Using Nursing Informatics in Clinical Area - Research Paper Example

Nursing Informatics Full There has been an unprecedented rise in the use of information technology over the recent years. Technology has also seeped into the nursing profession and has changed how information was retrieved and processed. Nursing informatics (NI) has been defined as a blend of computer science, information science and nursing science, aimed to achieve the management and processing of nursing data, information and knowledge to support and enhance the practice of nursing and provision of nursing care. The hybrid of nursing and computer science helps to develop more efficient health care processes by three ways: streamlining documentation and communication, providing decision support tools and contributing to patient safety. These three processes have been explored in detail in the paper, including their advantages and recommendations for improvement. The conclusion summarizes the paper and establishes the role of NI in providing effective health care. Keywords: nursing informatics, documentation, decision support, patient safety Nursing Informatics There has been an unprecedented rise in the use of information technology over the recent years. Computers have revolutionized the way information was handled by businesses and other professions. There are increasingly being used in the health care. Technology has also seeped into the nursing profession and has changed how information was retrieved and processed. The component of information retrieval, processing and usage is a vital part of nursing. Amongst the first ones to effectively use information as a tool to care for patients was Florence Nightingale. The data she had accrued regarding incidence of terminal diseases was of great help to treatment of patients during war. In today’s world, nurses can gather information with relative ease through the Internet and Electronic health records (EHR). This gives nurse a broader base to treat their patients. The importance of computers in nursing had been recognized early, as early as the 1950s, and today their common usage has sprouted more job opportunities in the field of health care informatics (McGonigle & Mastrian, 2008). The word informatics has originated from the French word informatique, and refers to the computer environment. Informatics includes the gathering and processing of information through technology. The imbuement of technology into different professions led to the emergence of another branch of informatics namely the medical informatics, concerned primarily with technology that helps deliver better care to patients. Nursing informatics (NI) has been defined as a blend of computer science, information science and nursing science, aimed to achieve the management and processing of nursing data, information and knowledge to support and enhance the practice of nursing and provision of nursing care (McGonigle & Mastrian, 2008). The American Nurses Association defines NI as the specialty that integrates nursing and computer science, to support patients, nurses and other health care providers in their decision making in all roles and settings; this assistance is achieved by usage of the information technology, information structures, and information processes (Lundy, Lundy, & Janes, 2009). The hybrid of nursing and computer science helps to develop more efficient health care processes by three ways: streamlining documentation and communication, providing decision support tools and contributing to patient safety. These three processes have been explored in detail in the rest of the paper. Streamlining documentation and communication Knowledge is firstly available in the raw form. For raw data to be used effectively, it needs to be manipulated and organized in a way that makes it easier for nurses and health care professionals to interpret the data. The nurses require data on patients such as patient name, social history, history of disease etc. When a nurse is able to organize this data, the patient’s health condition is presented in clearer terms. The data that has been put into an organized form can then be stored and be retrieved in the future if the patient presents again or for other medical records purposes. One of the ways in which informatics has been used in the field of health care is in the development of medical information systems. Data can be fed into these systems and retrieved when the need arises. An information system is responsible for the compilation of date so that it becomes meaningful information. Information and data differ in the respect that data is raw facts whereas information is the end product of the process of transformation of data into a more organized and meaningful form. The value and worth of information affects the decisions made by heath care professionals and profoundly influences the achievement of the aims of the health care service. Good information is relevant, usable, reliable and exhaustive. Since information helps nurses analyze and interpret data and put it into use, one can measure the differences in performance in order to assess the value of information. Its contribution in improving the performance of the service by health care professionals can be judged by the fact that streamlined paperwork can prevent wastage of time in going through files of medical records and paperwork. Thus, it helps increase the productivity of the nurses and enable them to be more efficient in their work. EMR can archive information for long periods of time, and so can be used for research purposes as well. Nursing data that has been put together in a sequential array facilitates communication as well. Information systems in particular help users to share information and to transmit it through computers and other tools over large distances, without the unnecessary usage of financial resources that could have had been needed otherwise. However, an impediment to the effective implementation of NI is that many nurses are not comfortable in using technology, since they have developed their own style of working that has improved their performance. A research also proved that compliance was lower in the group of nurses who used electronic patient diaries than those who did paper entry due to the insufficient ease of use (Hardwick, Pulido, & Adelson, 2007). This problem can be solved by training nurses about the appropriate operation of information systems and other technology, so that everyone follows a uniform method of service delivery. Interprofessional learning opportunities can be provided to nurses to develop and attain high levels of NI competencies. Nursing programs should integrate curriculum that focuses on engaging nurses in the retrieval and implementation of technology. Decision support tools Information helps a people evaluate and make decisions. Since the data has been collected and organized into databases, the chances for errors are reduced and the data is not made superfluous since many things need to be entered only once. Therefore, it becomes more comprehensive and can act as a more reliable material for decision-making. The usage of information through authentic reference texts and journals is important in decision-making. However, with the increasing use of technology, the idea that authentic information