clinical
outcomes.
C) Implementation is managed by IT; optimization is managed solely by clinical
staff.
D) Implementation takes 6 months; optimization takes 2 weeks.
ANSWERS> B - Optimization is an ongoing process that occurs after the initial
implementation to ensure the technology adapts to the changing needs of clinical
practice.
2. What is the primary goal of a System Optimization Proposal in a capstone
setting?
A) To prove the student can code in SQL
B) To identify a specific clinical workflow bottleneck and propose an EHR
modification that resolves it, backed by data.
C) To replace the entire existing EHR system with a new vendor.
D) To increase the hospital's IT budget by 20%.
,ANSWERS> B - The capstone focuses on incremental improvement. You must
identify a real problem (e.g., redundant documentation) and propose a targeted
EHR solution.
3. Which informatics framework is best utilized to assess how nurses interact with
the EHR and where system friction occurs?
A) Diffusion of Innovations Theory
B) The Systems Life Cycle (SLC)
C) The Technology Acceptance Model (TAM)
D) The Data-Information-Knowledge-Wisdom (DIKW) continuum
ANSWERS> C - TAM specifically evaluates perceived ease of use and perceived
usefulness, which are critical when assessing why an EHR workflow needs
optimization.
4. When formulating an optimization proposal title, which format is most aligned
with WGU capstone standards?
A) "Why Epic is Bad"
B) "Optimizing the Electronic Health Record to Reduce Nursing Documentation
Time in the Medical-Surgical Unit"
C) "A History of Nursing Informatics"
D) "How to Use Computers in Healthcare"
ANSWERS> B - A strong capstone title must be specific, identify the intervention
(optimizing the EHR), and state the measurable outcome (reducing
documentation time) within a specific population/setting.
Section 2: Identifying the Clinical Problem & Data Collection
, 5. A nurse informaticist notices that nurses are spending 30 minutes per shift
documenting intake and output (I&O) because the flowsheet requires navigating
through five different screens. What is the best method to quantify this problem
for the proposal?
A) Asking nurses how they "feel" about the workflow
B) Conducting a time-motion study and analyzing EHR audit log data
C) Reviewing the hospital's annual financial report
D) Counting the number of keyboards on the unit
ANSWERS> B - Objective data (time-motion studies and EHR audit logs) provides
the empirical evidence required to justify the optimization proposal.
6. What is "click burden" in EHR optimization?
A) The physical sound of the mouse
B) The excessive number of mouse clicks required to complete a single clinical
task, leading to cognitive fatigue and wasted time.
C) A virus that infects the hospital network
D) The number of times a patient clicks the call light
ANSWERS> B - Reducing click burden is a primary target of optimization proposals,
as it directly impacts nursing workflow efficiency.
7. Which of the following is an example of a qualitative metric used to build an
evidence-based rationale?
A) The number of clicks required to administer a medication
B) The average time spent logging in
C) End-user survey responses indicating high frustration with the current
admission workflow
