Healthcare technology and nursing leadership

Health Information Technology

Health information technology is the framework that acts as an umbrella to describe the comprehensive management of a variety of electronic methods that are used to manage information about people's health and health care, for both individual patients and groups of patients.

Health IT professionals play a significant role in improving the quality and safety of health by preventing medical errors, reducing health care costs, increasing administrative efficiencies, decreasing paperwork, and expanding access to affordable health care.

Health information technology provides the means to a safe, quality, and efficiency care today, into tomorrow, and in the future since the integration of technology is expanding in healthcare setting.

Informatics in Nursing

Informatics in nursing is the integration of computer science, information management into nursing practice. The emerging use of technology and informatics into the daily practice has revolutionizing the manner in which health care is delivered.

In five weeks journey, I have gained deep understanding about the integration of the Electronic Health Records and have realized its importance in improving the quality and safety of care and its relation to meaningful use (MU), interoperability, and HITECH.

With the emerging technology, all healthcare organizations have moved to the use of the Electronic Health Records instead of the paper. There has been a great improvement in the quality and safety of care after utilizing the EHR’s and increased collaboration among healthcare providers which lead to the concept of meaningful use- exchange of electronic health information for care delivery and quality reporting purposes. To effectively implement meaningful use within the practice, it is required to consider an important component which is interoperability- sharing data without losing context or meaning. If all of the above were achieved, the organization will receive its incentive and here where HITECH takes place.

Nursing Leadership

Nurse Leaders/Administrators are key factors to the successful implementation of new technologies and achievement of quality care and improved outcomes. Nurse leaders/administrators should established a shared vision for technology innovation and application in the work setting and share it with the staff in addition their responsibility of involving caregivers in technology design, selection, and evaluation. Nurse leaders must embrace, adopt, and implement technology while addressing leadership challenges of how to respond to and accelerate adoption of technologies to support practice. In healthcare settings, we need transformational leaders who support innovation in practice, create an environment where improvement is encouraged, adopted, and sustained.

Nursing Leadership plays a crucial role in leveraging technology in healthcare setting in addition to their important role of incorporating and successfully utilizing the new technology. Nurse leaders should develop new forms of knowledge and opportunities to the staff in order to increase their buy-in to the emerging technology.

References

Agency for Healthcare Research and Quality (AHRQ). (n.d.). Health Information Technology Integration. Retrieved on August 11, 2015 from http://www.ahrq.gov/professionals/prevention-chronic-care/improve/health-it/index.html

Cipriano, P. F. & Hamer, S. (2013). Enabling the Ordinary: More time to care. American Nurse Today. 8(11). SR2-SR4.

Healthcare Information and Management Systems Society (HIMSS). (2015). What is Nursing Informatics? Retrieved on August 11, 2015 from http://www.himss.org/resourcelibrary/TopicList.aspx?MetaDataID=767

Thede, L. (2012). Informatics: Where Is It? OJIN: The Online Journal of Issues inNursing. 17(1). 

WorkFlow

Workflow is defined as any task performed in series or parallel by two or more members of a work group to reach a common goal. At a regular level, workflow would allow users to deliver information to the appropriate people; organize information to be immediately used; ensure that the information is acted upon; and finally file information and record action taken.

Due the complexity of the procedure of healthcare that involves both clinical and administrative tasks, workflow concept is an ideal match with the specific need of the healthcare industry (Chaiken, n.d.). A common problem that I used to see in my work place is the use of both Electronic Health Record’s (EHR’s) and paper documentation. The use of EHR’s in Saudi Arabia is in its infancy stage; therefore, it is not being fully utilized. Nurses are still documenting on paper, but have to enter Doctor’s orders in the system such as blood tests and x-ray requests. Additionally, there are only two computers in the unit for the nurses to use which delay the work of some nurses since they have to wait before entering the orders.

 Nursing documentation is important to patient care since caring for one patient can involve many providers and information sources. Thus, there should be complete and accurate information related to patient care. Using both, EHR’s and paper documentation can increase the work load on nurses leading to missing some of the information or performed procedure to be documented which affect the quality of patient care. Even more, it can lead to many errors at hand off or transition points in addition to degradation of information.  Paper-based documentation cannot keep healthcare providers completely informed because it can be only in one place at a time. Thus, it cannot be shared between two providers or more health specialist at different locations simultaneously. This has a negative impact on optimization of information management in healthcare and leading to reducing productivity and quality of care provided (Altuwaijri, 2008).