could only be available through non-digital formats has changed. Professionals in health care are realizing the net advantages of automation in accessing and analyzing information to make decisions that entail safe and sound care and better patient outcomes. Osheroff and his colleagues (2007) regard decision support as the tool that “clinicians, staff, patients, or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care”. The Electronic Health Records (EHR) play an important role in this regard since they help nurses to retrieve data multiple times. The North American Nursing Diagnosis Association states that EHR help support decisions that are aimed to identify the patient’s problem or medical conditions (Brokel, 2007). Computer technology like handheld devices can be used by nurses to provide references for evidence-based practice and can help them in the transformation of clinical documentation of interventions and outcomes into evidence-based decision-making in nursing (Hardwick, Pulido, & Adelson, 2007). The EHR brings together research resources provided by agencies such as the PubMed, and to understand the condition of the patient in light of research findings. Nurses assess the processes of the workflow and are in constant interaction with the technology that is being used; therefore they know which process is feasible and which is not. For the effective use of technology in health care, nurses are made to engage in the design, implementation and evaluation of these technological processes. They utilize information systems and EHR to draw upon trends that the patient is showing. Decision-support tools used by nurses include reminders and alerts to assist them in remembering information and informing the doctors of any abnormalities and trends that the patient is exhibiting. Moreover, decisions that have been documented facilitate nurses in augmenting their critical reasoning and competence in decision-making and evaluation. Technology has advanced so much that computers can now generate diagnoses; these diagnoses can help nurses make decisions on the likely underlying medical cause, and also save up time that would be spent on looking up possible diagnoses in texts. The system could be improved by training nurses in the efficient retrieval of information to support the day-to-day decisions that they have to make. Decision support system can be accessed by nurses and networked data can bring together nurses and help them in making decisions collectively. Contributing to patient safety The goal of nursing informatics is to increase efficiency, safety and efficacy (Sensmeier, 2008). Information technology plays an integral role in devising a health system that provides “care that is safe, effective, patient-centered, timely, efficient, and equitable” (Bakken, 2006). In her opening sentences, Bakken (2006) remarks that the health information technolgies that are to be used as part of the health care system must support the nursing practice in a way that prevents medical errors and on the same hand enhance the safety of the patients; such technology should also aim to accomplish development of practice-based nursing practice and best practices for patient safety. Technology is used by nurses to retrieve information regarding patient safety at the point-of-care. If the information is accurate, it can enable the nurses to use interventions and guidelines that ensure the safety of the patient. Nursing errors can arise due to cognitive mechanisms of the brain. The chances of errors in the daily routine of a hospital setting are increased due to distractions and interferences. These can be particularly expected when there are a lot of patients to handle. Therefore, if nurses use computer technology, not only would their work be more streamlined, they can also look up diagnoses and retrieve patients’ records with ease; this can save up time and reduce the stress level of the nurses, leading to less likelihood of errors and thereby promoting patient safety. The clinical decision support system is a computerized application that offers immediate benefits for nurses and patients by detecting potential drug combinations, impending pharmacologic complications and enabling nurses to relate symptoms to side-effects (Lyons & Richardson, 2003). This represents the role informatics can play in ensuring higher levels of patient safety. Patient safety can further be improved in hospital settings where nurses do not use technological tools to aid them in their work. This can be done by introducing and encouraging the usage of technology and training nurses in using it effectively so that they can improve their performance and directly improve the level of patient safety that they provide. Thus, in conclusion, NI has started to gain significance in field of heath care. The greater use of technology closes the loop between evidence and practice, and helps in generating an effective cycle of evidence-based learning in nurses (Simpson, 2005). It can play an effective role is streamlining documentation. Organized records and easy access to them can save up time and allow nurses to communicate about them better. Informatics facilitates the decision-making process by nurses, and enables them to access medical literature easily and in less time. Documentation in computerized form can also reduce the occurrence of errors, and promote to patient safety. However, one of the main obstructions to the effective usage of technology in health care is problem of ease due to insufficient use of devices. This can be managed by increasing computer literacy in the nurses so that they can seek collective wisdom of inter-disciplinary and inter-organizational collaboration to transform clinical education, practice and research (Ozbolt & Saba, 2008). Reference List Bakken, S. (2006). Informatics for patient safety: a nursing research perspective. Annual Review of Nursing Research, 24, 219-254. Brokel, J. M. (2007). Capture, exchange and use data, information and knowledge within electronic health records. Iowa Nurse Reporter, 20(1), 25-27. Hardwick, M. E., Pulido, P. A., & Adelson, W. S. (2007). The use of hand-held technology in nursing research and practice. Orthopedic Nursing, 26(4), 251-255. McGonigle, D. & Mastrian, K. (2008). Nursing Informatics and the Foundation of Knowledge. Massachusetts, MA: Jones & Bartlett Learning. Lundy, K. S., Lundy, K. S., & Janes, S. (2009). Community Health Nursing: Caring for the Publics Health (2nd ed.). Massachusetts, MA: Jones & Bartlett Learning. Lyons, A. & Richardson, S. (2003). Clinical decision support in critical care nursing. AACN Clinical Issues: Advanced Practice in Acute & Critical Care, 14(3), 295-301. Osheroff, J. A., Teich, J. M., Middleton, B., Steen, E. B., Wright, A., & Detmer, D. E. (2007). A roadmap for national action on clinical decision support. Journal of the American Medical Informatics Association, 14(2), 141-145. Ozbolt, J. G. & Saba, V. K. (2008). A brief history of nursing informatics in the United States of America. Nursing Outlook, 56(5), 199-205. Sensmeier, J. (2008). Deep impact informatics and nursing practice. Nursing Management (Springhouse), 2-6. Simpson, R. L. (2005). Information technology. Practice to evidence to practice: closing the loop with IT. Nursing Management, 36(9), 12-17. Read More