Topic 1: Topic 1: Do you feel that nurses believe that there are ethical concerns related to nursing informatics?
Comment 1: (Lorraine)
While the adoption of electronic health record (EHR) systems promises a number of substantial benefits, including better care and decreased healthcare costs, serious unintended consequences from the implementation of these systems have emerged. Poor EHR system design and improper use can cause EHR-related errors that jeopardize the integrity of the information in the EHR, leading to errors that endanger patient safety or decrease the quality of care. These unintended consequences also may increase fraud and abuse and can have serious legal implications.
EHR systems can transform the way healthcare is delivered when these technologies are designed, implemented, and used appropriately. Designed and used inappropriately, EHRs add a layer of complexity to the already complex delivery of healthcare, leading to unintended adverse consequences such as dosing errors, failure to detect serious illnesses, and delays in treatment due to poor human-computer interactions or loss of data.
While much has been written about EHR-associated risks impacting information integrity, and the subsequent actual and potential impacts on quality of care and safety over at least the past decade, little has been done to systematically measure and analyze these risks, identify the root causes, and universally implement strategies (such as system design modifications and adoption of usability principles) to reduce risks.
Bowman S. (2013). Impact of electronic health record systems on information integrity: quality and safety implications. Perspectives in health information management, 10(Fall), 1c.
Comment 2: (anne)
I do believe that nurses can believe that there are ethical concerns related to nursing informatics. It is very easy to walk away from a computer and leave a patients information up and exposed to anyone that may walk by. I see this very often in practice where we get called away suddenly and leave information open where others can see it.
I also feel that the information needs to be protected more and that maybe the system can be set up so that only the proper people are able to login to the patients files. Too many environments allow for nurses to be able to look at all patients information even when they are not assigned to the patient. This is a very bad thing if a nurse should decide they want to look up information on someone that they know.
Informatics should have fail safes put into place so that the information is not seen by the wrong people. Even placing security screens over the computer screens would be helpful yet you do not see this in practice anymore.
As nurses we need to insure that the privacy of our patients is protected at all times.
Topic 2: Topic 2: Discuss how the use of health information (HI) technology has influenced your current nursing practice. Give examples.
Comment 1: (Lorraine)
The nursing profession is rapidly changing to keep up with advancements and new challenges in the healthcare field. As direct caregivers, nurses are in the front lines of patient care and consequently often feel the impact of changes in best practices more immediately than other healthcare professionals. In nursing, as with healthcare in general, informatics is being used to address the challenges of the day, significantly impacting the way nurses function in patient care. One of the primary ways that informatics has changed nursing practice is through documentation. Gone are the days of paper charts that had to be meticulously updated with handwritten notes. Today, nurses are more likely to input notes into electronic health records and other systems that keep a patient’s medical history up-to-date and easily accessible.
The Healthcare Information and Management Systems Society reported that as the result of electronic charting, nurses are able to obtain information quickly and efficiently, using the information to improve the daily workflow. Storing the information electronically is more easily available to all members of the care team, including the physician and other care providers, as well as staff teams at other healthcare organizations that the patient may visit. As the U.S. population becomes more mobile, it is increasingly important that their personal medical records can travel with them to any office or medical organization they may visit during their lifetime.
Health informatics is also an important part of care coordination in nursing. The ability to track staffing, workflow and communication can help nurses to identify areas where current processes can be improved. This can also help ensure that staffing levels remain adequate, which is critical for providing patients with the best possible care. If the nurse-to-patient ratio drops too low, patients are more likely to suffer adverse results. Maintaining adequate levels helps nurses provide the best possible care each day without burning out.
Informatics in Nursing: Impact and Importance | UIC Online (Links to an external site.)https://healthinformatics.uic.edu/blog/the-impact-of-health-informatics-on-nursing-practice/
Comment 2 (Erika)
The use of health information (HI) technology has had its positives and negatives, for example it has allowed for easier streamlining workflow and improved ability to access information. (Huston, 2020) And although some of the literature noted is cost cutting, this particular improvement may also have the opposite reaction to the implementation of health information technology. Other more negative issues that health information technology may have is that it may actually have higher costs to implement and requires constant training as of staff as the programs may change multiple times, or additional applications may be added as well. And, yet another possible downside to HI technology is that there is the potential for hacking and exposure of private health information.