My proposed solution for improving this workflow is to fully utilize the EHR’s and install a software system that replaces the paper work. Each staff nurse will have a computer with access to the EHR’s and it is the only place where nurses and other healthcare professionals do their documentation. The EHR's will save time and ease the documentation process for nursing staff in addition to its benefit in reducing medical errors caused by unclear hand writing. The electronic format will provide healthcare providers with easy access to the patient medical records at the same time in different geographical areas. Furthermore, EHR will enable information sharing across the organization and between different organizations, enhance services to the patients, and ensure security and privacy of patient information. Here is an article showing Saudi Physician’s perspective regarding EHR’s      

In a systematic review done by Hasanain, Vallmuur, & Clark, 2014 it has been shown that due to some technical, social, and resources barrier, there has been low uptake of HER’s implementation in Saudi Arabia hospitals. Leaders must manage, plan, and evaluate the new integrated technology and its effectiveness in the setting. They also should educate and train the staff about the new embraced technology to increase the staff buy-in and empower them to engage and utilize the integrated technology efficiently and effectively (Volgelsmeier, Scott-Cawiezell, 2009). Leaders should performed constant review and evaluation of the implemented new technology to evaluate its effectiveness (Gamble, 2009). Leaders should be involved in the selection, planning, implementation, and evaluation of the new technology.

Here is a video explaining how to optimize your clinical workflow in four steps

References

Altuwaijri, M. M. (2008). Electronic-health in Saudi Arabia. Saudi Medical Journal. 29(2). 171-178.

Chaiken, B. P. (n.d.). Workflow in Healthcare. Retrieved on 27 July 2015 from http://www.docsnetwork.com/articles/BPC97112.pdf

Gamble, K. (2009). Administrative. All systems down: as more applications go live, the pressure on CIOs to ensure server reliability is growing.Healthcare Informatics, 26(11), 20.

Hasanain, R., Vallmuur, K. & Clark, M. (2014). Prograss and challenges in the implementation of Electronic Medical Record in Saudi Arabia: A Systematic Review.Health-informatics- An international Journal. 3(2). 1-14.

Marley, K., Reck, D. (2006). The Role of Nursing Leadership in Clinical Transformation. Nurse Leader, 29-33.

Volgelsmeier, A., Scott-Cawiezell, J. (2009). The Role of Nursing Leadership in Successful Technology Implementation. JONA, 39(7/8), 313-314.

Nursing Leadership and Technology Integration in Healthcare Setting

Technology had already transformed the healthcare system; therefore, the integration of technology would significantly and positively impact the quality of the provided services. Nurse leaders and nurses are key frontrunners in developing the infrastructure for effective and efficient health information technology that transforms the delivery of care. Therefore, nurse leaders should have a deep understanding of health information technology in order to first incorporate it in their own administrative platform and then provide effective leadership for their hospital, health system, or clinic. The basic understanding of technology integration will enable nurse leaders to manage, educate, and engage all the staff. The engagement is not limited on specific individuals; however, all levels of leadership must be engaged to embrace and manage the challenge of this change which is new technology integration in the setting.

There are some initiatives such as the Technology Informatics Guiding Education Reform (TIGER ) that would help nursing leadership to integrate technology in their own administrative platform and in the clinical setting. The Technology Informatics Guiding Education Reform ( TIGER ) Initiative represents a comprehensive, interdisciplinary effort that is well suited to the integration of informatics into education, practice, administration, and research environments. One of the highest priorities of TIGER summit was to develop revolutionary leadership that drives, empowers and executes the transformation of healthcare through the use and integration of technology in addition to engaging more nurses in the development of a national healthcare information technology (NHIT) infrastructure.

Leveraging programs such as Leadership Strategies for Information Technology in Health Care that enable nurse leaders and nurses to develop the organization health IT strategic vision, proactively addressing challenges posed by the changing health care landscape is significant because it will support the evolving role of health informatics in healthcare. In addition, Nurse Leaders should ensure that all practicing nurses adopt and adhere to all policies and principles of the TIGER initiative while they are “Nurse Leaders” are adhering to it. Leaders need to promote the new vision and mission of technology integration among their staff to help them take ownership of the process. In addition, Nurse Leaders are responsible to communicate with the staff and provide them with the proper training for any new implemented technology in order to use it properly and efficiently. Education and communication will help in fostering an environment that is receptive to the technology changes being integrated in healthcare setting.

  

References

Marley, K., Reck, D. (2006). The Role of Nursing Leadership in Clinical Transformation. Nurse Leader, 29-33.

Vogelsmeier, A., Scott-Cawiezell, J. (2009). The Role of Nursing Leadership in Successful Technology Implementation. JONA, 39(7/8), 313-314.

