Nurses are the health care professionals that will spend the most time caring for patients, therefore technology will impact their work the most.
In the recent past designers of technology were more preoccupied with how technology could support or affect doctors and their work. Nurses were given the technology and expected to adapt their work to it. Because the nurse had not been considered in the design the chances were the technology hampered nursing workflow and the nurse would find ways to exclude the technology or work around it. Equipment that was introduced in the past may or may not have added value to nurses thus forcing them to nurse the equipment, as well as the patient.
In 2004 the Office of the National Coordinator of Health Information Technology set a 10 year time frame for the following goals: national adoption of interoperable electronic health records, sharing of information through interconnected healthcare professionals, personalized care, and improving public health through easier access to health info.
Also the Institute of Medicine recommended these 5 competencies for nurses: patient centered care, collaboration, evidence based practice, quality improvement, and informatics.
Healthcare informatics can be defined as technology; the resources, devices, and methods required for healthcare information, data storage, usage, acquisition, and retrieval
What are the specific ways that technological innovation can enhance nursing?
Technology can help improve the physical environment for both patients and nurses. Ergonomics can assist nurses in their physical tasks, such as lifting patients. Diagnostic and therapeutic equipment is becoming smaller and therefore more portable, for example
The interconnectedness of providers and resources is also an innovation that can help nurses access or share knowledge, expertise, and data. This has also facilitated patient care with remote monitoring and access to healthcare information. Nursing education has also benefited from such innovations as simulated laboratories and videoconferencing.
Efficiency and productivity can be more easily attained. Nurses can spend up to one third of their time documenting care. The devices that allow vital signs information to be transmitted directly to an electronic patient record eliminates the extra step of a nurse inputting the written information into the system later. Technology will let nurses accomplish regulatory compliance in less time through use of electronic forms and elimination of duplication of documentation.
Technology can also introduce new models of clinical care. Some examples are point of care testing, wireless communication, real time location systems, and telemedicine.
For nurses the ‘meaningful use’ of informatics can be summed up in three words: increasing care time.
The technology that is new will only achieve ‘meaningful use’ if there is a consistent application of it. There is definitely room for improving on the implementation of informatics. How will this change in the future?
Informatics nursing is a growing field, as healthcare organizations realize that having an information technology expert who is also as healthcare professional will help them implement the technology that will achieve better quality care.
The Healthcare Information and Management Systems Society(HIMSS) was founded in 1961 and is a healthcare membership organization that provides global leadership for the use of informatics in healthcare through discussions on healthcare policy, advocacy, and professional development initiatives in the area of information and management systems.
HIMSS also formed a nursing informatics community in 2003, recognizing the increasing importance of the informatics nurse in the advancement of health care quality.
HIMSS conducted a survey in 2009 to document the influence informatics nurses have on a healthcare organization. The results showed that these professionals are necessary for success in adopting technology into a workplace. The survey used a scale of 1 to 7 where one was a low rating with little influence and seven was a high rating with a lot of influence. Informatics nurses scored high in many areas with scores in the 5s and 6s and showed that they were an important part of increasing care quality and patient safety.
In the survey over 85% who answered stated that the professionals in there information systems department had clinical backgrounds, usually nursing.
Laboratory systems were at the top of the list of the applications that were in use at their organization, followed by pharmacy systems, PACs, radiology, wireless and clinical documentation systems. The two systems that are in the process of being implemented are computerized practitioner order entry and electronic prescribing although both of these were less than 50% of respondents’ answers.
What is the role of the informatics nurse in the information systems department? The top answer was user education, followed in order of importance, system implementation, user support, workflow analysis buy in from end users, and system design. Selection of devices, quality initiatives, system optimization, database and outcomes management were also answers provided by the respondents.
According to respondents informatics nurses spent the most time on system implementation followed by user education and support.
Respondents also gave a high score to the value that informatics nurses bring to these areas of informatics system; implementation, analysis, and design. The positive impact of In was also noted by respondents in the following areas; patient safety, workflow and user acceptance.
The fact that the informatics nurse had a clinical background greatly contributed to their impact on workflow that translates into system design, allowing for insight and clinical standards that non clinical information technology professionals would not have. This also contributed to greater user acceptance, knowing that the informatics nurse had the same perspective as the users did and were able to speak their terminology, understanding both technical and clinical implications; a bridge between the 2 departments so to speak. This resulted in greater ownership of the applications and a higher vested interest in it being successfully integrated. Informatics nurses were also able to recognize challenges and recommend changes or mitigation procedures. This bridge between technical and clinical will become even more critical when the incentives provided by the American Reinvestment and Recovery Act will be granted to healthcare organizations.
Where informatics nurses were perceived to have helped the organization attain the most success was in the area of technology doing no harm and the following responses are related to that challenge: administering correct patient medication, improving clinical and quality reporting, preventing never events, identifying conditions present on admission, and eliminating both documentation and registration redundancies. This is not to suggest however, that their influence is seen to be limited to just technology they also played a role in patient safety, change management and usability of systems.
Informatics nurses are also involved in emerging technology acceptance. The emerging technologies most likely to be implemented in healthcare organizations in order of most responses are: medical device integration, data warehousing, smart devices, remote monitoring, and personalized healthcare.
Part 2 next week will discuss the organizations that want to see nurses increase their presence in the design of health care informatics nationwide.
Article © My Nursing Uniforms.com / Young Lion Incorporated. Image Courtesy of Eklektikos from Flickr.
