The explosion in the implementation of technology into every single aspect of healthcare has created a whole new specialty of nursing called ‘nursing informatics’. Nursing informatics can be defined as the integration of technology and information in all aspects of nursing practice that promote (Hebda, Hunter, & Czar, 2019). The overall objective of nursing informatics is to improve the quality of patient care and patient outcomes. The persistent growth in healthcare has resulted in nursing informatics basically becoming a necessity, and all nurses have to have a general understanding of it to be effective in the clinical setting. Informatics allows for more control and better decision-making in the clinical setting. It also helps with the management of the healthcare environment on all levels. Nursing informatics has had profound effects on patient care and nursing practice.
Nursing informatics is having a massive impact on today's clinical practice. Informatics extends beyond just the nurse specialist to the point that nurses use it without realizing it. “In clinical practice, for example, nursing informatics can be used to track patient outcomes, find data trends, and assess workload and interventions” (McGonigle, Hunter, Sipes, & Hebda, 2014, p.324). In high acuity areas, they have telemetry monitors that allow nurses to remotely view the vital signs of critically ill patients. This significantly reduces the workload of the nurse and helps track real-time outcomes. Nurses can interpret and intervene when and if it is needed depending on these remotely viewed vital signs. There is a big push for electronic documentation and most hospitals have transitioned to an electronic documentation system. Some of the electronic documentation systems have alerts that notify the nurse of missed documentation or documentation that needs additional data. Future development of various technologies and career opportunities will further improve and impact nurses in a clinical and informatics capacity.
Nursing informatics is going to carry on saving time, reducing ineffective communication, limiting continuity of care problems, and helping address any potential problems in healthcare. An important way this growth will happen is through the increase in informatics nurse specialists due to the increasing demand seen in today's market. These career opportunities for nurses make sure that the needs of the healthcare team are present in the innovation of new technologies. These specialists can also help users troubleshoot problems in real-time. The new technologies being developed have the personnel that will be using them as the main focus and should reduce workload and increase productivity. This style of technology development that informatics has helped bring about will have massive effects on patient care for years to come.
Patient care has been one of the major areas that have been affected by nursing informatics. Nursing informatics has implemented a wide degree of technology that aids in the improvement of the quality of care that patients receive. A major way that informatics has improved patient care is through updates to include technology in the safety measures we take. Medication scanners have become mandatory to have attached to the workstation and the nurse has to scan the medication and document that they told their patient their rights. This method of documentation can alert the nurse to allergies that the patient had forgotten or that the nurse was not already aware of. This has reduced medication errors tremendously. The mobile workstation and electronic charting have reduced the time that the nurse spends documenting and has increased the time the nurse has available to teach the patient interventions, educate them, and help them with any of their needs. Documentation from procedural reports to lab results automatically populates into the patient's chart as soon as they are completed and reviewed by the appropriate personnel. Nursing informatics will always put patient safety and care at the forefront of change.
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As technology grows and becomes an even larger presence in healthcare, so will the relationship between the nurse informatics specialist and patient care. Nursing informatics will always maintain a primary goal of patient care and safety. A huge area that this can help is medical errors. They cause a significant amount of deaths every year. Programs that catch many overlooked data points in a patient's chart can reduce these incidences. “The next step is for information to become knowledge, which is information that the user can relate to other information and can apply to a task or use to reach an informed decision” (McGonigle, Hunter, Sipes, & Hebda, 2014, p.325). The establishment of superior methods of communication between facilities and providers will aid in the continuity of patient care between different facility visits. The implementation of these kinds of programs would revolutionize the care we provide, particularly in nursing. Nursing informatics affects everyone differently depending on how far they are into their career. The more seasoned nurse was taught a vastly different way to complete tasks within their scope of practice while in school. Heather Crowe states: “The second major change noted in my practice is when my employing hospital adopted a computerized charting and order entry system. Gone was the paper charting of my schooling. I was introduced to a world of computers where all information was placed in data fields. I became a data entry professional in addition to being a nurse. With this change, some major benefits were realized immediately. The most memorable to me was. No longer having to interpret handwritten doctor orders and progress notes from all disciplines. I certainly do not miss trying to figure out illegible doctor orders. Gone are the days of having to call the doctor who was insulted that you could not read their order” (2016).
The learning curve between a seasoned nurse and a new graduate nurse is a massive difference, as well as a disadvantage/advantage depending on the side. The seasoned nurse will probably require more training time and help than a new graduate nurse that most likely was already exposed to this in their schooling. Seasoned nurses, as well as other seasoned medical professionals, historically do not do well with change. Some are still trying to adapt to computers becoming an irreplaceable part of healthcare. This is a massive barrier to the implementation of informatics effectively across the board.
The barriers to nursing informatics are not just about the technological side. There is a multitude of barriers that we have to attack and break down. Learning curves of the nurses, computer illiteracy, funding for facilities, and integration of multiple programs to work cohesively. To get these nurses to learn, the hospital needs these up-to-date systems to train them which requires a ton of money. This comes from funding. Along with the funding, the facilities will need a person in charge of coordination for the operation of the technology. The informatics nurse specialist. This person is most often an in-house employee that has experience in informatics. There is an act that is trying to incorporate more technology and informatics into healthcare.
An initiative was formed to help combat the lack of integration of technology into the healthcare system. The Technology Informatics Guiding Education Reform (TIGER) was born. According to Hebda, Hunter, and Czar, “The TIGER initiative brought together nursing stakeholders to develop a shared vision, strategies, and specific actions for improving nursing education, practice, and the delivery of patient care through the use of health-informatics technology” (Hebda, Hunter, & Czar, 2019, p.36). This group is still very much active today, trying to promote growth in healthcare, which incorporates advancements being made in technologies. The group is also a big advocate for the need to change nursing education to include these changes in technology since it has real-world effects on nurses in the workforce today. This initiative raised awareness of the many obstacles that may slow or undermine the growth of nursing informatics.
In conclusion, the overall goal of nursing informatics is to improve the patient’s care and reduce the workload on the nurse so that more time can be spent at the patient's bedside providing relevant interventions. It directly affects nursing practice and is changing at an explosive rate. The rate is so fast that it is changing on an almost daily basis. There are a lot of barriers to change, as there are to any change in healthcare. Early exposure to students and persistent education to the seasoned clinical staff is of the utmost importance. These are the main factors that we can change now to reduce these barriers. This plan is reinforced by the TIGER initiative’s plan as we discussed earlier. They are a major player in keeping nursing practice up to date and changing to keep up with the best, and making us an example of how nurses can positively affect patient care from an informatics standpoint.
References
- Crowe, H. (2016). How Has Nursing Informatics Changed My Nursing Practice Since Graduating from Nursing School in 1993? Online Journal of Nursing Informatics, 20(2), 5.
- Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of Informatics for Nurses and Healthcare Professionals. NY, NY: Pearson.
- McGonigle, D., Hunter, K., Sipes, C., & Hebda, T. (2014). Why Nurses Need to Understand Nursing Informatics. AORN Journal, 100(3), 324-327. doi:10.1016/j.aorn.2014.06.012.
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