HUMAN/TECHNOLOGY INTERFACE

Healthcare is emerging into the new era of informatics technology. In today’s healthcare, healthcare professionals are encountering a wide variety of human-technology interfaces which increases the interaction between human and technology.

Human/Technology Interfaces is define as the hardware and/or software through which the user interacts with any technology such as computers, patient monitors, defibrillators, electronic thermometers, telephones and pagers. The availability of both, the principles and techniques for developing human/technology interfaces allowed the people to use the provided technology with minimal stress and maximum efficiency.

Patient care technology has become increasingly complex even though it has the potential to improve patient care. Furthermore, technology has transformed the way nursing care is conceptualized and delivered. Therefore, human technology interface is significant, as well as essential to nursing practice within healthcare today. The integration of technology within the nursing practice and patient care will ensure efficiency, accuracy, quality and safety for patients. Nurses effective use of the technology has the potential to produce a positive impact on nursing-sensitive patient outcomes with the support of nursing leadership. Effective nursing leadership can positively influence the effective development, dissemination, and use of technology. The interface of human with technology can make the lives of the people benefiting form it more efficient and easier; however, the new medical technologies could poses safety problems to the patient and healthcare providers if the users are not trained properly.

Caring and technology can be integrated in competent nursing care. The nurse is responsible to document nursing care and complete the electronic health record (EHR) while having the obligation to interact with the patient in the moment. To be able to complete the EHR, the nurse has to establish a caring and trustful relationship between self and the patient in order to perform a meaningful assessment and data collection process. 

 

References

Hill, T. (2013). Invited Editorial: Caring and Technology. Online Journal of Nursing Informatics, 17 (3). 2857.

Powell-Cope, G., Nelson, A. L. & Patterson, E. S. (2008). Patient safety and Quality: An evidence-based handbook for nurses. Rockville, MD. Agency for Healthcare Research and Quality. 

ICNP (International Classification for Nursing Practice)

The ICNP (International Classification for Nursing Practice) is a nursing classification being developed by the International Council of Nurses (ICN) in Geneva, Switzerland. The ICNP is a unified nursing language system. It is also a compositional terminology that facilitates the development of new vocabularies and cross-mapping existing vocabularies in order to enable nurses to describe and report their practice in a systematic way based on agreed terminology or dictionary of terms. The International Council of Nurses has released ICNP Alpha and Beta versions. Here is a link that would provide you with detailed information about ICNP and its versions, International Classification for Nursing Practice.

The ICNP composed of three dimensions:

                             I.   Nursing phenomena ( nursing diagnosis)

                          II.    Nursing actions (nursing intervention)

                        III.    Nursing outcomes

ICNP Vision

ICNP is an integral part of the global information infrastructure informing health care practice and policy to improve patient care worldwide.

Why Use ICNP?

The ICNP serve as a major force to articulate nursing’s contribution to health and healthcare globally in addition to promoting harmonization with other used classifications and the work of standardization groups in health and nursing. The objectives of the ICNP, as set out in the initial ICN publication, are:

1) To establish a common language for describing nursing practice in order to improve communication among nurses and between nurses and others.

 2) To describe the nursing care of people (individuals, families, and communities) in a variety of settings, both institutional and non-institutional.

 3) To enable comparison of nursing data across clinical populations, settings, geographic areas, and time.

4) To demonstrate or project trends in the provision of nursing treatments and care and the allocation of resources to patients according to their needs based on nursing diagnoses.

5) To stimulate nursing research through links to data available in nursing information systems and health information systems.

6) To provide data about nursing practice in order to influence health policymaking.

An International Classification of Nursing Practice (ICNP) is needed to support the processes of nursing practice since it makes a significant contribution to the acquisition of data about healthcare delivery, and to advance the knowledge necessary for cost-effective delivery of quality nursing care.

References

Clark, J & Lang, N. (1992). Nursing’s next advance: an internal classification for nursing practice. International Nursing Review. 39(4). 128.

Coenen, A. (2003). The International Classification for Nursing Practice (ICNP®) Programme: Advancing a Unifying Framework for Nursing. The Online Journal of Issues in Nursing. 8(2).

Hyun, S. (2002). Cross-mapping the ICNP with NANDA , HHCC, Omaha system and NIC for unified nursing language system development. International Nursing Review. 49(2). 99-110.

Warren, J. J. & Coenen, A. (1998). International Classification for Nursing Practice (ICNP) Most-frequently Asked Questions. Journal of the American Medical Informatics Association. 5(4). 335-336.