I have experienced the endless training of HI technology as it was newly implemented at the correctional facility I worked at. Many trial and error were witnessed and experienced. I recall how many nurses, mostly the nurses who had been at that facility for many years, were reluctant to switch from paper charting to HI technology. There was more than one system used and again, endless training due to this fact. However, once the system was implemented and everyone was trained it appeared to improve things. Everyone had access to charts with more ease and could view a patient chart simultaneously while in different locations if needed. Quicker access to patient information when needed, medication administration record was also easily accessible and even providers to could access from their home-work computers when needed to renew medications. It became very much liked after everyone got accustomed to using the new system.
Huston, Carol (2020). Technology and health. Professional Issues in Nursing eBook (5th ed.) [VitalSource Bookshelf]. Retrieved from: https://online.vitalsource.com/reader/books/9781975140366/epubcfi/6/8[%3Bvnd.vst.idref%3Dcopy]!/4/58/1:613[dru%2Cg (Links to an external site.).]
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Comment 1 Reply
I agree with you that issues related to poor system design of an electronic health record system and improper use of EHR systems can result in various forms of errors in healthcare settings. When electronic health record systems are not well designed, the chances for medical errors among patients will increase significantly, with an increased chance of poor outcomes among patients. For example, if an electronic healthcare system is not well designed with the right elements such as font size, such a system can increase the chances for the occurrence of medical errors because healthcare practitioners might struggle to fill in information related to the patient that is the dosage of a given medication. Although EHR systems can play a significant role in improving the quality of health care services provided to patients, a lot of caution needs to be taken in the designing of EHR systems to reduce the incidence of errors in healthcare settings (Barnett et al., 2016).
Barnett, M. L., Mehrotra, A., & Jena, A. B. (2016). Adverse inpatient outcomes during the transition to a new electronic health record system: observational study. BMJ, i3835. https://doi.org/10.1136/bmj.i3835
Comment 2 Reply
I agree with you that one of the main shortcomings related to EHR systems relates to the confidentiality of patient information. In many healthcare settings where healthcare practitioners utilize EHR systems, there are numerous instances where patient information may be accessed by third parties. For instance, in a healthcare facility, a health caregiver can forget to log off from an EHR system making patient information accessible to any third parties who may be walking by. The installation of an EHR system in healthcare facilities needs to be accompanied by effective rules and guidelines to protect patient information and prevent the access of patient data to third parties. Such guidelines would therefore help to protect the confidentiality of patients (Kruse et al., 2017).
Kruse, C. S., Smith, B., Vanderlinden, H., & Nealand, A. (2017). Security Techniques for the Electronic Health Records. Journal of Medical Systems, 41(8). https://doi.org/10.1007/s10916-017-0778-4
Comment 1 Reply
I agree with you that the use of health information has had a significant impact on nursing practice, including boosting productivity, enhancing communication, and promoting collaboration and teamwork in the workplace. Through various health information technologies, nurses can therefore be able to improve their productivity as they can access patient information quickly and store information related to patients efficiently, which promotes daily workflow. By relying on health information technology, nurses can therefore be able to perform all the tasks related to caring for patients, such as collecting patient history and keeping patient records efficiently. On the other hand, health information technology also promotes real-time communication in healthcare teams which can play a significant role in improving the quality of care provided to patients. Finally, healthy information promotes teamwork and collaboration among team members in a healthcare facility which can increase the chances of better patient outcomes (Kruse & Beane, 2018).
Kruse, C. S., & Beane, A. (2018). Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review. Journal of Medical Internet Research, 20(2), e41. https://doi.org/10.2196/jmir.8793
Comment 2 Reply
I agree with you that all health information has several benefits in healthcare settings, such as promoting productivity, enhancing communication, and encouraging interdisciplinary collaboration. It also has significant shortcomings. One of the major shortcomings of health information technology is that it’s expensive and time-consuming to implement in a healthcare facility. Because health information technology is always advancing and changing, health care facilities have to keep reinvesting in newer technology and training their staff members to use such technology. The consistent advancement of health information technology makes the implementation of such technology to be time-consuming and expensive for healthcare facilities (Feldman et al., 2018).
Feldman, S. S., Buchalter, S., & Hayes, L. W. (2018). Health Information Technology in Healthcare Quality and Patient Safety: Literature Review. JMIR Medical Informatics, 6(2), e10264. https://doi.org/10.2196/10264