The Impact of Informatics on Nursing Education and Promoting Quality of Health Care
Ms Rekha kumari
Assistant Professor, Sharda University, Greater Noida, UP
*Corresponding Author E-mail: rekha.kumari@sharda.ac.in
ABSTRACT:
In today’s dynamic health systems, technology plays an important role in education and nursing work. So it seems necessary to study the role of nurses and highlight the need for appropriate information technology educational programs to integrate with the ever-increasing pace of technology. A review accompanied by an extensive literature search in databases and a library search focused on the keywords were used. The criteria used for selecting studies primarily focused on nursing informatics and the importance of expertise in the effective use of information technology in all aspects of the nursing profession. In a critical assessment of emerging technologies, the key elements of nursing informatics implementation were considered as healthcare promotion, advanced systems, internet and network. In view of the nature and the development of the information age, it is required to receive necessary IT training for all categories of nurses. Due to the fast development of technology, in order to effectively take advantage of information technology in nursing outcome and quality of health care and to empower nurses; educational arrangement is recommended to set short-term and long-term specialized courses focusing on four target groups: studying, working, graduate, senior undergraduate, and graduate doctoral. The result of this study is expected to assist educational providers with program development.
KEYWORDS: Education, nursing, quality of health care, nursing informatics, technology.
INTRODUCTION:
Nursing informatics is the knowledge, behavior, and skills required for nurses to collect, store, retrieve, and process information. Nurses are learning on the job with practice the various application of Health Information Technology (HIT) in the clinical setting. Assessing and enhancing knowledge of professionals would encourage the adoption of informatics with open purview for practice. From simple mobile devices to e-ICU nursing informatics has influenced the practice undoubtedly. Studies have demonstrated that nurses have the right attitude to take informatics seriously. Courses exclusively teaching nursing informatics do not exist in India but institutes offer real time and online courses with the dilemma whether such professionals are accepted as ‘Health IT professionals’ and their role definition in various settings. Competency development still remains issue of concern to be explored by experts owing to large population and defining educational requirements for the task force2.
USE OF TECHNOLOGY:
The use of many types of technologies in healthcare, and specifically in nursing, has become a key component to providing patient care. As an integral element to health care, technology used within the nursing profession varies widely, and requires numerous skills for the utilization of specific technologies. Technology used daily by nursing personnel may include, but is not limited to, IV pumps, blood pressure machines, ventilators, naso/oropharyngeal suction devices, wound vacs, bladder scanners, ultrasound machines, glucose monitoring kits, barcode scanners, and computerized provider order entry systems (CPOE) and the EHR. Bedside monitors also assist nurses in the process of data collection, with input into the HER.
The Electronic Health Record (EHR), a type of electronic system, has become integral for managing all aspects of patient information. In fact, the EHR facilitates the utilization of the patient history, laboratory information, treatment plans, medications, and many other aspects of patient care. Electronic systems directly assist nurses in organizing data and information into presentable formats, from which knowledge and wisdom can be synthesized, all pertinent toward patient. The facilitation and use of information communication via electronic systems positively affects the process of clinical decision making, thereby increasing the opportunity for more accurate, timely, and effective use of knowledge and wisdom in the nurse’s decision-making process in patient care. In terms of facilitating information communication, the EHR is a comprehensive system that electronically enables the collection, storage, retrieval, and sharing of patient data and information.
EHRs support healthcare personnel, clinicians, and administrators with using and sharing more complete, accurate, and timely data. While integrating alerts, reminders, decisional support, electronic references, and many other features, EHRs have become elemental in the provision of patient care.
The proper use of technology enables the reduction in human error by providing congruency, giving the nurse multiple reference points for patient care throughout the decision making process. EHRs and CPOEs assist with effective communication between health care personnel, particularly in terms of communication between physicians and nurses. While technology is often thought of as being used at the bedside for direct patient care, clinical managers and nurse executives use administrative systems that facilitate staffing needs, as well as financial and resource management.
In the evolving healthcare field, it is fundamental that nurses’ needs are addressed in terms of technology. Competence in information and technology is essential not only for bedside nurses, but is also important for clinical managers and executives. The implementation of technology in health care requires the development of specific behavior, knowledge, and skills to articulate the needs of the individuals using the technology3.
COMPETENCIES:
The competency of nursing informatics specialists was determined through studying three categories including computer skills, informatics knowledge and informatics skills. It investigates four levels of nursing practice: beginning nurse, experienced nurse, informatics specialist, and informatics innovator.
The following competencies were rejected: diagnostic coding, desktop publishing, managing central facilities to enable data sharing and writing an original computer program Some components of accepted competencies are shown below in brief.
Computer Skills:
Selected computer skill competencies contain computerized searches and retrieving patient demographics data, the use of telecommunication devices, the documentation of patient care, the use of information technologies for improving nursing care, and the use of networks and computer technology safely.
