Nurses Are the Key to Linking IT with Better Patient Care

Nursing informatics is becoming an increasingly important part of healthcare. The American Nurses Association (ANA) defines nursing informatics as “a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice.” This fusion of healthcare and new technology has already begun to yield great results in time management and patient care.

The role of IT in nursing is a topic that has gained momentum over the past couple of years. In fact, the Alliance for Nursing Informatics (ANI) has even designated May 12 (Florence Nightingale’s birthday and the last day of National Nurse’s Week) as Nursing Informatics Day to provide an “opportunity to spread the word about Nursing Informatics” to colleagues. ANI is also the co-sponsor of the Technology Informatics Guide Educational Reform (TIGER) Summit, a gathering of leaders in nursing practice, education, informatics, and government agencies. The goal of the Summit is to “create a vision for the future of nursing that bridges the quality chasm with information technology, enabling nurses to use informatics in practice and education to provide safer, higher-quality patient care.” With the healthcare industry working towards President Bush’s goal of widespread adoption of electronic health records by 2014, this Summit presents an opportunity for professionals to come together to determine what changes need to occur in nursing practice and education.

Know Your Role!

Because nurses play such an important role in healthcare, it is necessary to have a system in place that prepares them to use information technology (IT) efficiently in the workplace. Perhaps no one is more familiar with this necessity than Laura Linn, Project Director for the Center for Health Transformation (CHT) and a member of the Advisory Board for the Duke University School of Nursing. Linn has extensive experience in healthcare IT, and is a former Clinical Nurse Specialist in Critical Care. MDNG spoke with Linn about nurses’ involvement in IT implementation, and the obstacles that must be overcome in order for new information technologies to succeed.

“I find that a lot of critical care nurses, because we’re data-driven, certainly use a lot of information and a lot of very specific data points to assess the patient,” says Linn. “We are very surrounded in critical care units by technology and data, so I think that naturally when you like critical care you certainly like IT.”

Linn also mentioned that while nurses may not want to adopt IT until it is “absolutely necessary,” most have embraced the progression of nursing informatics simply by recognizing the advantages it offers not only to them, but to their patients as well. In fact, a study released by CDW Healthcare last September reported that 86% of the 559 participating nurses believed there was a link between information technology and improved patient care. The survey also noted several challenges faced by healthcare professionals who want to incorporate health IT in practice, such as poor integration and operability, regular system failures, and limited accessibility to information and applications. The study provides nurses and vendors with valuable information regarding the improvements that need to be made in order for IT systems to be beneficial for all parties.

The Cutting Edge

Many hospitals and healthcare organizations have already taken steps to implement Electronic Health Records (EHRs). One of the most notable pioneers in EHR implementation has been the Veterans Health Administration (VHA), which began computerizing patient records in 1985. In 2005, the VHA provided a computerized patient record system which proved very effective for the ICU at San Francisco VA Medical Center. Nurses throughout the 120-bed hospital were able to “go to any computer station and check on a patient’s medications, lab results, clinical reminders, or physician notes on a diagnosis.” The system enabled nurses to click on an on-screen tab and pull up a menu of the patient’s medical information, including x-rays, pathology slides, video views, scanned documents, cardiology exam results, wound photos, dental details, endoscopies, and other pertinent information. The fast and easy access to vital information afforded by this technology helps increase patient safety and reduces time that would normally be spent shuffling through a paper trail.

According to Linn, electronic prescribing (e-prescribing) is another application of information technology that has met with great success. Similar to EHRs, e-prescribing also enables healthcare professionals to access important patient information at the point of care users can verify which medications patients are taking, discover which drugs they are allergic to, identify potential drug-drug interactions, etc—and quickly create, modify, and transmit prescriptions for medications. By providing healthcare professionals with the ability to quickly access vital drug information, e-prescribing systems can help save lives. Linn cites the example of a patient who is unable to provide physicians with important information: “You could be in an accident and not be conscious and have [the nurses] pull up your information. You are just as safe as if you were able to say ‘Wait, I’m allergic to that medication.’”

Quick access to information leads to safer patient care and better outcomes for patients. In addition to its obvious safety and time-saving benefits, e-prescribing may also actually cut down on medical errors, too. The Institute for Safe Medication Practices (ISMP) estimates that each year “indecipherable or unclear prescriptions require more than 150 million calls from pharmacists asking doctors for clarification,” and that “7,000 deaths [can be] attributed to medication errors.” E-prescribing has the potential to significantly decrease both of these problems.

Maintaining Focus

When asked what steps still need to be taken in order to establish a better healthcare system, Linn carefully explained that it is important to focus on what has been introduced so far. Rather than trying to develop new systems, she says that the goal should be to take what we have now and integrate it into as many healthcare facilities as possible. Linn also stressed the importance of “giving physicians the incentives to put technology in the office,” so that they can have a workflow design that “doesn’t interrupt what they are doing, but enhances the care they are giving.”

Make no mistake about it—the need for nurse informaticists is steadily growing, and there are no signs of this trend slowing down. According to an industry survey cited in a Dallas Morning News article, “at least 75% of nurse informaticists are developing or helping their healthcare facilities adopt clinical information or documentation systems.” Because there are so few nurses that have doctoral degrees in nursing informatics, nursing schools are having difficulty finding qualified faculty to train new nurses for this specialized role. With such an urgent need for professionals to help bridge the gap between IT and healthcare, look for nursing informaticists to play an even greater role in healthcare in the future.