Informatics Knowledge:
Selected informatics knowledge competencies are the recognition of the use or importance of nursing data for improving practice, and the recognition of the fact that the computer can only facilitate nursing care and that there are human functions that cannot be performed by computers, the formulation of ethical decisions in computing, the recognition of the value of clinicians’ involvement in the design, selection, implementation, and evaluation of systems in health care, the description of the present manual systems, the definition of the impact of computerized information management on the role of the nurse and the determination of the limitations and the reliability of computerized patient monitoring systems.
Informatics Skills:
Informatics skills competencies includes the interpretation of information flow within the organization, the preparation of process information flow charts for all aspects of clinical systems, the development of standards and database structures to facilitate clinical care, education, administration or research. It also includes the development of innovative and analytic techniques for scientific inquiry in nursing informatics and new data organizing methods and research designs with the aim of examining the impacts of computer technology on nursing, and the conducting of basic science research to support the theoretical development of informatics. Information literacy skills, competencies, and knowledge are investigated among educators, administrators and clinicians of nursing groups nationally.4
BARRIERS AND FACILITATORS:
Due to the capacity of internet, different types of health services are accessible to people on communication networks all over the world. E-health technology has been investigated in different aspects to find the factors influencing on its promotion. Since the number of internet users are increasing; it is essential to study the barriers and facilitators to enhance internet based health care services outcome.5 Integration Issues with other Software Systems, Use of multiple applications, Duplicate documentation, Poor Usability, Data organization, Customization Inability, Ease of use and efficiency, Software Challenges, Analytics, Software challenges unrelated to usability impacted effective use, Reliability and trustworthiness of the data, Study participants shared perceived concerns about the reliability, quality, or trustworthiness of the data being entered, Hardware Challenges cabling or connectivity issues between devices , Training Concerns, Unclear Roles and Lack of Coordination among Stakeholders and Insufficient Technical Support6
ADVANCE INFORMATION APPLICATION SKILLS
· Educates professionals and updates self about patient care devices
· Cardiac monitor
· Glucometer
· Mechanical ventilator
· Mobile devices
· Simulation devices
· Other devices as per setting e.g. dialysis machines, RFID devices, Telehealth, e-ICU, public health informatics, Artificial intelligence and automation technology
· Use of electronic health record
Participates in software development and contributes in digital health initiatives
· Updates and educates to new features of EHR Able to manage EHR information
· Nursing documentation-
i. Analyze and utilizes digital patient progress contributing to quality improvements
ii. Evaluates and improves the documentation process related to nursing care plan
iii. Utilizes patient information and clinical parameters in improving nursing care
iv. Updates and pilots Standard operating procedures (SOP)/ Clinical decision support system (CSSD)
v. Updates consent and procedural information on digital platform
vi. Works in collaboration with quality team to focus on events documented digitally
· Demonstrate use of standardized clinical terminology including SNOMED CT, ICD classification as applied to clinical practice
· Collaborates at national level about interoperability of system
· Big Data Analytics2
Ø Interpret and utilize data for efficient nursing care
Ø Analyze and interpret data; collaborates with health professionals for enhancing quality patient care
· Telehealth
Ø Updates, contribute and educates about the use of telecommunication technologies in patient care
Ø Explores and participates in development of Telehealth technologies in quality care
· Cloud Computing in Health
· Updates self and educates about concept of cloud computing
· Demonstrate use of cloud computing applications at organizational level
· Updates and educates about ethical and legal aspects of digital healthwould be necessary for nursing professionals to deliver patient care effortlessly and also empower nursing students to enter in clinical environment glyph by glyph without feeling flustered. Students and nurses are at present practicing many of the skills set learnt on their own or trained by professionals as and when need arises. It is time that nurses stood up and worked towards adding standardized nursing language such as North American Nursing Diagnosis Association (NANDA) in EHR which had been proposed and continued to be emphasized in the revised EHR standards for India which are acceptable but no further steps have been taken to incorporate it in the system yet.2
CONCLUSION:
Radical changes in healthcare in India is driving health professionals towards prompt adoption of Information and Communication Technology (ICT) as it is bound to enhance practice, reach to far-out places and ease the ways to provide healthcare to the second largest populated country of the world. Nurses can choose to swim with the tide or against it but the option to adopt ICT would be inevitable in future. Nurses would have to work with ICT applications unceasingly in any setting24. The scope of informatics competency skills for nursing professionals needs to remain flexible as it will keep intensifying with information technology dynamically presenting the novel fac of healthcare day by day 5.
CONFLICT OF INTEREST STATEMENT:
The corresponding author confirms on behalf of all authors that there have been no involvements that might raise the question of bias in the work reported or in the conclusions, implications, or opinions stated.
SOURCE OF FUNDING:
Not Applicable Ethical Clearance- Not Applicable
REFERENCES:
Received on 30.05.2019 Modified on 18.06.2019
Accepted on 05.07.2019 ©A&V Publications All right reserved
Int. J. of Advances in Nur. Management. 2019; 7(3):285-288.
DOI: 10.5958/2454-2652.2019.00067.2